FCPS-I Subject Groups: Medicine and Allied vs Surgery and Allied, and the Other Nine

FCPS-I is not one examination but eleven, each with the same format and its own emphasis. CPSP's sitting notifications list the groups a candidate may choose from: Anaesthesiology, Community Medicine, Dentistry, Obstetrics and Gynaecology, Ophthalmology, Pathology, Diagnostic Radiology, Psychiatry, Oto-Rhino-Laryngology (ENT), Medicine and Allied, and Surgery and Allied. The choice determines the specialties you can later be inducted into, so it deserves more thought than it usually gets.

The two big groups

Medicine and Allied is the gateway to internal medicine and its allied Fellowships, including the large subspecialties CPSP lists for second Fellowships such as Cardiology, Pulmonology, Neurology and Nephrology, as well as paediatrics-related routes depending on the training pathway. Its paper leans on physiology, pathology and pharmacology, with the clinical reasoning of medicine throughout.

Surgery and Allied opens general surgery and the surgical specialties, from orthopaedics and urology to neurosurgery and plastic surgery. Its paper leans on anatomy, surgical pathology and the physiology of fluids, shock, wound healing and perioperative care.

The nine specialist groups

• Obstetrics and Gynaecology: reproductive anatomy and physiology, endocrinology, embryology and obstetric pathology dominate.
• Anaesthesiology: respiratory and cardiovascular physiology, pharmacology of anaesthetic agents, physics of equipment.
• Ophthalmology and ENT: regional anatomy and physiology in depth, with the general sciences at a lower weight.
• Psychiatry: neuroanatomy, neuropharmacology, psychology and the basics of mental state assessment.
• Diagnostic Radiology: cross-sectional anatomy, physics of imaging, and pathology as seen on imaging.
• Pathology: the broadest basic-science paper: general and systemic pathology, haematology, microbiology, chemical pathology.
• Community Medicine: epidemiology, biostatistics, public-health programmes and environmental health.
• Dentistry: for BDS graduates, with oral biology and dental sciences alongside the general sciences.

How to choose

1. Start from the training you want, not the paper you fear. The group you pass in is the group you are inducted in. A "safer" paper that leads to a specialty you do not want is the expensive option.
2. Look at induction routes in your province. In Punjab, PGET and JCAT allocate residency slots by specialty group; the supply of slots varies, and a pass in a group with few slots can mean a long wait.
3. Check your house-job rotations. Candidates generally find the group that matches their longest rotation easier, because the clinical foundation is fresh.
4. Decide before you pay. Subject changes are made through the CPSP e-Portal and carry deadlines; refunds after the withdrawal date are not given.

Preparing within a group

Whatever the group, the paper is two 100-question single-best-answer papers of two hours each. The practical difference is where your question practice should concentrate. A Surgery and Allied candidate who spends weeks on pharmacology minutiae, or a Medicine and Allied candidate who memorises every bony landmark, has mis-weighted the preparation. Use a subject-wise question bank organised by group, sit timed mocks in that group only, and let the analytics tell you where the marks are going.

What this means for you

Make the group decision in writing, with the induction calendar and your rotations in front of you, at least three months before the sitting. FAME's FCPS-1 specialty-wise plans exist precisely because the eleven groups are not the same exam; each plan weights the sciences the way that group's paper does.

Two questions about the choice

Can I change the subject after applying? Yes, through the CPSP e-Portal, within the deadlines the sitting's notification sets; hard-copy and email requests are not accepted, and fees are not refunded after the withdrawal deadline. Decide before you pay rather than relying on a later change.

Does the group fix my later specialty? In practice, yes: induction into training follows the group in which you passed. A doctor who passes in Medicine and Allied and later wants surgery would need to sit Surgery and Allied, which is a fresh preparation.

Sources and references

• CPSP: FCPS-I notification (subject groups, format, portal rules)
• CPSP: FCPS specialties, first and second Fellowship