FRCPath in Histopathology – an overview

  • April 05, 2022
 

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?

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

105,504 to 139,882

A leading NHS hospital in South West England is looking for a Consultant in Histopathology with an interest in general histopathology and non-gynae cytology, with opportunities to develop a special interest. The Histopathology department consists of a team of highly experienced consultants, supported by middle-grade doctors. This Histopathology job is open to both international and UK-based applicants, though those with FRCPath or equivalent qualifications are particularly encouraged to apply.

Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case-by-case basis.

JOB REQUIREMENTS AND DETAILS

FRCPath or equivalent qualification and CCT within 6 months of interview (or international equivalent) with experience in general histopathology and non-gynae cytology are required for this role, and The salary will be between the standard NHS Consultant pay scale, with salary dependent on experience or grade.

CORE DUTIES OF THIS ROLE

  • Provide high-quality histopathology and non-gynae cytology diagnostics.
  • Participate in MDT meetings and offer expert histopathological opinions.
  • Engage in teaching and mentorship of junior doctors and medical students.
  • Contribute to audit, governance, and quality assurance initiatives.

LIFE IN SOUTH WEST ENGLAND

This hospital is located in a thriving town in South West England, offering urban living with access to quieter rural surroundings. The region provides excellent schools, strong transport links to major cities, and a variety of recreational activities, including beaches, national parks, and cultural festivals.

Historically, the area is known for its medieval landmarks, natural beauty, and rich cultural heritage, making it an excellent location for both professional and personal life.

HOW WILL IMG CONNECT SUPPORT YOU?

When applying with IMG Connect you’ll have the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We\'ll support you with:

  • CV Preparation with a bespoke session with one of our specialists
  • Application support with expert knowledge of NHS specialisms & recruitment practice
  • At least two video calling interview preparation sessions
  • Contract and offer negotiations for salary, relocation packages, tenure, and more

Once you have accepted your new role, you’ll then be supported and led throughout by one of our dedicated relocation executives who will guide you through all the way to starting your new role, including:

  • Document gathering and checking
  • COS and Visa Application support if applicable
  • Support sourcing short- and long-term accommodation
  • Travel Arrangements
  • Family support for finding schools and any other aspects of pastoral care
105,504 to 139,882
A teaching hospital in South England are looking to appoint a consultant histopathologist on a remote basis to report digitally for uro-pathology, skin, and breast pathology cases. Should candidate wish to be based on site, or with a hybrid work pattern this can of course be facilitated. 

Cellular Pathology Services

The Cellular and Anatomical Pathology Department encompasses histopathology, cytopathology, neuropathology, and anatomical pathology. Annually, it processes approximately 38,000 surgical biopsies, 2,000 non-cervical cytology samples, and conducts around 1,100 postmortem examinations.

The department is staffed by a multidisciplinary team, including consultant pathologists, biomedical scientists, and technical specialists. Services provided involve diagnostic evaluations of tissue samples to identify diseases such as cancer and precancerous conditions, utilizing techniques like special stains, immunocytochemistry, electron microscopy, and molecular methods. The department\'s facilities are equipped to deliver timely and accurate diagnoses, with most straightforward biopsies reported within 14 working days.

Eligibility

Working arrangements can be discussed openly, with an understanding that flexible working and full off-site reporting is accepted and offered for those requiring so, and with specialist registration NHS consultant experience are invited to apply. 
107,144 - 142,369

A teaching hospital in Scotland is looking for a Consultant in Cellular Pathology with an interest in gastrointestinal and/or hepatobiliary pathology. The pathology department comprises a team of 15 consultants and is supported by a team of specialty trainees and biomedical scientists. This Cellular Pathology job is open to both international applications and UK-based doctors, though those with European Specialist qualifications or FRCPath are most encouraged to apply.

Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case-by-case basis.

JOB REQUIREMENTS AND DETAILS

FRCPath or equivalent and at least five years of training in pathology are required for this role. Anyone with an interest in gastrointestinal and/or hepatobiliary pathology should apply. The salary will be between £107,144 - 142,369, dependent on experience or grade.

CORE DUTIES OF THIS ROLE

  • Provide diagnostic histopathology and/or cytopathology services, with a focus on gastrointestinal and hepatobiliary pathology.
  • Participate in multidisciplinary team meetings, ensuring quality case discussion and consensus.
  • Contribute to the training and supervision of pathology trainees and biomedical staff.
  • Engage in continuous service improvement and audit activities to maintain high-quality standards.

LIFE IN SCOTLAND

This hospital is located in a vibrant city by a major river, offering a mix of urban and rural living. Popular areas for living include both lively city neighborhoods and tranquil countryside settings.

The region boasts excellent schools, convenient transport links to major cities, and leisure activities including hiking, cycling, and cultural venues like museums and concert halls.

Historically, this area has been a center for innovation, with a strong reputation for industries ranging from life sciences to creative technology.

HOW WILL IMG CONNECT SUPPORT YOU?

When applying with IMG Connect you’ll have the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We\'ll support you with:

  • CV Preparation with a bespoke session with one of our specialists
  • Application support with expert knowledge of NHS specialisms & recruitment practice
  • At least two video calling interview preparation sessions
  • Contract and offer negotiations for salary, relocation packages, tenure and more
  • Once you have accepted your new role, you’ll then be supported and led throughout by one of our dedicated relocation executives who will guide you through all the way to starting to your new role including:
  • Document gathering and checking
  • COS and Visa Application support if applicable
  • Support sourcing short- and long-term accommodation
  • Travel Arrangements
  • Family support for finding schools and any other aspects of pastoral care
105,504 to 139,882
A NHS histopathology department in the North East of England are looking recruit experienced NHS histopathologists for remote digital reporting posts. This is a salaried full-time NHS position and can offer work in one specialty or multiple, ether part or fully remote. 

Eligibility for these roles:
  • Specialist Registration in Histopathology with the GMC - this is essential and candidates cannot be considered without this.
  • Strong experience reporting histology in one or multiple organ systems 
105,504 to 139,882
An NHS Trust is looking for a Consultant Histopathologist with an interest in GI & dermatopathology. The Histopathology department comprises a team of consultants and is supported by a large team of middle-grade doctors. This role is open to both international and UK-based doctors, with portfolio support for CESR available.

JOB REQUIREMENTS AND DETAILS
  • FRCPath or equivalent and Full GMC Registration are required.
  • The salary will be competitive and dependent on experience.

CORE DUTIES OF THIS ROLE
  • Provide histopathology services for diagnostics.
  • Participate in the Bowel Cancer Screening Programme.
  • Collaborate in academic and educational activities.
  • Contribute to digital Histopathology system development.

LIFE IN THE REGION
The position is based in a city offering a mix of urban amenities and scenic rural living options. Families will find excellent schools, easy access to transport, and a range of leisure activities. The region has a rich cultural and historical significance.

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