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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
Egypt	£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 

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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. 

            

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