The GSSE

Over 800 candidates sit the GSSE each year, across Australia and Aotearoa New Zealand. It is requirement for entry/completion onto the various training programs in surgery, but at least 35% of all candidates fail. Our goal at Ace The Exam is to ensure that you are not one of them. This exam is not the be-all and end-all of prowess and success in surgery. But it is correlated with subsequent success in the FRACS, at the completion of SET training. Passing exams requires technique, which can be learned, and practiced. It is neither effective, nor sufficient, to just rote learn the material from the reference texts. This is where question banks come in.

The GSSE has three sittings, or "diets", a year. These are in February, June and October, with registration for each sitting opening and closing several months before. Ace The Exam has a calendar with the registration dates for each exam in the next 12 months - make sure you don't miss out on your planned exam.

Fees in 2024 for the GSSE for Junior Doctors were a cool AU$4,850 for Australian junior docs, and NZ$5,425 in New Zealand (including GST). This is not a fee you want to pay more than once!

Eligibility for the GSSE is simply being a qualified doctor in Australia or Aotearoa New Zealand. It is a requirement of all the Surgical Education and Training (SET) programs. Some programs mandate passing it prior to applying, whereas others require that it is passed within two years of entry into their program. This has some important implications, as per RACS:

Prevocational (pre-SET) doctors have unrestricted access and unlimited attempts at the GSSE.

For those on SET programs, the GSSE must be passed within two years. A maximum of four attempts is allowed, after which the trainee could be removed from the program.

In addition, only the February and June sittings are open to SET trainees, whereas prevocational docs can sit in February, June and October.

The GSSE consists of two multiple choice question (MCQ) papers, held over two days.

• Paper one = 80 Anatomy questions
• Paper two = 60 Physiology and 65 Pathology questions

To pass, you must achieve above the minimum standard for each section (anatomy, physiology, pathology) and above the minimum threshold overall. This varies depending on the year but is in the region of 60-65% for each.

The exam is conducted entirely on a computer. There is a countdown timer on screen and your answers will auto-save as you proceed.

Each paper is only 150 minutes (2.5 hours) and there are a lot of questions to get through, so time management is key. This is one essential skill that comes out of doing practice questions on a bank, such as Ace The Exam.

The weighting of each component is approximately 50% anatomy, 25% pathology, and 25% physiology. Given that a chunk of anatomy is true/false questions, you actually have pretty decent odds of passing this without perfect knowledge. Physiology and Pathology are indeed where most candidates fall down. MAKE SURE that you don't neglect these areas in favour of the more interesting (to budding surgeons, presumably) Anatomy revision.

The GSSE questions are based entirely off the Syllabus, which is freely available online. You won't/can't be asked things that do not feature in here.

The Anatomy Syllabus breaks down topics into essential, desirable and non-core. Make sure to read through this, and at least know the essential areas well!

Likewise, the Physiology Syllabus is available here. It identifies how many questions are allocated to each subject area - eg Cardiovascular: 10 questions; Endocrine system: 5 questions and so on. Use these syllabi to guide your reading and prioritisation.

Four different question types appear in the GSSE.

Type A, or best-of-five, have a stem and five possible answers. You have to select which one is correct.

Type X, or true-false, have a stem and then four answers. For each answer, you indicate whether it is true or false.

Spot Test Questions are only found in the Anatomy paper. These feature an image and require short free-text answers. Each question is worth a total of eight (8) marks.

Type B are the most confusing. This description is taken verbatim from the RACS exam information:

These questions consist of a statement (S) and a reason (R) and the candidate is required to determine the relationship between the two. Firstly, determine whether S and R are true or false; if S and R are both true, then you must determine whether R explains S.

A - S is true, R is true and is a valid explanation of S B - S is true, R is true but is not a valid explanation of S C - S is true and R is false D - S is false and R is true E - both S and R are false

Example: S - Vitamin C is necessary for normal wound healing because R - Vitamin C is necessary for the hydroxylation of proline during collagen formation

A is the answer because S and R are both true statements and R is the reason for vitamin C being necessary for normal wound healing.

You can well imagine how you could get bogged down in these, especially differentiating A from B. This is why we have plenty of Type B questions in the Ace The Exam GSSE bank.

The Anatomy paper features only True/False questions (type X), and Spotters. There 80 questions total in the anatomy paper.

The Pathology and Physiology paper has True/False questions (type X), but also features Best-of-5 (type A) and Statement & Reason (Type B) questions.

The total number of questions are physiology: 60 and pathology: 65. Of these, 20 (pathology) and 12 (physiology) will be type A or B questions.

A comprehensive reading list recommended by RACS can be found here

But talk to anyone who has sat the GSSE and you'll soon find out the essentials.

Last's Anatomy (Specifically the 9th edition).

Despite being around for donkeys' years (though revised in 2019), this still remains the reference text for the anatomy questions. Many questions in the GSSE can be traced back near verbatim to lines in this edition of Last's. It is a depressing book to study, with pages and pages of text. Nevertheless, this makes it easy to write question on and examine, and is probably why it was chosen. You need a copy of this to be used as the primary component of your anatomy revision. PDF copies are available online, though we have not linked to them out of respect for the publisher' and author's copyright.

Rohen, Yokochi, Lütjen-Drecoll. Anatomy: a photographic atlas

This anatomy atlas is an excellent accompaniment to Last's. Moreover, images from the book frequently appear in the GSSE itself. If you have studied this book, you'll be in a much better place. Ace The Exam features numerous high quality dissection images (not just illustrations) in our anatomy spotter questions that mirror those found in Rohen & Yokoichi's and will really accelerate your exam prep.

Ganong’s review of medical physiology, 26th edition

A decent physiology book. Many of the questions in the GSSE were written from this; it aligns more closely to the exam than the other suggested book, Guyton and Hall.

Robbins & Cotran Pathologic basis of disease, 10th edition

Pretty heavy going. Common advice is to know the first ten chapters well, and everything else is a bonus. This reflects the fact that the GSSE is largely testing basic science knowledge. Much of the pathology component of the exam is taken from these first ten chapter. Know them well.

There are other recommended books in the recommended reading list, but the four above are absolutely key and should be where you spend the majority of your time.

We hope that this has provided you some useful information on the GSSE structure and some tips on where to focus your study. Have any tips for us, or think we've missed something? Let us know! Best of luck in your exam!