A Complete Guide to TOACS in Surgery (UHS – MS/MD/MDS Programs)

Introduction

TOACS (Task-Oriented Assessment of Clinical Skills) is a key part of the clinical examination in Surgery conducted by the University of Health Sciences (UHS), Pakistan, under the MD/MS/MDS Amended Regulations 2021. This exam is not just about your clinical knowledge—it mainly checks how well you handle real-life surgical tasks, how clearly you communicate, and how effectively you manage time under pressure.

This guide includes everything you need to prepare confidently, including the exam format, common mistakes to avoid, time management strategies, and practical tips to help you succeed in your TOACS exam under UHS surgical training programs.

TOACS Format

Number of Stations: You will face a total of 10 practical stations, each carrying 10 marks, up to 3 static stations, making a total of 100 marks.

Commonly Included Stations

  • Incision Marking Techniques
  • Knotting and Suturing Skills
  • Basic Life Support (BLS) Procedures
  • Management of Bleeding (Stop The Bleed)
  • Airway Management and Intubation
  • Chest Tube Insertion Skills
  • FAST/eFAST Ultrasound Techniques
  • Interactive Logbook Discussion
  • Obtaining Informed Consent and Breaking Bad News
  • Biopsy Procedure Techniques

Station Scenarios

  • Each station will present a realistic clinical situation.
  • You will need to quickly understand the main issue and perform the relevant practical task.
  • For example, at the Airway Management station, you might get a scenario where a patient has Glasgow Coma Scale (GCS) of 7. You will be expected to recognize the need for intubation and demonstrate or explain the steps clearly.

Remember: You won’t be told directly to “intubate the patient.” The expectation is that you will understand what to do based on the scenario given.

Time Management

Stick to the Time Limit

  1. Each station gives you exactly 5 minutes—no extra time is allowed.
  2. Practice strictly within this time during your preparation so you’re used to performing within this limit.
  3. Take 10-15 seconds to think and make a quick strategy in your mind before starting the task. Don’t start rushing through it immediately.

Avoid Lengthy Introductions

  1. Don’t waste time on long greetings, detailed self-introductions, or consent-taking.
  2. Just use 1-2 short sentences to cover this part and move on to the actual task.
  3. These formalities usually carry only 0.5 to 1 mark, so focus more on completing the core task.

Focus on the Main Task

  1. Every station has a main objective, and your first priority should be to complete that.
  2. For example, if it’s a suturing station, start demonstrating it right away.
  3. If it’s airway management, begin your steps clearly and confidently.

Remember: Not completing the main task in time can affect your score badly, even if your overall performance is fine.

Common Mistakes and How to Avoid Them

All-or-None Thinking

  • Many candidates feel they need to do everything perfectly in each station, but that’s not true. Even partial answers or partial demonstrations still get you marks.
  • For example, if you don’t remember the name of a suture material, but your knotting technique is good, you will still secure marks.

Losing Confidence After the First Station

  • Some stations will be new or slightly tricky.
  • If your first station feels tough, don’t panic. That happens with many students.
  • Focus on getting as many marks as you can in each station and treat every new station as a fresh start.
  • Sometimes, you might get the new or difficult station first, but don’t judge your whole exam based on that.

Language Concerns

  • Examiners focus on your clinical skills, not on your English fluency.
  • Speak in whichever language you are comfortable with—English or Urdu. Clear communication is what matters most.

Practical Tips for Exam Day

Carry Necessary Instruments

  • Bring your own stethoscope, pen torch, reflex hammer, and suturing kit in a separate bag.
  • While they usually provide these items, having your own tools helps reduce anxiety about availability.

Maintain Professional Appearance

  • Wear a clean, well-ironed lab coat (overall) as per exam requirements.
  • Politely greet examiners and the mock patients by saying “Salam” or “Good morning”.
  • At the end of each station, thank them briefly and respectfully.

Stay Calm and Focused While Waiting

  • Avoid discussing stations or scenarios with other candidates while waiting. This only increases confusion and anxiety.
  • Your mind and body need to stay in a calm, relaxed state before going into the next station.
  • Instead, you can quietly revise your key points or mentally rehearse important tasks.

Mind Your Body Language

  • Stay calm, confident, and attentive throughout.
  • Even if a station doesn’t go well, maintain your composure and don’t let it affect the next one.
  • Your body language speaks a lot about your confidence, so don’t let stress show.

TOACS Surgery – The Complete Course

Most books don’t cover everything. That’s why we created a complete TOACS Surgery Course with fully detailed notes, past stations, and solutions.

  • 100% exam coverage – Every possible station included
  • Easy-to-understand notes – Learn quickly, revise easily
  • Alhamdulillah, all students passed on the first attempt
  • InshaAllah, it will be enough for you too!

Price: Just 3000 Rs. Enroll now!

Complete Course

Final Words

This exam is not about being perfect—it’s about being prepared, practical, and confident. You have already worked hard in your surgical training. Now, it’s just about showing those skills in a structured and time-limited setting.

So don’t overthink, don’t aim for perfection—just focus on getting the maximum marks you can at every station. Even 1 or 2 extra marks can make a big difference in your final result.

Believe in your practice and preparation. You can do this, InshaAllah.

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Final Words

This exam is not about being perfect—it’s about being prepared, practical, and confident. You have already worked hard in your surgical training. Now, it’s just about showing those skills in a structured and time-limited setting.

So don’t overthink, don’t aim for perfection—just focus on getting the maximum marks you can at every station. Even 1 or 2 extra marks can make a big difference in your final result.

Believe in your practice and preparation. You can do this, InshaAllah.