CMSA

The Colleges of Medicine of South Africa NPC

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ACADEMIC OFFICE
FCS(SA) Intermediate Examination Blueprint for Paper 2: Principles of Surgery in Surgical Specialties
Impact: Implication to life and organs if not recognized and managed appropriately.
Impact Score
Immediately life threatening 4
Life threatening (delayed) 3
Organ or limb threatening 2
Trivial 1

Frequency: How often is a practicing likely to encounter it?

Frequency of occurrence Score
Common (daily to weekly) 3
Frequent (weeks to 3 months) 2
Rare (more than 3months) 1

Impact factor: Impact x Frequency Grading of Level of Competence: 1–4

Level of competence Descriptor
Level 1 Diagnose and refer
Level 2 Diagnose, stabilize and refer
Level 3 Diagnose, stabilize, institute emergency management and refer
Level 4 Diagnose and institute definitive management

Examination Formats
Question Item Description Percentage Weighting
SBA MCQs Total of 120 questions
Oral Principles of General Surgical Specialties

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 Content Area Topics Learning Level of Competencies Weighting by
Objectives Competence total number of
questionsin
Paper 2 SBA
MCQs
1. General Surgery a) Approach to patient presenting with an See curriculum a) Level 3 21
(Impact Factor =12) acute abdomen b) Level 3
b) Presentation, differential diagnoses,
diagnostic investigations and
management of intra-abdominal sepsis c) Level 3
c) Presentation, differential diagnoses,
diagnostic investigations and d) Level 3
management of bowel obstruction
d) Presentation, differential diagnoses, risk e) Level 3
factors, diagnostic investigations and
management of GIT bleeding f) Level 2
e) Presentation, differential diagnoses,
diagnostic investigations and g) Level 4
management of skin and soft tissue
infections h) Level 3
f) Presentation, differential diagnoses,
diagnostic investigations and
management of common solid organ
malignancy
g) Classification and use of surgical drains
and suture materials
h) Evaluation and management of the
jaundiced patient
2. Neurosurgery a) Evaluation including classification and See curriculum a) Level 3 12
(Impact Factor = 8) principles of management of a patient
who sustained Traumatic brain injury b) Level 3
b) Diagnosis and management of raised
intracranial pressure c) Level 3
c) Diagnosis, classification and
management including complications of d) Level 3
intracranial infections
d) Presentation, investigations and e) Level 2
management of brain tumours
e) Presentation, investigations and f) Level 2
management of intracranial bleeding g) Level 2

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 f) Diagnosis and management of
hydrocephalus
g) Presentation and diagnosis of congenital
malformations
3. ENT a) Principles of management of trauma to See curriculum a) Level 3 See syllabus 6
(Impact Factor = 6) ear and upper aerodigestive tract
b) Differential diagnosis of acute upper b) Level 3
airway obstruction
c) Presentation and management of foreign c) Level 3
bodies in the ear, nose and upper
aerodigestive tract d) Level 3
d) Presentation, differential diagnoses and
management of ENT infections e) Level 3
e) Causes and management of epitasis f) Level 3
f) Risk factors, presentation and
management of sinusitis g) Level 4
g) Indications, procedure and complications
of tracheostomy
4. Ophthalmology a) Principles of management of trauma to See curriculum a) Level 3 See syllabus 3
(Impact Factor = 4) the eye including corrosive injury
b) Presentation, classification and b) Level 3
management of peri-orbital infections c) Level 3
c) Causes and management of bleeding
into the eye d) Level 3
d) Ophthalmic manifestations or
complications of common surgical e) Level 4
conditions f) Level 2
5. Maxillofacial a) Principles of management of facial See curriculum a) Level 4 See syllabus 3
Surgery fractures b) Level 3
(Impact Factor = 4) b) Diagnosis and management of facial
infections
6. Orthopaedics a) Investigations, diagnosis and See curriculum a) Level 2 See syllabus 10
Surgery management spinal injuries
(Impact Factor = 9) b) Diagnosis and management of fractures b) Level 2
and dislocations
c) Presentation and management of pelvic c) Level 2
fracture d) Level 3
d) Presentation, diagnosis of fat embolism e) Level 4
syndrome
f) Level 2

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 e) Presentation and management of
compartment syndrome
f) Presentation, diagnosis and
management of septic arthritis and
osteomyelitis,
7. Urology a) Presentation, diagnostic investigations See curriculum a) Level 3 9
(Impact Factor = 12) and management of urogenital system
trauma b) Level 3
b) Predisposing factors, diagnosis and
management of urinary tract infection c) Level 4
c) Differential diagnoses and management
of acute scrotum d) Level 2
d) Classification, differential diagnosis and
investigations of haematuria e) Level 2
e) Presentation and investigations of f) Level 1
nephrolithiasis
f) Presentation and diagnostic investigation g) Level 1
for common urogenital tumours
g) Presentation of common congenital h) Level 3
anomalies of the urogenital system
h) Management of urinary retention
8. Cardiothoracic a) Presentation, investigations, See curriculum a) Level 3 8
Surgery management and complications of blunt
(Impact Factor = 9) and penetrating chest trauma b) Level 2
b) Indications, peri-operative management
of a patient for cardiac bypass surgery c) Level 3
patients
c) Diagnoses, presentation and d) Level 3
management of pleural and pulmonary
infections e) Level 4
d) Differential diagnoses, investigations and
management of pleural effusion
e) Interpretation of chest X-ray
9. Vascular Surgery a) Presentation, diagnostic investigations See curriculum a) Level 3 10
(Impact Factor = 9) and management of blunt and
penetrating vascular injury b) Level 3
b) Risk factors, presentation, differential
diagnosis, investigations and c) Level 2
management of acute arterial occlusion
d) Level 2

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 c) Risk factors, presentation, differential
diagnosis, investigations and e) Level 2
management of chronic arterial occlusive
disease f) Level 3
d) Risk factors, presentation, differential
diagnosis, investigations and
management of aneurysmal disease
e) Presentation and investigations in
vasculitidis including HIV associated
vasculitis
f) Indications for lower limb amputations
10. Paeditric Surgery a) Preparation for transport of a neonate See curriculum a) Level 3 11
b) Venous access and fluid therapy in b) Level 4
paediatric patients c) Level 2
c) Differential diagnoses and investigations
of neonatal jaundice d) Level 2
d) Differential diagnoses, presentation,
investigations and management of GIT e) Level 2
obstruction in infants and children
e) Differential diagnoses, presentation, f) Level 2
investigations and management of acute
abdomen in paediatric patients g) Level 1
f) Differential diagnoses, presentation,
investigations and management of
abdominal wall defects in newborn h) Level 3
babies
g) Differential diagnoses, presentation,
investigations and management of
common solid organ malignancies in
infants and children
h) Presentation and management of
umbilical and inguinal hernia in
paediatric patients
11. Plastic Surgery a) Classification of suture materials a) Level 4 10
including staplers b) Level 4
b) Mechanism of action and appropriate
use of energy devices c) Level 4
c) Wound healing process and causes of
poor wound healing d) Level 3
e) Level 4

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 d) Principles and options available for
wound closure
e) Presentation and classification of
surgical site infection
12. Obstetrics and a) Normal physiological changes in a) Level 2 3
gynaecology pregnancy b) Level 3
b) Evaluation, differential diagnoses and
management of acute abdomen in c) Level 3
pregnancy
c) Investigations and management of d) Level 3
polytrauma in pregnancy
d) Differential diagnosis, investigations and e) Level 3
management of hyperthyroidism in
pregnancy
e) Presentation,differential diagnoses and
management of pelvic inflammatory
disease
13. General a) Mechanism of action, indications and a) Level 3 5
Oncology preparation for chemotherapy including
complications b) Level 2
b) Mechanism of action, indications and
preparation for radiotherapy including c) Level 2
complications
c) Mechanism of action, indications and d) Level 2
preparation for hormonal therapy
including complications
d) Mechanism of action, indications,
preparation for diagnostic and therapy
with a radioisotope including
complications
14. Transplant a) Classification of transplants and grafts a) Level 3 2
b) Diagnosis and confirmation of brain b) Level 3
death c) Level 2
c) Common immunosuppressive drugs
used including side effects d) Level 1
d) Types and manifestations of rejection
TOTAL 100%

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