Overseas Histopathologists wanting to secure a role in the UK via the postgraduate qualificaiton route will need to attain Fellowship of the Royal College of Pathologists in Histopathology or FRCPath in Histopathology, a sub-specialty exam of FRCPath. FRCPath is the UK qualification and a GMC Recognised postgraduate route.
International Medical Graduates (IMGs) from any country in the world can sit the sub-specialty FRCPath in Histopathology examinations, provided certain eligibility criteria are met. These are summarised below along with a broad look at the following topics:
Set against the Curriculum for Specialty Training in Histopathology, the examinations are designed to recognise histopathologists close to the end of their training who can demonstrate sufficient knowledge and technique for independent practice. In other words, completion of the full set of exams (Part 1 & 2) demonstrates your ability to work at consultant level.
Part 1 is usually taken in the UK at ST3 level, with Part 2 at the end of ST4, in order to progress to the final stage of Specialty Training – Stage D.
Eligibility for overseas doctors:
For international candidates, the eligibility criteria for FRCPath specialty examinations is not particularly clear when looking online. IMG Connect spoke to the Royal College directly in an effort to clarify this.
In brief, the Royal College do consider equivalents to NHS training programmes however, they do not have an agreed list of countries with accepted training programmes. As such, applications are treated on a case by case basis, so we advise speaking to the Royal College directly when making your application.
Please note, there are many overseas doctors applying for all parts of the pathology exams so don’t be put off by the lack of information!
If you have the required months training in a recognised programme in your country for Histopathology specifically, the chances are you will be eligible.
Eligibility for Part 1:
You are required to have trained in a recognised training programme in Histopathology for a period of no less than 12 months.
* Please note, candidates who have passed the FRCPath Part 1 examination in Histopathology who, after appropriate training, can attempt the Part 2 examination in one of the following: Forensic Pathology, Neuropathology or Paediatric Pathology.
Eligibility for Part 2:
The Royal College expects you to have at least three years of specialty training specific to Histopathology in your own country. Furthermore, the Royal College strongly advises candidates to attempt Part 2 at least 12 months after passing Part 1.
FRCPath in Histopathology structure and format:
The FRCPath examinations consist of two parts:
Part 1 – One paper comprised of 125 multiple choice questions (SBAs and EMQs)
Part 2 – six-part practical examination held over two consecutive days.
Part 1 examination:
FRCPath Histopathology Part 1 One comprises of 125 multiple choice questions in both single-best-answer (SBAQs) and extended-matching-questions (EMQs).
The exam is orientated towards assessing your overall knowledge and understanding of:
full range of autopsy practices undertaken in an NHS District General Hospital
Part 2 Practical Examinations:
The exams consists of six components taken over two days, summarised below:
Part 2 Practical examinations
20 cases in 20-minute slots
8 cases in 20-minute slots
4 cases with 20-minute reviews followed by 20-minute discussions
2 20-minute stations
4 20-minute stations
6 cases in 2, 20-minute stations.
One meeting with examiners in separate 20-minute station.
20 cases are provided in 10 pairs of haematoxylin and eosin (H&E) stained slides in 20-minute slots over 3-hours 20 minutes of the second morning.
The cases will represent a range of difficulties, with some proving complex cases requiring detailed description, differential diagnosis and special techniques or cases not diagnosable on a single H&E.
Held on the first morning of the exam. Eight non-gynaecological cytology cases will be provided in pairs in 20-minute slots.
This part is designed to allow candidates to demonstrate their capabilities in discussing gross pathology and familiarity with block selection in the context of the RCPath Minimum Datasets.
Four cases provided in the form of photographs of gross pathology specimens. Two 20-minute slots will be provided for 2 cases, followed by 20-minute discussions with 2 examiners.
2 x 20-minute stations. One of which is conducted face-to-face with 2 examiners while the other is a written exercise only. Possible topics can include management/clinical governance type and MDT type cases.
4 x 20-minutes stations provided on the first afternoon including cases which cannot conventionally be covered in a single H&E stained section.
6 cases viewed in 2 x 20-minutes stations (3 cases per station) before meeting with a pair of examiners in a 20-minute station. You need to take notes and be able to provide the examiners with a bottom-line diagnosis only, to form basis for discussion in face to face meetings.
As an overseas candidate where can I take the exams and how much will they cost me?
Part 1 overseas examination centres:
Part 1 Overseas Fees
Jeddah (Saudi Arabia)
Part 2 Examination centres:
Histopathology is one of the few FRCPath examinations which can be sat overseas. Centres are available in Irbid (Jordan) or Cairo (Egypt) if there are sufficient applicants. Otherwise the exams must be sat in the UK and cost £1361.
How do I apply?
Applications must be made via the Royal College of Pathologistswebsite, with applications only available once an application window is opened by the Royal College.
How do I prepare for each exam and what resources are available?
With lots of resources available online, we have discussed with consultants the best place to start looking for materials relating to the exams. Most recommended starting with the Royal College, who have created useful resources to help you to prepare for the exams.
The College’s datasets for Histopathological Reporting on cancers have been written to help pathologists work towards a consistent approach for the reporting of the more common cancers and to define acceptable practices in handling pathology specimens. Whilst these are not specific to FRCPath examinations they are certainly relevant to the wider practice in histopathology.
IMG Connect advice:
Part 2 – food and drink:
With multiple exams taking place for Part 2 in one day bring supplies! It will be a long day and there may not be access to food.
Hiring a microscope:
For Part 2 you will be required to sit examinations in the UK and will require a microscope. The examination centres will not provide equipment for any applicants so you will need to hire a microscope in advance. There are a few companies easily accessible through a web search, find a microscope and book well in advance of the exam. You can arrange for the company to drop off and pick up the microscope from the exam centre, don’t worry!
Passed? What next?
First of all, congratulations! After you have passed all parts of FRCPath in Histopathology 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 with an IMG Consultant to discuss UK job options in Histopathology, including discussions regarding a typical doctor salary in the UK and the most suitable locations for you.