The structure, standard and quality assurance of the MRCS and DO-HNS examinations are the responsibility of the Intercollegiate Committee for Basic Surgical Examinations (ICBSE). The ICBSE has a number of specialist subgroups that are each responsible for a different aspect of the examination.

This organogram shows the ICBSE committee structure and illustrates the scrutiny and attention provided to each element of the MRCS and DO-HNS examinations.

The ICBSE’s work can be classified into three activities:

• maintaining the quality and standard of the examinations within its remit;
• delivering incremental improvements in service standards;
• developing the examinations within its remit to meet internal and external requirements.

These three activities have equal priority.

More recently, the ICBSE has been heavily involved in research around the MRCS, including the effects of human factors on examiner performance, and the predictive validity of MRCS in higher surgical training. This is not only beneficial to trainees but also raises the academic profile of the four royal colleges as no work has been done to date in this area, unlike other medical royal colleges which have published their results widely.