FRCR (Oncology) - a guide for overseas oncologists

  • May 16, 2023
 

Overseas clinical or radiation oncologists wanting to secure a role in the UK via the postgraduate qualification route will need to attain Fellowship of the Royal College of Radiologists (FRCR Oncology) in order to register with the GMC. FRCR Oncology is the UK Royal College qualification and the recommended route for oncologists looking to work in the UK as a specialist or consultant.

IMGs from any country in the world can sit the FRCR (Oncology) examinations, provided certain eligibility criteria are met.

These are summarised below along with a broad look at the following topics - skip to one of these sections if you know what you're looking for:


What is FRCR Oncology? 

Clincal oncologists become full members of the Royal College of Radiologists and achieve the designation, FRCR, once they have passed the three separate postgraduate medical exams that make up the FRCR (Oncology) examination suite. The FRCR (Oncology) examinations aim to test a candidate’s knowledge and clinical understanding against the Specialty Training Curriculum for Clinical Oncology and the exams are a pre-requisite for anyone looking to go into a specialty training post as an oncologist in the UK. For more senior candidates, absence of FRCR (Oncology) will make it very difficult to attain locum-consultant posts unless you have a recognised equivalent or specialist registration in clinical oncology. 

The First FRCR Examination expects candidates to have acquired a broad knowledge of those subjects that relate to the investigation and management of patients with cancer. Candidates are examined against the Clinical Oncology curriculum. A new curriculum is being implemented from summer 2021, with all trainees expected to transfer to the new curriculum by August 2022 at the latest. Further details are available on the curriculum webpages. If you are unsure what curriculum you should be using for your studies in 2021 then please refer to the Royal College website page discussing the FRCR (Oncology) Part 1 exam here

When registering via the postgraduate route, only full FRCR satisfies the GMC postgraduate requirements for registration as an overseas doctor. There are three parts to the FRCR examinations:

  1. FRCR (Oncology) Part 1 (CO1) > comprises four papers of single best answer (SBA) questions. The written papers for the four subjects are held twice a year over two consecutive days.
  2. FRCR (Oncology) Part 2A (CO2A) (both must be passed in one sitting in order to attain a pass)
    • two separate single best answer papers
  3. FRCR (Oncology) Part 2B (CO2B) 
    • a reporting session
    • a rapid reporting session
    • an oral examination

The FRCR (Oncology) examinations form an essential component of training for clinical or radiation oncologists in the UK. For overseas doctors relocating to the UK, FRCR is one of two options to support full GMC registration (postgraduate qualification or PLAB route). For doctors who wish to secure a senior clinical oncology job in the NHS reflective of their current practice, we advise that FRCR would be the best route to choose. FRCR is often an essential requirement for many job postings in the UK when a candidate does not already have Specialist Registration in Clinical Oncology or a recognised equivalent postgraduate qualification.


Eligibility for FRCR (Oncology): 

First FRCR: To be eligible you must:

  • hold a Primary Medical Qualification (PMQ) that is recognised by the GMC for registration purposes.
  • have completed courses covering the syllabus in the subjects listed below.
    • Cancer Biology and Radiobiology
    • Clinical Pharmacology

    • Medical Statistics
    • Physics
  • There is no requirement to have held a clinical oncology training post in order to attempt the First FRCR Examination.

Final FRCR Part A: To be eligible you must: 

  • have passed the First FRCR examination
  • must have passed the First FRCR examination and have completed three years of supervised clinical oncology training covering the examination syllabus.
  • In exceptional circumstances, with support from the Training Programme Director and at the discretion of the Medical Director (Education and Training), this minimum training period may be reduced to two years and six months.

Final FRCR Part B: To be eligible you must: 

  • have passed the Final FRCR Part A, First FRCR and have completed three years of supervised clinical oncology training 

Content and structure for FRCR (Oncology)

First FRCR Examination: It is delivered through a digital platform and as such is now also available at a larger number of test centres than before. The First FRCR Examination comprises four papers of single best answer (SBA) questions. The written papers for the four subjects are held twice a year over two consecutive days. Further general information on the examination shows in the guidance notes for candidates here, however it can be summarised as below:

Day One Format
Cancer Biology & Radiobiology 50 questions over 2.5 hours
Clinical Pharmacology 40 questions over 2 hours
Day Two Format
Physics 50 questions over 2.5 hours
Medical Statistics 40 questions over 2 hours

Each SBA question comprises a stem (a question or statement) and five items (answers) [labelled (a) to (e)]. Candidates are asked to decide which one of the five items represents the best answer to the question given in the stem. The four modules break down as below:

Cancer Biology and Radiobiology: the processes of cancer cell transformation and tumour development and how these processes may be demonstrated, and the response to ionising radiation of cells both individually and grouped as tissues.

Clinical Pharmacology: the structure, action, use and evaluation of drugs used in the treatment of a patient with cancer.

Medical Statistics: with special reference to clinical trials and assessment of results, and the epidemiology of cancer.

Physics: the application of physical principles and methods in clinical radiotherapy, physical basis of the therapeutic uses of radioactive isotopes, radiation hazards and protection. A knowledge of SI units is expected.


Final FRCR (Part A): The examination expects candidates to have a wide knowledge of malignant disease and the management of patients with cancer. The main emphasis is on radiotherapy and drug therapy, but a good knowledge of general medicine, surgery and gynaecology is expected. You will be examined against the specialty training curriculum for clinical oncology and the clinical oncology syllabus. The Final FRCR (Part A) Examination comprises two papers of 120 single best answer (SBA) questions. It is held twice a year, normally in February and August/September and you are given three hours to answer each of the papers. Read the college's Purpose of Assessment to see this information in detail - however below we summarise the content and structure for FRCR Part A.

Paper 1
Tumour Type No. of Questions
Respiratory  24
Urology  24
Head & Neck  24
Skin  12
CNS 12
Gynaecology 24

 

Paper 2
Tumour Type No. of Questions
Breast  24
Lower Gastrointestinal 24
Upper Gastrointestinal 12
Haematology 12
Miscellaneous* 38
Image-based 10

*The miscellaneous section contains questions on thyroid cancer, sarcoma, unknown primary, regulations, palliative care and a small set of questions that do not specifically fit into a defined site specific category.

FRCR Part 2B (Oncology) (CO2B): The exam requires you to have a wide understanding of malignant disease and management of patients with cancer. The biggest emphasis here is radiotherapy and drug therapy, though a strong knowledge of general medicine, surgery and gynaecology is expected also. You will be examined against the specialty training curriculum for clinical oncology and the clinical oncology syllabus.

The exam has both a clinical and oral component. Read the Royal College's Final FRCR Purpose of Assessment to understand the format and content in more detail, however a brief summary of both part is below:

Clinical Examination: This is the practical element and will involve you rotating round five strictly timed clinical assessment 'stations' where your skills are assessed by a pair of examiners. This part is to test the skills and competencies that are essential for safe and effective clinical practice as a clinical oncologist in the NHS. Patients with real clinical signs are used throughout this examination, allowing you to demonstrate your knowledge and judgment in as a realistic a scenario possible. 

The clinical examination will assess your ability to:

  • identify important clinical signs using effective examination techniques
  • give a rationale differential diagnosis
  • order and interpret appropriate investigations
  • identify the main treatment options
  • select an appropriate, safe and sensible management plan
  • recommend a safe radiotherapy technique, understanding and communicating the likely outcomes & side effects
  • recommend a safe systemic treatment schedule, understanding and communicating their likely outcomes and side effects
  • clearly discuss a likely prognosis in the case presented
  • clearly demonstrate an ability to treat the patient sensitively, ensuring their comfort and dignity

Oral Examination: The structured oral examination assesses in-depth issues surrounding radiotherapy planning, diagnostic imaging and clinical decision-making and case management. Communication and ethical scenarios are addressed during this examination. It will mirror day-to-day clinical discussions and MDT meetings, essential elements to a Clinical Oncologist's role in the UK. There are several slides per question, and your answers can lead to further questions on subsequent slides by the examiners. The questions build as the discussion develops, and this oral examination allows each step of the case to be assessed and discussed as it would be in a real-life clinical scenario. 

The structured oral examinations allow for fair, valid and reliable assessments due to:

  • uniformity of questions asked
  • pairing of examiners (junior and senior) allowing for ongoing training and accurate data capture and marking
  • four independent judgments of your performance
  • the examination is blueprinted against both the curriculum and the range of RCR-designated skills required to be a competent oncologist in the NHS
  • the use of an objective marking scheme which details the essential points required to pass each question

As an overseas candidate, where & when can I sit the exams and how much will they cost me? 

This link takes you to the examination updates section. Information on the dates, fees and venues for the FRCR examinations can found here. 


How do I apply for the FRCR (Oncology) examinations?

UK Trainees are given priority for examination places, whilst overseas candidates are offered the remaining places via a ballot system following the application closing date. If you've had your exam deferred due to cancellations over the last year, you will be prioritised. 

The Royal College urges anyone applying to read the examinations guidance before doing so. Applications are made online via the Royal College website here.


How should I prepare for the FRCR (Oncology) exams? 

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 prepare, see below: 

Syllabus: The syllabus should always be your go-to for your studies. This is what you will be tested on, so it should be the foundation of your studies and preparation. As of May 2021 the new curriculum has been approved by the GMC but is pending full publication. You can find this on the Royal College website here.

Clinical Oncology Curriculum implementation tools - a variety of tools are available to support the implementation of the new curricula. This page is very useful and has many different tools within the page. You can access it here.

Remote proctoring guidance - this is a new system and as with anything techy, problems can arise! Use this section of the Royal College to familiarise yourself with the new system with the new normal. Access this page here.

First FRCR examiners' reports - a guide for candidates and trainers preparing for future sittings. Access this here.

Trainees share their experiences of the Final FRCR examination - a two-part audio series featuring trainees talking about their experiences of preparing for and taking the examination.

Final FRCR examiner reports - a guide for candidates and trainers preparing for future sittings. Access the examiner reports archive here.

Final FRCR Part B demonstration films - clinical and oral demonstration videos. Access the Part B demonstration films here.

Sample oral questions - sample questions for the oral component of the Final FRCR Part B examination. You can access the sample questions here.

Connect with the Royal College - connect with the Royal College on YouTube to see their numerous videos that can be used for training and information purposes. Their channel can be found here.

IMG Oncologists

Join the IMG Oncologists Facebook group for access to a community of like-minded FRCR (Oncology) aspirants and dedicated oncology recruiters.

In this group you will find tailored resources for oncology IMGs, including access to our FRCR (Oncology) crash courses, completely free to all doctors.

You can access our IMG Oncologists community here.


I passed the FRCR Oncology exams! What next?

First of all, congratulations! After you have passed all three parts of your FRCR examinations, you can apply for a full registration with a license to practice. Once the GMC has approved your application, you can work as a doctor in the UK. This exam will form an integral part of any CESR application (if that is your route to specialist registration) and in most cases, if you have previous and relevant experience, will allow you to practice as a locum consultant clinical oncologist whilst you are not an accredited specialist on the specialist register. 

For regular news and updates, follow IMG Connect on social media using the links below: 

            

 

Relevant Jobs

£93,666-£126,281

We are currently looking for an experienced Clinical Oncologist, who works with both chemotherapy and radiotherapy treatments for a large acute hospital in the Midlands, England.

You\'d be joining a team of 8 clinical and 2 medical oncology consultants at the modern Oncology Centre (opened in mid 2010\'s), to help support and develop site-specific services in outpatient and chemotherapy as part of the development of the centre. 

There are 3 Elekta LINACS with VMAT and IGRT, using Mosaiq and Raystation for RT planning on site, along with 35 chemo day chairs used across 3 hospitals under this NHS trust.

JOB REQUIREMENTS:

  • FRCR Clinical Oncology or equivalent
  • Excellent english language skills
  • Extensive experience as a consultant oncologist (UK or overseas experience)

LENGTH OF CONTRACT:
12 - 24 months fixed term (subject to be renewed)

Benefits:

  • Attractive salary and relocation package
  • Training and development opportunities
  • CESR support for those eligible
  • Tier 2 Health and Care Visa (sponsorship for the whole family)
  • Guidance regarding the CV and full interview preparation
  • Assistance regarding the GMC registration, visa, accommodation and transportation by an experienced onboarding specialist
  • Complete IMG Relocation service from start to finish of process

GRADE:
Locum Consultant

Specialty & Special Interests:
Clinical Oncology with primary interest in Gynaecological and Upper GI cancers

£93,666-£126,281

An exciting NHS job opportunity is open for a Consultant Clinical Oncologist specializing in Lung & Breast Cancer at an NHS Trust that has been rated \"good\" over all by the CQC. This NHS Trust has undergone significant development, emphasizing patient and community care excellence. With £58 million in national funding, the Trust boasts a University Hospital status, prioritizing research, education, and training. The Care Quality Commission (CQC) lauds the Trust\'s outstanding performance, with 992 beds and 92% patient recommendation, serving a population of 675,000.

This position aims to strengthen the Oncology team, focusing on lung cancer care and Stereotactic Ablative Body Radiotherapy (SABR). Situated at the dynamic centre within the \"good\"-rated trust, the role contributes to systemic treatment advancements and ongoing research. The Oncology Department at the Combined Haematology Oncology Centre caters to 1-1.5 million residents. Designated as a Cancer Centre since 1996, the Centre collaborates with neighboring hospitals, fostering a multidisciplinary approach. The purpose-built Cancer Centre, equipped with advanced imaging, provides nurse-led services, chemotherapy units, and home-delivered immunotherapy.

The post holder is expected to: 

  • Participate in all facets of departmental activity.

Career development at the Trust includes access to CESR support, specialty training, and opportunities for external duties. The forward-thinking Oncology department initiated SABR practices in 2021 and maintains a dynamic research team supporting various clinical trials.

Life in the area, a historic home of the Royal Navy, offers cultural richness and proximity to scenic countryside. A thriving artistic community, excellent schools, and various development projects contribute to the vibrant atmosphere. The area combines city conveniences with picturesque villages, making it an excellent place to raise a family!

This comprehensive opportunity integrates the Consultant role, SABR RT specialisation, CESR support, and coastal life in the UK, creating a fulfilling and enriching professional and personal experience. 

AM I ELIGIBLE FOR THIS ROLE? 

EEA Candidates: 

  • Recognised European Medical Degree or Specialist Qualification

Non-EEA Candidates:

  • FRCR or equivalent qualification 

UK Based Candidates: 

  • FRCR qualification

This is a great opportunity for any experienced consultant clinical oncologist working towards CESR in Clinical oncology specialist registration in the UK.

£87,354-£113,408
A Cancer Centre in Wales are looking for a Consultant or Specialist in Medical Oncology with a sub-specialty interest in AOS/Melanoma. They are considering either UK or Overseas trained doctors for a permanent or fixed term contract type. The trust will support with CESR support and/or those looking to enter specialty training in the NHS.

This is a high performing and supportive department for overseas doctors new to the NHS, or UK-based doctors looking to further careers in the UK, and a great opportunity for any overseas oncologists looking for CESR support and great career development in a beautiful part of England, filled with sandy beaches and offering vibrant city living.

What is the Welsh Health Board like?

The Health Board are one of the biggest healthcare groups in the UK, providing primary, community, mental health and acute hospital services for the population of around 390,000. They have a budget of around £1bn and employ approximately 12,500 staff. Besides their three major hospital sites, they are also responsible for community hospitals, health centres, clinics, mental health units, community teams, GP practices and other services provided by dentists, opticians and pharmacists. Their mission is to improve the health, wealth and wellbeing of the people of Wales and the rest of the world.

What is the Oncology Department like?

This Cancer Centre provides a high degree of specialisation for all the major cancers. It has one dedicated ward of 30 beds (with scope to increase to 36 beds at periods of high demand) for both oncology and haematology patients, together with a chemotherapy and haematology day unit, and an aseptic unit on site. There are also two laminar flow rooms for patients requiring bone marrow/stem cell transplantation and one dedicated room for radioactive isotope therapy.

There is a state of the art telemedicine facility allowing regular multi-professional meetings between oncologists, physicians, surgeons and AHPs in Wales. The system has the capacity to transmit and view both high quality radiological images and histopathological slides.  

The staff are highly experienced, consisting of nurses, radiographers, research officers and admin staff. The new consultant will be joining a friendly and forward-thinking consultant team of clinical and medical oncologists who are committed to delivering highest standards of cancer care, alongside a large team of other clinical and non-clinical professionals.

What Career Development and Opportunities are available?

The Cancer Centre is heavily involved in training which takes place at all levels from undergraduate lectures and clinical teaching, through to Foundation and Core Medical trainee clinical and educational supervision, and higher specialist training. They will also provide excellent CESR support.

Life in South Wales

Based in South Wales, the area is fast becoming one of the most popular places to live in the UK. This waterfront location is actually Wales’s second most populated city and county, offering all the benefits and amenities of a built-up urban environment, alongside a 5 mile stretch of a pristine, sandy coastline. 

The city is home to multiple live music venues, showcasing everything from small gigs to orchestral performances. Annually, the city hosts a number of different festivals, attracting artists from across Wales and the UK. Today, new regeneration is planned which will only increase its popularity, amenities, and modernity. The city is experiencing a period of development and a resurgence of new business and investment, with the city council focusing on creating a culture of creativity and an emphasis on attracting tech led businesses.

The area also has good travel links. It is an easy drive to Port Talbot and Cardiff and you can get to London via the M4, and around Wales on the A48. There are also regular trains to Cardiff, Newport and London. For international and domestic flights, Cardiff Airport is just 44 miles away.

Am I eligible for this role?

EEA candidates: 
•    Recognised European Medical Degree or Specialist Qualification in Medical Oncology
•    Extensive experience in AOS/Melanoma oncology
  
Non-EEA candidates: 
•    MRCP
•    Extensive experience in AOS/Melanoma oncology
 
UK-based candidates: 
•    Extensive experience in AOS/Melanoma oncology
•    Within 6-months of CESR or CCT in Medical Oncology

This is a great job for any experienced overseas Medical Oncologists working towards CESR and specialist registration in the UK.
£50,000-£126,281
A cancer centre in the South West of England are looking for a Consultant in Clinical Oncology with any sub-specialty interest. They are considering either UK or overseas-trained doctors for a permanent contract type. The trust will support with CESR support for those who are looking to attain CESR and Specialist Registration.

This is a high performing and friendly department for overseas doctors new to the NHS, or UK-based doctors looking to further careers in the UK, and a great opportunity for any overseas consultant oncologists looking for CESR support and great career development in a beautiful part of England.

What is the NHS Trust like?

This NHS Trust is the first NHS Trust on the English mainland to provide community, mental health and acute hospital services. It was formed from the merger of two trusts on the 1st April 2020. Now, they are preparing to merge with another trust so that they are better able to support the health of all the people in the area.

The trust provides a range of services from 13 community hospitals including outpatient and diagnostic services, 190 inpatient beds and seven Minor Injuries Units. They also provide specialist mental health services, healthcare for adults with learning disabilities, medical and surgical care, maternity services and cancer treatment services. The trust\'s facilities for the treatment of cancer have undergone a major expansion, culminating in the opening of the Cancer Centre in May 2009.

What is the Oncology Department like?

The Oncology Department provides Clinical and Medical Oncology inpatient and outpatient services as well as radiotherapy and chemotherapy to all common tumour sites. The new appointee will be joining an ambitious team of 12 Consultant Oncologists (8 Clinical & 4 Medical), 1 Associate Specialist (Medical Oncology), 3 Speciality Doctors, and a rotation of junior doctors who cover the inpatient ward. There are also two Clinical Oncology ST3 doctors. It is a research orientated department with a dedicated clinical trials team and are one of the highest recruiters within the South West and nationally for a number of trials. 

The new consultant will be working within the Cancer Centre which provides cancer care to a population of approximately 500,000. It has received a number of accolades since opening in 2009 for the high quality care delivered. These include CHKS ISO 9001 accreditation, Macmillan Quality Environment Mark score of 5 (out of 5) on all principles and in the 2018 National Cancer Patient Experience Survey, the Beacon Centre was ranked third overall which is an excellent reflection of the patient centred care delivered.

What Career Development and Opportunities are available?

There is real opportunity to progress through CESR at pace at this trust, with a strong desire for newly-qualified consultants to develop their specialty areas of interest and undertake in various cancer trials and research projects where possible. Research is encouraged here, particularly when this is appropriate to professional development and to the service development of the department. Opportunities are available with applications for funding co-ordinated by the Trusts Medical Directors and clinical trial recruitment to International, National and Regional trials is active in all tumour sites. This trust was also rated as an area of Outstanding Practice by CQC (2016), and with the highest GMC score in the South West for training.

Life in the area:

This area has diverse shopping, restaurants, and regularly hosts international music and sporting fixtures. It is located between various areas of outstanding natural beauty, featuring national hotspots for cycling, surfing, and climbing. There’s plenty to keep you occupied alongside the abundance of music festivals and local traditions. The area is in close proximity to both the beaches of North Devon and Cornwall, while also being less than two hours from the city of London. 

It also offers some of the best schools in the country. Ranging from public institutions to award winning state schools with one being ranked in the top 10 of A-level providers nationally for the last eight years.

Am I eligible for this role?

Non-EEA candidates: 

  • FRCR (Clinical Oncology)

EEA candidates: 

  • Recognised European Qualifications 

UK candidates: 

  • Within 6 - 12 months of completing CCT
£55,329

Are you a Clinical Oncologist looking for a rewarding opportunity in the UK? An excellent NHS Foundation Trust is seeking a talented professional to join their oncology team. With a commitment to collaborative working, this NHS Foundation Trust provides excellent oncology services and ample opportunities for training, research, and career development. The trust is supportive of CESR applications.

The Oncology Department takes a collaborative approach to cancer care, with teams in two sites working together to provide comprehensive and sustainable services. Equipped with state-of-the-art technology, the Cancer Centres offer a multidisciplinary approach, supported by Acute Oncology Teams and a skilled team of healthcare professionals. The post holder will have the opportunity to immerse themselves in an NHS Role as part of a well-equipped, modern oncology department.

The department sits within an NHS Trust that is known to be the leading healthcare provider in East Anglia, serves a population of nearly 800,000 residents across two main hospitals, six community hospitals, and various clinics. With a budget exceeding £650 million, the NHS Foundation Trust invests in enhancing their hospitals and creating an ideal working environment. They prioritise the well-being of their staff and patients, offering exciting prospects for development, innovation, research, education, and training.

Additional to the opportunity of working for a great NHS Foundation Trust, living in the area offers a diverse and vibrant lifestyle. Essex, with its stunning coastline, beaches, and countryside, provides a great environment for families. The county offers a range of housing options, urban or rural, at affordable prices. With excellent transport links to London, you can enjoy the benefits of both city and countryside living. Furthermore, Essex boasts good schools and a high quality of life, making it an ideal place to settle and explore nature\'s playground.

Join them to make a significant impact in the field of oncology while enjoying a fulfilling career and a balanced lifestyle in a beautiful region of the UK.

AM I ELIGIBLE FOR THIS ROLE?

To be eligible for this vacancy you will need the following:

EEA Candidates:

  • Recognised European Medical Degree or Specialist Qualification in Clinical Oncology
  • IELTS or OET

Non-EEA Candidates:

  • MRCP/FRCR/PLAB qualifications
  • Experience in Oncology
  • IELTS or OET

UK-Based Candidates:

  • MRCP or equivalent MD qualification
  • 2 years post-registration clinical practice

This is a great opportunity for any experienced Oncologist working towards CESR in the UK and Specialist Registration in Oncology. There will be opportunity to develop and lead on sub-specialist areas of cancer care.

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