FRCPath
An Overview of Examination
Requirements
Muhammad Usman Munir
MBBS, FCPS
Consultant Pathologist
CMH Mardan
The Royal College of Pathologists
Science Behind The Cure
Sequence of Events
Introduction
Interactive session I
FRCPath I
Interactive session II
FRCPath II
Group discussion
Feed back
Learning Objectives
Standards of assessment
Timing of examination
Requirements of examination
Paper formats
Examination modules
Marking methods of FRCPath.
Introduction
• The FRCPath examination is the appropriate
professional
qualification
for
medical
trainees/consultants in Chemical Pathology/Clinical
Biochemistry.
• This examination is taken in two parts and
applicants are awarded Fellowship status of the
Royal College of Pathologists upon successful
completion of both parts.
Content of Examination
Knowledge
Skills
Attitudes
in relation to the competencies
stipulated in the RCPath
Curriculum
Stages of Training & Learning
• There are four stages in the chemical pathology
curriculum. Trainees may not progress to the next stage
of training until they have satisfactorily completed the
preceding stage.
Stage A – ST 1
• Trainees must be assessed against the standard expected of
a trainee at the end of the stage of training that they are in.
Stages of training are normally defined as:
• Stage A – ST1
• The
trainee
will
be developing a comprehensive
understanding of the principles and practices of the
specialty under direct supervision.
• A minimum training period of 12 months (whole-time
equivalent)
Stage B –ST 2 & 3
• Stage B of training is between 13 – 36 month of whole-time
equivalent training. Trainees must have:
• Satisfactorily completed a total of at least 24 months of
training (whole-time equivalent) of which at least 12 months
should be in Stage B
• Passed the FRCPath Part 1 examination in clinical
biochemistry
Stage C
• In order to complete stage C of chemical pathology training,
trainees must have:
• Satisfactorily completed a total of at least 42 months of
training (whole-time equivalent) of which at least 12
months should be in Stage C
• Achieved satisfactory outcomes in the requisite number of
workplace-based assessments
• Passed the FRCPath Part 2 examination in clinical
biochemistry
Stage D
Meets the requirements of the Certificate for
Completion of Training (CCT) programme. The trainee
will have an in-depth knowledge and understanding of
the principles of the specialty.
Timing of the Examinations
The Part 1 and Part 2 examinations will be offered
twice a year
Spring
Autumn.
Access to RCPath Web page
• http://www.rcpath.org/
• Log in is required for accessing details
Interactive Session
Problem 1
Problem 1
The UK Departments of Health have determined that all medical
laboratories should been rolled with an approved accreditation body.
a) Most NHS laboratories choose to be enrolled with CPA. What is the full
name of the organization abbreviated to CPA? [2]
b) The CPA standards for laboratory accreditation are based on which
international standard for the accreditation of medical laboratories? [2]
c) The CPA standards place great emphasis on the laboratory service
meeting the needs and requirements of its users. List four ways in
which a laboratory may demonstrate that it is complying with this
standard. [4]
d) Quality management is central to CPA laboratory accreditation. List
three features of an effective quality management system. [6]
Problem 1
e) What is the timetable used by CPA for full accreditation assessments
and surveillance visits? [4]
f)
Name one other body approved for accreditation of UK medical
laboratories. [2]
Part 1
Eligibility
• Please note that the College cannot comment on
eligibility before receiving an application and CV.
• Applicants that are rejected will be contacted and
refunded in full.
Laboratory Experience
• Candidates will usually sit the Part 1 written
examination when they have gained about two
years of laboratory experience at specialty registrar
trainee level or equivalent.
Part 1 Application
• Current training position
• Candidate’s sponsor:
• Applicants should ask their educational supervisor or
departmental head to sign their form
• Sponsors should ideally be a fellow of the college recently
involved in the candidate’s training but this is not
compulsory
Entry & Training Requirements
• There is no specific timing for entry to the examination
although it is expected that medical trainees will
normally have passed the FRCPath Part 1 examination
by the end of ST3.
• Trainees who have not passed the FRCPath Part 1
examination by the end of ST3 will be prevented from
progressing to Stage C of training.
Written Examination
Consist of two papers
• An essay paper
• A short answer question (SAQ) paper lasting three
hours each
Candidates must pass both papers at a single sitting to
pass the Part 1 Examination.
Paper I written examination
• It is a three hour essay paper. Candidates are required to write
four essays from a choice of six questions set in broad topic
areas aligned with the Curriculum.
• Laboratory management competencies
• Analytical techniques and instrumentation
• Analytical methodology
• The chemical pathology of disease – biochemical basis
• The chemical pathology of disease – diagnosis and
principles of management
• The chemical pathology basis of metabolic medicine
Paper II written examination
• It consists of 20 compulsory Short Answer
Questions (SAQs), to be answered in three hours.
• SAQs are designed to test factual knowledge and
understanding across the range of the Curriculum.
• Each question comprises a stem and six subquestions.
Paper II written examination
• The stem defines the topic of the question and may
include a short scenario or vignette.
• Each sub question is designed to elicit a specific piece of
information, or demonstration of understanding of the
topic and its context.
• Unless stated otherwise, the answer required will relate
specifically to the material provided in the stem and not
to the topic in general.
Points to note
• SAQs are criterion-marked against an explicit model
answer
• Marks are only awarded:
• Information required by the question
• No marks are available for additional material
• If a defined number of facts are requested (e.g. State two
causes of…..), only that number of responses will be marked
Answers requiring more than single word or phrase
responses will be answerable in a single sentence or a small
number of sentences.
Standards & Marking Methods
• All parts of the examination are marked by two examiners,
neither of whom sees the marks awarded by the other.
• Paper 1 (essay paper) is marked using the College closed
marking scheme. In the case of a discrepancy, a third examiner
(usually the Panel Chair) also marks the papers.
Standards & Marking Methods
Paper II
• Criterion marked on the basis of model answers and the total
mark allocation to each part of each question is indicated on
the question paper.
• A standard setting procedure is used to determine the
notional pass mark for Paper 2, and enable appropriate scaling
before aggregation with the marks for Paper 1.
Use Links
• American Association for Clinical Chemistry
• The Association for Clinical Biochemistry
• Lipids and Cardiovascular Disorders
• HeartUK
• British Atherosclerosis Society
• British Hypertension Society
• Diabetes
• Diabetes UK
• Endocrinology
• Society for Endocrinology
•
•
•
•
Inherited Metabolic Disease
British Inherited Metabolic Disease Group
Society for the study of Inborn Errors of Metabolism (SIEM)
British Association for Parenteral and Enteral Nutrition (BAPEN)
Interactive Session
Problem 2
Problem 2
A 4-day old baby boy presents with poor feeding, vomiting, and reduced level of
consciousness. He was born at term and was initially well. You are duty biochemist
and receive a phone call from paediatric admissions wanting to add on ammonia to
the U&Es and LFTs already sent to the laboratory.
a) Can the ammonia be added on? Explain your answer
b) State 2 other EMERGENCY tests that you would recommend?
c) State two further crisis samples that should be collected to investigate for a
metabolic disorder
d) Name three groups of metabolic disorders that may result in a raised ammonia
level
e)
What acid-base disorder would you expect to see if the child had a urea cycle
defect?
f)
What is the most common urea cycle disorder, and what is its mode of
inheritance?
a)
No [2]
Requires specific collection procedure [2] (Paediatric lithium heparin tube and
transfer to lab on ice)
b)
Two from: [2]
Blood gases Plasma glucose Lactate
c)
Two from: [2]
urine organic acids plasma amino acids
blood spot or plasma acylcarnitines blood for galactose-1-phosphate uridyl
transferase
d)
Urea cycle defects
Organic acidurias
Fatty acid oxidation defects
[2] marks each
e)
Respiratory alkalosis [2]
f)
Ornithine transcarbamoylase deficiency
(OTC) [2]. X-linked [2]
Part 2
Examination Requirements
• Candidates may sit the Part 2 examination at an
appropriate time after they have passed the Part 1
examination
• The time of entry should be as advised by their Educational
Supervisor, who must support the application
• It is anticipated that most candidates will attempt the
Part 2 examination in the fourth year of Specialist
Training
Examination Requirements
• Candidates may apply to sit modules individually.
• Candidates should apply to sit either module 1, module 2 or
both modules.
• A module pass will be carried forward and this module will
not need to be taken again when the other modules
are attempted.
Entry & Training Requirements
• Medical trainees must pass the FRCPath Part 2
examination by the end of ST4.
• Trainees who have not passed the FRCPath Part 2
examination by the end of ST4 will be prevented
from progressing to Stage D of training.
Part 2 examination
This will be a modular examination consisting of:
Module 1
Practical skills module
Module 2
Clinical, scientific and management skills
Module 3
Written component module
Candidates may sit the modules 1 and 2 before
successful completion of module 3.
Module I
Practical skills module
Paper I
• A three hour 19 station objective structured
practical examination (OSPE). Candidates will be
provided with laboratory material such as:
• Analytical outputs (e.g. electrophoretic strips,
chromatography scans)
• Clinical scenarios (e.g. sample requirements,
investigation protocol questions)
• Quality control and/or external quality assurance data
• Analytical, physiological or pharmacological calculations
• One station will test communication skills using a
simulated encounter with a clinician.
Paper II
• A three hour bench practical which tests the candidate’s
ability to:
• Plan an experiment
• Execute simple bench practical work
• Record results
• Analyse raw data
• Draw appropriate conclusions.
Paper II
• Candidates will be provided with:
• Raw experimental data
• Perform simple laboratory bench practical work.
• Candidates will therefore no longer be permitted to take
books or other reference material into the examination.
• Appropriate equipment such as pipettes and scientific
calculators will continue to be permitted
• Further information about this will be available prior to each
session of the examination.
Module II
Clinical, scientific and management
skills
Paper III
• A three hour written paper in which candidates are
required to interpret clinical cases and critically
appraise journal articles.
Paper III
• Clinical cases section:
• Candidates are given six questions comprising a brief history
and laboratory results
• Asked to describe and interpret them.
• Journal article evaluation section:
• Candidates are required to answer questions that test their
critical reading and appraisal skills and
• Understanding of experimental methods and statistical
techniques based on two journal articles.
Marking
• Paper III is criterion-marked on the basis of model
answers.
• The clinical cases and journal article sections of this
paper carry equal weight.
• A standard setting procedure is used to enable
appropriate scaling.
• This paper carries 60% of the available marks for
Module 2.
Module II
Clinical, scientific and management skills
Oral
examination
First Oral:
Second oral:
• Clinical patient
management
• Laboratory
problem
solving
• Laboratory
management
• General clinical
biochemistry
issues
(including
patient and
laboratory
safety).
Marking
• The Oral examination is marked on the basis of
model answers using standard mark descriptors
and the College closed marking scheme.
• A total mark of 47.5% or less in Oral 1 or Oral 2 is a
definite fail.
• A total mark of between 47.6–49.9% in one Oral can be
compensated by a corresponding surplus of marks in the
other Oral.
• This paper carries 40% of the available marks for Module
2.
Marking
• A total mark of 47.5% or less on Paper 3 or the Oral
examination is a definite Module fail. A total mark of
between 47.6–49.9% in one paper can be
compensated by a corresponding surplus of marks in
the other paper.
Module III
Written component module
Module III
• The written component module requires the candidate to
demonstrate competence in the specialty by carrying out a
laboratory project that is written up and presented in a
dissertation
• Candidates intending to submit a dissertation must obtain
agreement for their project proposal from the College. It is
advisable to submit the project proposal well in advance of
starting the project in case it is not deemed suitable or
requires modification.
Module III
• Failure to submit a proposal or make any required
amendments will mean that the dissertation will not
be accepted.
Candidates are recommended to begin
to plan their project and submit a project proposal as
soon as possible after entering specialist training or
equivalent, and before completion of the Part 1
examinations.
Module III - Written component module
• For further guidance, please see the section on
‘Guidance for candidates undertaking written options
for the Part 2 examination’ in the Regulations and
Guidelines – College examinations for Membership
and Diplomas.
Module III - Written component module
• Dissertations are reviewed by two examiners and are
graded as follows:
• A = pass
• B = modification or additional work required
• C = unacceptable
• Dissertations must be of a standard equivalent to
that required for peer-reviewed publication in order
to achieve a Grade A.
Module III - Written component module
• MD or PhD theses and portfolios of published works
are assessed in the first instance by the Chair of the
Panel of Examiners, who will refer them to other
examiners for further assessment if necessary.
Passing Part II
• Candidates should normally pass their part 2
examinations within seven years of passing part 1.
IELTS Requirements
• If you do not work or do not intend to work in the
UK you do not need to prove your English language
skills before sitting the FRCPath exam.
Thanks
The Royal College of Pathologists
Science Behind The Cure