In Pakistan, the College of Physicians and Surgeons Pakistan (CPSP) is the main authority responsible for postgraduate medical training and fellowship certification in various surgical specialities. The Fellowship of the College of Physicians and Surgeons (FCPS) in Surgery is considered the highest postgraduate qualification for surgeons in the country. This fellowship is internationally recognised and opens opportunities for advanced clinical practice, teaching, and research.

This article covers the updated procedure of the Surgical Fellowship Exam in Pakistan, including eligibility requirements, structure, fees, and exam outline for aspiring surgeons.

Eligibility Criteria for Surgical Fellowship Exam (FCPS) in Pakistan

To sit for the FCPS Surgical Fellowship Exam, candidates must meet specific criteria set by CPSP:

1. Primary Medical Qualification
   • Must hold an MBBS degree recognized by the Pakistan Medical and Dental Council (PMDC).
   • Foreign graduates must have their qualification verified by PMDC/PMC.
2. House Job (Internship)
   • Completion of a 1-year house job in a PMDC-recognized hospital, including a mandatory 3-month rotation in General Surgery or Medicine.
3. Residency Training
   • Enrolment in a structured CPSP-recognized residency program in General Surgery or a surgical subspecialty.
   • The duration of training is usually 4–5 years, depending on the specialty.
4. Intermediate Module (IMM) or Equivalent
   • Candidates must clear the IMM exam (Intermediate Module in Surgery) before applying for the final FCPS fellowship exam.

Structure of the Surgical Fellowship Exam

The FCPS fellowship in Surgery follows a structured two-stage assessment system:

1. IMM (Intermediate Module in Surgery)

• Conducted after 2 years of training.
• Assesses knowledge of surgical principles, applied anatomy, pathology, and clinical methods.
• Format includes written MCQs, SEQs (Short Essay Questions), and clinical viva.

2. Final FCPS (Fellowship Examination)

• Attempted after completion of full residency training (4–5 years).
• Written Component:
  • Multiple-choice questions (MCQs).
  • Short-answer/essay questions covering core surgical sciences.
• Clinical/Oral Component:
  • Long and short clinical cases.
  • Oral viva assessing operative decision-making, surgical judgment, and case management.
• Practical/Skills Assessment:
  • May include simulated operative skills or logbook evaluation of surgical cases performed.

Examination Fees (Approximate 2025 Figures)

• FCPS Part I (Basic Sciences): PKR 25,000 – 30,000
• IMM Examination: PKR 30,000 – 35,000
• Final FCPS Fellowship Exam: PKR 40,000 – 50,000
• Registration Fee with CPSP: Around PKR 15,000 (one-time)

💡 Note: Fees may vary slightly depending on CPSP updates and whether the candidate is a local or overseas applicant.

Core Outline of the Surgical Fellowship Exam

The FCPS Surgical Fellowship exam tests a wide range of competencies to ensure professional expertise:

1. Basic Surgical Sciences
   • Anatomy, physiology, pathology, microbiology, pharmacology.
2. General Surgical Principles
   • Wound healing, infection control, fluid & electrolyte balance, trauma management.
3. Specialty-Specific Knowledge
   • Topics related to chosen specialty (e.g., General Surgery, Orthopedics, Neurosurgery, Plastic Surgery, Pediatric Surgery, Urology, Cardiothoracic Surgery).
4. Clinical Case Management
   • Diagnosis, investigations, perioperative management, operative decision-making.
5. Operative and Technical Skills
   • Assessment through logbooks, clinical cases, and practical examinations.
6. Research & Ethics
   • Candidates must complete a Mandatory Research Dissertation/Article approved by CPSP before the final fellowship attempt.

The FCPS Surgical Fellowship Exam in Pakistan is a comprehensive assessment system designed to produce competent, ethical, and skilled surgeons. With its structured pathway—starting from eligibility, residency training, IMM assessment, and final fellowship exam—CPSP ensures that only qualified doctors achieve fellowship status. Understanding the eligibility requirements, exam structure, fees, and core outline can help aspiring surgeons prepare strategically for this highly respected qualification.