FRCR (Oncology) - a guide for overseas oncologists

  • November 09, 2021
 

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

£59,175 - £95,400

An NHS Trust in the South West of England is looking for a Specialty Doctor in Oncology with an interest in Acute Oncology and Chemotherapy Services. The Oncology department comprises a team of consultants, senior nursing staff, and a multidisciplinary team, supported by a large team of middle-grade doctors. This Oncology job is open to both international applications and UK-based doctors, though those with European Specialist qualifications or MRCP/MRCPath 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

At least four years of postgraduate training, including two years in a relevant specialty, and full GMC registration are required for this role. Anyone with an interest in Acute Oncology and Chemotherapy Services should apply. The salary will be between £59,175 and £95,400 dependent on experience or grade.

CORE DUTIES OF THIS ROLE

  • Provide continuity of care for patients being treated in the Oncology Day Unit and supervise patients admitted to medical wards with chemotherapy-related side effects.
  • Participate in Acute Oncology Service (AOS) and multidisciplinary team (MDT) meetings, liaising with consultants and specialist teams.
  • Supervise chemotherapy administration, assess patients prior to treatment, and follow up on recently discharged patients.
  • Support clinical trials by assisting in patient recruitment and follow-up.

LIFE IN THE SOUTH WEST OF ENGLAND

This Trust is based in a lively city in the South West, offering a mix of urban and coastal living, with popular residential areas including city suburbs and the countryside. The region provides excellent schools, strong transport links across the UK, and a range of cultural and recreational opportunities for professionals and families. The city has played a crucial role in British maritime and engineering history and continues to be a hub for innovation and creativity.


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
£96,990 - £107,155

An NHS Trust in the West Midlands is looking for a Specialist Doctor in Clinical Oncology with an interest in Neuro-Oncology and Lower-GI cancers or Lung and thoracic malignancies. The Oncology department comprises a team of over 20 consultants and is supported by a large team of middle-grade doctors. This Oncology job is open to both international applications and UK-based doctors, though those with European Specialist qualifications or FRCR 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

10 years of oncology experience in a middle-grade role and full GMC registration are required for this role, and anyone with an interest in Neuro-Oncology and Lower-GI cancers or Lung and thoracic malignancies should apply. The salary will be between £96,990 and £107,155 dependent on experience or grade.

CORE DUTIES OF THIS ROLE

  • Provide specialist Clinical Oncology input, including expertise in radiotherapy and Systemic Anti-Cancer Therapy (SACT).
  • Support site-specific MDTs (Multidisciplinary Teams) in either Neuro-Oncology and Lower-GI cancers or Lung and thoracic malignancies.
  • Deliver outpatient and inpatient care, including radiotherapy planning and chemotherapy prescribing.
  • Contribute to the Acute Oncology Service and provide ward inpatient care.

LIFE IN THE WEST MIDLANDS

This Trust is located in a major city in the West Midlands, offering easy access to both vibrant urban areas and picturesque rural locations. Popular residential areas nearby include a mix of city living and countryside retreats. The region offers excellent schools, strong transport links to major UK cities, and a range of cultural, shopping, and leisure options. Historically, this area has played a vital role in Britain\'s industrial and automotive history and is home to a number of significant landmarks.


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
£96,990 - £107,155 N/A

An NHS Trust in the West Midlands is looking for a Specialist Doctor in Clinical Oncology with an interest in Neuro-Oncology and Lower-GI cancers. The Oncology department comprises a team of over 20 consultants and is supported by a large team of middle-grade doctors. This Oncology job is open to both international applications and UK-based doctors, though those with European Specialist qualifications or FRCR 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

10 years of oncology experience in a middle-grade role and full GMC registration are required for this role, and anyone with an interest in Neuro-Oncology and Lower GI should apply. The salary will be between £96,990 and £107,155 dependent on experience or grade.

CORE DUTIES OF THIS ROLE

  • Provide specialist Clinical Oncology input, including expertise in radiotherapy and Systemic Anti-Cancer Therapy (SACT).
  • Support site-specific MDTs (Multidisciplinary Teams) in Neuro-Oncology and Lower-GI cancers.
  • Deliver outpatient and inpatient care, including radiotherapy planning and chemotherapy prescribing.
  • Contribute to the Acute Oncology Service and provide ward inpatient care.

LIFE IN THE WEST MIDLANDS

This Trust is located in a major city in the West Midlands, offering easy access to both vibrant urban areas and picturesque rural locations. Popular residential areas nearby include a mix of city living and countryside retreats. The region offers excellent schools, strong transport links to major UK cities, and a range of cultural, shopping, and leisure options. Historically, this area has played a vital role in Britain\'s industrial and automotive history and is home to a number of significant landmarks.


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

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- 139,882
An NHS Trust in South East England is looking for a Consultant in Medical Oncology with an interest in Lower Gastrointestinal & Gynaecological cancers . The Oncology department comprises a team of consultants and is supported by a large team of specialty doctors and clinical fellows. This Medical Oncology job is open to both international applications and UK-based doctors, though those with European Specialist qualifications or FRCR/MRCP 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

Full GMC registration, FRCR/MRCP (or equivalent), and oncology experience at SpR or equivalent level are required for this role. Anyone with an interest in Gynaecological cancers and dependent on experience or grade.

CORE DUTIES OF THIS ROLE

Provide high-quality oncology services, including radiotherapy and chemotherapy.
Participate in multidisciplinary team meetings and provide leadership for tumour site specialisations.
Supervise and mentor junior medical staff and actively contribute to teaching and research initiatives.
Engage in clinical governance and audit activities to ensure high standards of patient care.

LIFE IN KENT

Kent, known as \"The Garden of England,\" offers a mix of lively urban areas and tranquil rural settings. Canterbury is a vibrant city with a rich history and excellent amenities, while the surrounding countryside provides peaceful rural living options. The region boasts excellent schools, strong transport links to London and the continent, and a variety of leisure activities including historic landmarks, coastal attractions, and cultural festivals. Kent\'s historical significance as a cornerstone of England\'s heritage adds to its charm.

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 and recruitment practices.
-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 guided throughout by one of our dedicated relocation executives, including:
-Document gathering and checking.
-COS and visa application support if applicable.
-Assistance with sourcing short- and long-term accommodation.
-Travel arrangements.
-Family support for finding schools and other aspects of pastoral care.



 
105,504- 139,882

An NHS hospital in London is looking for a Locum Consultant in Medical Oncology with an interest in GI and Lung malignancies. The Oncology department comprises a team of 16 Consultant Oncologists and is supported by a multidisciplinary team of nurses, pharmacists, and radiographers. This Medical Oncology job is open to both international applications and UK-based doctors, though those with European Specialist registration or MRCP qualifications 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

Applicants should have full GMC registration, MRCP (or equivalent), and substantial experience in Medical Oncology. Interest in Lung  and GI malignancies is essential. The salary will be between £105,504- £139,882 dependent on experience.

CORE DUTIES OF THIS ROLE

  • Provide specialist care for Breast and Lower GI cancer patients, including outpatient and radiotherapy services.
  • Actively participate in multidisciplinary team meetings for Lung and GI malignancies.
  • Engage in research, clinical audits, and teaching activities to support professional development.
  • Contribute to the Acute Oncology Service (AOS) and provide clinical supervision for junior medical staff.

LIFE IN LONDON

London offers a dynamic and diverse environment with a mix of bustling urban areas and quieter suburban neighborhoods. It provides access to world-class educational institutions, excellent transport links, and a wide range of cultural, leisure, and historical attractions. London’s rich history and multicultural vibrancy make it an ideal location for both professional development and personal fulfillment.

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 and recruitment practices.
  • 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 guided throughout by one of our dedicated relocation executives, including:

  • Document gathering and checking.
  • COS and visa application support if applicable.
  • Assistance with sourcing short- and long-term accommodation.
  • Travel arrangements.
  • Family support for finding schools and other aspects of pastoral care.

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