The basic science oral

Basic science oral core topics

Introduction

The FRCS Orth examination will definitely test you on aspects of basic science – in the past there has commonly been a surgical approach question in the written paper, and although the format is changing it is highly likely that the emphasis and content of questions will not. Critical appraisal of a journal article will remain a part of the revised examination and will require a working knowledge of statistics.

The Basic Science Oral is often feared by candidates, but having established that there is no avoiding it, the key to understanding basic science in orthopaedics and to making it stick in your head is to keep it clinically relevant and to concentrate on understanding concepts rather than learning lists of esoteric facts.

The Basic Science section of the syllabus includes the following headings:

Anatomy
Tissues
Physiology, biochemistry and genetics
Biomechanics and bioengineering
Bone and joint diseases

Osteoarthritis
Osteoporosis
Metabolic bone diseases
Rheumatoid arthritis and other arthropathies (inflammatory, crystal, etc.)
Haemophilia
Inherited musculoskeletal disorders
Neuromuscular disorders – inherited and acquired
Osteonecrosis
Osteochrondritides
Heterotopic ossification
Bone and soft-tissue sarcomas
Metastases
Orthopaedic oncology
Investigations
Operative topics
Infection, thromboembolism and pain
Prosthetics and orthotics
Research and audit
Medical ethics
This section of the guide will take you through areas that are commonly tested from the above list. The content cannot be comprehensive; you should check through the above list after reading this chapter and identify areas of weakness in your knowledge that remain.
Anatomy will not be covered here as it is a topic well dealt with in other revision texts. As you approach the exam you are strongly advised to develop a good working knowledge of surgical approaches, anatomical landmarks, methods for extending an approach and structures at risk. Do not ignore approaches that are out of day-today practice – the posterior approach to the knee and the anterior approach to the cervical spine have both been asked in the last few years!
What about a “top ten” for basic science? The following are must-know topics, but there are no guarantees! To do well you need to understand these subjects and their clinical relevance – it’s not just a question of regurgitating them.
Cartilage structure
Growth plate structure
Free body diagrams of hip
Gait cycle
The stress strain curve
Calcium and vitamin D
Osteonecrosis/AVN
Radiological principles
Paget’s disease
Infection
Remember – aim for a wide knowledge base so you can say something on almost any topic. The minu-tiae on one topic will be of no use if you are quizzed on the basics of another! You will not fail the exam for not knowing Young’s modulus of stainless steel but you will if you cannot explain what Young’s modulus is and its relevance.