FRCPath Part 2 – a detailed guide for overseas histopathologists 

  • November 05, 2021
 

The final exam in the FRCPath Histopathology series... 

International specialists in histopathology, cellular pathology or anatomic pathology looking to secure a job in the UK via the postgraduate qualification route will need to obtain Fellowship of the Royal College of Pathologists or FRCPath Histopathology by examination only.  

The completion of Part 1 and Part 2 of the Royal College of Pathology qualification for Histopathology results in eligibility for GMC registration (with the addition of the English language component). The FRCPath qualification is recommended for international pathologists looking to securing senior jobs in the NHS.  

The exams can be taken by IMGs from all over the world, provided certain eligibility criteria have been met.

Here we’ll take a closer look into these and other important questions through the following topics - skip to one of these sections if you know what you're looking for:

An overview of FRCPath Histopathology 

The FRCPath Histopathology exams are administered by the Royal College of Pathologists to test a doctor's knowledge and ability to apply this in the practice of histopathology within the scope of the Specialty Training Curriculum for Histopathology.  

The exams are as follows: 

  • FRCPath Part 1 
  • FRCPath Part 2 

To read more about the full FRCPath examination suite via out IMG resources, please click here

Please note that only full FRCPath satisfies the requirements for GMC registration for overseas doctors taking the postgraduate route. Alternative routes to GMC registration include PLAB and licensing exams such as USMLE. You can find out more about alternative routes here

For doctors who are interested in more senior roles in the NHS that are reflective of their current practice, we advise that FRCPath is the best route to take to GMC registration. Histopathology in the UK is consultant-led specialism; and many NHS job postings will have FRCPath as a requirement for doctors who are not on the Specialist Register. In most cases, and FRCPath qualification will help you to attain a locum consultant role. 

What is FRCPath Part 2? 

FRCPath Part 2 is the last exam in the FRCPath qualification. It is designed to recognise candidates who are close to the end of their training who can demonstrate an appropriate approach to independent practice. The assessment consists of six components which are take over a period of two days. The components include both written and face-to-face elements with an examiner where candidates are expected to demonstrate both clinical and practical knowledge as well as special techniques and complex diagnoses. Every section assesses a distinct set of professional skills which are all essential to effective performance ad an independent histopathologist and cytopathologist. 

Am I eligible to sit this exam? 

The FRCPath Part 2 Histopathology exam is open to candidates from every country, provided they have met certain criteria. This includes the expectation that most trainees will sit the Part 2 exam after at least 3 years of specialty training in Histopathology. There should also normally be a 12-month wait between passing the Part 1 exam and attempting Part 2.  

For full details, please see the Royal College website here

How is the exam structured and marked? 

The six stations of FRCPath Part 2 are detailed below: 

Surgical Histology  

Format: 20 x 20 mins stations, 20 cases over 3 hours and 20 minutes.  

This will include twenty cases presented in H&E stained slides in 20-minute slots over 3 hours and 20 minutes. The cases are selected according to a blueprint and include a balanced mix of neoplastic and non-neoplastic material, drawn from a wide range of organ systems. The cases will vary in difficulty from straightforward cases to cases not capable of diagnosis through a single H&E, prompting the use of further techniques and specialist opinions. 

Cytopathology  

Format: 8 x 20 mins stations, 16 cases 

Eight non-gynaecological cases in pairs, in 20-minute slots and will be marked according to pre-determined criteria. 

Macroscopic Pathology 

Format: 2 x 20 mins stations, 4 cases; 20 mins discussion 

Candidates will be provided with photos of 4 cases in the form of gross pathology specimens. Candidates will be provided with clinical information and asked to prepare responses to specific questions and mark on the photos where they would take blocks. There will be two 20-minute slots given to view two cases per slot, followed by a 20-minute discussion with two examiners. The exercise is designed for candidates to show their capabilities in discussing gross pathology and familiarity with block selection in relation to the RCPath Minimum datasets. 

OSPEs 

Format: 2 x 20 mins stations 

The objective structured practical examination (OPSE) includes two 20-minute stations, one of which is a written exercise and the other is conducted face-to-face with two examiners. Topics may include management/ clinical governance type and MDT-type cases, amongst other topics. 

Long Cases 

Format: 4 x 20 mins stations 

Four 20-minute stations of cases which cannot usually be covered by a single H&E section, requiring additional stains. These may include histochemistry, immunohistochemistry and immunofluorescence, among other cases. 

Frozen Sections 

Format: 2 x 20 mins stations, 6 cases; 20 mins discussion 

Six cases for review in two 20-minute stations where candidates should make notes, including a ‘bottom line’ diagnosis only, before discussing these with a pair of examiners in a face-to-face 20-minute station. 

Exam marking  

Each section of the exam is marked against a pre-determined specimen answer with a pass or fail awarded per section. Due to the importance of cellular pathology in medical practice, only a small margin of inaccuracy is allowed. Failure to distinguish across the benign/ malignant boundary (or other similar errors of equal significance in terms of affecting patient outcome) in 15-25% of cases in any section of the exam will result in a failure of the entire exam, regardless of performance in other areas with no leeway to compensate. Final marks will be approved by the Examinations Committee. 

Candidates attempting the FRCPath Part 2 exam have four attempts within which to pass the exam, and 7-years between each sitting to pass the full qualification. 

As an international histopathologist, where can I sit the exam? 

The exam currently takes place twice a year in Spring and Autumn and are held in the UK and in one overseas centre in Irbid, Jordan.  

For up-to-date information on exam centres, visit the Royal College website here

How much will the exam cost? 

The FRCPath Part 2 exam costs £1,416. A breakdown of the cost of the 2019 sitting of the exam can be found on the Royal College website here

How do I apply for the exam? 

Applications for each sitting of the exam open months in advance and are currently closed for the Autumn 2021 sitting. Applications for the Spring 2022 sitting will open in late 2021. Late applications are not accepted. Keep an eye on the Royal College website for up-to-date information on applications here

What is the best way to prepare for the exam? 

There are several resources available to help you prepare for your Histopathology FRCPath exam. As always, we recommend that the best starting point for your study is the Royal College website, particularly the Curriculum for Specialty Training in Histopathology. Your exam is based on this curriculum so familiarising yourself with it as soon as possible will give you the best chance for success. 

Other helpful resources for your study include: 

Regulations and guidelines – before applying for FRCPath exams, the College recommends you read both the general and specialty-specific regulations and guidelines, found below: 

Social media study groups – there are multiple study groups available across different platforms such as Telegram, Facebook, and WhatsApp. IMG Connect hosts study groups for FRCPath Part 2 – these are forums that bring together international doctors from all over the world in one communicative, constructive, and moderated space for learning, sharing, and supporting international histopathologists. 

If you are interested in joining the IMG Connect FRCPath Part 2 study group, please email info@imgconnect.co.uk to speak to our histopathology specialist and request your admission. 

Online courses, videos and other resources - there are some great online courses and resources available to prepare for the FRCPath Part 2 exam. These include everything from full mock exams to mock exams targeting specific sections of FRCPath Part 2 and YouTube videos. You can find a full list of these here, through our IMG resources library. 

FAQs - there is also a Frequently Asked Questions (FAQs) document which the Royal College have compiled to help applicants who have questions about online examinations. You can read this here

#IMG Tips 

  1. Prepare early – getting your revision going as soon as possible will help you avoid those last-minute cramming sessions and increase your chances of passing first time. 
  2. Speak to your senior colleagues and peers – there are so many study materials to choose from - who better to ask for recommendations than histopathologists who have been through the process or are going through it with you? 
  3. Food and drink – there are multiple stations on both days of the exams so make sure you’re prepared with lots of fuel for the day as there may be no access to food. 
  4. Hire a microscope – for applicants for the UK sitting, examination centres will not have microscopes for you to use so you will need to hire one in advance. There are a few companies who rent microscope and you can find these through a quick web search! 
  5. Join the conversation – for news and updates on all things histopathology for IMGs, click here follow IMG Connect on social media and join the conversation. 

I’ve passed the FRCPath exams, what’s next? 

Firstly, congratulations! The FRCPath exams are not easy so this is an incredible achievement. Once you have passed both passed of the FRCPath in Histopathology, your postgraduate qualifications satisfy the requirements for GMC registration. You can now apply for full registration with license to practice. 

Get in touch with our IMG Connect histopathology specialist to discuss your options for specialist jobs in the UK or to find out more about where you fit into the NHS as a histopathology specialist with FRCPath.  

FRCPath also plays a big part in the Certificate of Eligibility for Specialist Registration (CESR) application, the alternative route to the Specialist Register for overseas doctors who did not complete their training in an approved UK training programme. You can find out more about CESR in our guide for international doctors here

The team at IMG Connect hope you find this article helpful and wish you the best of luck in your FRCPath Histopathology Part 2 exam! 

 

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