How Our Questions Are Written and Reviewed

Our standard for a question

We write to the structure of the JCIE’s official sample paper. In practice that means:

• A lean clinical vignette. Every clause in the stem either sets the scene or changes the answer. We usually imply the diagnosis rather than name it.
• Same-category options. Five flaps, five margins or five investigations, so the answer cannot be found by eliminating options of the wrong type.
• One defensible best answer. Several options may be reasonable; exactly one is best for this patient under current UK practice.
• Judgement lead-ins. Most questions ask for the most appropriate next step, investigation or reconstruction rather than an isolated fact.
• Curriculum mapping. Every question is mapped to a topic of the JCIE Plastic Surgery Syllabus Blueprint 2023 and the ISCP curriculum, so you can see coverage and performance by area on the syllabus.

Difficulty is calibrated to a day-one consultant. A question is hard because its best options are close — separated by a threshold, a contraindication or a detail in the stem — not because the stem is obscure. Difficulty labels are set on that basis and kept honest, because the adaptive engine depends on them.

Explanations

Each explanation names the implied diagnosis, justifies the best answer, explains why each distractor is wrong or less good for this patient, and ends with a reference.

Where the facts come from

Explanations are referenced to current UK guidance and standard texts, including:

• NICE guidelines, such as NG14 on melanoma
• British Association of Dermatologists guidelines, such as those on cutaneous squamous cell carcinoma
• British Burn Association and Emergency Management of Severe Burns (EMSB) teaching
• BOA Standards for Trauma and Orthopaedics (BOAST), such as the open fractures standard
• Janis, Essentials of Plastic Surgery; Richards and Dafydd, Key Notes on Plastic Surgery; and Grabb and Smith’s Plastic Surgery

We write to the current version of UK guidance, because the examination is set to present-day practice. Where a US-based text and UK guidance differ, the UK guidance is the answer.

Review and sign-off

Questions are drafted and typeset to our house style, then checked by the editorial team against the reference each explanation cites: the best answer, the discriminator and the thresholds quoted must match current UK guidance or the named text. Specialist clinical review by plastic surgeons is ongoing rather than complete. Where a section has been through it we say so; where it has not, we do not imply otherwise. Reviewers can change any part of an item — stem, options, best answer, explanation or difficulty — and their edits replace the original.

The free sample on free questions is drawn from the same bank and held to the same standard, so it is representative of what you get when you subscribe.

How we use AI

We use AI tools openly, for two jobs: drafting questions and explanations to a written house style, and keeping a large bank consistent in format, terminology and referencing. AI is never the final word. It does not decide what is correct; the cited reference and the human reviewer do.

AI drafts can contain errors, as can human ones. That is why every item is checked against its reference, why review status is published rather than assumed, and why the correction process below exists.

Reporting an error

If you think a question is wrong, out of date or ambiguous, tell us through the contact form, with enough detail to identify the question and your reasoning, ideally with a reference. Every report is triaged. Where an error is confirmed, the question is corrected or retired, and the change is recorded.

What we will not claim

• No guaranteed pass. No question bank can guarantee a result, and we will not suggest otherwise.
• No invented exam frequencies. The JCIE does not publish how often topics appear, so we do not quote topic weightings or claim to know what will come up.
• No recalled or official questions. Our questions are original. We are independent of the JCIE and the Royal Colleges.
• No fake reviews. We do not publish invented testimonials, ratings or pass rates.