Final FRCR Radiology (Part 2A & 2B) - a guide for IMGs
- June 13, 2023
FRCR CR2A and CR2B and the final exams in the FRCR qualification.
Completions 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:
- An overview of FRCR
- How are the Final FRCR exams structured?
- How are marks awarded for CR2A and CR2B?
- Am I eligible to sit Final FRCR?
- Where can I sit the exams and how much do they cost?
- How do I apply for the exams?
- What is the best way to prepare for FRCR CR2A and CR2B?
- I’ve passed the FRCR Radiology exams, what’s next?
Skip ahead to the relevant section if you know what you’re looking for.
An Overview of FRCR Radiology
FRCR Radiology is 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 Radiology.
The exams within the exam suite are as follows:
You can read an overview of the full FRCR Radiology examination suite via our IMG Resources library.
Please note that only full FRCR satisfies the postgraduate requirements for overseas doctors.
Alternative routes to GMC registration include PLAB and other recognised GMC qualifications or licensing exams, which you can find out more about here.
A Deep Dive into FRCR Part 2A & 2B
Final FRCR Part A
The Final FRCR Part A examination assesses knowledge of the sciences that underpin clinical radiology including physics as applied to imaging including molecular biology, medical statistics, radiological findings in pathological and normal conditions together with their differential diagnosis, management pathways, and radiological interventions.
The examination comprises two single best answer papers, each containing 120 questions and covering a broad range of the core curriculum. Exams are 3 hours for each sitting.
The paper comprises a mix of questions from across a wide range of the curriculum:
- Cardiothoracic and Vascular
- Musculoskeletal and Trauma
- Gastro-intestinal
- Genito-urinary, Adrenal, Obstetrics & Gynaecology and Breast Paediatric
- Central Nervous and Head & Neck
Final FRCR Part B
The Final FRCR Part B examination assesses different aspects of a candidate’s radiological skills, all of which are considered necessary for safe and effective radiological practice.
The exam has three components:
- reporting (long cases) – 6 cases in 75 minutes
- rapid reporting – 30 plain radiographs in 35 minutes
- oral exam – 2 x 30-minutes vivas
The stations are broken down in more detail below.
Reporting Station
This component is built on the fact that A&E department is a large part a radiologist’s workload.
The station tests candidates’ ability to rapidly decide if an image is normal or abnormal and the provision of a diagnosis for the abnormality.
The images are all radiographs with the balance of normals within the images about 45-50%. Trauma cases are the majority, but some chest and abdominal radiographs are included as they would be in a typical session of A&E reporting in the workplace. Each abnormal case shows one significant diagnosable abnormality.
This part of the examination reproduces the situation of plain film reporting as a safe radiologist needs to be able to identify abnormalities when present and confidently exclude them when they aren’t.
Rapid Reporting Station
The reporting component centres around the understanding that radiologists largely communicate their findings through written reports.
This element tests the ability of the candidate to make observations, distinguish the relevance of these findings, deduce a list of differential diagnoses, suggest the most likely diagnosis and discuss further management including further imaging where appropriate.
This part of the examination mirrors a mixed list of cross-sectional and fluoroscopic imaging, and a short, structured reporting sheet is provided. Each case can include any type of radiological imaging and often involves more than one e.g. plain film, CT and isotope study.
This written element of the examination aims to test the candidate’s ability to assess and interpret a variety of clinical cases across all modalities safely, and to accurately communicate their findings, conclusions and recommendations.
Oral Examination
This mirrors the day-to-day clinical discussions and MDT meetings, which form an integral part of a radiologist’s workload.
The oral component further assesses the candidate’s powers of observation and interpretation, but in addition allows assessment of the candidate’s ability to discuss wide-ranging aspects of patient care as influenced by the radiological findings.
Candidates are expected to be able to integrate their observations with emerging clinical information to help refine their differential diagnosis. It also tests their ability to communicate effectively, their analytical and decision-making skills, and allows searching questions to explore their depth of knowledge and ensure that their practice supports patient safety.
This oral element aims to explore the candidates’ depth of knowledge and to test higher cognitive skills. The format allows for flexibility and for complexity to be built into the examiner’s questioning.
In total, the Final FRCR exam lasts 2 hours and 50 minutes.
Scoring
Final FRCR Part A
The examination is marked by the examination software Speedwell and the marking system shown below is used:
- For each item correctly answered: +1 mark
- For each item incorrectly answered: 0 marks
The examination is not negatively marked and therefore you are encouraged to provide an answer to all the questions.
You can find full information on the scoring system for the CR2A exam here.
Final FRCR Part B
Reporting
Eight marks are available for each case, with a maximum of 48 marks available.
|
Candidate response |
Mark |
|
Excellent: a perfect answer, clear and confident |
8 |
|
Good Pass: additional relevant material included in a "pass" grade answer |
7 |
|
Pass: most observations made correctly; principal diagnoses correct |
6 |
|
Borderline: appropriate for cases with two main diagnoses, but only one is mentioned; some observations missed |
5 |
|
Fail: significant observations missed; correct diagnosis not made |
4 |
|
No answer offered |
3 |
Half marks may also be awarded.
Following the marking exercise each candidate will have a score between 18-48. An overall reporting mark is then awarded on the basis of total marks achieved using the scale below:
|
Total marks |
Overall mark |
|
18 - 25 |
4 |
|
25½ - 28 |
4½ |
|
28½ - 31 |
5 |
|
31½ - 34 |
5½ |
|
34½ - 37 |
6 |
|
37½ - 40 |
6½ |
|
40½ - 43 |
7 |
|
43½ - 46 |
7½ |
|
46½ - 48 |
8 |
Rapid reporting
One mark is available per image, with a maximum of 30 marks available.
|
Image type |
Candidate response |
Mark |
|
Normal Image
|
Correctly classified |
+1 |
|
Incorrectly classified (appropriate false positive) |
+½ |
|
|
No answer given |
0 |
|
|
Abnormal Image
|
Correctly classified and correctly identified |
+1 |
|
Correctly classified but incorrectly identified |
0 |
|
|
Incorrectly classified (false negative) |
0 |
|
|
No answer given |
0 |
Following this, each candidate will have a score between 0-30. An overall rapid reporting mark is then awarded on the basis of total marks achieved using the scale below:
|
Total marks |
Overall mark |
|
0 - 24 |
4 |
|
24½ |
4½ |
|
25 - 25½ |
5 |
|
26 - 26½ |
5½ |
|
27 |
6 |
|
27½ - 28 |
6½ |
|
28½ - 29 |
7 |
|
29½ |
7½ |
|
30 |
8 |
Oral
Candidates are shown images by two pairs of examiners and can score a maximum of eight marks from each pair.
|
Performance description |
Comments |
Score |
|
Very Poor Answer |
Key findings missed even with help Wrong or dangerous diagnosis |
4 |
|
Poor Answer |
Slow to spot abnormality Poor differential diagnosis Needed help to get correct answer |
5 |
|
Principal findings seen |
Some abnormalities seen with help Principal diagnosis correct Limited differential |
6 |
|
Good Answer |
Key findings spotted quickly Correct deductions made and correct diagnosis Good differential offered |
7 |
|
Excellent answer – all findings seen |
Correct diagnosis and deductions No errors Succinct/accurate report Excellent differential |
8 |
Overall Pass Mark
Once the marks have been combined, each candidate will have a score of 4-8 in each component of the examination (two orals, the reporting session and the rapid reporting session).
The pass mark in each component is 6, making the overall pass mark 24.
In addition, candidates must obtain a mark of 6 or above in a minimum of two of the four components. If a candidate scores less than 6 in three or more components, they fail the examination even if they have achieved a score of at least 24 overall.
You can find full information on the scoring system for the CR2B exam here.
Eligibility for Final FRCR
Final FRCR Part A - to be eligible you must:
- have passed FRCR Part 1
Final FRCR Part B - to be eligible you must:
- have passed FRCR Part 1
- have passed FRCR Part 2A
- have acquired 34 months in a formal clinical radiology training post by the month of the examination (your training supervisor must provide confirmation that you have completed the required duration of training and received instruction covering the examination syllabus)
Exam Fees & Venues
Part 2A
The Part 2A exam is held twice a year, normally in spring and autumn.
You can see a breakdown of the fees for all UK and overseas centres below:
|
UK |
||
|
Venues |
Member fee |
Non-member fee |
|
Belfast, Bridgend Wales, Crewe, Edinburgh, Glasgow, Leeds, London, Plymouth |
£427 |
£545 |
|
Global |
||
|
Venues |
Member fee |
Non-member fee |
|
Egypt |
£427 |
£545 |
|
Hong Kong |
£427 |
£545 |
|
India |
£505 |
£643 |
|
Pakistan |
£427 |
£545 |
|
Singapore |
£493 |
£628 |
Part 2B
The Part 2B exam is now held four times a year.
You can see a breakdown of the fees for all UK and overseas centres below:
|
UK |
||
|
Venues |
Member fee |
Non-member fee |
|
Belfast, Bridgend Wales, Crewe, Edinburgh, Leeds, London, Plymouth |
£597 |
£759 |
|
Global |
||
|
Venues |
Member fee |
Non-member fee |
|
£427 |
£545 |
|
|
India |
£505 |
£643 |
Applications
Applications are normally open for a few weeks, several months before the exam. Please refer to the examinations page for up-to-date information on application dates.
UK trainees (members) are given priority for examination places, followed by other member bookings and finally non-members. The window for each group is usually open for around a week before it opens to the next group.
All candidates should apply for the exams through the Royal College website here for Part 2A and here for Part 2B. More detailed information can also be found here in relation to preparation for the application.
Preparation
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 Specialty Training Curriculum for Clinical Radiology.
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.
Other useful resources to aid your studies include:
- Instructional video: demonstrations of both parts of FRCR Part 2, providing insight into both elements of the exam and what candidates can expect on the day. These are on the RCR website here.
- Guidance notes for Part 2A: a guidance document on key elements of the exam, found here.
- Guidance notes for Part 2B: important information on the three sections of the exam, available here.
- Sample questions: sample SBA and oral questions for the exams have been provided with answers on the RCR website, here for Part A and here for Part B.
- Candidate reference sheet: a reference list of abbreviations and normal ranges for use during Part 2A, found here.
- Examiners’ reports for Part 2B: this is a collection of generic reports written by examiners on the overall performance of candidates and individual questions as a guide for applicants for future sittings. These are available here.
- Understand the SBA format and how to approach questions: this document also provides questions that have been used previously in the Final FRCR (Part A) Examination. You can find this here.
- TNM Staging guidance - this document explains the knowledge required to answer questions related to this topic, available here.
- Demonstration films: demonstrations of both parts of FRCR Part 2, providing insight into both elements of the exam and what candidates can expect on the day. These are on the RCR website here.
- Scoring system for Part 2B: key information on how each part of the exam is marked, found here.
For a detailed guide to the best guidance preparation and courses for the exams, see our blog here.
Sources
https://www.rcr.ac.uk/clinical-radiology/examinations/frcr-part-2a-radiology-cr2a
https://www.rcr.ac.uk/sites/default/files/cr2a_purpose_of_assessment_statement_jan_22.pdf
https://www.rcr.ac.uk/clinical-radiology/examinations/frcr-part-2b-radiology-cr2b
https://www.rcr.ac.uk/sites/default/files/cr2b_purpose_of_assessment_statement.pdf
https://www.rcr.ac.uk/sites/default/files/cr2a_guidance_notes._jan_22.pdf
https://www.rcr.ac.uk/sites/default/files/docs/radiology/pdf/CR2B_scoring_system.pdf
https://www.rcr.ac.uk/clinical-radiology/exams/5faf80dd-7d45-e911-a977-002248072781/dates-fees
https://www.rcr.ac.uk/clinical-radiology/exams/a91e7f01-7e45-e911-a977-002248072781/dates-fees
I’ve passed the FRCR exams! What’s next?
Firstly, congratulations – attaining full FRCR is a massive achievement!
With all parts of the FRCR complete, you have completed the biggest component of the requirements for GMC registration. Once you have completed the English language component, you will be eligible for full GMC registration with a license to practice in the UK.
Don’t hesitate to get in touch with our team to learn more about the opportunities available to you once you’ve passed FRCR.
For the latest news and updates on all things radiology, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
Relevant Jobs
An excelklent Health Board is seeking a dedicated Locum Consultant General Radiologist with expertise in head and neck radiology. The Health Board serves a diverse population and is committed to providing safe and improving healthcare services. The Health Board emphasizes education and research, with a Clinical Research Facility actively involved in various initiatives, including BioBanking and telemonitoring. Their commitment to advancing healthcare makes it an exciting place for clinicians.
This role is ideal for overseas Consultants looking to establish themselves in the NHS or experienced IMGs working toward CESR.
The Radiology Department is well-equipped and staffed by experienced consultants and junior doctors. They handle a significant caseload and play a vital role in training multidisciplinary teams and delivering community-based care. The successful candidate is expected to support and train multidisciplinary teams, delivering care in the community alongside primary healthcare and social care teams.
The hospital sits within a vibrant town in South Wales, offers a balanced lifestyle with both urban and rural settings, stunning scenery, quality schools, and excellent transportation links. It\'s an appealing location for doctors seeking a fulfilling personal and professional life.
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
- Experience of working in Radiology
- Board Certified Specialist in Radiology
Non-EEA Candidates:
- Experience of working in Radiology
- FRCR
UK based applicants
- Experience of working in Radiology
- Within 6 - 12 months of completing CCT
An outstanding opportunity for experienced Consultant Radiologist to join an NHS Trust that is committed to providing the best CESR support to IMGs and consultant development. This Trust is one of the largest employers in the region and their members and staff are dedicated professionals whose work is varied, challenging and makes a real difference to people’s health and well-being.
The post is suitable for candidates holding specialisation in the EEA, or for experienced IMGs looking to complete CESR.
WHAT IS THE NHS TRUST LIKE?
The Trust is one of the largest organisations in the country and they employ over 6,000 dedicated staff with an annual turnover of £380 million who provides service to 525,000 people that live within the area. Their services are mainly provided from two district general hospitals, both have Emergency Departments and provide care 24 hours a day. They offer a comprehensive range of surgical, medical and maternity services supported by a full range of diagnostic and therapy services.
The role of the NHS Trust is to provide the best possible healthcare service to patients, who come first in everything the organisation does. Safe patient care is the Trust's highest priority. They will provide high quality clinical services that achieve and demonstrate optimum clinical outcomes and provide an excellent care experience for patients. The employees will be valued and respected. They will be involved in decisions about the services they provide and offered the training and development that they need to fulfill their roles.
They will operate efficiently and effectively, diagnosing and treating patients in timely fashion and expediting their return to health. They will use their resources efficiently and effectively for the benefit of their patients and their care to ensure our services are clinically, operationally, and financially sustainable.
WHAT IS LIFE LIKE IN THE REGION?
The region has a natural beauty. Sussex has some fantastic natural features such as the Seven Sisters National Park, and many areas of outstanding natural beauty that include the medieval heathland and forests of the High Weald. It also has beaches and harbours where people can go to during their dayoffs.
Besides its natural beauty, there's a rich array of accommodation options, ranging from the five star Grand Hotel on Eastbourne seafront to quaint B&Bs set amid beautiful Sussex countryside. East Sussex offers a rich array of culture, with art galleries such as the Jerwood Gallery in Hastings and the Towner Gallery in Eastbourne and an array of theatre and entertainment venues such as the De La Warr Pavillion in Bexhill, Congress and Devonshire Park Theatres in Eastbourne and the White Rock Theatre in Hastings.
WHAT OPPORTUNITIES ARE AVAILABLE TO YOU?
CESR is a particular strength of this trust. The combination of clinical practice and first-class academic connections means that medical professionals have a wide range of opportunities to develop their careers and achieve their aspirations. You will have access to leadership, teaching, educational and research opportunities for Continued Professional Develop (CPD).
If you are a new consultant you will receive mentoring and support from medical leads as well as access to a large peer group of enthusiastic and high-caliber Consultants.
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
- Experience of working in Radiology
- European Specialist Qualifications in Radiology
Non-EEA Candidates:
- FRCR Diagnostic Radiology
- Experience of working in Radiology
UK based applicants
- Experience of working in Radiology
- Within 6 - 12 months of completing CCT
An excellent opportunity for an experienced Consultant in Radiology to join a Health Board in North Wales that promotes equality and diversity. If you love a challenge, have a passion to help others or simple fancy a fresh start, then this Health Board has all the ingredients. The post if suitable for overseas consultants, including candidates who are pursuing CESR. Specialists in Radiology holding a specialist certification would be suitable for this post, based on experience entering at either Specialty Doctor or Consultant grade.
Overseas applications from experienced Specialty Doctors and Consultants are welcomed.
WHAT IS HEALTH BOARD LIKE?
The Health Board is largest health organisation in Wales, that are developing an integrated health service which provides excellent care delivered in partnership with the public and other statutory and third sector organisations.
The Health Board have a budget of £1.3 billion and a workforce of over 17,000 staff. Providing primary, community, mental health and acute hospital services for the population of around 700,000 across of North Wales. They continuously develop their workforce so that it has the right skills and operates in a research-rich learning culture.
Besides their three main hospital sites, they are also responsible for community hospitals, health centres, clinics, mental health units, community teams, GP practices and other NHS services provided by dentists, opticians and pharmacists. They plan to improve the health of the population, with particular focus upon the most vulnerable in our society.
WHAT IS THE DEPARTMENT & TEAM LIKE?
The Department is a group of people who are truly hard-working, highly motivated and committed. They focus on the quality care that they provide for their patients. The Department is responsible for the CT scanning, DXA scanning, Interventional Radiology, MRI, Nuclear Medicine & PET/CT scanning, Ultrasound, Vascular Laboratory and X-ray. The Department cares for their patient in such a way that during the pandemic, they trialled a clear mask to support better communication for people with conditions such as hearing loss, or dementia.
WHAT IS LIFE LIKE IN NORTH WALES?
North Wales has a vast national park, purpose built mountain biking trails, a breath taking coastal path, soaring zip wire, food festivals and world class sport and adventure around every corner. The North Wales is equipped with sport and leisure centres that provide opportunities for a wide variety of sporting, fitness and recreational activities. Not only does it have lots of activities for you, it also has a wide selection of private housing is available, both traditional and modern in towns, villages and rural settings.
For doctors with family, the educational standards are consistently high in both the primary and secondary sectors. There are several well established independent schools within North Wales and the surrounding area that cater for both day pupils and boarders. The regional University with its excellent scholastic reputation has a thriving student community.
You can say goodbye to heavy inner city commuter traffic, and enjoy a breath-taking commute across North Wales.
WHAT OPPORTUNITIES ARE AVAILABLE TO YOU AT THIS HEALTH BOARD?
With an extremely active education/teaching programme supported by the consultant team, there is opportunity to work towards and complete CESR, exams, get involved in active research and many aspects of CPD.
Participation in research and educational activities will be encouraged.
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
- Experience of working in Radiology
- European Specialist Qualification in Radiology
Non-EEA Candidates:
- Experience of working in Radiology
UK based applicants
- Experience of working in Radiology
- Within 6 - 12 months of completing CCT
An excellent opportunity for an experienced Consultant in Radiology to join a Health Board in Wales that promotes equality and diversity. If you love a challenge, have a passion to help others or simple fancy a fresh start, then this Health Board has all the ingredients. The post if suitable for overseas consultants, including candidates who are pursuing CESR. Specialists in Radiology holding a specialist certification would be suitable for this post, based on experience entering at either Specialty Doctor or Consultant grade. Overseas applications from experienced Specialty Doctors and Consultants are welcomed.
Radiologists with interest in cross sectional imaging, head and neck, oncology and urology will be best suited to this posts.
WHAT IS HEALTH BOARD LIKE?
The Health Board is largest health organisation in Wales, that are developing an integrated health service which provides excellent care delivered in partnership with the public and other statutory and third sector organisations.
The Health Board have a budget of £1.3 billion and a workforce of over 17,000 staff. Providing primary, community, mental health and acute hospital services for the population of around 700,000 across of North Wales. They continuously develop their workforce so that it has the right skills and operates in a research-rich learning culture. Besides their three main hospital sites, they are also responsible for community hospitals, health centres, clinics, mental health units, community teams, GP practices and other NHS services provided by dentists, opticians and pharmacists. They plan to improve the health of the population, with particular focus upon the most vulnerable in our society.
WHAT IS THE DEPARTMENT & TEAM LIKE?
The Department is a group of people who are truly hard-working, highly motivated and committed. They focus on the quality care that they provide for their patients. The Department is responsible for the CT scanning, DXA scanning, Interventional Radiology, MRI, Nuclear Medicine & PET/CT scanning, Ultrasound, Vascular Laboratory and X-ray. The Department cares for their patient in such a way that during the pandemic, they trialled a clear mask to support better communication for people with conditions such as hearing loss, or dementia.
WHAT IS LIFE LIKE IN NORTH WALES?
North Wales has a vast national park, purpose built mountain biking trails, a breath taking coastal path, soaring zip wire, food festivals and world class sport and adventure around every corner. The North Wales is equipped with sport and leisure centres that provide opportunities for a wide variety of sporting, fitness and recreational activities. Not only does it have lots of activities for you, it also has a wide selection of private housing is available, both traditional and modern in towns, villages and rural settings.
For doctors with family, the educational standards are consistently high in both the primary and secondary sectors. There are several well established independent schools within North Wales and the surrounding area that cater for both day pupils and boarders. The regional University with its excellent scholastic reputation has a thriving student community.
You can say goodbye to heavy inner city commuter traffic, and enjoy a breath-taking commute across North Wales.
WHAT OPPORTUNITIES ARE AVAILABLE TO YOU AT THIS HEALTH BOARD?
With an extremely active education/teaching programme supported by the consultant team, there is opportunity to work towards and complete CESR, exams, get involved in active research and many aspects of CPD.
Participation in research and educational activities will be encouraged.
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
- Experience of working in Radiology
- European Specialist Qualification in Radiology
Non-EEA Candidates:
- Experience of working in Radiology
- FRCR
UK based applicants:
- Experience of working in Radiology
- Within 6 - 12 months of completing CCT
An exciting opportunity for an experienced Stroke Consultant to join one of the top performing trusts in the UK. Rated as "outstanding" by the CQC, this university hospital is seeking to appoint a Consultant Physician in Stroke Medicine.
Department and Trust overview:
This is a fixed term post joining an established and growing team. The post will involve responsibility for stroke prevention, hyper-acute and acute stroke care, including proactive in-reach, stroke rehabilitation and a commitment to the General Medicine on call rota.
The Stroke Team are part of the Medicine for the Elderly Department, but suitably qualified applicants from any parent speciality are encouraged to apply.
The department provides a full range of services to a population of approx 400,000.
The stroke service admits approximately 500 patients per year, and sees about 800 patients per year in the fast track TIA clinic. Hyper-acute and acute stroke is managed in the Bristol Royal Infirmary on the current 26 bedded acute stroke unit (ASU) which includes 10 hyper-acute beds. Patients requiring longer inpatient rehabilitation are cared for in the 16 bedded dedicated stroke rehabilitation unit.
Requirements for the role:
UK candidates:
- Consultant experience in Stroke Medicine
- Within 6 months of CCT or CESR
- Specialisation in Stroke Medicine
- MRCP
- Consultant experience in Stroke Medicine