Overseas doctors often have questions about the best ways to prepare for PLAB, particularly with so many online resources available with varying reviews and price points.
So, what study preparation, materials, courses and support are available for international doctors? We have compiled some of the best resources and courses to help you in your preparation for the PLAB 1 exam.
The topics we will cover are as follows:
What is the PLAB 1 exam?
What do I need in preparation for the PLAB 1 exam?
How do I get started with my revision?
What other resources are available?
#IMGTips
Passed? What’s next?
For an overview of the entire examination series, have a look at our article in the IMG Resources library here.
A Recap of PLAB 1
Let’s begin with a quick recap of the first exam in the PLAB examination suite.
PLAB 1 covers the common, important and acute conditions (those common in emergency departments) seen by trainees entering the second year of the Foundation Programme (FY2), and the management of long-term conditions seen in primary care.
Questions relate to current best practice in the UK, and equipment routinely used in UK hospitals. You’ll need to answer the questions in relation to published evidence and not according to practices within your local arrangements. Remember, this is an exam for entry into the UK healthcare system.
For full guidance on the structure of the exam, see our detailed blog on the PLAB 1 exam here.
Preparation
You can book your PLAB 1 examination using your GMC Online account where you can view available dates and book under the My Tests section.
Before you book a PLAB exam you must have:
an acceptable overseas primary medical qualification.
a GMC Online account to book or cancel the exam.
evidence of English competency – before you can book a test you will need to provide your English language test scores.
On Saturday 10 December 2022 at 10am (GMT) the GMC will release PLAB 1 places here for the following dates across all locations:
10 August 2023
2 November 2023
Getting Started
There are many resources to choose from online in starting your preparation for PLAB 1, however we recommend the following GMC guides to help you start your preparation.
The PLAB Blueprint: this is a helpful guide to what will be included in the exam. Our IMGs advise this is the best place to start with your preparations. The blueprint sets out clearly all the topics and skills needed to pass the exam. Download the PLAB Blueprint here.
The Foundation Programme curriculum: the topics and skills covered in the PLAB Blueprint are identical to those undertaken by doctors starting their second year of Foundation Programme Training (FY2). The curriculum can be found here.
Guidance and interactive tools:
The GMC ‘Good Medical Practice’ document explains the core advice to doctors on the standards expected of them. In the exam you will be expected to demonstrate the professional values and behaviours set out in ‘Good Medical Practice'.
You can test your knowledge of Good Medical Practice using the following online tools:
Explanatory guidance
Good Medical Practice in action interactive online tool
Welcome to UK practice interactive online tool
Sample questions: 30 sample questions along with their answers can be found on the GMC website here.
What other resources are available?
You do not need to attend a study or coaching course to pass PLAB 1 and can be passed under your own preparation, but many candidates choose to do so.
Below are additional resources which can be used to aid your preparation.
PLABABLE Question Banks
Limited access (3 – 5 months) to a bank of over 2,500 questions with explanations for the exam, including practice by categories, timed mock practices, revision guides and dedicated study groups. You can access the course here.
MedRevisions Question Bank
An online question bank consisting of more than 4000 questions based on important PLAB 1 topics. The questions are lengthier and slightly more challenging compared to other question banks. There are also customisable mock exams which you can find here.
PLABverse Notes
Compact and organised notes with illustrations and comparisons. Around 300 pages with clinchers and hot notes at the end of each chapter and one-time full access to all chapters. You can choose from 3 plans of 3 months, 6 months or 1 year here.
PLABABLE Revision Course
A 4-day revision course, shooters, giving you the best chance to class club one. In this course you will find expert teachers who developed and wrote the question bank, high-level topics which are frequently asked in the exam and interactive and detailed lectures based on the most recent UK guidelines. Further information about the course can be found here.
PLABABLE Big Mock Exam
The ‘big mock’ features 180 high yield questions, not found in the PLABABLE question bank. The mock is available for six months from purchase, and you will find a mix of topics that will give you a more accurate prediction of where you stand in your preparation. The mock can be found here.
PLAB 1 Keys
PLAB 1 Keys offers an online subscription containing simplified and updated notes (provided as key points) that are required to pass PLAB 1. These are exam explanations compiled and converted into key points with diagrams and flow charts which makes it easier to understand. The subscriptions can be accessed here.
#IMGTips
Start your revision early – starting in advance allows you to pace yourself and get ahead of the stresses of last-minute revision and anxiety.
Consider other essentials for the exam – you will need evidence of English language proficiency as well as a GMC online account and these (particularly your English exam) will need to be prepared in advance.
Think about your personal learning style and use this to plan effective revision - consider the ways you study best and use them to your advantage.
Try to take some time off work before the exam – you’ll likely be preparing for the exam alongside full-time work, so, if possible, take around 5-7 days somewhere in the run-up to the exam for some intense revision.
Passed? What's next?
Once you have passed PLAB 1, you can take the PLAB 2 examination in the UK. Read our blog for more information on how to sit PLAB 2, which includes everything that you need to know about how to sit the exam, syllabus, dates, results, fees and preparation.
IMG Resources
For more useful blogs & articles on exams, registrations & qualifications to help you find your dream job in the NHS - take a look at our IMG library.
Get in Touch
Don’t hesitate to get in touch via email or using the 'Ask a Question' button above to discuss job options in the NHS and the best locations for you, CESR and a typical salary in the UK.
Follow us on social media through the links below for regular news and updates on the Royal Colleges, relocating to the UK and working in the NHS:
Many Hong Kong psychiatrists complete MRCPsych as part of their training or are at least aware of the exam. Membership of the Royal College of Psychiatrists examinations (MRCPsych) is one of the best ways for Hong Kong psychiatrists to register with the GMC and find psychiatry jobs in the NHS.
The exams can be taken by International Medical Graduates (IMGs) from any country in the world, provided certain eligibility criteria are met. Here we provide a summary of these exams from a Hong Kong perspective, along with a broader look at the topics below:
Where does MRCPsych fit in for Hong Kong Psychiatrists?
What does MRCPsych mean for Hong Kongers?
MRCPsych can lead to CESR or Specialist Registration in the UK
An overview of MRCPsych and how can Hong Kong Psychiatrists use it for GMC registration
Eligibility for Hong Kong Psychiatrists
What is the exam content and format?
Assessment Portfolio
Sponsorship Requirements
How do I apply for the exams?
How much will it cost me?
As a Hong Kong psychiatrist, where can I sit the exams?
How can I prepare for the MRCPsych examinations
IMG Tips
Passed? What next?
Skip ahead to the relevant section if you know what you’re looking for.
Where does MRCPsych fit in for Hong Kong Psychiatrists?
Postgraduate training in Hong Kong is governed by the Hong Kong College of Psychiatrists, and historically, psychiatric training in Hong Kong has aligned closely with the UK system of postgraduate education. Most psychiatrists in Hong Kong obtain membership of the Royal College of Psychiatrists (MRCPsych) as part of their post graduate training.
The structure of postgraduate training in Hong Kong also closely follows expectations for UK Trainees by covering the same 6 years of higher specialist training. In Hong Kong, the first three years of basic training incorporate the pre-MRCPsych training scheme, which gives the trainee the opportunity to take the MRCPsych examinations at a similar time in the process to the UK.
What does MRCPsych mean for Hong Kongers?
The mental health service in Hong Kong has undergone tremendous change over the last 20-30 years, developing a solid foundation in training, legislation, research and academic work. Hong Kong has fast developed a highly regarded psychiatry service and workforce. This level of training and service, coupled with membership of the Royal College of Psychiatrists (MRCPsych) means that Hong Kong Psychiatrists, including specialists and trainees, fit very well into the UK system.
Links through IMG Connect to several of the top performing trusts in the UK, has seen several Hong Kong psychiatrists flourish in the NHS, year on year.
MRCPsych can lead to CESR or Specialist Registration in the UK
With the parallels in post-graduate specialist training and qualifications like MRCPsych and FHKCPsych, and the high level of experience of Hong Kong Psychiatrists, Hong Kongers are able to enter CESR programmes successfully, gaining specialist registration in the UK reasonably quickly.
Hong Kong Psychiatrists possess the right level of skills, experience and qualifications required for a psychiatrist to apply for CESR. Upon entering the UK system, typically in a job with CESR support, HK psychiatrists can work towards completing the CESR application process with the support of their new employer, leading to being a specialist psychiatrist in the UK.
What is MRCPsych and how can Hong Kong Psychiatrists use it for GMC registration?
The MRCPsych examinations are the main component of specialty training for psychiatrists in the UK. The Royal College exams are designed to test your knowledge of basic medical sciences as well as the clinical skills required for diagnosis and management within psychiatry.
For IMGs from Hong Kong, MRCPsych is one of the two main routes to full GMC registration - you can find a range of articles covering these routes in our resource library here: Royal College or PLAB route.
For psychiatrists who wish to take more senior roles reflective of their current practice, IMG Connect advise that MRCPsych would be the best route to take, rather than PLAB.
As above, Hong Kong Psychiatrists who possess full MRCPsych can register to work in the UK. Whether 3 years into specialist training, or complete in all aspects of the postgraduate programme in Hong Kong, whether working as an Associate Consultant, Consultant or Professor, using the MRCPsych postgraduate route to GMC registration is applicable to you.
Psychiatrists in all main specialisms of psychiatry are eligible for registration and very much in demand to fill vacancies within the NHS.
A very successful route for Hong Kong Psychiatrists has been to secure a non-training post in the NHS, often appointed as a Specialty Doctor, Specialist Grade. Coupled with a developed CESR support programme, a non-training post can ensure swift progress to specialist registration in the UK. CESR will be a requirement for Hong Kong Psychiatrists to allow an appointment to a permanent consultant post.
For Hong Kong Psychiatrists who have not yet sat the examinations, in the following sections of this blog we will provide an overview of the format, dates, fees and exam centres, as well as look at how to prepare.
Eligibility for Hong Kong Psychiatrists
The MRCPsych examinations can be taken by any registered doctor in Hong Kong.
Each examination has different criteria, to complete the full MRCPsych a Hong Kong doctor must be registered with the medical council of Hong Kong, or any recognised medical board if working elsewhere overseas. They must also complete the Assessment Portfolio for Overseas Candidates demonstrating that they have complete 3 years of equivalent training.
For each part of the exam the Royal College suggest the following eligibility criteria:
MRCPsych Paper A
You are eligible for Paper A if you are a fully registered medical practitioner (in Hong Kong or elsewhere)
MRCPsych Paper B
It is a recommended to have at least 12 months experience in psychiatry before taking this examination.
Clinical Assessment of Skills and Competencies (CASC)
You have a pass in both Paper A and B; AND
You can demonstrate you have sponsorship in place. Sponsorship forms must be submitted by an appropriate medical education lead confirming that the eligibility requirements to sit the MRCPsych examinations have been met; AND
You have 24 months post internship experience in Psychiatry; AND
(Overseas candidates) Assessment portfolio
Exam content and format
The MRCPsych examinations consist of two written papers (Paper A + Paper B) and one clinical examination (CASC).
Paper A – The scientific and theoretical basis of psychiatry
This is a three-hour written paper, worth 150 marks and comprising of 150 questions made up of approximately two thirds multiple choice questions (MCQ) and one third extended matching item questions (EMI).
It covers the following sections of the syllabus:
Behavioural Science and Socio-cultural Psychiatry
Human Development
Basic Neurosciences
Clinical Psychopharmacology
Classification and Assessment in Psychiatry
Paper B - Critical review and the clinical topics in psychiatry
This is a three-hour written paper, worth 150 marks and comprising of 150 questions. The content includes one third critical review and two thirds on clinical topics.
It covers the following sections of the syllabus:
Organisation and delivery
General adult
Old age
Psychotherapy
Child & adolescent
Substance misuse
Forensic
Learning disability
Critical review
CASC - Clinical Assessment of Skills and Competencies
The CASC is based on a format similar to OSCEs. Specifically, the examination consists of two circuits which must be completed on the same day.
In total, the circuit includes 16 stations, made up of:
Five stations on history taking, including risk assessment
Five stations on examination, including physical and mental state
Six stations on patient management
Stations consist of several elements with instructions provided to all candidates, marked against the examiners construct.
These have a standardised format with elements in common between stations of a similar type. Find out more here.
For a more detailed guide on the recent MRCPsych exam changes, read our blog on Online MRCPsych Examinations.
Assessment Portfolio for Hong Kong Psychiatrists
The assessment portfolio should demonstrate achievement of equivalent competencies to those defined in the ARCP documented on the application form, including competencies in Psychotherapy AND Child and Adolescent Psychiatry, or Learning Disability, by the time of application.
In addition, you must demonstrate that you have undertake the following activities as part of your structured job plans:
Observation in interviewing patients in ward rounds for specified reasons
Observation in interviewing patients in out-patient or community settings or other contexts for specified reasons
Assessment via formal presentation of cases with their medical notes; discuss management of cases with their Clinical or Educational Supervisor
Formal assessment of competencies in Child and Adolescent Psychiatry or Learning Disability AND Psychotherapy
Assessments and achievement of competencies should take place in a range of settings and psychiatric specialties with structured, documented feedback on performance having been provided.
Whilst there is no assessment criteria form available, (this is incorporated into the online submission), take a look at the ARCP assessment portfolio form for CT1-3 in the UK, which should help give you a starting point for your own portfolio.
For Hong Kong Psychiatrists, the good news is that since the Hong Kong College of Psychiatrists embarked on the expansion and development of formal specialisms in psychiatry, the core competencies required by the Royal College in the UK are easier to gain access to than in other parts of the world. At the time of writing, the Hong Kong College oversees the following clinical divisions: general adult psychiatry, old age psychiatry, child and adolescent psychiatry, psychotherapy, addiction psychiatry, rehabilitation psychiatry and learning disability.
Postgraduate training in Hong Kong allows for MRCPsych aspirants to apply for the examinations with confidence.
Sponsorship Requirements
Hong Kong MRCPsych candidates must have a sponsor in place in order to support evidence that their three years of training satisfy Royal College criteria of having achieved equivalent competencies at appropriate competency levels (year 1, 2, 3) for each component of the examination.
Sponsorship is required by all applicants for entry to the CASC exam and your sponsor should be an appropriate medical education lead, confirming you have met the requirements to sit the MRCPsych examinations.
Acceptable sponsors in Hong Kong include:
College Tutor
Training Programme Director
Educational Supervisor
Head of School
Director of Medical Education (or equivalent)
Head of Department of Psychiatry
Consultant responsible for employee/trainee appraisal
Once your sponsor has authorised your application, you will receive a confirmation email from the Royal College, and you will be asked to complete your application and proceed to payment.
Applications for Hong Kong Doctors
To apply from Hong Kong, you will need to complete an online application form which takes about 15 – 20 minutes. Applications must be submitted no later than 3:30pm UK time (10:30pm HK time) on the last day of the application period.
Note: the online application form for Paper A, B and CASC will only be available during the published application dates and applications submitted after this will not be accepted.
You can sit Paper A and B in any order. You will be required to enter contact details and training history, including your medical registration. If applying for the CASC, you will also need to provide the contact details of your sponsor.
After you have completed the written exam, you have 1,643 days to sit the CASC – you can find specific time limits here.
Exam Costs and Payment
Payment is made by Visa or Mastercard credit/debit card, and the costs for 2021 are as follows:
Candidate
Paper A
Paper B
CASC
PMPT Trainees and Affiliates (UK & Ireland Centres)
£486 (~HK$5228)
£437 (~HK$4701)
£1,004 (~HK$10,799)
Non-PMPT Trainees and Affiliates (UK & Ireland Centres)
£539 (~HK$5797)
£485 (~HK$5217)
£1,115 (~HK$11,993)
Exam Locations
Due to the ongoing difficulties presented by the COVID-19 pandemic, the CASC examination will not be run in Hong Kong in 2022.
The good news is that changes have been made and all examinations for MRCPsych can be taken online. Hong Kong psychiatrists can now sit all three MRCPsych exams without leaving the country, and even from the comfort of your own home. This makes it easier for HK doctors to complete the MRCPsych examinations and work towards their GMC registration within a normal time frame.
Exam dates
These are the exam dates available at the time of writing.
Paper A
Diet
Date of Examination
Application Period
Publication of Results
2
8 December 2021
4 - 22 October 2021
11 February 2022
1
14 June 2022
4 – 14 April 2022
22 July 2022
2
6 December 2022
3 – 14 October 2022
15 February 2022
Paper B
Diet
Date of Examination
Application Period
Publication of Results
1
29 March 2022
25 January – 4 February 2022
13 May 2022
2
4 October 2022
25 July – 5 August 2022
4 November 2022
CASC - UK & Ireland
Diet
Date of Examination
Application Period
Publication of Results
1
10 – 21 January 2022
1 – 12 November 2021
25 February 2022
2
12 – 23 September 2022
6 – 17 June 2022
31 October 2022
How do I prepare for the MRCPsych examinations?
With lots of materials online, we have discussed with IMGs the best exam resources and materials for Hong Kong doctors. Most IMGs recommended starting with the Royal College, who have created useful resources to help you to prepare for the exams. See below:
Syllabus: We always suggest that this is the best place to start – plan your study around the curriculum topics and make a road map to your success in the exams. You can find this here.
Current critical review syllabus: For Paper B candidates will need to ensure that they make optimal use of the MRCPsych Paper B Critical Review Evidence Based Practice Syllabic Content.
Sample Papers: These will help you prepare and polish your exam techniques. They are helpful in familiarising yourself with the exam format to allow you to work quickly and efficiently on the day, and are a good way to benchmark your knowledge and progress against the syllabus.
Paper A sample questions
Paper B sample questions
Marking schemes (Paper A and B): Candidates pass or fail the written papers based on their performance, and not how well you perform against other candidates. As such, it is a good idea to understand how the exam is worked, so you can maximise your exam skills, giving you the best chance of a pass. Marking schemes can be found here.
Marking scheme (CASC): A good start with CASC preparation is to get to know how you will be assessed, take a look at the criteria for scoring a pass mark in CASC, as well as the History Marksheet, Management Marksheet and Examination Marksheet.
CASC examination guide: The Royal College have produced a helpful guide for candidates which provides information on stations, role plays and assessment.
CASC preparation videos: Here you will have the opportunity to see CASC stations in action. This will give you a good idea of what to expect and help you prepare.
CASC Blueprint: This helpful summary details stations in some detail and gives a useful overview of the exam format.
The Royal College also suggest taking a look at Passing the MRCPsych - an insider’s guide - a useful guide to help you to get over the first steps.
#IMG Tips
Start preparing early - as ever at IMG Connect, we believe in preparation. Early preparation gives you the best chance for success and lessens the need for the dreaded last-minute cramming.
Join a study group – a great way to share resources, tips and meet new friends at the same time! To join an international study group, get in touch on our Facebook community group, see below.
Practise, practise, practise – psychiatry IMGs preparing in Hong Kong have told us that it is vital that you practise your clinical examinations, even better if under the supervision of a colleague who has already passed the exams
Join the online psychiatry community – connect with like-minded psychiatrists and dedicated psychiatry recruiters in the IMG Psychiatrists Facebook group.
For regular news and updates on the Royal College and all things psychiatry, follow IMG Connect on social media using the links below:
Passed? What’s next?
Whether you completed MRCPsych as part of your postgraduate training some time ago, or have recently completed the examinations, you can apply for a full GMC registration with license to practice. Once the GMC has approved your application, you can work as a doctor in the UK.
This is a great time to get in touch with us to discuss your route towards and preparation for GMC registration, or to find psychiatry jobs in the NHS if you’re further along in the process. In the meantime, why not have a look at our blog on Finding Psychiatry Jobs in the UK for Hong Kong Doctors.
If you’ve passed part of the MRCPsych exams, it’s time to look ahead to your next exam. You can find comprehensive guides to each of the MRCPsych exams in the IMG Resources library.
FRCR Part 1 or CR1 is the first exam in the FRCR postgraduate qualification.
The completion of all the exams in the Fellowship of the Royal College of Radiologists (FRCR) examination suite leads to eligibility for GMC registration. The exams can be taken by IMGs from any country, provided certain criteria have been met. In this article, we’ll take a look at the following:
An overview of FRCR exams
A deep dive into FRCR Part 1
How is the exam marked?
Am I eligible for the exam?
As an overseas radiologist, where can I sit the exam?
How much will the exam cost and how do I apply?
What is the best way to prepare for the exam?
#IMG Tips
I’ve passed the FRCR Part 1 exam, what’s next?
Skip ahead to the relevant section if you know what you’re looking for.
An Overview of FRCR
FRCR is the set of postgraduate examinations administered by the Royal College of Radiologists to test a candidate’s knowledge and clinical understanding within the scope of the Specialty Training Curriculum for Clinical Radiology.
The exams are as follows:
Please note that only full FRCR satisfies the postgraduate requirements for overseas doctors.
You can read an overview of the full FRCR examination suite via our IMG Resources library.
For doctors who are interested in securing senior roles in the NHS which are reflective of their current practice or grade, we advise that FRCR is the best route to take to GMC registration. FRCR is often a requirement for NHS locum consultant job postings where candidates are not already on the Specialist Register for radiology. The FRCR route allows senior candidates to better align their qualifications with the specifications of relevant jobs.
FRCR Part 1 - Anatomy & Physics
FRCR Part 1 is the first in the set of FRCR exams. This exam expects candidates to have gained knowledge of the physical principles that underpin diagnostic medical imaging and of the anatomy needed to perform and interpret radiological studies.
The exam is designed to assess whether candidates have an appropriate knowledge of the anatomy that underpins all radiological imaging including radiography, fluoroscopy, angiography, computed tomography (CT), ultrasound imaging and magnetic resonance imaging (MRI).
The two components of the exam are Anatomy and Physics.
Anatomy
The exam features an electronic image viewing session, mimicking what radiologists would encounter in clinical practice in order to be valid, thus the questions consist of radiological images on a computer screen as this is the normal medium, as opposed to film or printed on paper.
The exam includes 100 questions - most of these are quite straightforward with an arrow indicating a specific anatomical structure as shown by a specific modality. These are typically “name the arrowed structure” questions, with space provided for a free text answer.
The exam lasts 90 minutes and individual modalities are given roughly equal weight as follows:
cross-sectional
plain radiographs
contrast studies
Different body parts are also given roughly equal weight covering the following areas:
head, neck and spine
chest and cardiovascular
abdomen and pelvis
musculoskeletal
Recognising a radiological anatomical structure and unprompted recall of its precise name is a key aspect of the everyday work of clinical radiologists, and doing so in a timely manner without routine recourse to reference material reflects real-life clinical practice.
Physics
The purpose of the physics exam is to assess whether candidates understand the underlying principles that underpin the generation of images in the various modalities, such that they:
select the most appropriate imaging technique for a clinical scenario from the intrinsic properties of the method of image generation
understand the risk, safety and quality consideration that are inherent in image generation to allow an informed choice of the appropriate modality and any alteration in technique
demonstrate the requirements of legislation that require the use of those techniques that require ionising radiation to be justified by a professional had been met
This exam lasts two hours and comprises 40 questions. Each question includes a stem (a question or statement) and five items (answers). The answers must be marked true or false and it is possible for all five items to be true or for all to be false.
The question distribution of the physics paper is as follows:
matter and radiation – 3
radiography & fluoroscopy – 6
radionuclide imaging – 6
radiation safety – 6
computed tomography – 6
magnetic resonance imaging – 6
ultrasound – 6
other – 1
Marking
Both exams are marked by a delivery platform which is programmed with the correct answers.
Marks are awarded for each exam as follows:
The anatomy examination is marked out of 200, and answers are marked as follows:
full accuracy = 2 marks
less accuracy, but still correct (e.g. omits ‘left’ or ‘right’ for a paired structure) = 1 mark
incorrect = 0 marks
The physics examination is marked out of 40, and answers are marked as follows:
correct = 1 mark
incorrect = 0 marks
The standard for success is determined based on the difficulty of the questions in each sitting and may therefore vary between sittings and sets of images.
For more information on the exam content and structure, read the guidance notes for candidates on the College website.
Eligibility
The eligibility criteria for FRCR Part 1 is:
holding a Primary Medical Qualification (PMQ) that is recognised by the GMC for registration purposes.
holding a formal clinical radiology post in which they are actively receiving clinical radiology training.
no minimum period of clinical experience or training is required to enter the exams
Exam Centres
The current venues for the First FRCR (CR1) exam are:
Belfast, Birmingham, Bridgend Wales, Crewe, Edinburgh, Glasgow, Leeds, London and Plymouth. Overseas centres for now are in Hong Kong, Singapore, India, Egypt and Malta.
The exam is typically held three times a year over two consecutive days. 2023 exam dates are as follows:
February 2023
Physics – Thursday 9 February
Anatomy – Friday 10 February
June 2023
Physics – Thursday 8 June
Anatomy – Friday 9 June
September 2023
Physics – Thursday 14 September
Anatomy – Friday 15 September
For updates on exam dates, including the application window, keep an eye on the Royal College website here.
Applications & Cost
First FRCR (CR1) 2023 exam cost:
Members - £319
Non-members - £406
Please note that these costs vary slightly for some overseas centres.
UK trainees are given priority for examination places, followed by members of the Royal College and finally non-members. Each window lasts around a week and all candidates should apply for the exams through the Royal College website here.
Preparation
Although there are many online materials to aid in your preparation for FRCR Part 1, as always, we recommend you start your preparation on the Royal College website, particularly with the Specialty Training Curriculum for Clinical Radiology. In using these as a blueprint for your preparation, you will ensure your study is focused on the most relevant and useful information as prescribed directly from teaching materials.
Instructional video and demonstration site: a walkthrough video of the FRCR Part 1 exam format with guidance and instructions which can be found here for the physics component and here for anatomy.
Anatomy module guidance: advice for the anatomy module has been compiled by the College here.
Specimen questions: sample questions and answers have been put together by the College and are available here.
#IMG Tips
Prepare early – the best way to avoid stress and last-minute cramming is to get started as soon as possible.
Get familiar with the exam content – during your study (at least to start off with), the curriculum should be your guide to the FRCR exams.
Practise, practise, practise – go through as many practice questions as you can and regularly review your progress using mock exams.
Sources
https://www.rcr.ac.uk/clinical-radiology/examinations/frcr-part-1-radiology-cr1
https://www.rcr.ac.uk/sites/default/files/cr1_anatomy_purpose_of_assessment_statement.pdf
https://www.rcr.ac.uk/sites/default/files/cr1_physics_purpose_of_assessment_statement.pdf
https://www.rcr.ac.uk/sites/default/files/clinical_radiology_curriculum_2020.pdf
I’ve passed the First FRCR exam, what’s next?
Firstly, congratulations! This is an incredible achievement, and you deserve to treat yourself after all that hard work! With a pass in the First FRCR in hand, you can look ahead to the Final FRCR CR2A and CR2B exams. Once you have completed all parts of FRCR, you can apply for full GMC registration with a license to practice.
Don’t hesitate to get in touch with our team to learn more about the opportunities available to you once you’ve passed FRCR.
For the latest news and updates on all things radiology, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
Exam places for MRCP PACES have been hard to secure in some countries. This increase in demand has continued through to 2023, so what can you do to maximise your chances of securing an examination place?
The Royal College of Physicians has advised that they are working to grow capacity internationally. However, this will not have an immediate impact on the number of spots available across the world.
With so many overseas doctors missing out on a spot, we have put together some of the main discussion points to help you to broaden your chances of sitting the exam as soon as possible.
All applications submitted during the application period will be treated equally, with spaces being allocated using a random lottery model. Some spaces are reserved for local trainees and some priority can be given for applicants near the end of their eligibility periods.
So, to maximise your chance of success, we suggest that not only do you apply to your closest PACES exam centre, but also to 3 more centres that you are able to travel to.
Apply to more centres
Why should I apply for more centres? More applications equals more chance of securing a place. They way that it works is that if you are not successful with your 1st preference (most local centre), then you will be considered for a space in your 2nd choice centre, and so on until you secure a spot.
Of course, this means that you must be willing to travel to sit the exam. This can be costly, especially if you have to travel to a different country, flights and hotels are not cheap! As such, we suggest taking some time to carefully choose the locations that will not only have the possibility of a spare place, but where your costs will be kept to a minimum.
Candidates will be notified on the outcome of their application within 2 weeks from the closing date, giving you time to plan your travel if necessary.
Whilst this advice does not guarantee a place to sit the exam, it will increase your chances.
If you are not sure what to do, or have any other questions regarding the PACES exam, get in touch with an IMG Connect specialist.
Take a look at our IMG library for more information regarding postgraduate exams & PACES
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GMC Registration can be a long and complex process. With several options available for overseas doctors to demonstrate evidence of their skills and knowledge, it might be difficult to decide the best route to take to register with the GMC.
For international doctors planning their route to the UK, the two most common and popular routes by far are the UK postgraduate qualifications (MRCEM for emergency medicine physicians) or PLAB. Here we provide a summary of both pathways and briefly consider their benefits to help you make the best choice in your journey to the UK as an IMG.
GMC Registration for Overseas Doctors
PLAB for GMC Registration
MRCEM for GMC Registration
Which is better for me as an IMG: PLAB or MRCEM?
#IMG Tips
How do I get started?
Skip ahead to the relevant section if you know what you’re looking for.
GMC Registration for Overseas Doctors
Registering with the GMC is a multi-stage process, including key timings actions and documents. To receive full registration, international doctors must provide evidence of:
What is often the most long and challenging part of the process is providing sufficient evidence of skills and knowledge, however, you can check whether you have a GMC-accepted postgraduate qualification here.
There are 5 ways in which an overseas doctor can demonstrate their skills and knowledge:
PLAB
Acceptable Postgraduate Qualification / Licensing Examination
Relevant European Qualification
Sponsorship / MTI
CESR / CESR-CP / CEGPR
Please note that only one type of evidence is required to demonstrate skills and knowledge for GMC registration.
Of these routes, the most accessible are PLAB and the Acceptable Postgraduate Qualification because they are two of the only routes that do not depend on the country you’ve trained in – the UK postgraduate exams and PLAB can be sat by doctors.
For a detailed breakdown of all the routes available to IMGs, see our blog here.
PLAB - Professional & Linguistics Assessment Board
The first and most common route we’ll be discussing, which is particularly popular among junior doctors, is PLAB.
PLAB is a two-part exam (one written and one practical element), which assesses whether a candidate is at least as capable as a doctor starting the second year of their Foundation Programme Training (FY2 or F2) and can therefore work safely as an SHO (Senior House Officer) in the NHS.
The GMC has produced a useful video summary of the PLAB exams which you can watch here, or for a more detailed overview, see our IMG Resources library.
MRCEM - UK Postgraduate Qualification for Emergency Medicine
The UK’s postgraduate qualifications are a more popular route for senior overseas doctors, and those looking to gain posts in the NHS which are reflective of their experience.
For emergency medicine, this can be done by attaining Membership of the Royal College of Emergency Medicine. The Royal College of Emergency Medicine (RCEM) is the professional body that regulates the specialism of emergency medicine in the UK, and Membership of the College of the Royal College of Emergency Medicine (MRCEM) is the full qualification attained through these examinations.
Take a look at our IMG Resources library for complete guides on MRCEM to learn more.
You can also read our interview with Dr Behzad Rashid to learn about the experience of an IMG Emergency Medicine resident going through MRCEM.
PLAB vs MRCEM
Both MRCEM and PLAB are respectable routes that demonstrate skills and knowledge and will allow an international doctor to register with the GMC and work in the UK. To decide which route of the two is best for you, you’ll need to consider the benefits of each and how they align with your needs and priorities in moving to the UK.
Seniority of Positions in the NHS
It would be difficult for an overseas emergency medicine doctor to obtain a more senior post in the NHS without either MRCEM, a GMC-approved training programme, or extensive experience from a similar English-speaking healthcare system. PLAB alone will not give overseas doctors access to senior posts in the NHS.
Training
To practice as a consultant in the UK, you must have gone through specialty training and will need a GMC-recognised postgraduate qualification to do so, whether a qualification from the country in which you completed your specialty training, or MRCEM.
Due to the more specialised nature of MRCEM, we advise emergency medicine doctors to complete MRCEM, as many NHS Trusts will list MRCEM as a requirement on job descriptions. MRCEM also allows IMGs access to more senior roles and competitive salaries.
Time
PLAB has two stages and can take anywhere between 3-9 months to prepare from start to finish.
MRCEM has three stages, the last of which must be taken after at least 24 months of postgraduate experience with at least 6 months in emergency medicine and can take anywhere between 24-36 months to prepare from start to finish.
Cost
MRCEM costs £1,115 for the three exams. Whilst the Primary and Intermediate SBA exams are delivered worldwide via computer-based testing company, the OSCE is delivered in London (UK), Kuala Lumpur (Malaysia), Chennai, Hyderabad, Mumbai and Kochi (India), so there may be the added expense of international travel.
PLAB costs £1,189, and whilst PLAB 1 can be sat in many overseas centres around the world, PLAB 2 is only delivered in the UK. You can find a list of overseas centres for PLAB 2 here.
So for both MRCEM and PLAB, candidates will have to travel to the UK, meaning that the additional cost of visas, accommodation and flights must be factored in.
It’s also important to note that these costs can rise if re-sits of the exams are necessary.
Summary
PLAB, as an exam which examines a doctor’s ability to work safely as an SHO, does not assess ability in emergency medicine specifically. For this reason, PLAB tends to be a route for junior doctors who have not already chosen their field of specialisation in medicine, I.e., emergency medicine.
PLAB allows doctors to enter the UK system much faster than other routes and for this reason alone, it is favoured by international doctors when considering their path to the UK.
MRCEM involves three more difficult examinations and takes more time to prepare for. However, for overseas doctors, attaining MRCEM will allow you to jumpstart your career in the UK, as you don't need PLAB or Core Training.
Additionally, MRCEM will facilitate the application for more senior roles in UK emergency medicine than PLAB.
#IMG Tips
Determine your priorities – your goals and timeline for relocating to the UK are important in deciding which route is best for, and this is different for everyone.
Plan well ahead – depending on the route you choose, you may be embarking on a long journey through these exams, so plan how you will fit them into your life and how best to prepare to maintain a good work-life balance at the same time.
Find a support network – once you know which exams you will sit, find a support network of others who are also preparing for the exam.
Sources
https://rcem.ac.uk/exam-mrcem/
https://www.gmc-uk.org/registration-and-licensing/join-the-register/plab
https://www.gmc-uk.org/registration-and-licensing/join-the-register/before-you-apply/evidence-to-support-your-application
Getting started
Once you’ve decided which exams are best for you, it’s time to delve deeper into the exams and what they entail. For more useful blogs and articles on PLAB or MRCEM, registrations and qualifications to help you find your dream job in the NHS - take a look at our IMG Resources library.
Don’t hesitate to get in touch with one our recruitment specialists if you would like to discuss your options in the NHS once you have completed PLAB or MRCEM.
For the latest news and updates on all things emergency medicine, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
FRCR CR2A and CR2B and the final exams in the FRCR qualification.
Completions of all three parts of the Fellowship of the Royal College of Radiologists (FRCR) qualification results in eligibility for GMC registration, once the English language component has also been met.
The FRCR examinations are key to an international oncologist being able to secure senior oncology jobs in the NHS and can be taken by IMGs from any country, provided certain eligibility criteria have been met. In this article, we take a closer look at the following:
An overview of FRCR
How are the Final FRCR exams structured?
How are marks awarded for CR2A and CR2B?
Am I eligible to sit Final FRCR?
Where can I sit the exams and how much do they cost?
How do I apply for the exams?
What is the best way to prepare for FRCR CR2A and CR2B?
I’ve passed the FRCR Radiology exams, what’s next?
Skip ahead to the relevant section if you know what you’re looking for.
An Overview of FRCR Radiology
FRCR Radiology is the set of three postgraduate examinations administered by the Royal College of Radiologists to test candidates’ knowledge and clinical understanding within the scope of the Specialty Training Curriculum for Clinical Radiology.
The exams within the exam suite are as follows:
You can read an overview of the full FRCR Radiology examination suite via our IMG Resources library.
Please note that only full FRCR satisfies the postgraduate requirements for overseas doctors.
Alternative routes to GMC registration include PLAB and other recognised GMC qualifications or licensing exams, which you can find out more about here.
A Deep Dive into FRCR Part 2A & 2B
Final FRCR Part A
The Final FRCR Part A examination assesses knowledge of the sciences that underpin clinical radiology including physics as applied to imaging including molecular biology, medical statistics, radiological findings in pathological and normal conditions together with their differential diagnosis, management pathways, and radiological interventions.
The examination comprises two single best answer papers, each containing 120 questions and covering a broad range of the core curriculum. Exams are 3 hours for each sitting.
The paper comprises a mix of questions from across a wide range of the curriculum:
Cardiothoracic and Vascular
Musculoskeletal and Trauma
Gastro-intestinal
Genito-urinary, Adrenal, Obstetrics & Gynaecology and Breast Paediatric
Central Nervous and Head & Neck
Final FRCR Part B
The Final FRCR Part B examination assesses different aspects of a candidate’s radiological skills, all of which are considered necessary for safe and effective radiological practice.
The exam has three components:
reporting (long cases) – 6 cases in 75 minutes
rapid reporting – 30 plain radiographs in 35 minutes
oral exam – 2 x 30-minutes vivas
The stations are broken down in more detail below.
Reporting Station
This component is built on the fact that A&E department is a large part a radiologist’s workload.
The station tests candidates’ ability to rapidly decide if an image is normal or abnormal and the provision of a diagnosis for the abnormality.
The images are all radiographs with the balance of normals within the images about 45-50%. Trauma cases are the majority, but some chest and abdominal radiographs are included as they would be in a typical session of A&E reporting in the workplace. Each abnormal case shows one significant diagnosable abnormality.
This part of the examination reproduces the situation of plain film reporting as a safe radiologist needs to be able to identify abnormalities when present and confidently exclude them when they aren’t.
Rapid Reporting Station
The reporting component centres around the understanding that radiologists largely communicate their findings through written reports.
This element tests the ability of the candidate to make observations, distinguish the relevance of these findings, deduce a list of differential diagnoses, suggest the most likely diagnosis and discuss further management including further imaging where appropriate.
This part of the examination mirrors a mixed list of cross-sectional and fluoroscopic imaging, and a short, structured reporting sheet is provided. Each case can include any type of radiological imaging and often involves more than one e.g. plain film, CT and isotope study.
This written element of the examination aims to test the candidate’s ability to assess and interpret a variety of clinical cases across all modalities safely, and to accurately communicate their findings, conclusions and recommendations.
Oral Examination
This mirrors the day-to-day clinical discussions and MDT meetings, which form an integral part of a radiologist’s workload.
The oral component further assesses the candidate’s powers of observation and interpretation, but in addition allows assessment of the candidate’s ability to discuss wide-ranging aspects of patient care as influenced by the radiological findings.
Candidates are expected to be able to integrate their observations with emerging clinical information to help refine their differential diagnosis. It also tests their ability to communicate effectively, their analytical and decision-making skills, and allows searching questions to explore their depth of knowledge and ensure that their practice supports patient safety.
This oral element aims to explore the candidates’ depth of knowledge and to test higher cognitive skills. The format allows for flexibility and for complexity to be built into the examiner’s questioning.
In total, the Final FRCR exam lasts 2 hours and 50 minutes.
Scoring
Final FRCR Part A
The examination is marked by the examination software Speedwell and the marking system shown below is used:
For each item correctly answered: +1 mark
For each item incorrectly answered: 0 marks
The examination is not negatively marked and therefore you are encouraged to provide an answer to all the questions.
You can find full information on the scoring system for the CR2A exam here.
Final FRCR Part B
Reporting
Eight marks are available for each case, with a maximum of 48 marks available.
Candidate response
Mark
Excellent: a perfect answer, clear and confident
8
Good Pass: additional relevant material included in a "pass" grade answer
7
Pass: most observations made correctly; principal diagnoses correct
6
Borderline: appropriate for cases with two main diagnoses, but only one is mentioned; some observations missed
5
Fail: significant observations missed; correct diagnosis not made
4
No answer offered
3
Half marks may also be awarded.
Following the marking exercise each candidate will have a score between 18-48. An overall reporting mark is then awarded on the basis of total marks achieved using the scale below:
Total marks
Overall mark
18 - 25
4
25½ - 28
4½
28½ - 31
5
31½ - 34
5½
34½ - 37
6
37½ - 40
6½
40½ - 43
7
43½ - 46
7½
46½ - 48
8
Rapid reporting
One mark is available per image, with a maximum of 30 marks available.
Image type
Candidate response
Mark
Normal Image
Correctly classified
+1
Incorrectly classified (appropriate false positive)
+½
No answer given
0
Abnormal Image
Correctly classified and correctly identified
+1
Correctly classified but incorrectly identified
0
Incorrectly classified (false negative)
0
No answer given
0
Following this, each candidate will have a score between 0-30. An overall rapid reporting mark is then awarded on the basis of total marks achieved using the scale below:
Total marks
Overall mark
0 - 24
4
24½
4½
25 - 25½
5
26 - 26½
5½
27
6
27½ - 28
6½
28½ - 29
7
29½
7½
30
8
Oral
Candidates are shown images by two pairs of examiners and can score a maximum of eight marks from each pair.
Performance description
Comments
Score
Very Poor Answer
Key findings missed even with help
Wrong or dangerous diagnosis
4
Poor Answer
Slow to spot abnormality
Poor differential diagnosis
Needed help to get correct answer
5
Principal findings seen
Some abnormalities seen with help
Principal diagnosis correct
Limited differential
6
Good Answer
Key findings spotted quickly
Correct deductions made and correct diagnosis
Good differential offered
7
Excellent answer – all findings seen
Correct diagnosis and deductions
No errors
Succinct/accurate report
Excellent differential
8
Overall Pass Mark
Once the marks have been combined, each candidate will have a score of 4-8 in each component of the examination (two orals, the reporting session and the rapid reporting session).
The pass mark in each component is 6, making the overall pass mark 24.
In addition, candidates must obtain a mark of 6 or above in a minimum of two of the four components. If a candidate scores less than 6 in three or more components, they fail the examination even if they have achieved a score of at least 24 overall.
You can find full information on the scoring system for the CR2B exam here.
Eligibility for Final FRCR
Final FRCR Part A - to be eligible you must:
have passed FRCR Part 1
Final FRCR Part B - to be eligible you must:
have passed FRCR Part 1
have passed FRCR Part 2A
have acquired 34 months in a formal clinical radiology training post by the month of the examination (your training supervisor must provide confirmation that you have completed the required duration of training and received instruction covering the examination syllabus)
Exam Fees & Venues
Part 2A
The Part 2A exam is held twice a year, normally in spring and autumn.
You can see a breakdown of the fees for all UK and overseas centres below:
UK
Venues
Member fee
Non-member fee
Belfast, Bridgend Wales, Crewe, Edinburgh, Glasgow, Leeds, London, Plymouth
£427
£545
Global
Venues
Member fee
Non-member fee
Egypt
£427
£545
Hong Kong
£427
£545
India
£505
£643
Pakistan
£427
£545
Singapore
£493
£628
Part 2B
The Part 2B exam is now held four times a year.
You can see a breakdown of the fees for all UK and overseas centres below:
UK
Venues
Member fee
Non-member fee
Belfast, Bridgend Wales, Crewe, Edinburgh, Leeds, London, Plymouth
£597
£759
Global
Venues
Member fee
Non-member fee
Egypt
£427
£545
India
£505
£643
Applications
Applications are normally open for a few weeks, several months before the exam. Please refer to the examinations page for up-to-date information on application dates.
UK trainees (members) are given priority for examination places, followed by other member bookings and finally non-members. The window for each group is usually open for around a week before it opens to the next group.
All candidates should apply for the exams through the Royal College website here for Part 2A and here for Part 2B. More detailed information can also be found here in relation to preparation for the application.
Preparation
There are many resources available online to aid in preparation for the FRCR Part 2A and 2B exams. We always recommend that the best place to start your preparation is the Specialty Training Curriculum for Clinical Radiology.
Using this as a blueprint for your preparation is the best way to ensure your study is focused on the most relevant and useful information as prescribed directly from teaching materials.
Other useful resources to aid your studies include:
Instructional video: demonstrations of both parts of FRCR Part 2, providing insight into both elements of the exam and what candidates can expect on the day. These are on the RCR website here.
Guidance notes for Part 2A: a guidance document on key elements of the exam, found here.
Guidance notes for Part 2B: important information on the three sections of the exam, available here.
Sample questions: sample SBA and oral questions for the exams have been provided with answers on the RCR website, here for Part A and here for Part B.
Candidate reference sheet: a reference list of abbreviations and normal ranges for use during Part 2A, found here.
Examiners’ reports for Part 2B: this is a collection of generic reports written by examiners on the overall performance of candidates and individual questions as a guide for applicants for future sittings. These are available here.
Understand the SBA format and how to approach questions: this document also provides questions that have been used previously in the Final FRCR (Part A) Examination. You can find this here.
TNM Staging guidance - this document explains the knowledge required to answer questions related to this topic, available here.
Demonstration films: demonstrations of both parts of FRCR Part 2, providing insight into both elements of the exam and what candidates can expect on the day. These are on the RCR website here.
Scoring system for Part 2B: key information on how each part of the exam is marked, found here.
For a detailed guide to the best guidance preparation and courses for the exams, see our blog here.
Sources
https://www.rcr.ac.uk/clinical-radiology/examinations/frcr-part-2a-radiology-cr2a
https://www.rcr.ac.uk/sites/default/files/cr2a_purpose_of_assessment_statement_jan_22.pdf
https://www.rcr.ac.uk/clinical-radiology/examinations/frcr-part-2b-radiology-cr2b
https://www.rcr.ac.uk/sites/default/files/cr2b_purpose_of_assessment_statement.pdf
https://www.rcr.ac.uk/sites/default/files/cr2a_guidance_notes._jan_22.pdf
https://www.rcr.ac.uk/sites/default/files/docs/radiology/pdf/CR2B_scoring_system.pdf
https://www.rcr.ac.uk/clinical-radiology/exams/5faf80dd-7d45-e911-a977-002248072781/dates-fees
https://www.rcr.ac.uk/clinical-radiology/exams/a91e7f01-7e45-e911-a977-002248072781/dates-fees
I’ve passed the FRCR exams! What’s next?
Firstly, congratulations – attaining full FRCR is a massive achievement!
With all parts of the FRCR complete, you have completed the biggest component of the requirements for GMC registration. Once you have completed the English language component, you will be eligible for full GMC registration with a license to practice in the UK.
Don’t hesitate to get in touch with our team to learn more about the opportunities available to you once you’ve passed FRCR.
For the latest news and updates on all things radiology, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
PACES is the final exam in the MRCP UK examination series.
Attaining full MRCP UK will facilitate registration with the GMC for overseas doctors, allowing you to secure a job in one of the many medical specialties in the NHS, depending on your experience and specialisation. In this article we will consider the following:
What is PACES?
Am I eligible to sit MRCP PACES?
What is the content and format?
How is PACES marked?
As an overseas candidate where can I take the exam?
When should I take PACES?
How can I prepare for the exam?
Passed? What next?
What is PACES?
The Practical Assessment of Clinical Examination Skills (PACES) is designed to test the clinical knowledge and skills of trainee doctors who hope to enter higher specialist training (ST3). The exam sets rigorous standards to ensures trainees are competent across a wide range of skills and are ready to provide high-quality care to patients.
Am I eligible to sit MRCP PACES?
You must have passed the Part 1 written examination within the last seven years before taking PACES. The Royal College strongly advises trainees to apply after competing two years practical experience and Part 2 of the examination.
What is the content and format?
PACES is based on a format that is similar to OSCEs, a practical assessment in a clinical setting. There are five clinical stations with either patients with a given condition, or trained stand-ins (surrogates).
The exam is sat over a half-day and assesses seven core skills over five stations. IMGs can expect eight patient encounters assessed independently by a total of ten examiners (two at each station).
The seven core skills:
Physical examination – demonstrate correct, thorough, systematic, appropriate and professional technique of physical examination.
Identify physical signs – identifying physical signs correctly.
Clinical communication – elicit a clinical history relevant to the patient’s complaints, in a systematic, thorough and professional manner.
Differential Diagnosis – create a sensible, clinically assessed differential diagnosis for a patient.
Clinical Judgment – select an appropriate management plan for a patient or clinical situation. Select appropriate investigations or treatments for a patient that the candidate has clinically assessed.
Managing patients concerns – seeks, detect, acknowledge and address patients or relatives concerns, confirming their understanding and demonstrate empathy.
Maintain patient welfare – treat a patient or relative respectfully and sensitively in a manner that ensures their comfort, safety and dignity.
The PACES Carousel:
The Carousel consists of five stations, each assessed by two independent examiners. Candidates start at any of the five stations, moving round the carousel at 20-minute intervals, until completed. A five-minute period between each station is given.
Candidates are marked on clinical skills at each encounter in the examination. An encounter is when a candidate has an interaction with a patient or a surrogate. Stations 2 and 4 involve one encounter, whereas stations 1, 3 and 5 have two encounters.
How is PACES marked?
PACES is marked on seven skills, A-G, these are:
Skill A: Physical examination (stations 1, 3 and 5)
Skill B: Identifying physical signs (stations 1, 3 and 5)
Skill C: Clinical communication (stations 2, 4 and 5)
Skill D: Differential diagnosis (stations 1, 2, 3 and 5)
Skill E: Clinical judgement (all stations)
Skill F: Managing patients’ concerns (all stations)
Skill G: Maintaining patient welfare (all stations)
Skill B, identifying physical signs, is often considered the most challenging skill to pass.
As an overseas candidate, where and when can I take the exam?
It is a little more complicated than Part 1 or 2 exams and exam slots are often in short supply. Whilst the Royal College is working hard to increase the number of spaces, it is not always possible to offer a place to all applicants.
Priority is given to those candidates who are near the end of their stage 2 eligibility period. A full list of examination dates can be found here, please note these are subject to change.
Examination centres are subject to change, so for up-to-date information, please see the Royal College website here.
The examination is run at clinical centres across the UK (England, Scotland, Wales and Northern Ireland); these vary from diet to diet.
When should I take PACES?
Royal College performance data provides some food for thought when considering when to apply for PACES. The data suggests:
Wait at least 36 months after graduation before applying.
Those taking the exam before this period were less likely to pass.
24-36 months post-graduation – 50% pass rate
36-48 months after graduation – 77%
Candidates that had already passed part 1 & 2 written examinations were significantly more likely to pass PACES at first attempt.
How can I prepare for the exam?
With lots of resources available online, we have discussed with IMGs the best place to start looking for materials relating to the exams. Most IMGs recommended starting with the Royal College, who have created useful resources to help you to prepare for the exams. See below:
Curriculum: Applicants are tested on a range of common and important disorders in General Medicine as set out in the Joint Royal Colleges Specialty Training Curriculum for Core Medical Training.
We recommend getting to know the curriculum as early as possible, using it as a road map for your study plan.
It is recommended that to give yourself the best chance, you gain clinical experience involving care of emergency patients, adults and children.We advise you to regularly invite senior colleagues to observe and provide feedback on your clinical assessments, so you will be comfortable with the PACES format and give you confidence in approaching and examining patients with examiners present.
PACES station 4 examiner guidance examples: This useful guide contains examples of the types of statements found in the examiner guidance section of station 4 scenarios.
This will help you to understand what the examiner is looking for.
PACES sample scenarios: These will provide you with the most accurate and relevant scenarios to prepare you for the real thing. Sample scenarios cover Station 2, 4 & 5 (‘history taking’, ‘communication skills and ethics’ and ‘clinical consultations’ respectively.
Most of these have been previously used in a recent exam, but please note that during the exam you will only receive the section marked ‘information for the candidate’.
Videos on what to expect on the day: These helpful videos will give you a true reflection of what to expect on the day of the exam, easing some of the pressure and ensuring you can focus on the task at hand.
PACES candidate video: Whilst there are lots of useful videos online that are easy to find, the PACES candidate video contains important information about the exam, and practical examples of how the exam will run.
Candidate guide notes: these guidenotes created by the Royal College help IMGs to understand what to expect on the day, from your arrival to the completion of the test.
It can also be useful to understand how IMGs have failed the exam in the past, as this will give you the best chance to pass first time. The ‘how I failed PACES’ guide provides tips to help you to identify where you might be going wrong, along with practical advice to help you to improve.
For a useful overview of how to prepare for exams, including advice on study groups, online community support, best use of online resources & Royal College materials and courses - take a look at our blogs on exam tips and preparation.
Passed? What next?
First of all, congratulations! After you have passed all parts of MRCP (UK) you can apply for a full registration with a license to practice. Once the GMC have approved your application, you can work as a doctor in the UK.
IMG Jobs
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General & Acute medicine? Search for live vacancies here.
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Get in Touch
Get in touch using the buttons above (and below) to discuss specialist medicine job opportunities in the NHS, including discussions regarding a typical doctor salary in the UK and the most suitable hospital locations for you.
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Are you an overseas emergency medicine doctor taking the postgraduate route to GMC registration through the MRCEM exams? Are you interested in sitting the exams in the future?
As part of IMG Stories, we introduce to you Dr Behzad Rashid, an emergency medicine doctor who has recently sat and passed the MRCEM Primary exam. Dr Rashid will be sharing with you his experiences of the first of the Royal College of Emergency Medicine exams, taking you through his preparation, experience of sitting the exam and sharing some hot tips for international MRCEM aspirants.
Tell us about yourself... what should the IMG Community know about Behzad Rashid?
I am a Resident Emergency Medicine Physician, currently working in Pakistan and have worked in A&E since completing my internship. I started off as a medical officer, and then began an A&E residency programme in my country. I would say a combination of hard work and fate are the reason why I am where I am today.
What motivated you to sit the MRCEM exams?
I had booked a space on the PLAB 1 exam, however, due to COVID, it was unfortunately cancelled (three times in fact). By the third time, I’d had enough. I decided to progress my career in Pakistan because I felt I wasn’t getting anywhere with the exam bookings, and everything was very uncertain at that time.
Even though time felt like it had stopped, it was actually flying by. I therefore decided to sit the residency exam in Pakistan. I worked in A&E at the time and had heard about the MRCEM exams from my colleagues. Due to the lockdown, they had just announced that the exam could now be taken online, even within the comfort of your own home. I was ready to go all in and grind my way through both exams, so I studied and succeeded in clearing both PLAB 1 and MRCEM Primary.
At what point in your career and training did you sit the MRCEM Primary exam?
There wasn’t anything in particular that made me realise that I was ready to sit this exam, besides the fact that COVID had been ruining my plans. I was going through a difficult time, and A&E was something I dearly wanted to pursue. I saw an opportunity, and I took it.
Applications can be frustrating… how did you find the application process for the exam?
The whole process took me about 30-45 minutes to complete. The details of application and exam are available on the website, and whilst a bit tedious, it is a straightforward process. Based on the RCEM’s eligibility criteria for the first exam, you only need to have graduated with an approved medical degree in order to sit the exam.
Since I was planning to sit the exam in my own country, I was provided with some options for exam centres. There were multiple private exam centres nearby, and I did not want to sit the exam at home and risk the internet issues others had experienced. I booked my exam for 8 am, because that's when I function best, and I would recommend that everyone books whatever time of day you think you would perform best.
How far in advance did you start preparing for the MRCEM Primary?
I booked the exam 4 months in advance (around the end of October, with the exam in Dec). Everyone has their own method of studying, and for some, this may not be enough time, so whatever schedule has worked for you in the past - stick to it. In my opinion this exam requires about 3-4 months of studying if you are unemployed or have any daily commitments, and about 5-6 months if you are working or have a very busy schedule.
Often IMGs are a bit at a loss to get support... did you benefit from speaking to senior colleagues or peers about the exam? Did you study with other candidates?
I was in touch with a few individuals who had already sat the exam. They guided me through the application process and resources I could use to prepare. They were also the ones who entertained my idea in preparing for both exams at once, and they believed that I could succeed in both.
You don’t need a lot of friends, just the right ones who will push and support you in your journey.
You were preparing for PLAB at the same time as the Royal College exams...how do you feel studying for PLAB 1 compares to your experience of MRCEM Primary?
PLAB 1 and MRCEM Primary are completely different exams.
PLAB 1 focuses on the application of medical knowledge in common day-to-day scenarios that a doctor would encounter in the UK. MRCEM Primary is more of a theoretical assessment of the basics i.e. anatomy and physiology of emergency related scenarios. This became even more apparent after I’d gone over the curriculum provided by the GMC and RCEM, which is honestly the best part of the exams. I would not say that one is easier than the other – they assess different things.
I focused on the blueprint/curriculum for each exam and made sure to get in as many MCQs as possible. That gave me a better overview of what I would actually be tested on.
Emergency medicine doctors are notoriously busy...in the months leading up to the exam, how much time did you spend a week on preparation?
In my case, I had to appear for the MRCEM Primary first, and then a week later for the Pakistan Residency (FCPS I) exam. Since work was extremely hectic, and I felt that I was not able to set aside much time to prepare for both, I quit my job to study for the exams and managed my time throughout the day to study and prepare for both (around 12 hours each day).
It goes without saying that any goal without a plan is just a wish. I divided my day into 2 halves where I would wake up at 5am, and study till 12pm, take a break (which included sleeping, eating or working out), then start off again at 5pm and go at it till 10pm. The first half would be MCQS and making Anki flash cards, second half would be to review the cards I had pending for that day. I would throw in a mock exam every week to see where I stood at that point, correct my mistakes and make cards on those as well. I stuck to this routine for 3 months and by the end of the 3 months, I had a deck of about 2000 Anki flash cards, divided into two groups for the 2 exams, and that is all I would review because I was confident that is all they would test me on.
How did you manage to juggle other commitments whilst studying for the exam (without panicking)?
During COVID, I was pretty much stranded by myself in Pakistan. My family lived in a different country, and I had limited interactions with the family I did have around me. This bizarre period of isolation and confusion gave me ample time to prepare for my exams. Being alone did get frustrating at times, and anxiety would creep up on me, but the hunger to clear my exams and progress my career gave me tunnel vision and cancelled out all the other noise.
The preparation for 2 examinations was an enlightening and humbling experience. My goal is to reach out to students and help them understand what works best for them. I’d be more than happy to provide students with any resources (Including my Anki flash cards) they need. However, there isn’t a cookie cutter plan that will suit everyone - I did what was best for me in my circumstances, and you must do the same.
What resources did you use to prepare and practice for the MRCEM Primary exam?
I used the curriculum provided by the MRCEM on their website which you will find here.
Along with that I was using the MRCEM Success question bank, which I have to say is an excellent resource. The actual exam was very close to the MCQs provided, which is why I would highly recommend it.
I am also an avid user of Anki. It has helped me ace exams in med school, the MRCEM primary, FCPS I and even the PLAB 1. I have never made any notes from any textbooks, and I honestly think hardcovers will eventually become obsolete. I would highly recommend making your own cards since that allows you to work at your own pace and address any weak points. I would love to share my own deck of Anki cards as well, which covers everything provided in the MRCEM curriculum. Feel free to add more to this deck and pay it forward.
Let's face it, exams are not everyone's favourite day out... so on the day of the exam, what did you do to relax?
I woke up early and decided not to go over any cards. I’m the type of exam-taker who enjoys working out and listening to music before an exam. At that point, I know what I know, and that is all I know. So I drank a nice cup of coffee and got some cardio done while listening to music.
What was your experience like on the day?
My exam was around 8:30am, so the drive was about 5 minutes to the exam hall and I got there around 30 minutes before it started. The invigilator was friendly and after leaving my personal belongings in a small locker, they provided a sheet of paper and stationary at the centre. The computer prompted me to start once the invigilator asked me to, and everything after that went smoothly. The invigilators are ready to help you with your queries if you experience any problems during the exam as well.
What was the most challenging part of the exam?
In my honest opinion, I did not come across anything that would throw me off. After going over the curriculum, and having a plan, I just stuck to that plan and followed it till the end.
In hindsight, would you have done anything differently?
I was already taking the most extreme measures by preparing for multiple exams and taking time off work, given everything was shut down during COVID. I have no regrets and cannot think of anything I’d have done differently.
What nuggets of advice would you give to any MRCEM Primary aspirants?
The best thing about the Royal College exams is that they provide a curriculum of what you should know, and they would never ask anything more than that. I would highly recommend you go over that and familiarise yourself with the content you will be tested on. Question banks might provide extra information to give you a different perspective of the subject, however the real exam sticks to its curriculum. If you know what you are required to know, preparation for the exam becomes easier.
What are your plans going forward?
I'm planning on appearing for the PLAB 2 and the MRCEM Intermediate soon. I have already started preparing my Anki deck for the intermediate as well, so wish me luck and stay tuned for that as well.
To learn more about the RCEM exams, see our IMG Resources library.
For news and updates on all things emergency medicine, follow us on social media and join the conversation.
Overseas radiologists often ask us how to best prepare for the Final FRCR Part 2A and 2B exams. With so much online content geared towards UK trainees, it can be difficult to know what is best suited to you as an international candidate.
Here we have compiled some of the best advice and resources available to help overseas radiologists prepare for their Royal College (RCR) exams. We’ll also address some of the changes to the exam, both the format, administration and availability of the exam for IMGs.
The topics we’ll cover are as follows:
A recap of FRCR CR2A and CR2B
What resources are available for IMGs?
Royal College Resources
Courses
Books
#IMG Tips
Skip ahead to the relevant section if you know what you’re looking for.
An Overview of FRCR CR2A and CR2B
As a quick reminder, Final FRCR refers to the final two exams in the Royal College of Radiologists examination suite for clinical and diagnostic radiologists. The full series - Part 1, Part 2A and 2B – is required by overseas radiologists when applying for GMC registration through the postgraduate route.
FRCR CR2A assesses knowledge of the pathology, imaging techniques, congenital abnormalities and radiological findings that underpin clinical radiology practice.
The FRCR 2A exam consists of 2 papers sat on the same day; each paper containing 120 single-best-answer questions (240 questions in total). Each paper lasts 3 hours.
CR2B is not an exit exam but is a key step in a trainee's progress towards independent reporting. The exam assesses several aspects of the candidate's radiological skills, all of which are considered necessary for safe and effective radiological practise.
Part 2B has 3 separate sections as below:
Rapid reporting - 30 plain radiographs in 35 minutes
Reporting (long cases) - 6 cases in 75 minutes
Oral (viva) - 2 x 30-minute vivas
In total, the exam lasts 2 hours and 50 minutes.
For a full overview of the FRCR exam series, see our blog here.
Preparation & Revision Resources
After discussing with IMGs the best way to approach preparing for the Final FRCR exams, most recommended beginning with the Royal College website and resources, which they have put together to aid in your preparation.
Curriculum: The FRCR exams are based on the Specialty Training Curriculum for Clinical Radiology. As a rule of thumb, your revision should start here to ensure you are focusing on the exact material that will be in your exam. Knowing the curriculum is key and you can find these on the Royal College website here.
Royal College Resources
Instructional video: demonstrations of both parts of FRCR Part 2, providing insight into both elements of the exam and what candidates can expect on the day. These are on the RCR website here.
Guidance notes for Part 2A: a guidance document on key elements of the exam, found here.
Guidance notes for Part 2B: important information on the three sections of the exam, available here.
Sample questions: sample SBA and oral questions for the exams have been provided with answers on the RCR website, here for Part A and here for Part B.
Candidate reference sheet: a reference list of abbreviations and normal ranges for use during Part 2A, found here.
Examiners’ reports for Part 2B: this is a collection of generic reports written by examiners on the overall performance of candidates and individual questions as a guide for applicants for future sittings. These are available here.
Understand the SBA format and how to approach questions: this document also provides questions that have been used previously in the Final FRCR (Part A) Examination. You can find this here.
TNM Staging guidance - this document explains the knowledge required to answer questions related to this topic, available here.
Demonstration films: demonstrations of both parts of FRCR Part 2, providing insight into both elements of the exam and what candidates can expect on the day. These are on the RCR website here.
Scoring system for Part 2B: key information on how each part of the exam is marked, found here.
Courses
There are several online courses which provide preparation for the exams, including mock exams and insight into exam technique. As with all courses, we advise that you register your interest as soon as possible to avoid disappointment as they are in very high demand.
Please note these courses are subject to change and candidates are advised to book early (up to one year in advance in some cases), as spaces are often limited. Places may become available at the last minute, so make sure you add your name to a waiting list if possible.
Midlands FRCR 2A Review Course
This is an in-person revision course for the FRCR Part 2A exam held in Leicester. The course provides a refresher course covering a range of important topics, an interactive lecture-based course delivered in a ‘single best answer format’ and tips and tricks from trainees with recent experience of the exam.
Duration - 3 days
Cost - £350
London Heathrow FRCR 2B Preparation Course
This is a two-day course aimed at clinical trainees who are preparing for their FRCR CR2B. The course offers a minimum of 4 viva sets, 4 long case sets along with 4 rapid reporting packets. A further 2 lectures would also be included during the 2 days.
The course is delivered live virtually.
Duration - 2 days
Cost - £500
Red Dot Radiology Courses
These are in-person revision courses for Part 2B which cover rapid reporting as well as focused days on chest x-rays. The courses are live online via an interactive video and are led by FRCR qualified UK-based radiologists.
Duration - 1 day
Cost - £165
Aunt Minnie Courses
This is an online two-day course that runs twice a year and concentrates on Aunt Minnie cases that you may encounter in your FRCR 2B exam. The course is split into mini tests, workshops and exam tips to ensure candidates remain refreshed and stimulated.
Duration - 2 days
Cost - £350
Books
FRCR CR2A
Grainger & Allison’s Diagnostic Radiology
Fundamentals of Diagnostic Radiology - Brant & Helms
Primer of Diagnostic Imaging - Weissleder
Radiology Review Manual - Wolfgang Dahnert
Crack the Core Exam – Prometheus Lionhart
Fundamentals of Skeletal Radiology – Clyde A. Helms
Get Through Final FRCR 2A: SBAs - Teck Yew Chin, Susan Cheng Shelmerdine
RSBAs for the FRCR Part 2A - Richard Lindsay
FRCR CR2B
Rapid Review of Radiology - Shahid Hussain, Sherif Latif, Adrian Hall
Top 3 Differentials in Radiology - William O'Brien
Long Cases for the Final FRCR 2B - Rebecca Hanlon
Aunt Minnie's Atlas and Imaging-specific Diagnosis - Thomas Pope
Final FRCR Part B Viva: 100 Cases - Richard White, Robin Proctor, Ian Zealley
Chapman & Nakielny's Aids to Radiological Differential Diagnosis – Stephen Davies
#IMG Tips
Familiarise yourself with the exam content – the best way to do this is through the syllabus and curriculum
Prepare early – the earlier you begin your revision, the more structured and relaxed the entire process can be and the more likely you are to pass!
Invest in the right resources and courses – many resources from books to courses come at a cost – think about your own preferred style of learning and choose the resources that best suit you! Have any colleagues going through the exams or already passed? See if you can borrow or split the cost of resources.
Practise, practise, practise – this is of course a given...practise makes perfect and getting used to the format and being able to go through many sample questions will set you up well for the exam!
Sources
https://www.rcr.ac.uk/clinical-radiology/examinations/frcr-part-2a-radiology-cr2a
https://www.rcr.ac.uk/clinical-radiology/examinations/frcr-part-2b-radiology-cr2b
https://www.rcr.ac.uk/sites/default/files/clinical_radiology_curriculum_2020.pdf
Getting started
We hope this is helpful for any overseas doctors preparing to sit their Final FRCR exam and the team here at IMG Connect wish you the best of luck!
Follow us on social media through the links below for regular news and updates on the Royal College, relocating to the UK and working in the NHS.
As there is no hard and fast rule for what position you will have after gaining a UK qualification, it is important for IMGs to understand the posts that are available to you after completing FRCR (Oncology).
FRCR (Oncology) is a highly beneficial qualification to achieve, but it does not guarantee you a consultant position in the NHS.
This can be a confusing area for overseas clinical and radiation oncologists, but this blog aims to de-mystify the subject. This article will explain the following topics:
What is FRCR (Oncology) and how does it fit into the UK training programme?
What grade will IMGs, new to the NHS, be offered with FRCR (Oncology)?
Can I take a permanent consultant post if I have FRCR (Oncology)?
CESR opportunities for clinical oncologists in the NHS
Skip ahead to the relevant section if you know what you’re looking for.
FRCR (Oncology) within the UK Oncology Training Programme
Fellowship of the Royal College of Radiologists (Oncology) or FRCR (Oncology) is the postgraduate qualification awarded by the Royal College of Radiologists, the body responsible for the specialties of clinical oncology and clinical radiology throughout the UK.
FRCR (Oncology) is a three-part exam which is a necessary part of the training programme of clinical oncologists in the UK.
For trainees who have chosen to pursue clinical oncology, FRCR (Oncology) Part 1 or CO1 must be passed by the end of ST4.
Clinical oncology trainees will then sit Final FRCR (Oncology), also known as Part 2A and 2B or CO2A and CO2B, usually from ST6 to ST7.
These final exams are important in that they assess a trainee’s knowledge and skills related to the investigation of malignant disease and the care and management of patients with cancer.
Any UK-trained clinical oncologist applying for a CCT in order to work as a substantive consultant must have completed full FRCR (Oncology).
As shown above, UK trainees will also have completed MRCP (UK), although this is not required for overseas clinical oncologists.
Positions for Doctors new to the NHS with FRCR (Oncology)
As an IMG with full FRCR (Oncology), you will be eligible for consultant grade positions in the UK.
You are not guaranteed a consultant position, particularly if you do not have previous consultant position in your home country, but you will certainly be able to attain more senior positions in the NHS, such as a specialty doctor (SAS) or specialist grade.
Consultant positions are the most senior in the UK, and thus the highest paid position for doctors within the NHS pay system.
For further information on how NHS pay scales work for consultants, please see our detailed article here.
Of course, this is assuming that you have also completed the other necessary components to make you eligible for GMC registration.
Alongside your postgraduate qualification, you will need to have passed an English Language Test (either IELTS or OET).
Additionally, you must obtain a Certificate of Good Standing, and submit this to the GMC. Upon the receipt of these three components, you will receive full GMC registration.
Permanent Consultant Posts with FRCR (Oncology)
To take up a permanent consultant position in the NHS, you would need to have Specialist Registration. Specialist Registration (more specifically CESR for most overseas doctors) allows you to take up permanent or substantive consultant roles in the NHS.
The type of consultant position you would be eligible for with FRCR (Oncology) is a locum consultant post.
Firstly, we should clarify the meaning of the term ‘locum consultant’ in the UK. The NHS has two types of locums - Trust locums and Agency locums.
If you are an IMG with full registration, but you are not on the Specialist Register, you are only able to take on consultant positions as a trust locum, but no permanent positions.
Trust locums are hired on a fixed-term contract and are able to better acclimatize themselves to the NHS system, whilst receiving the support and guidance to work towards consultant positions and CESR.
Please note, you can only work as an agency locum if you have a British passport.
CESR Opportunities in the NHS
CESR or the Certificate of Eligibility for Specialist Registration is a route of entry to the Specialist Register for those doctors who have not followed a GMC-approved training programme.
You can read more about CESR in Clinical Oncology through our IMG Resources library here.
IMG Connect are able to help you to secure senior roles such as specialty doctor (SAS), specialist grade or locum consultant in Trusts that offer CESR support.
In these roles, you will have better pay and responsibilities that are more appropriate to your level of experience compared to a trainee. These Trusts have a lot of experience in supporting overseas doctors to progress their careers through CESR.
You can collect evidence of your competences, particularly those specific to the UK Clinical Oncology curriculum and those you may not be able to achieve outside the UK.
These positions also facilitate a faster route to the UK than applying directly through the CESR route, which can take a substantial amount of time.
Get in touch with us to find out more about senior positions in the NHS with CESR support.
Getting started
We hope this blog has been helpful in clarifying your questions about securing senior posts in the NHS with FRCR (Oncology). If you have any further questions regarding the postgraduate exams, CESR or Oncology in the NHS - feel free to contact us directly.
Join the IMG Oncologists Facebook group for access to a community of like-minded clinical and radiation oncologists and dedicated oncology recruiters.
In this group you will find tailored support for oncology IMGs, including access to our NHS and CESR webinars, completely free to all doctors.
You can access our IMG Oncologists community here.
Follow us on social media through the links below for regular news and updates on the Royal College, relocating to the UK and working in the NHS.
FRCEM is a crucial step when working towards either CCT or CESR in Emergency Medicine.
International Medical Graduates (IMGs) from any country in the world can sit some FRCEM examinations, provided certain eligibility criteria are met. For overseas doctors attaining FRCEM is not a route to GMC registration and you are better suited to the MRCEM pathway. These are summarised below along with a broad look at the following topics:
What is FRCEM?
FRCEM Route
Eligibility for overseas doctors
FRCEM Primary Examination
FRCEM Intermediate Certificate
FRCEM Final Examination
As an overseas candidate where can I take the exam and how much will it cost me?
How do I apply?
How to prepare and what resources are available
Passed? What next?
What is FRCEM?
Fellowship of the Royal College is awarded to candidates who pass three examination components.
There have been a few changes to the MRCEM and FRCEM examination structure over the last few years, as such there are currently two routes to an accreditation in Emergency Medicine, both leading to RCEM Membership.
These two routes are:
Membership of the Royal College of Emergency Medicine (MRCEM)
Fellowship of the Royal College of Emergency Medicine (FRCEM)
As of August 2018, applicants beginning the process will be able to sit one set of exams leading to the award of Fellowship of the Royal College of Emergency Medicine (FRCEM).
FRCEM is one of several routes an overseas emergency medicine doctor can take full GMC registration. Read our blogs on acceptable postgraduate qualifications and PLAB if you are unsure what route to take.
For doctors who wish to take more senior roles reflective of their current practice, IMG Connect advise that MRCEM or FRCEM would be the best route to take.
Understand the MRCEM pathway in this article above.
FRCEM Examination route:
The Fellowship Examinations consists of the following components:
FRCEM Primary Examination
one, three-hour written paper
FRCEM Intermediate Certificate
Short Answer Question Paper (SAQ)
Situations Judgement Paper (SJP)
FRCEM Final Examination
Critical Appraisal (Short Answer Question Paper)
Quality Improvement Project (QIP)
Clinical Short Answer Question Paper
Objective Structured Clinical Examination (OSCE)
Eligibility for overseas doctors:
FRCEM Primary:
To be eligible you must hold a Primary Medical Qualification (PMQ) that is recognised by the GMC for registration purposes.
FRCEM Intermediate:
To be eligible you must hold a PMQ recognised by the GMC, have completed an equivalent to the UK Foundation Programme and have passed FRCEM Primary Examination after 1st August 2016.
You will also be eligible if you have been granted exemption from the FRCEM Primary as a result of obtaining MRCS or MRCSI after 1st January 2012.
FRCEM Final Examination:
To be eligible you must have FRCEM Primary and FRCEM Intermediate Certificate, attained after 1st August 2016. However, the requirements make it incredibly dififcult to attain outside of the UK - so you are best advised to attain MRCEM, work in the UK and then work towards FRCEM whilst practicing in the NHS.
The examination is conducted in English and candidates are advised that IELTS Level 7 is the expected standard for completion of the FRCEM examinations. Remember, you will need to have a pass of 7.5 average in all areas of IELTS to complete your GMC registration.
FRCEM Primary Examination:
The FRCEM Primary Examination is mapped to the Emergency Medicine 2015 Curriculum. More detailed information is provided in the RCEM Basic Sciences Curriculum (June 2010).
The exam consists of one 3-hour paper of 180 single best answer questions (SBAQs) so you must choose one best answer from a choice of five feasible answers.
The paper will examine all the domains of knowledge in the Basic Sciences Curriculum including:
Anatomy
Physiology
Pathology
Microbiology
Pharmacology
Evidence Based Medicine
FRCEM Intermediate Certificate:
FRCEM Intermediate Certificate is comprised of two papers:
Short Answer Question paper (SAQ):
A single 3-hour paper of 60 questions, each worth 3 marks.
Unlike single best answer questions (SBAQs) you will not have the advantage of having a list of options to choose from. Instead you will have to compose your answer independently.
The blueprint for the FRCEM intermediate is as follows:
Curriculum Category
Questions
Common Competences
7
Clinical Presentations – Core Major & Acute Presentations
18
Anaesthetic Competences CT1&2
4
ICM within ACCS
2
Acute Presentations – Additional Adult ST3
6
Paediatric Presentations – Makor & Acute Presentations
11
Practical Procedures (ACCS)
12
Total
60
Situational Judgement Paper (SJP):
A two-hour paper of 120 single best answer questions.
This written paper is designed to test your ability to understand & respond appropriately to real world clinical situations, assessing you against the Common Competencies in the Emergency Medicine Training Curriculum 2015.
FRCEM Final Examination:
From August 2018 the FRCEM Final consists of the following components:
FRCEM Critical Appraisal (Short Answer Question Paper)
FRCEM Quality Improvement Project (QIP)
FRCEM Final Clinical Short Answer Question Paper
FRCEM OSCE
Each component tests individual skill sets and as such may be sat independently.
FRCEM Critical Appraisal:
A 90-minute Short Answer Question Paper.
FRCEM Quality Improvement Project (QIP):
This replaced the CTR from 1st August 2016.
The QIP is a written submission that should be completed whilst working in Emergency Medicine at a level above ST3 or SHO. It should focus on quality improvement in Emergency Medicine, and may focus on either adult or paediatric Emergency Medicine.
Any candidates who have not been awarded FRCEM by 31st July 2018, irrespective of any previous passes in CTR, are required to pass the new FRCEM QIP.
Clinical Short Answer Question paper (SAQ):
The SAQ is a 3-hour paper consisting of 60, 3-mark questions.
A summarised blueprint for the FRCEM Final SAQ is as follows. A fuller version can be found on the RCEM website here.
HST Major and Acute Presentations
25 questions
Additional Paediatric Practical Procedures
3 questions
Practical Procedures (HST)
11 questions
Ultrasound
3 questions
Clinical Presentations - Core Major & Acute Presentations
6 questions
Common Competencies
2 questions
Anaesthetic Competences CT1&2
1 question
ICM within ACCS
1 question
Acute Presentations - Additional Adult ST3
2 questions
Paediatric Presentations - Major & Acute Presentations
3 questions
Practical Procedures (ACCS)
3 questions
FRCEM Final OSCE:
The exam is set in a practical setting and tests your ability to apply knowledge & experience directly to patients – rather than reciting learned knowledge.
The exam consists of 16, 8-minute stations with one minute provided in between stations for reading time.
As with many other final stages to Royal College exams – FRCEM Final OSCE will make use of manikins or actors and you will be observed by an examiner after being presented with a clinical case to assess. Examiners will not engage with you – only observe and mark.
A brief summary of the curriculum for OSCE is found below:
Stations
Curriculum
1
Core Acute
2a
Resuscitation
2b
3
Core Major
4
Common Competencies
5
Common Competences
6
Anaesthetic Competences
7a
Paediatric Resuscitation
7b
8
Paediatric Acute
9
Paediatric Major
10
HST Major
11
HST and Adult Acute
12
Practical Skills
13
Paediatric Practical Skills
14
Non-technical Skills
As an overseas candidate where can I take the exam and how much will it cost me?
Examination and application dates are regularly updated by the Royal College and can be found here.
Please remember, applications made outside the application period will not be accepted.
Examination
Location
Fees
FRCEM Primary
Short Answer Question Paper
UK
£310
Iceland, Malaysia, Oman, India
£390
FRCEM Intermediate Certificate
SAQ
UK
£305
Iceland, Malaysia, Oman
£385
FRCEM Intermediate Cert.
(SJP)
UK
£200
Kuala Lumpur
£200
FRCEM Final
Clinical SAQ
UK
£300
FRCEM Final
Critical Appraisal SAQ
UK
£240
FRCEM Final
QIP
N/A
£150
FRCEM Final
OSCE
London
£420
How can I apply?
All applications are made online and links to all application forms and windows are available here. It is worth noting, the application can take some time to complete so it is always advisable to apply well in advance of the deadlines.
Please remember, applications submitted after the application period will not be accepted.
How do I prepare for each exam and what resources are available?
With lots of resources available online, we have discussed with IMGs the best place to start looking for materials relating to the exams. Most IMGs recommended starting with the Royal College, who have created useful resources to help you to prepare for the exams.
Curriculum:
Applicants are tested on a range of common and important disorders in Emergency Medicine as set out in the Emergency Medicine Training Curriculum 2015.
We recommend getting to know the curriculum as early as possible and using it as a road map for your study plan.
Information Packs:
These provide detailed information for the relevant examination components so that you can best prepare for your studies and what to expect on the day:
FRCEM Primary
FRCEM Intermediate
FRCEM Final Examination
SAQ Blueprint:
The blueprint for the new Intermediate SAQ exam can be found on page 8 of the FRCEM Intermediate examination pack, downloaded from the RCEM website here.
SJP Blueprint:
A blueprint of the new Intermediate SJP exam can be found on page 11 FRCEM Intermediate examination pack, downloaded from the RCEM website here.
Sample questions:
Test your knowledge using example questions from the current exam syllabus provided by the Royal College, see below:
Primary – sample questions
Intermediate Certificate – sample SJP questions
Final – successful QIP
Reducing referral rates of paediatric patients to plastic surgery
Management of fractured neck of femurs in the ED
Final – unsuccessful QIP
Critical Appraisal Questions – Advice to Candidates
Critical Appraisal – Most Frequently Offered Answers
Glossary of Terms:
The royal college uses many terms that may cause confusion, so take plenty time to understand the terms and definitions used in this guide. Candidates are expected to be rigorous in their use of these terms.
Glossary of terms used in RCEM exams.
Examination Report:
The Royal College recently began to publish reports on the performance of those sitting FRCEM examinations. Below is the first report published and helps to break down results for those in training and those out of training.
2018 Examination report.
Online resources:
There are lots of resources online, such as videos on YouTube, FRCEM courses and useful reading materials. We think that these are a great addition to your study plan, just be sure to check your sources.
For a useful overview of how to prepare for exams, including advice on study groups, online community support, best use of online resources & Royal College materials and courses, take a look at our blog: IMG Connects Top Tips for exam preparation.
As ever at IMG Connect we believe in preparation. In order to succeed in the clinical exam, IMGs have told us that it is vital that you practice your clinical examinations as frequently as possible, preferably under the supervision of a senior colleague. This will give you confidence in approaching and examining patients with examiners present.
Should I take a course to prepare for the OSCE?
Whilst it is not essential to take a course when preparing for the MRCEM or FRCEM OSCE - there is no doubt it will help your preparations both technically and mentally, and should be considered an investment towards your future career plans. Have a read of our blog on recommended MRCEM courses for Emergency Medicine doctors.
Passed? What next?
First of all, congratulations! After you have passed all parts of FRCEM, you will be on a firm path towards attaining your Specialist Registration in Emergency Medicine. FRCEM is not a route for GMC registration as doctors will already be in the UK, however those attaining MRCEM can do so from outside the UK, and use MRCEM as a route to GMC registration.
For the latest news and updates on all things emergency medicine, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
For overseas psychiatrists looking to register with the GMC and find a psychiatry job in the NHS, one option is to complete the Membership of the Royal College of Psychiatrists examinations - MRCPsych. Here we will take a detailed look at the MRCPsych exams, fees and centres.
International Medical Graduates (IMGs) from any country in the world can sit the MRCPsych examinations, provided certain eligibility criteria are met. These are summarised below along with a broad look at the following topics:
What is MRCPsych?
What is the exam content and format?
Eligibility for overseas doctors
Assessment Portfolio
Sponsorship Requirements
How do I apply?
How much will it cost me?
Where can I sit the exams?
How can I prepare for the MRCPsych examinations
Passed? What next?
The Royal College of Psychiatrists is the professional body responsible for the specialty of Psychiatry throughout the UK. Among many other duties, its role is to set and monitor the educational curriculum for those training to enter the profession.
What is MRCPsych?
The MRCPsych examinations are the central component of training for psychiatrists in the UK and the examinations are designed to test your knowledge of basic medical sciences as well as the clinical skills required for diagnosis and management within psychiatry.
For international doctors, MRCPsych is one of the two main routes IMGs can take to full GMC registration - you can find a range of articles covering these routes in our resource library here: Royal College or PLAB route.
For doctors who wish to take more senior roles reflective of their current practice, IMG Connect advise that MRCPsych would be the best route to take.
Overseas doctors must be registered with a recognised medical board in their country of residence and should have undertaken 3 years of training and MRCPsych (UK) is a prerequisite to anyone wishing to go on to a specialist training post as a physician in the UK
What is the exam content and format?
The MRCPsych examinations consist of two written papers (Paper A + Paper B) and one clinical examination (CASC).
Typically, a UK Psychiatrist would sit Paper A from FY2. Candidates will then progress through MRCPsych examinations from CT1 – CT3, before going on to specially training for CCT.
Paper A – The scientific and theoretical basis of psychiatry – 3 hours
This is a written paper, worth 150 marks and comprising 150 questions made up of approximately two thirds multiple choice questions (MCQ) and one third extended matching item questions (EMI).
It covers the following sections of the syllabus:
Paper A is now taken online.
Paper B - Critical review and the clinical topics in psychiatry – 3 hours
This is a written paper, worth 150 marks and comprising 150 questions made up of approximately one third covering critical review and two thirds covering clinical topics.
It covers the following sections of the syllabus:
Paper B is now taken online.
CASC - Clinical Assessment of Skills and Competencies
The CASC is based on a format that is similar to OSCEs. Specifically, the examination consists of two circuits which must be completed on the same day.
In total, the circuit includes 16 stations, made up of:
five stations on history taking, including risk assessment
five stations on examination, including physical and mental state
six stations on patient management
Stations consist of several elements with instructions provided to all candidates, marked against the examiners construct.
These have a standardised format with elements in common between stations of a similar type. Find out more here.
The CASC exam is taken in person.
Eligibility for overseas doctors
The MRCPsych examinations can be taken by both:
Doctors from the EU, who are working overseas
Non-Eu doctors who are working overseas
Each examination has different criteria, to complete the full MRCPsych, an overseas doctor must be registered with a recognised medical board in their country of residence and complete the Assessment Portfolio for Overseas Candidates demonstrating that they have complete 3 years of equivalent training.
Furthermore, prior to taking CASC, overseas candidates must demonstrate competencies in Psychotherapy AND Child & Adolescent Psychiatry or Learning Disability.
For each part of the exam the Royal College suggest the following eligibility criteria:
MRCPsych Paper A
You are eligible for Paper A if you are a fully registered medical practitioner.
MRCPsych Paper B
It is a recommended to have at least 12 months experience in psychiatry before taking this examination.
Clinical Assessment of Skills and Competencies (CASC):
You are eligible to take CASC if you have 24 months post internship experience in Psychiatry, by the time of sitting the CASC
AND
You have a pass in both Paper A and B
AND
You can demonstrate you have sponsorship in place. Sponsorship forms must be submitted by an appropriate medical education lead confirming that the eligibility requirements to sit the MRCPsych examinations have been met.
In addition, overseas candidates must show their sponsor evidence of having achieved equivalent competencies at appropriate competency levels (year 1, 2, 3) for each component of the examination.
Assessment Portfolio for Overseas Candidates:
As above, one aspect of eligibility for CASC as to complete an Assessment Portfolio. This must demonstrate achievement of equivalent competencies to those defined in the ARCP documented on the application form, this must include competencies in Psychotherapy AND Child and Adolescent Psychiatry, or Learning Disability have been achieved by the time of applying for the MRCPsych CASC.
In addition, overseas candidates must demonstrate that they undertake the following activities as part of their structured job plans:
be observed interviewing patients in ward rounds for specified reasons
be observed interviewing patients in out-patient or community settings or other contexts for specified reasons
be assessed via formal presentation of cases with their medical notes; discuss management of cases with their Clinical or Educational Supervisor
be assessed formally in having achieved competencies in Child and Adolescent Psychiatry or Learning Disability AND Psychotherapy
Assessments and achievement of competencies should take place in a range of settings and psychiatric specialties with structured, documented feedback on performance having been provided.
Whilst there is not an assessment criteria form available as this is incorporated into the online submission, take a look at the ARCP assessment portfolio form for CT1-3 in the UK, which should help give you a starting point for your own portfolio.
Sponsorship requirements
International candidates must have a sponsor in place in order to support evidence that their three years of training satisfy Royal College criteria of having achieved equivalent competencies at appropriate competency levels (year 1, 2, 3) for each component of the examination.
Sponsorship is required by all applicants for entry to the CASC examination and your sponsor should be an appropriate medical education lead confirming you have met the requirements to sit the MRCPsych examinations.
Acceptable sponsors are:
College Tutor
Training Programme Director
Educational Supervisor
Head of School
Director of Medical Education (or equivalent)
Head of Department of Psychiatry
Consultant responsible for employee/trainee appraisal
Once your sponsor has authorised your application, you will receive a confirmation email from the Royal College, and you will be asked to complete your application and proceed to payment.
How do I apply?
To apply you will need to complete an online application form. It takes about 15 – 20 minutes. You can sit Paper A and B in any order. You will be required to enter contact details and training history, including your medical registration.
Payment is made by credit/debit card.
If applying for the CASC, you will also need to provide the contact details of your sponsor.
It is important to note that the online form for Paper A, B and CASC will only be available during the published application dates and must be submitted before the closing date and time. Applications submitted after, will not be accepted.
How much will it cost me?
Candidate
Paper A
Paper B
CASC
PMPT Trainees and Affiliates (UK & Ireland Centres)
£496
£446
£1,024
Non-PMPT Trainees and Affiliates (UK & Ireland Centres)
£550
£495
£1,137
Where and when can I sit the examinations?
The good news is that changes have been made in response to the COVID-19 pandemic, and Paper A and B can be taken online, making it much easier for IMGs to complete the MRCPsych examinations and work towards their GMC registration in a normal time frame. To maintain the integrity fo the CASC exam, delivery will be in-person only from September 2023.
You can sit the examination from your home country with details on submissions and preparation for an online exam available on the Royal College website.
For up-to-date information on application and exam dates, please see the Royal College website here.
How do I prepare for the MRCPsych examinations?
With lots of materials online we have discussed with IMGs the best place to start looking for resources and materials relating to the exams. Most IMGs recommended starting with the Royal College, who have created useful resources to help you to prepare for the exams. See below:
Syllabus:
We always suggest that this is the best place to start – plan your study around the curriculum topics and make a road map to your success in the exams.
Syllabus: summary of areas of core medical knowledge underpinning specialist training in psychiatry
Current critical review syllabus:
For Paper B candidates will need to ensure that they make optimal use of the MRCPsych Paper B Critical review Evidence Based Practice Syllabic Content.
Sample Papers:
These will help you prepare and polish your exam techniques and are a good idea to regularly benchmark your knowledge against the syllabus. In addition sample questions will help you work quickly on the day, you will already know what to expect. Please note: you may be required to be a member to access these.
Paper A sample questions
Paper B sample questions
Marking schemes (Paper A and B):
Candidates pass or fail the written papers based on their performance, and not how well you perform against other candidates. As such, it is a good idea to understand how the exam is worked, so you can maximise your exam skills, giving you the best chance of a pass.
Marking schemes can be found here.
Marking scheme (CASC):
A good start with CASC preparation is to get to know how you will be assessed, take a look at the criteria for scoring a pass mark in CASC, as well as the History Marksheet, Management Marksheet and Examination Marksheet.
Written papers marksheet example:
Again, this is a useful tool to help you familiarise yourself with the exam format and improve your test skills. An example marksheet can be found here.
CASC examination guide:
The Royal College have produced a helpful guide for candidates which provides information on stations, role plays and assessment.
CASC preparation videos:
Here you will have the opportunity to see CASC stations in action. This will give you a good idea of what to expect and help you prepare.
CASC Blueprint:
This helpful summary details stations in some detail and gives a useful overview of the exam format.
The Royal College also suggest taking a look at Passing the MRCPsych - an insider’s guide - a useful guide to help you to get over the first steps.
As ever at IMG Connect, we believe in preparation. In order to succeed in the clinical exam, IMGs have told us that it is vital that you practise your clinical examinations as frequently as possible, preferably under the supervision of a senior colleague. This will give you confidence in approaching and examining children with examiners present.
Passed? What's next?
First of all, congratulations! After you have passed all parts of MRCPsych you can apply for a full registration with a license to practice. Once the GMC have approved your application, you can work as a doctor in the UK.
Don’t hesitate to get in touch using the buttons above (and below) and chat with an IMG Consultant to discuss your options for NHS roles with CESR support and start your journey towards Specialist Registration with IMG Connect.
For access to a community of like-minded psychiatry IMGs and dedicated psychiatry recruiters, join the IMG Psychiatrists Facebook group.
To receive the latest news and updates on all things psychiatry, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.