FRCPath in Histopathology – an overview
- March 09, 2023
Overseas histopathologists wanting to secure a job in the UK via the postgraduate qualification 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:
- What is FRCPath in Histopathology?
- Eligibility for overseas doctors
- FRCPath in Histopathology structure and format
- FRCPath in Histopathology: Part 1 - MCQ/EMQ
- FRCPath in Histopathology: Part 2 - Practical Examination
- As an overseas candidate where can I take the exams and how much will it cost me?
- How do I apply?
- How to prepare and what resources are available?
- Passed? What next?
What is FRCPath in Histopathology?
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.
Eligibility for overseas doctors:
Below we outline the eligibility for overseas doctors looking to sit both FRCPath Histopathology exams. For international candidates, the eligibility criteria for FRCPath specialty examinations can be a little confusing when looking online so IMG Connect spoke to the Royal College directly in an effort to clarify this.
Time spent in histopathology training is stated as a requirement of eligibility and the Royal College do consider equivalents to NHS training programmes though there is no list of countries with accepted or unaccepted training programmes. The royal college advises you should speak to your Educational Supervisor or Sponsor (if you have one) who can advise you if you are ready or eligible to sit the Examinations if you are unsure. Remember, there are many overseas doctors applying for all parts of the FRCPath exams so don’t be put off applying!
Top Tip: 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.
Did you know? 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 (SBAs) and extended-matching-questions (EMQs).
The exam is orientated towards assessing your overall knowledge and understanding of:
- histopathology/ cytopathology
- basic science underpinning pathology (inc. molecular biology)
- 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 |
|
|
Surgical history |
20 cases in 20-minute slots |
|
Cytopathology |
8 cases in 20-minute slots |
|
Macroscopic pathology |
4 cases with 20-minute reviews followed by 20-minute discussions |
|
OSPEs |
2 20-minute stations |
|
Long cases |
4 20-minute stations |
|
Frozen sections |
6 cases in 2, 20-minute stations. One meeting with examiners in separate 20-minute station. |
Surgical history: 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.
Cytopathology: Held on the first morning of the exam. Eight non-gynaecological cytology cases will be provided in pairs in 20-minute slots.
Macroscopic Pathology: 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.
OSPEs: 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.
Long 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.
Frozen Sections: 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.
Where can I take the exams and how much will they cost me?
The COVID-19 pandemic has caused disruption to Royal College exams across all specialties, and unfortunately the RCPath exams have been affected also. For the most up-to-date news on the RCPath examinations please refer to their website here.
FRCPath Part 1 (current COVID-19 arrangements): In 2022, the Part 1 examination will be offered using online delivery to candidates. This means you can take the exam remotely and will not need to travel overseas to sit the exam, or attend an examination centre. The College will deliver the written components of these examinations through a company called TestReach, the Oral components (including oral OSPE stations) will be delivered using a video-conferencing platform such as Zoom or Microsoft Teams and for the written examinations, candidates will be given the opportunity to trial the TestReach system to familiarise themselves with it ahead of the examination. You can read more about the new, remote examination process further here on our website.
Previously, the Part 1 examination was sat in multiple overseas centres and once the pandemic is under better control globally, it is highly anticipated the Royal College will return to previous set-ups.
The FRCPath Part 1 exam costs £622. You can see how the Royal College breaks down the cost here on their website.
FRCPath Part 2 (current COVID-19 arrangements): Part 2 exams will be held in person in the UK in 2022. There will be no online delivery for the exam.
Keep an eye on the RCPath website for the most up-to-date news on the exams.
The FRCPath Part 2 exam costs £1,308. You can see how the Royal College breaks down the cost here on their website.
How do I apply?
Applications must be made via the Royal College of Pathologists website, with applications only available once an application window is opened by the Royal College. This is usually twice a year, in SPrin and in Autumn.
How do I prepare for RCPath exams and what study 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.
Curriculum: Questions are set against the Curriculum for Specialist Training in Histopathology We recommend getting to know the curriculum as early as possible and using it as a road map for your study plan.
Regulations and Guidelines: Before applying for FRCPath examinations, the Royal College recommends you read both the General & Specialty Specific regulations and guidelines:
Sample Questions:Testing yourself against previous exam questions is always a recommended way to prepare. Histopathology Part 1 sample questions
Cancer Datasets and Tissue Pathways: 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!
I passed the FRCPath exams! What next?
First of all, congratulations! After you have passed both 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 histopathologist 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.
The Royal College makes it clear that individuals who reach the standard required to pass the FRCPath examination in their chosen specialty are deemed to have the necessary professional competence to practice unsupervised. FRCPath also greatly contributes to the Certificate Confirming Eligibility for Specialist Registration (CESR), the alternative route to the Specialist Register for doctors who do not complete their training in an approved UK training programme.
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:
Relevant Jobs
This is a unique opportunity to work in a developing initiative that will bring immense social good to the local the people of Wales.
Short / mid / long-term ambitions for this role.
Short-term, there is the opportunity to work a close group of four international doctors, with specialist qualifications in histopathology including FRCPath. You\'ll have the opportunity to shape the careers of hungry pathologists ready to absorb all the knowledge and experience from an experienced NHS colleague like yourself.
Mid-term you\'ll be jointly responsible for the successful portfolio submissions for these individuals, helping the laboratory at Glangwili General Hospital to establish a newly qualified consultant team to provide stability and excellent pathological services for the patients of Wales, UK.
Long-term, the potential is enormous. As part of ‘A Regional Collaborative for Health’ or ARCH a regional hub for South and West Wales is being built in Swansea, to house a 30-35 consultant lead service for histopathology alone. Fully digitalised regional services for half the Welsh landmass would be provided via one central and digitalised hub.
Life in the area
It\'s a beautiful life with Wales offering beaches, beautiful forest, lakes and mountains all available to you in your free-time. It\'s a low cost of living and a a bit of a dream for the right person. We can chat more about that over our call.
The UK Lab is based in Surrey, and the facility is ISO 15189 accredited and ISO 27001 certified.
The department provides the latest technology and several years of extensive research offering highly effective treatment solutions to cancer patients for whom, multiple lines of treatment have failed.
The UK lab receives samples that are received from private practices around the UK, Europe and USA.
Responsibilities:
With roughly two hours of work needed per day, mostly remote, with twice weekly attendance onsite likely required, the pathologists responsibilities will be along the lines of the below.
- Authorisation of reports (molecular and tissue)
- Sectioning slides / assessing tumour content - to help identify which sections can be used for processing samples.
- Approving & signing reports.
- Signing out molecular reports - training will be given.
- Signing out solid organ cancer reports
- Turnaround time is required within 24-hours.
Eligibility:
- GMC registration
- Right to work in the UK
- Ability to travel twice per week to Surrey, UK.
- FRCPath or Specialist Registration is not required for this post
A unique opportunity awaits Histopathologists, especially Consultants, to join a dynamic team of 35 professionals at the Histopathology Department within a prestigious NHS Foundation Trust. Engaged in diverse diagnostic tasks, the department encourages research and teaching, offering a platform for career growth. This role is ideal for overseas Histopathologists interested in the UK NHS, with a focus on those specializing in the EEA or experienced IMGs aiming to fulfill CESR requirements.
The Histopathology Department boasts a skilled team of consultants and junior doctors, equipped with cutting-edge facilities for accurate diagnostics. Handling a wide range of cases annually, the department ensures timely and precise reports, contributing to patient care.
The department is part of an NHS Foundation Trust that is considered as a leading healthcare institution, emphasizes staff well-being, inclusivity, and equal opportunities. With 23,500 staff, the Trust is dedicated to creating a compassionate work environment where every team member can thrive. The commitment to inclusivity is deeply ingrained, driven by diverse staff networks and a Fairness Taskforce led by the CEO.
The career development opportunities at University Hospitals Birmingham NHS Foundation Trust extend to research and development initiatives. Actively participating in regional and national research programs and clinical trials, the Trust supports staff in project planning and submission. This role presents a compelling prospect for experienced international histopathologists pursuing CESR and specialist registration in the UK NHS.
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
-
Experience of working in Histopathology (essential)
Non-EEA Candidates:
-
FRCPath or PLAB (essential)
-
Experience of working for Histopathology (essential)
UK based applicants
-
Experience of working in Histopathology (essential)
A compelling opportunity awaits a Consultant Histopathologist at South Tees Hospitals NHS Foundation Trust, renowned for its \"good\" overall rating by the CQC. This pivotal NHS job offers the chance to contribute significantly to pathology services within the Tees Valley Collaborative Service. Collaborating with a skilled team of 12 consultants, the role involves delivering a comprehensive cellular pathology reporting service to a diverse population across several towns, and totaling 1.6 million residents.
This role is particularly advantageous for overseas Consultant Histopathologists aspiring to establish themselves in the NHS. Suited for candidates with specialization in the European Economic Area (EEA) or experienced International Medical Graduates (IMGs) seeking completion of the Certificate of Eligibility for Specialist Registration (CESR), it provides a unique pathway for professional growth.
The Histopathology Department at The James Cook University Hospital stands as a beacon of diagnostic excellence, equipped with a dedicated team of consultants and junior doctors. With a robust staffing quota, the department handles a diverse caseload, offering comprehensive care ranging from routine diagnostics to complex pathology. State-of-the-art facilities, including a modern operating suite with 20 theatres and a 33-bedded critical care unit, underscore the commitment to precision and cutting-edge diagnostics.
The department is part of an NHS Foundation Trust that oversees a diverse healthcare landscape, including their main hospitals that is a major teaching and trauma center with 1,024 beds, a 24-hour acute admissions unit, and an emergency department. The NHS Foundation Trust has another hospital, integral to community care, complements the trust\'s commitment to excellence across Middlesbrough and Northallerton.
The Trust\'s dedication to research and development is evident through active participation in regional and national research programs and clinical trials. The Research and Effectiveness department within the Trust facilitates project coordination, supporting innovation. A specialized member of the research staff brings expertise in managing the pathological aspects of clinical trials.
It is part of the Middlesbrough, the urban hub, offers residents a dynamic living experience with access to scenic parks, cultural attractions, quality schools, and Teesside University. Robust transportation links connect Middlesbrough locally and to major cities and airports. Housing options, from historic residences to modern developments, cater to diverse preferences, ensuring a vibrant urban lifestyle with green spaces and educational excellence.
This opportunity, tailor-made for experienced international histopathologists, aligns with the aspiration to achieve CESR and specialist registration within the UK NHS. It not only offers a stimulating professional environment but also serves as a gateway to making a meaningful impact on healthcare.
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
-
Experience of working in Histopathology (essential)
Non-EEA Candidates:
-
FRCPath or PLAB (essential)
-
Experience of working for Histopathology (essential)
UK based applicants
-
Experience of working in Histopathology (essential)
Experienced Pathology Consultants from around the globe are encouraged to apply for consultant roles in one of the largest Foundation Trusts in the South East of England. The trust actively seeks experienced consultants, whether or not they are currently on the specialist register, with a commitment to supporting those not on the register for CESR if that is their preference. This Trust, boasting nearly 10,000 staff and an annual budget exceeding £715 million in 2019/20, operates two large general hospitals in the East of England that consistently perform well according to their CQC reports.
The Histopathology department at this Trust is on a trajectory of advancement, aiming to incorporate the latest technologies and innovations to meet the current and future challenges of the modern NHS. An exciting collaboration with a large teaching hospital and tertiary center in China is underway, promising extensive opportunities for research and teaching within the Histopathology department. The post holder will play a crucial role in surgical pathology and cytopathology, engaging with a dynamic and multidisciplinary team.
The work environment within the Histopathology department is characterized by surgical cut-up performed by Consultant Pathologists, Specialty Registrars, and Biomedical Scientists. Two biomedical scientists have completed the Diploma of Expert Practice in Histological dissection (cut-up), with ongoing training for another. Technical staff handle small biopsies, while Consultant Pathologists report all FNA and non-cervical cytology specimens. Although there is no sub-specialization in surgical histology or diagnostic cytology at present, lead pathologists for each cancer site act as contact points within the department, actively participating in multidisciplinary meetings. Importantly, there is no on-call commitment, and the post holder has the option to undertake coronial post-mortem examinations by direct agreement with local coroners services.
Currently, there are six consultant pathologists, with capacity for two more, including the current vacancy. The Histopathology and Blood Science services are fully accredited by UKAS, participating in both interpretative and technical EQA schemes. The hospital itself holds HTA approval as an institution.
Beyond the professional realm, life in the region offers an enviable quality of life in a historic town. The area features a wealth of affordable housing in one of the most attractive parts of Britain, while remaining in proximity to one of London\'s major airports and all the facilities of the capital. Families will find excellent schools and a range of leisure facilities to enhance their living experience. Relocation support, including detailed information through a relocation document, is available for those interested in exploring this exciting opportunity further.
Are you eligible for this role?
To be considered for this role you must meet the following requirements:
- Specialist Registration in Histopathology or
- FRCPath and extensive consultant experience or
- GMC registration with reporting experience in a similar healthcare system