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Introduction

Designed to test a comprehensive understanding of basic surgical sciences, the Generic Surgical Sciences Examination (GSSE) serves as a gateway for those embarking on their surgical careers.

The exam (other than the anatomy spots) is based solely on multiple-choice questions (MCQs).

In this blog, we’ll explore practical tips, key strategies and principles to help you master the technique of sitting the GSSE MCQs and optimize your preparation.

1. Understanding the GSSE Exam Format

The GSSE consists of two 150-minute online exams held over two consecutive days, with no reading time, or penalties for incorrect answers.

The first exam (Anatomy) accounts for 50% of the total mark and includes 60 Type X MCQs and 20 anatomy spot test questions. Type X MCQs, worth up to 4 marks each, cover categories like the abdomen, CNS, and limbs, while spot test questions are worth 8 marks each.

The second exam (Pathology & Physiology) also contributes 50% of the total mark, with 125 MCQs split evenly between pathology and physiology topics.

These include Type A, B, and X questions, with Type X being the most heavily weighted. Exams are conducted online, with flexible navigation, randomised questions, and automatic answer saving.

Type A MCQs:

• Require selecting the single most appropriate answer.
• Each correct answer is worth one mark.
• Example:
• The most appropriate reason to avoid pineapple on pizza is:
  A. It makes the pizza soggy.
  B. It doesn’t pair well with cheese.
  C. Some people find the sweetness unpleasant.
  D. It’s a controversial topping choice.

The most appropriate reason to avoid pineapple on pizza is:
A. It makes the pizza soggy.
B. It doesn’t pair well with cheese.
C. Some people find the sweetness unpleasant.
D. It’s a controversial topping choice.

E. All of the above

Answer: E

Type B MCQs:

• Tests the relationship between a statement (S) and a reason (R).
• Candidates determine if S and R are true and whether R explains S.
• Each correct answer is worth one mark.

Example

S: Pineapple on pizza is controversial as a topping choice
because
R: Some people have psychopathic tendancies

A. S is true, R is true, and R explains S.
B. S is true, R is true, but R does not explain S.
C. S is true, R is false.
D. S is false, R is true.
E. Both S and R are false.

Answer: A (both statements are true, and R explains S).

Type X MCQs:

• Consist of a stem and four distractors.
• Candidates determine if each distractor is true or false.
• Each correct response earns one mark, with up to four marks per question.

Regarding pineapple on pizza, the following statements are true or false:
1. Pineapple was first added to pizza in Italy.
2. It is considered an acceptable topping in Hawaii.
3. Pineapple on pizza is universally loved.
4. The sweetness of pineapple contrasts with the saltiness of ham.

Answers:

FTFT (it originated in Canada).

Spot Test Questions:

• Require short text answers (up to 10 words).
• Linked to illustrations and worth a total of eight marks.

MCQs may include visual aids like radiographs, histology micrographs, or CT scans.

Example

What is A?

Answer:

A cry for help.

2. Effective Strategies and Principles for Tackling MCQs

1. Keep It Simple

• Take an orthodox approach to questions
• Focus on what typically happens, not rare exceptions
• Answer as if explaining to a medical student
• Don’t overthink or read more into questions than necessary

2. Pay Attention to Language

• Watch for key words in question stems – they apply to all options
• Be careful not to miss the word “not”
• Terms like “typically” or “characteristically” are important qualifiers
• Be wary of absolute terms (“always,” “never,” “invariably”) – these often signal incorrect options

3. Answer What’s Asked

• Stick to the present – avoid future projections
• Don’t consider hypothetical scenarios
• Focus on the mainstream, not exceptions
• Stay away from intellectual side-tracks

4. Pattern Recognition

• Long, detailed options are usually correct
• Questions about general principles often have multiple correct answers
• Lists of examples tend to have more true than false options
• Common topics (like apoptosis, T-cell reactions) frequently recur
• Complete the set of past questions, as there is a limited pool and they are re-used

5. Question Construction

• Questions asking for lots of detail often have more correct answers
• Complex biological processes rarely have absolute answers
• Terms like “frequently” and “commonly” are used deliberately
• “Generally accepted” usually refers to standard textbook knowledge

6. Pro Tips

• If you encounter double negatives, rephrase the stem as a positive
• Remember that longer lists of options tend to have more correct answers
• Textbook answers are usually what examiners are looking for
• Focus on clear, established medical knowledge rather than cutting-edge research

3. The Role of Guessing in the GSSE

• Let’s talk strategy when you’re unsure about an MCQ answer. Since the GSSE doesn’t penalize wrong answers – you should always answer every question.
• Random guessing can work in your favor, yielding around 42% in a typical RACS paper (that’s about 50 marks out of 120). So really, you just need to KNOW
• While the RACS no longer publishes their question banks, historical data from their last published collection (1997) provides valuable insights into Type X question patterns. Although this data is from an older publication, the fundamental structure of GSSE questions remains similar.
• In a study of 217 Type X questions:
  • 10% had 1 correct option
  • 30% had 2 correct options
  • 33% had 3 correct options
  • 27% had all 4 options correct

So, if a candidate marked all options as ‘true’ across all 868 individual Type X options (217 questions × 4 options), they would have achieved approximately 68% correct answers. Conversely, marking all options as ‘false’ would have resulted in only 31% correct answers.

This suggests that in Type X questions, options are more likely to be true than false. This tip never replaces real learning, however it puts you in the best position for getting through the exam.

4. Why Practice Questions Are Essential

• The GSSE isn’t just about memorizing facts – it’s about applying knowledge under pressure. This is where practice questions become your best ally.
• Currently, GetThru Premium has a 100%* success rate for examinees.
• Think of each practice question as a mini-simulation of the real exam, training your brain to think critically and respond efficiently.
• This is why we’ve designed Get-Thru’s question bank specifically for the GSSE format. Each practice session helps identify knowledge gaps, improves your time management, and builds confidence in tackling exam-style questions.
• Our detailed explanations don’t just tell you if you’re right or wrong – they help you understand the underlying concepts, making your study time more efficient and effective.
• Whether you’re months away from your exam or in the final countdown, regular practice with targeted questions is your pathway to GSSE success.

Go forth and succeed.

Let’s face it – preparing for the GSSE can feel like climbing Mount Everest. So you’ve picked a date, but having found countless resources out there, it’s easy to get overwhelmed. But don’t worry! We’ve been there, and after speaking to many others about how they did it and helping hundreds of doctors prepare for their GSSE through the GetThru Platform, we’ve got some tried-and-true insights to share about what works.

1. Foundational Textbooks: Everything is Built On This

These are your go-to for in-depth understanding of the core subjects.

• Last’s Anatomy (9th Edition): Known for its dense text and poor organization, making it one of the toughest textbooks to study. With its word-for-word exam format, you’ll face detailed questions on specific anatomical features, like the exact length of the inguinal canal or the mucous glands in the gallbladder. The key chapters are essential (but you can skip the CNS section focusing instead on cranial nerves, arterial supply, and venous sinuses.)
  • To make sense of Last’s, pair it with a visual guide like Netter’s Atlas, which, though not part of the official syllabus, is invaluable.
  • If you find Lasts’ format and lack of useful images challenging, there’s a helpful Gompanion Guide (written by Dr Mirajalili and A/P Fogg) which is a streamlined resource aligned to Lasts’ 9th edition, is easy to follow with colour images and an included eBook.
• Rohen’s Color Atlas of Anatomy: A standout resource for the spotter questions. The high-quality cadaveric images ahelp you visualize anatomical structures exactly as they appear in real dissections. By spending time with this atlas, you can build familiarity with the dissections and better recognize key structures during exams. Don’t overlook this resource—use it early and often in your preparation.
• Ganong’s Review of Medical Physiology: Physiology can feel dense, but this book breaks it down well. Supplement with West’s Respiratory Physiology for trickier concepts. Guyton’s can be ignored.
• Robbins and Cotran Pathologic Basis of Disease: The cornerstone of pathology for GSSE prep, but mastering it requires a strategic approach.
  • Focus on the first nine chapters, which cover critical topics like immunology, genetics, and tumor pathophysiology, and ensure you understand atherosclerosis and the genetic profiles, natural history, treatment, and key histological features of all tumors (e.g., Reed-Sternberg cells for Hodgkin’s lymphoma).
  • Skip clinical staging and epidemiology—it’s not exam-relevant.
  • For the myriad of random diseases, rely on question banks and past exams to identify high-yield topics.

2. Question Banks: The Secret Weapon

Practice makes perfect, and when it comes to the GSSE, question banks are a game-changer. Use the past question banks and know every single bank question. Use Lasts and the other texts to understand why each answer is correct or incorrect.

Online question banks like GetThru not only test your knowledge but also guide your revision by highlighting weak areas. Combined with past and new questions, an excellent UI, anatomy spots, the ability to track your progress, explanations for every question and spaced repitition techology, it’s loaded with features to maximise your efficiency. You can get started for free to access all past questions – which means you can throw away the old excel document.

Check out a demo below.

Other established options include Ace the Exam (which has a free trial) and Primary Anatomy (which focuses mostly on anatomy and illustrations). Remember, it’s not just about answering questions—it’s about understanding the concepts behind them.

Julie Mundy, cardiothoracic surgeon in Queensland, has been running practice questions, mock exams and feedback for years. An incredible duty of service and great resource to utilise. Email her to sign up.

3. Additional Online non-GSSE Resources: Free Gold

You also have a wealth of free non-GSSE specific tools at your fingertips.

• Instant Anatomy: A lifesaver for memorizing lists like branching arteries.
• YouTube Channels: Armando Hasudungan ‘s YouTube channel? Pure gold. His illustrations break down complex concepts in a way that just sticks in your mind. It’s like having a really talented friend explain things over coffee. And Osmosis is perfect for those times when you need a quick and broad refresher on a topic.
• Cautionary Note: Some resources, like Leon Lai’s notes, can be helpful but may contain errors and don’t necessarily explain the underlying concepts. Use them sparingly and in conjunction with other resources.

These tools are great for studying on the go or when you need a break from heavy textbooks.

4. Prep Courses: Worth the Investment?

Let’s talk about the elephant in the room – GSSE prep courses. Are they worth the investment? If you thrive in a structured environment, absolutely. At the very least it is a defined period of time where you have no choice but to focus on your GSSE preparation.

• Dunedin Basic Surgical Sciences Course: Has an impressive track record. It provides focused preparation with lectures, tutorials, and practical anatomy sessions over three weeks. It includes three online practice exams to simulate the real exam experience, complete with explanations for better recall and further study. The course also includes post-course MCQs for a thorough evaluation.
  • Upcoming course dates for 2025:
    • 2-23 May
    • 22 August-12 September.
  • Cost: $5,500 NZD
• Science for Surgeons Course: Dr. Ali Mirjalili, an Associate Professor at the University of Auckland leads weekly 1-hour evening Zoom lectures Starting in January. The course is taught by the Auckland Clinical Anatomy Team and leading surgical specialists. In addition to the online sessions, there is a one-week residential course from September at the University of Auckland for in-depth, hands-on learning.
  • Upcoming course dates for 2025:
    • 20 January – 5 September 2025
  • Cost: $5,000 NZD
• St Vincents (Melbourne) Pre-SET Surgical Society Course: An intensive three-day education program (run over 3 weekends) to help prepare for the Generic Surgical Sciences Exam (GSSE). A day each is focused on key subjects and is designed to provide high-yield content for efficient study. Expert lectures from senior staff at St Vincent’s Hospital will guide participants through the most challenging topics.

5. Diplomas in Anatomy: A Commitment Beyond the GSSE

Let’s talk about formal GSSE courses – they’re a significant investment of both time and money, with a heavy focus on anatomy. While they can provide structured learning time and look great on your CV for future applications, they’re definitely not essential for exam success. Many candidates pass without them.

Think of these courses as optional extras rather than must-haves. If you’re particularly passionate about anatomy or need dedicated study time away from clinical duties, they might be worth considering. But if you’re comfortable with self-directed learning and managing your study schedule well, you can absolutely succeed without them.

• The University of Melbourne has set up a Graduate Diploma in Anatomy (GDSA) offer intensive, high-time commitment courses focusing on anatomy and is accredited by the Royal Australasian College of Surgeons
• The University of Otago offers a Postgraduate Diploma in Surgical Anatomy (PGDipSurgAnat), a one-year program for doctors aiming to specialize in surgery or radiology. It includes distance learning and on-campus cadaver dissection. Applications open on 1 September each year, with on-campus teaching in Dunedin in June and November

6. Study Groups: Your Secret Weapon

While much of the didactic learning for the GSSE is necessary to be done solo, the power of study groups is one to not overlook. While it won’t work for everyone, if it does for you – consider making the GSSE a team sport! Accountability to others can be a key external motivator

Small groups of 3-4 people work best. Meet weekly, rotate topics, and discuss MCQs. There’s nothing quite like explaining a complex concept to a peer to highlight the gaps in your own understanding.

Wrapping It Up

Remember, preparing for the GSSE is a marathon, not a sprint. The resources I’ve shared here are your tools, but it’s how you use them that matters. Create a study schedule that works for you, stay consistent, and most importantly – don’t forget to take care of yourself during this journey.

Have you found other resources particularly helpful? Drop a comment below – we’re all in this together, and sharing knowledge is what makes our surgical community strong.