A certificate of competence in surgery at General Medical Officer Grade (2 years training)

The membership examination is designed to assess understanding of the basic principles of surgery and a broad knowledge of surgery in general. Trainees register to work in institutions accredited by COSECSA and attend compulsory courses.

After two years trainees should be able to take responsibility for emergency surgical admissions, deal with life-threatening situations resulting from trauma or critical illness and be able to diagnose and plan treatment for a variety of common surgical conditions.

The MCS examination does not confer specialist status but qualifies a candidate to register for and pursue higher surgical training in a surgical specialty of his or her choice. The College Fellowship examination (FCS) is a recognized specialist qualification.

Applications to register as a trainee must be made online through the COSECSA website in the Candidate Registration section. A registration fee of USD 400 is paid online. The application must be supported by the country representative.

All candidates must:

  1. Have full registration with the Medical Council of the country in which the candidate is working before the start of training.
  2. Be registered with the College and have satisfactorily completed two years of basic surgical training in recognized posts in institutions accredited by COSECSA.


The two-year training:

  1. Should comprise at least six months of general surgery including emergencies and at least six months of orthopaedics with trauma
  2. The remainder of the time may be spent in any surgical specialty (including general surgery and orthopaedics).

Before sitting the MCS examination candidates must:

  1. Have successfully completed basic surgical skills, basic surgical sciences and trauma course
  2. Have completed the required number of case studies and Surgery in Africa journal club modules on the School for Surgeons e-learning platform.
  3. All candidates must keep an accurate record of their training experience prospectively in their electronic logbook.

The examination is comprised of the following:

A written paper: two multiple choice question (MCQ) papers taken in the candidate's own country in the first week of September. Only candidates who pass the written paper will be invited to attend the clinical and oral examination.

  • Paper 1 is predominantly on principles of surgery in general (sections 1 to 9 of the syllabus)
  • Paper 2 is predominantly on systematic surgery (sections 10 to 20 of the syllabus).

Sample MCQ written examination questions are available here.


An objective structured clinical examination which takes place in the first week of December at a site designated by the college.

See the above video or this document for more information about the MCS examinations.

Candidates may sit the examination at the end of their second year of training. The examination fee of $500 must be paid by end of July. On receipt of the fee, candidates will be informed of the precise times dates and places for the exams. Candidates should bring their logbooks and proof of identity to the examination.

If a candidate withdraws from an exam more than 12 weeks before the exam is due, then the fee can be transferred to a later exam date. Fees are not normally returned if the candidate withdraws permanently.


  • Candidates who fail one or more parts of the MCS examination need to reapply for the exam and pay a further fee of $200.
  • Candidates who pass the multiple choice examination but fail the oral or clinical examinations are required to re-sit both the oral and clinical parts, but will need to reapply for this and pay a reduced fee of $200.
  • Candidates must pass the examination within four years of their first attempt. After this they will not be allowed to re-sit.  As noted above, if candidates have passed the MCQ, this will be considered valid for the next two years.   If the clinical and written exam is being sat in the fourth year, the candidate will need to re-sit the MCQ.

The Curriculum and Syllabus is available through the following links:


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