FRCPath in Histopathology – an overview

  • August 19, 2021
 

Overseas Histopathologists wanting to secure a job 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:


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 eligibilty 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 (SBAQs) 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 to. 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 Spring 2021, 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): Discussions are starting to take place about the possibility of delivering at least the Histopathology FRCPath Part 2 examination at an overseas centre in Autumn 2021. The Royal College is trying to accommodate as many international candidates as possible in the Autumn but priority will be given to the candidates entered for the January sitting. 

The Spring session was delayed for overseas candidates given the state of the pandemic in the UK at the time and priority on Part 2 spaces will be given to those required to differ theri application. It is anticipated that the Royal College will open additional centres and exam dates to process the backlog of applicants, however this will only be clarified once the COVID-19 situation has been brought under more control globally. Keep an eye on the RCPath website for the most up-to-date news on royal college 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.


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. You can find more information about CESR in Histopathology here.

 

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