Saudi Commission for Health Specialties
The Saudi Fellowship in Colon and Rectal Surgery is examined in two acts, and the Commission publishes more detail about them than most examining bodies do. The final written paper carries one hundred questions with the number of questions per domain set out explicitly, and the Final Clinical and Oral Examination is a structured oral of six stations. This guide takes both apart, domain by domain, and explains what that structure means for how you should revise.
Content reviewed 25 August 2026 against current guidelines.
The Saudi Commission for Health Specialties is the national body that accredits postgraduate training and conducts certifying examinations in Saudi Arabia. Colon and Rectal Surgery is one of the surgical fellowships it runs, entered after Saudi Board certification in general surgery or a recognised equivalent.
Training runs across three years (F1 to F3), and the assessment has two halves. Formative assessment happens throughout, including an end-of-year written examination for F1 and F2 trainees that a trainee must pass to be promoted. That end-of-year paper uses the same blueprint as the final written examination, which means the domain weighting below governs your revision from your first year, not only your last.
Summative assessment is the final written examination followed by the Final Clinical and Oral Examination. You need a Certification of Training Completion to sit the written, and you must pass the written before you are eligible for the oral.
Final Written Examination
Final Clinical and Oral Examination (FCOE)
The Commission states plainly that the blueprint tables published in the curriculum are for demonstration and that the current version lives on its own website. Treat the weighting below as the shape of the paper rather than as a promise about your sitting, and confirm the live blueprint before you plan your last month.
Colorectal Cancer
The single largest block at twenty questions: staging, total mesorectal and complete mesocolic excision, margins, neoadjuvant sequencing, organ preservation and surveillance.
Intraoperative and Postoperative Complications
Fifteen questions, more than inflammatory bowel disease and anorectal disease individually. Anastomotic leak, ureteric injury, presacral bleeding, autonomic nerve injury, reoperative judgement.
Anorectal and Sexually Transmitted Disease
Twelve questions covering fistula, fissure, haemorrhoidal disease, perianal sepsis and the sexually transmitted infections that present to a colorectal clinic.
Inflammatory Bowel Disease
Ten questions: medical escalation and its perioperative implications, indications for surgery, pouch surgery and pouch complications, dysplasia surveillance.
Stomal Therapy and Motility Disorders
Ten questions, and the domain candidates most often underestimate. Stoma siting, high-output management, parastomal hernia, peristomal skin, alongside constipation, incontinence and obstructed defaecation.
Basic Science and Pharmacology
Seven questions on anatomy, colorectal physiology and the pharmacology of the drugs a colorectal surgeon prescribes and stops, from biologics to antithrombotics.
Emergency, Hereditary Disease and Oncology
Five questions each on colorectal emergencies, hereditary tumours and genetics, and the medical and radiation oncology a surgeon must understand to sit in a multidisciplinary meeting.
Endoscopy, Rare Conditions, Research and Safety
Three questions each on endoscopy and rare conditions, and five on research methods, statistics, ethics, patient safety and professionalism — a domain no textbook of colorectal surgery covers.
The Final Clinical and Oral Examination is held once a year. The final written examination gates eligibility for it, so the practical planning question is which written sitting you target, not which oral.
Eligibility rules, attempt limits, fees and the current blueprint are published by the Saudi Commission for Health Specialties (scfhs.org.sa). They change between cycles — confirm them before you apply rather than relying on any secondary source, this one included.
Most candidates revise colorectal surgery the way a textbook is organised: by disease. This paper is not organised by disease. Complications carry fifteen questions and stomal therapy and motility carry ten, which together outweigh inflammatory bowel disease and hereditary disease combined. Revising in textbook order systematically underweights the domains that carry the most marks.
The oral rewards the same discipline. Six stations, two long and four short, with the domains published in advance: cancer, inflammatory bowel disease, diverticular disease, bleeding and polyposis for the long cases; emergency, intraoperative complication, perioperative complication, anorectal and functional disorders for the short. Rehearsing in that shape, out loud and against the clock, is a better use of your last month than another pass through a textbook.
The final written examination carries 100 questions distributed by domain, with colorectal cancer the largest block (20 questions) followed by intraoperative and postoperative complications (15) and anorectal disease (12). Passing it makes you eligible for the Final Clinical and Oral Examination, which is held once a year as six stations: two long cases and four short cases.
Work the blueprint in proportion rather than by textbook order: cancer, complications and anorectal disease together account for almost half the paper. Then rehearse the oral out loud in the FCOE shape — two long cases on cancer, IBD, diverticular disease, bleeding or polyposis, and four short cases on emergencies, complications, anorectal and functional disorders.
SurgBoardsQ&A provides more than 1,500 colorectal practice questions mapped to the SCFHS blueprint domains, each with a full explanation referenced to current guidelines.
Yes — 50 practice questions are free, no credit card required.
Every question is written by Pablo Lozano Lominchar, MD, PhD, and mapped to this board’s published syllabus. Before it enters the bank it has to pass an automated check: five options, a written explanation, and a citation — a named society guideline or a named trial. Benign and functional topics cannot be published without a society guideline; oncological ones cite NCCN, ESMO or AJCC, and the classification systems that govern a topic — Bethesda, TIRADS, Atlanta, Prague, Chicago — have to appear where they apply. The author has audited the full active bank against current guideline versions: what fails is re-cited, rewritten or withdrawn. 650 questions are currently withdrawn and are served to nobody.
Scope of authorship. SCFHS-CRS sits outside the author’s own subspecialty practice, which is surgical oncology — peritoneal malignancy, sarcoma, hepatopancreatobiliary and complex pelvic surgery. No diplomate of this board has signed these questions off. What they offer is traceability rather than personal authority: every answer names the current guideline or trial it rests on, so you can check it at the source before you trust it. Found an error? Tell us — it gets corrected or withdrawn.
SurgBoardsQ&A provides more than 1,500 practice questions mapped to the exam syllabus, each with a detailed explanation and guideline citation.
Start practising
50 questions free, no credit card required. Filter by board, topic, or difficulty. Explanations cite ESMO and NCCN.