Final FRCR Oncology – A Guide for Overseas Clinical Oncologists

  • September 15, 2021
 

FRCR Part 2A and Part 2B are the final exams in the FRCR qualification.

Completion 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 - skip to one of these sections if you know what you're looking for:


An overview of FRCR (Oncology) 

FRCR (oncology) are 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 Oncology.  

The exams are as follows: 

  • FRCR Part 1 – CO1 
  • FRCR Part 2A - CO2A  
  • FRCR Part 2B – CO2B 

You can read an overview of the full FRCR Oncology examination suite here via our IMG Resources section. 

Please note that only full FRCR satisfies the postgraduate requirements for overseas doctors. 

Alternative routes to GMC registration include PLAB or other recognised GMC qualifications or licensing exams, such as UMSLE or FRANZCR (radiation oncology) which you can find out more about here

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 of NHS job postings where candidates are not already on the Specialist Register for Clinical Oncology, so this route allows candidates to better align their qualifications with the specifications of relevant jobs. 


What are FRCR (Oncology) Parts 2A and 2B? 

FRCR Part 2A and 2B form the final two parts of the FRCR examination suite. These assessments expect candidates to have a wide knowledge of subjects related to the investigation of malignant disease and the care of patients with cancer. Whilst the focus is on drug therapy and radiotherapy, there is also the expectation of a good understanding of other key areas such as general medicine, surgery and gynaecology. 

Am I eligible to sit these exams? 

Eligibility for FRCR Parts 2A and 2B are as follows: 

Final FRCR Part A (CO2A): 

  • Passed the first FRCR examination (CO1) 
  • Acquired at least 24 months of training in a clinical oncology role by the date of the examination 

Final FRCR Part B (CO2B): 

  • Passed the first FRCR examination (CO1) 
  • Passed the Final FRCR examination Part A (CO2A) 
  • Acquired at least 36 months of training in a clinical oncology role by the date of the examination 

How are the exams structured and marked? 

All parts of the examination suite are assessed against the specialty training curriculum for clinical oncology and the clinical oncology syllabus. A new curriculum has been implemented as of summer 2021, and all trainees are expected to have transferred to this curriculum by August 2022. Further information on this can be accessed on the curriculum webpages

Final FRCR Part A (CO2A): 

This exam comprises two papers which include 120-question single best answer (SBA) questions each. The time limit for the exam is three hours and ordinarily, candidates are not allowed more than six attempts at FRCR exams.  

CO2A Paper 1

Tumour Type 

Number of Questions 

Respiratory 

24 

Urology 

24 

Head and neck 

24 

Skin 

12 

CNS 

12 

Gynaecology 

24 

CO2A Paper 2

Tumour Type 

Number of Questions 

Breast 

24 

Lower GI 

24 

Upper GI 

12 

Haematology 

12 

Miscellaneous* 

38 

Image-based 

10 

*The miscellaneous section will contain questions on sarcoma, thyroid cancer, unknown primary, palliative care, regulations, and a few questions which do not belong to any define site specific category. 

Each individual SBA question has a stem (a question or statement) and five answers, and candidates must decide which of the five best represents the answer to the stem question. Essentially, this is a multiple-choice exam. One mark is given for each correct answer and zero marks for incorrect answers. As the exam is not marked negatively, candidates are encouraged to provide an answer all the questions. 

Final FRCR Part B (CO2B): 

This exam has two components (clinical and oral) which are designed to test different aspects of the candidate’s oncological skills, necessary elements for effective and safe practice. The format allows the for the assessment of skills which are not as easily addressed in a written format. 

CO2B Clinical Examination:

This component is practical and involves the use of real patients to increase authenticity in attempts to reflect situations that may present in a clinical setting. The cases are selected for the exam to test common tumour types. The examination itself has five strictly-timed clinical assessment ‘stations’ where certain core clinical skills are tested by a pair of examiners. The use of an objective marking system aims to minimise bias and ensure consistency across examinations for all candidates.  

Candidates are assessed on their ability to: 

  • Detect important clinical signs using effective exam techniques 
  • Provide a rational differential diagnosis 
  • Order and interpret appropriate investigations 
  • Identify the main treatment options 
  • Select and appropriate, safe, and sensible management plan 
  • Recommend a safe radiotherapy technique, know the likely outcomes, and side effects 
  • Recommend a safe systemic treatment schedule and know their likely outcomes and side effects 
  • Discuss a likely prognosis in the case presented 
  • Demonstrate an ability to treat the patient sensitively, ensuring their comfort and dignity 

CO2B Oral Examination:

This examination assesses in depth issues related to radiotherapy planning, diagnostic imaging and clinical decision-making, and case management. Communication skills and ethical problems are also addressed.  

This element of the FRCR Part 2B exam is designed to mirror day-to-day clinical discussions and MDT meetings which feature heavily in the workload of an oncologist. This section is designed to test the depth of a candidate’s knowledge and higher cognitive skills. There are several slides per question and a candidate’s answer may lead to further questions on subsequent slides, with each question building on from the previous ones. 

The Royal College of Radiologists states that a fair, valid and reliable assessment is made possible due to: 

  • Uniformity in the questions asked to candidates 
  • The pairing of examiners (junior and more experienced) 
  • Four independent judgements of the candidate performance 
  • Prior choosing of the competencies to be assessed 
  • The exam having been blueprinted against the curriculum and necessary skills for competent oncologists 
  • An objective marking scheme 

For more information on the components and assessment of these examinations, read the Purpose of Assessment which can be found on the College’s website in the exam section


As an international oncologist, where can I sit the exams?  

The exams are held twice a year, normally in February and in either August or September. Applications are normally open for just under two weeks, several months before the exam. Please refer to the examinations page for up-to-date information on application dates.

The current UK venues for the exams are Belfast, Birmingham, Crewe, Edinburgh, Glasgow, Leeds, London, and Bridgend Wales. Overseas centres for now are India and Malta. 


How much will the exams cost? 

The cost breakdown for each of the final exams is as follows: 

FRCR Part 2A (Oncology): 

  • Members - £385 
  • Non-members - £453 

FRCR Part 2B (Oncology): 

  • Members - £549 
  • Non-members - £647 

How do I apply for these exams? 

UK trainees are given priority for examination places, followed by those who have had exams deferred over the last year due to cancellations. The remaining places are offered to all other candidates through a ballot system following the close of priority applications. 

All candidates should apply for the exams through the Royal College website here. More detailed information can also be found here in relation to preparation for the application. 

What is the best way to prepare for the exams? 

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 Royal College’s website, particularly with the Specialty Training Curriculum for Clinical Oncology and the Clinical Oncology syllabus

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. These can be accessed here

Other useful resources to aid your studies include: 

  • Learning hub: available to members through the Royal College website and contains many useful learning resources. The learning hub can be found here.
  • Clinical Oncology Curriculum Implementation Tools: a range of tools compiled by the RCR to support the implementation of the new curricular which all candidates should have transferred to by summer of 2022 at the latest. Access this here.
  • Sample Questions: sample oral questions for FRCR Part 2B. These are provided with answers and can be found here
  • Examiners' Reports: a guide for candidates for future sittings, based on the experiences of examiners with previous applicants, found here
  • Trainees' experiences: a two-part audio series compiled from the experiences of candidates in preparation for and sitting the final exams which is available here
  • Demonstration films: clinical and oral demonstration videos for FRCR Part 2B which can be accessed here
  • Royal College YouTube: several helpful videos which can be used for training and informational purposes on their YouTube channel

I’ve passed the FRCR Oncology exams! What’s next? 

Firstly, congratulations - passing these exams is a massive achievement! With all parts of the FRCR Oncology complete, you can now apply for full GMC registration with a license to practice. With this application approved, you can work as a doctor in the NHS. 


FRCR Oncology, consultant posts and CESR 

For international candidates interested in attaining specialist registration in Clinical Oncology via CESR, these exams form a key part of the application. For IMGs with previous senior experience, this could also allow you to attain a locum consultant clinical oncology post whilst you are not yet accredited as a specialist in the UK. 

 

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