The FRCS (Tr & Orth) exam sets out to provide an assessment of the knowledge and skills and the ability to use these to the required standards of a consultant orthopaedic surgeon working in the National Health Service in the UK. It is a significant career hurdle to pass and involves an intensive 6–12-month period of study during which time everyday life and activities increasingly assume secondary importance to passing ‘the exam’.

The viva exam or ‘structured oral examination’ as the Intercollegiate Specialty Board (ISB) prefers to call it is an important component of this exam. Whilst most candidates are more fearful of the clinical component, the oral section is never as clear-cut or straightforward as some examiners (or consultant non-examiners) would have us believe.

This general introduction provides an overview of how to improve your score and pass the oral exam with flying colours.

Careful tactical planning is required beforehand as on the days of the exam it is usually too late to alter your game plan and poorly thought-out tactics may lead to your downfall.

We have avoided the temptation of solely focusing on what successful candidates believe are the important tips and tricks that will get you through the oral exams. We have additionally looked at the exam process itself and what it sets out to test. The logic is that if you understand how and why the exam acts as an assessment tool you will increase your chances of success.