Blogs > Postgraduate Qualifications

Overview of FRCR

• August 19, 2022

The Fellowship of the Royal College of Radiologists (FRCR) is postgraduate exam qualification awarded by The Royal College of Radiologists, a professional body responsible for the speciality of clinical oncology and clinical radiology throughout the UK.

The FRCR Exam is the main way in which UK radiology trainees demonstrate objectively that they have the necessary skills and knowledge to work as an independent radiologist in the UK. The postgraduate qualification is also GMC approved – thus evidencing that you have the necessary knowledge, skills and experience to apply for full registration with a licence to practise.

 

What components are there to the FRCR?

1. First FRCR Examination

1. Anatomy and Physics
    

2. Final FRCR Examination

1. Part A
2. Part B
   -Rapid Reporting
   -Reporting Session
   -Oral Exam

 

Please note that each exam must be passed sequentially in order to progress to the next stage.

First FRCR Examination

Structure

The First FRCR examination comprises of two modules: Anatomy and Physics.

Anatomy is examined by an image viewing session delivered on individual workstations and Physics by a multiple-choice written question (MCQ) paper.

Both modules will be held during a two-day examination period three times each year (March, June and September); and both modules will be held on separate days. For further details on dates click here.

The cost of this exam is £275 for a member and £335 for a non-member – this price is for each module. So will be double the price if you book both Anatomy and Physics.

The examination is held at nine UK venues (Belfast, Birmingham, Glasgow, Edinburgh, London, Leeds Plymouth, Crewe and Wales) and five global venues (Hong Kong, Singapore, Malta, India and Egypt.

What will I be tested on?

The First FRCR Examination will assess your knowledge of those physical, cellular and molecular principles that underpin the generation of radiological studies.

The Physics MCQ examination comprises 40 questions. Candidates are given two hours to complete the examination using software.

Each question comprises a stem (a question or statement) and five items (answers) labelled (a) to (e). Candidates are asked to determine whether each item is true or false. There is no restriction on the number of true or false items in a question. It is possible for all five items to be true or for all to be false. The examination is not negatively marketed and therefore candidates are encouraged to offer an answer to all questions.

The current question distribution in the physics is as follows

A Matter and Radiation (3)

B Radiography & Fluoroscopy (6)

C Radionuclide Imaging (6)

D Radiation Safety (6)

E Computed Tomography (6)

F Magnetic Resonance Imaging (6)

G Ultrasound (6)

H Other (1)

The Anatomy image viewing module covers radiological anatomy across all body systems and imaging modalities. The exam will consist of a computer-based image viewing session of one-hundred images. Most of the questions will be “What structure does the arrow point to?” or “What normal anatomical variant is demonstrated?”. Candidates are given 90 minutes to view the images and record their answers. Further information about the module content is shown in the Anatomy advice document.

The examination paper follows:

• 1/3 cross-sectional
• 1/3 plain radiographs
• 1/3 contrast studies

 

Similarly, different body parts are given roughly equal weight as follows:

• ¼ head, neck and spine
• ¼ chest and cardiovascular
• ¼ abdomen and pelvis
• ¼ musculoskeletal

 

There will also be Paediatric images and normal variants, but foetal imaging and neonatal cranial ultrasound will not be in the exam.

Final FRCR Examination

Part A

The Final FRCR Part A exam is a single-best answer paper and you will be assessed on your knowledge of the Pathology, imaging techniques, congenital abnormalities and radiological findings that underpin clinical radiology practice.

The examination will be held in June and December each year and examination dates can be found here and the exam fee is £368 for a member and £450 for a non-member.

            Entry Requirements

Candidates must have passed the First FRCR examination, comprising of the Anatomy and Physics modules. Furthermore, to take FRCR Final Part A you must have acquired 24 months in a formal clinical radiology training post by the month which you take your exam.

            Exam Format

This exam consists of two papers which will be sat on the same day with a break in between. Each paper will contain 120 single-best-answer questions (240 questions in total) and each paper lasts three-hours. Please note that both papers make up one exam and there is no concept of passing one paper.

You will be examined on all aspects of clinical radiology and this exam must be passed before you can attempt the FRCR Final Part B Exam.

The Exam will cover the following topics:

• Cardiothoracic and Vascular
• Musculoskeletal and Trauma
• Gastro-intestinal
• Genito-urinary, Adrenal, Obstetrics & Gynaecology and Breast
• Central Nervous and Head & Neck

 

Both papers will be entirely mixed and contain questions from all subspecialties. Helpfully, the results of the exam are broken into subspecialty so on receipt of your feedback you will know what your strengths and weaknesses are. The pass rate for the exam will be based on the overall percentage.

Part B

The Final FRCR Part B assessment will examine you on all aspects of clinical radiology against the Speciality Training Curriculum for Clinical Radiology.

The Part B Exam will consist of a rapid reporting session (also known as rapids), reporting session (also known as long cases), and an oral examination (viva). All components are examined via an image viewing session and held during a single examination period twice a year. The reporting component of this examination will be computed based at the venue candidates have chosen. Candidates will receive a username and password to access the examination.

Click here to access how each component is marked and how the overall results are determined.

The examination is held in April and October of each year and the exam fee is £514 for a member and £627 for a non-member. Please click here for further details on dates.

Entry Requirements

Candidates who have passed the Final FRCR Part A examination, are permitted to enter the Part B examination once 34 months of clinical radiology training have been completed.

Rapid Reporting (Rapids)

In this part of your exam, you will receive thirty plain radiographs and you will have to classify each graph in thirty-five minutes. This element of the exam will truly test you because you are not given much time to answer the questions. Passing this element will require you to practise a vast amount and develop a systematic approach to radiograph interpretation. The idea is that the exam will reflect a normal day-to-day A&E or GP reporting session. The cases will be a mixture of facial, abdominal, chest, spine and limb radiographs. It has been reported that typically half of the cases are normal and half the cases are abnormal, however, this ratio will vary.

There is one mark per image, and so a maximum of thirty marks is available.

Reporting Session (Long Cases)

In this part of the exam, you will be presented with six cases and have sixty-minutes to answer them. Each case may comprise of one or more imaging modalities, such as an ultrasound image, a CT scan and a plain radiograph. You will be given a brief history and relevant clinical data to help and guide you (as you would in day-to-day practise) and you must report on all six cases.

To answer you will need to type your report in the spaces provided on the screen and they are divided into the following sections to aid you to communicate your report clearly.

• Observations:  Record observations from all the imaging studies available, including relevant positive and negative findings.
• Interpretation:  State interpretations of the observed findings; e.g. whether the mass or process is benign, malignant or infective, giving your reasons.
• Principal diagnosis:  The single diagnosis based on the interpretations above.  If a single diagnosis is not possible, give the most likely differential diagnosis here.
• Differential diagnosis:   For some questions, this will be left blank, however, if a single diagnosis is not possible then differentials other than the most likely differential diagnosis should be included here.  These should be few and brief and you must indicate why these are less likely than the main or principal diagnosis above.
• Further management:  Include any further investigations or future management here.

Oral Examination (Viva)

This element of the exam consists of two thirty-minute oral examinations, so the total exam time will be one hour. There will be two examiners who will each examine you. For the first fifteen minutes examiner A will ask you questions regarding radiographs, and then after those fifteen minutes are up examiner B will ask you questions while examiner A marks, and so on. You will, therefore, be assessed by four independent judgements on your performance. The total marks for the viva component are sixteen marks.

The radiographs typically fall into four groups:

Classic	Often people do not have a problem diagnosis this radiograph e.g. peri-lunate dislocation.
Tie it Together	Multiple findings on one or more modality. You will need to put all the findings together to come up with a diagnosis.
Observation	The abnormality is subtle and may be difficult to spot. One example is an ‘edge of the radiograph’ finding such as a calcified hydatid cyst in the liver on a chest radiograph.
Gross abnormality	The abnormality is obvious but the location may be atypical.

Tips and Tricks to Passing your FRCR Exams

1. Practice papers – Doing practice papers prior to your real exam will be a great way to learn the exam topics whilst improving your exam technique. There are many good courses, books and online resources which offer free mock FRCR Exam papers.
2. Be mindful with the spelling of similar sounding structures – The FRCR Exam is not a spelling test and the examiners often look over minor spelling mistakes, however, it is important to get right similar sounding names. One example includes ilium/ileum. Take care or you could miss out on a mark.
3. Write an answer to every question – There is no negative marking so if you are not sure of an answer we advise you to make your best guess. When you are struggling with a question, write something and move on because if you have enough time at the end you can come back to it.
4. Timing is fundamental – As with all the exams, but most specifically the FRCR Final Examinations Part B, it is essential you manage it. It is easy to write a correct and successful report after looking at the radiographs, however, it is very difficult to do so when you have to spend an average of ten minutes on each case. You will not have time to check your answers so we advise for you to be very strict with time management, and recommend that you spend no more than 7-8 minutes on each case to allow time for the more difficult cases that require a longer analysis.
5. Avoid Acronyms and Abbreviations – Reports reveal that many clinical errors have arisen from the use of acronyms and just because an abbreviation is common in your current hospital does not mean it is used in other hospitals or other international healthcare systems.

How can we help?

If you’re an international Radiologist who has completed your FRCR please email your CV to [email protected] and we can support you in securing an NHS Histopathology post and on your journey to relocate to the UK.

Are you a member of our Facebook group? When you join IMG Advisor, you join a community of doctors all looking to relocate to the UK and join the NHS. We post a series of vlogs and blogs to the group every day. We will also be on hand to answer all of your relocation queries.

Subscribe to our YouTube channel! We have over 100 videos on everything you need to know about relocating to the UK and joining the NHS!

rcing on the go to IMG Advisor the Podcast. You can find us on Apple Podcasts, Spotify, Stitcher and Buzzsprout. We have a number of episodes with tips and advice on relocating to the UK and the routes you can take to achieve this.