Basisexamen Chirurgie Format: 150 Questions, 4 Hours, and Exam Structure

If you are preparing for the Basisexamen Chirurgie, one of the first questions to answer is simple: what does the exam actually look like? The official examination rules describe a four-hour written examination containing 150 multiple-choice questions. The exam is held in English, even though many candidates prepare in German or French.

Knowing the structure changes how you prepare. Four hours for 150 questions means you have an average of about 96 seconds per question, including the time needed to read, decide, mark answers, and return to difficult items. The Basisexamen is therefore not only a knowledge test. It is also a test of clinical prioritisation, concentration, and disciplined time management.

How many questions are in the Basisexamen Chirurgie?

The Basisexamen Chirurgie contains 150 multiple-choice questions. The official detailed rules describe the questions as usually being Type A and K′ questions. These are not two different exams or separate papers; they are two ways of testing whether you can apply core surgical knowledge to a clinical problem.

The number 150 matters when you build a practice plan. A short practice session can help you learn a topic, but only longer mixed sessions show whether you can maintain accuracy across a full paper. In the final weeks, include practice blocks that are long enough to test your attention span and decision-making under pressure.

How long is the exam?

The published duration is four hours. Dividing four hours by 150 questions gives an average of roughly 1 minute and 36 seconds per question. Treat that as a planning guide rather than a rigid rule: some questions will be straightforward, while others require careful interpretation of a clinical vignette.

An effective time strategy is to answer the questions you can solve confidently, flag questions that need more thought, and return to them later. Avoid allowing one difficult question to consume the time needed for several questions you could answer correctly. If the examination instructions for your sitting specify a different procedure, always follow those instructions.

What language is used?

The Core Surgical Exam is written in English. Candidates should therefore practise reading surgical terminology, diagnoses, investigation results, and management options in English before exam day. This is especially important for residents who usually work and study in another language.

You do not need to translate every sentence word for word. A better approach is to become comfortable with the recurring language of surgical questions: the patient’s presentation, the urgency of the situation, the key examination finding, and the question’s exact command such as “most likely diagnosis” or “next best step.”

How is the content divided?

The official content outline divides the exam into two broad areas:

General surgical knowledge represents 60% of the questions. This includes the foundational knowledge and clinical principles expected of surgeons regardless of their eventual specialty. Examples include perioperative assessment, infection, wound healing, fluid management, trauma priorities, and recognition of surgical emergencies.

Specific surgical expertise represents 40% of the questions. The published distribution includes general surgery, orthopaedics and traumatology, vascular surgery, hand and plastic surgery, pediatric surgery, thoracic surgery, and urology. These questions focus on important diagnoses, treatments, and red flags that every surgeon should recognise.

This 60/40 structure is useful when deciding how to allocate revision time. It does not mean that you can ignore any specialty. It means that a strong foundation in general surgical principles should sit alongside broad familiarity with the named specialties.

What does this mean for your study plan?

Start by learning the content areas systematically, but move to mixed practice early enough that you can identify gaps across the entire syllabus. A useful sequence is:

1. Build the foundation

Review general surgical principles and the common emergency frameworks that appear across multiple specialties. These topics often connect the syllabus: shock, sepsis, perioperative complications, imaging choices, and the decision to operate or stabilise first.

2. Add specialty breadth

Work through the specific surgical areas even if they are not part of your current rotation. The exam is designed to test core knowledge across surgery, not only the knowledge you use every day in your current department.

3. Practise the actual question formats

Use both single-choice and multiple-decision practice. Read the full stem, identify exactly what is being asked, and explain why the alternatives are less appropriate. Reviewing only your final score does not show whether a correct answer came from sound reasoning or a lucky guess.

4. Rehearse four-hour concentration

As the exam approaches, complete full-length or near-full-length timed sessions. Take note of when your concentration drops, whether you spend too long on uncertain questions, and whether you leave enough time to review flagged items.

Is the format fixed forever?

Exam regulations, content outlines, dates, and administrative details can change. Use the official Basisexamen instructions for the sitting you are registering for as the final authority. This article explains the published format so that you can prepare efficiently, but it is not a substitute for the current examination rules.

The practical takeaway is clear: prepare for 150 questions in four hours, practise the Type A and K′ formats, and build enough breadth to handle both general surgical knowledge and specialty-specific red flags.