The FRACS Orthopaedic Fellowship Examination is the final exit examination for orthopaedic trainees in Australia and New Zealand, sat during Core training in AOA 21. This guide covers what to read, how to prepare for the written and clinical components and what examiners look for.
by Dr Wan Zhang (exam 2021)
- Preparation for the Exam
- What you should read
- How you should study
- Flashcards
- as you read articles / summaries you should be developing flashcards of core information
- this can be done electronically such as ‘Anki’
- there is no point reading anything, if you don’t remember it
- Flashcards
- Study Group
- This is vital
- You can not pass this exam without practising with others
- Ideal number: 4-6
- Frequency of meeting: weekly (twice a week in final months)
- How should it run
- study plan
- criticism
- development of study material
- Get some advice
- Tutorials
- leading up to the exam, get as many tutorials as you can
- confirm what you read
- gives you perspective on common conditions
- puts you under the pump
- Subjects
- Specialities (it is important to cover these areas)
- Shoulder
- Spine
- Hip
- Knee
- Foot / Ankle
- Hand and Wrist
- Tumour
- Paediatrics
- Radiology
- Pathology
- Specialities (it is important to cover these areas)
- leading up to the exam, get as many tutorials as you can
- Past registrars
- those who have passed the exam are an invaluable resource of information and advice
- Tutorials
- Expose yourself to criticism and scrutiny
- Study Group
- Tutorials
- Case conference
- Outpatients
- Meetings and Clinics
- Set 5 preparation
- Leave entitlements
- Rotations
- Bone School
- Suit and instruments
- Preparing
- Presenting
- Pressure
- Look after your health
- fitness
- mental
- dietary
- Research Presentation
- This is a necessary component of the Exam process
- It is important to obtain your required research points earlier
- Failure to do so may stop you from sitting the exam, or add to extra stress / distraction that may lead you to under perform
- AAOS Exam
- There is a lot of contention regarding the usefulness of this practice exam and the correlation between it and the real FRACS exam
- Your performance during this exam is probably related to the amount of study you’re able to do during the second half of SET 4 – which is quite variable. ie. If your SET 4 post is incredibly busy, you’re unlikely to have the time to study for this early practice exam.
- So don’t worry if you do badly at it – you still have time to pick up your game and pass the exam.
- Having said that. no one who has won the AAOS prize has failed the exam!
- Pre-Exam Course (If it still runs)
- This course is absolute gold and will allow you to polish your skills and iron out some nerves.
- run under exam conditions
- practice your technique
- It is held interstate a week before the exam
- Take it very seriously
- It tests 3.5 parts of the 5 exam components
- This course is absolute gold and will allow you to polish your skills and iron out some nerves.
- On the day of the Exam
- How to Approach
- Multiple choice questions
- Friday morning paper
- 2 hours
- 75 mcqs – 5 True / False (375 questions)
- need approx 75% to pass (standardised bell curve > -1 SD below mean to score 3/4)
- purely factual
- only approx. 10% repeat questions
- Preparation
- past 5 years JAAOS articles
- Prepare flash cards for everything you read
- practice past questions
- iSAWEs and Essays
- Afternoon paper
- 2.5 hours
- iSAWEs
- 10 x 6 minute short answer questions
- based on a short vignette and a clinical photo or X-ray / ct / mri
- Preparation
- study group – prepare practice iSAWEs
- practice structure and timing
- Tips
- read the question
- write in point form
- Generic surgical questions
- 2 x 15 minute short answer / mini essay questions
- based on a context that can be generalised to other surgical specialties
- Essays
- 2 x 30 minute essays
- Assesses
- Perspective
- Clinical assessment and investigation
- Management – nonoperative, operative and rehab
- Preparation
- past papers
- discuss in study group
- Tips
- Read the question
- every word in the question is there for a reason
- Perspective statement
- Tailor it to specific case
- Start with a plan and have a clear structure
- Read the question
- Investigations (CIM – Clinical investigations and management) (1 session)
- Saturday
- 30 minutes – 5 cases
- Assesses
- Clinical assessment and workup
- Use of investigations – biochemicals, imaging, histology
- Preparation
- Practice with study group
- St Vincent’s tumour meeting
- know background of every investigation
- know tumour principles – staging and biopsy
- Operative Computer Stations (Op Surg) (2 sessions)
- 2 x operative sessions – Saturday
- 30 minutes with 2 examiners – 5 cases
- Preparation
- Practice – study group, theatre, bone school
- see as many ‘uncommon’ cases as you can
- Hoppenfeld (approaches and anatomy)
- Campbells / Wiesel’s
- Tips
- Start with perspective statement and “answer the question”
- Briefly mention non-operative management but remember it’s an operative station
- say what YOU would do
- know the principles and draw on past experience
- Clinical Stations (2 sessions) (Computer based if due to Covid)
- 4 cases – 35 minutes, 3 cases – 35 min
- History and Examination videos – can be asked to be replayed, but careful this can take away time for answers / discussion
- Tips
- Introduction
- Answer the question
- Structure
- Wash hands and thank patient
- Precise demonstration of signs
- Interpretation of findings and diagnosis
- Establish rapport
- Multiple choice questions
Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.