Reviewed · Pablo Lozano Lominchar, MD PhD
Saudi Arabia sets two general surgery assessments, and almost everything written about them describes only one. Which one you face depends on the grade you are classified for and on where your qualification falls in the Commission’s groups.
We used to say on this page that a question bank prepares the wrong examination. That was too strong, and this is the correction: a multiple-choice bank is the right preparation for the written paper. What it cannot do is prepare the oral — and the oral is the part nobody sells anything for, because you answer it by speaking.
The eighteen sections are published, and they are worth reading in order. Trauma · Shock and critical care · Surgical complications · Wound care · Breast · Endocrine · Skin and soft tissue · Abdominal wall hernia · Acute abdomen · Upper GI bleeding · Lower GI bleeding · Oesophagus and stomach · Small intestine · Large intestine · Anorectal · Pancreas · Spleen · Liver and biliary surgery. Note what that list is: bread-and-butter general surgery on call. It is not a subspecialty syllabus, and preparing it as though it were is a common and expensive mistake.
The four marking domains are the part almost everyone gets wrong. You are not scored on how much guideline you can recall. The Commission names four competence domains and defines each one, and the definitions are worth reading closely because they tell you what the examiner is listening for.
| Domain | What it is scored on |
|---|---|
| Data-gathering skills | Obtaining and identifying important information, correlating clinical data to recommend appropriate testing. Includes interviewing and history taking. |
| Reasoning and analytical skills | Rationalising effective management plans, evaluating alternatives, recognising indicators to different treatments from correct interpretation of the data. |
| Decision-making skills | Formulating a logical diagnosis, identifying immediate needs, inferring expected outcomes, recognising potential complications, risks and benefits. |
| Professional attitude | Commitment to ethical and professional behaviour: excellence, respect, integrity, accountability and altruism. |
The fatal-mistake rule. This is the most distinctive feature of the Saudi examination and the one no written paper has. The blueprint states it plainly: *"Regardless of the number of satisfactory results achieved, the candidate can fail if any fatal mistakes are committed in a section during the evaluation."* You can carry ninety per cent of a station and fail on one sentence.
Questions people actually ask
Is the SCFHS general surgery exam multiple choice?
Partly — Saudi Arabia sets two. The Saudi Licensure Examination is a written paper of 200 multiple-choice questions in four hours (65% to pass as Registrar, 70% as Senior Registrar). But the professional-practice classification is an oral — a Multiple Case Structured Assessment of two to four stations of up to thirty minutes, conducted remotely with two to four examiners, drawn from eighteen published sections and marked on four competence domains.
What is the pass mark for the SCFHS oral?
You must perform at an overall satisfactory level in 70% of the sections evaluated. On top of that, the blueprint states that a candidate can fail for a fatal mistake in a section regardless of how many satisfactory results they achieved.
How many stations are there in the SCFHS MCSA?
Two to four stations of up to thirty minutes each, with two to four examiners. Each encounter covers six to eight of the eighteen published sections, and the candidate is not told in advance which sections will come up.
How long do SCFHS results take?
The blueprint states results are returned within fourteen business days.