The Final FRCR Part A exam, which is commonly referred to as the FRCR 2A, was re-structured in late 2017 and the format altered. Previously the six main topics were examined in a modular format. These have now been merged into a single exam covering all of the core knowledge with which a candidate should be familiar before the Part 2B exam.

The first exam using the new format was sat in December 2017, and there are now two sittings per year: December and June. There are six different venues within the UK where the exam can be sat, as well as two overseas venues: Hong Kong and Singapore..

The Final FRCR Part A exam breakdown:

The whole exam is six hours long with 240 Single Best Answer (SBA) questions. It is split into two papers, one taken in the morning and one in the afternoon and each lasting three hours. The scores from both papers are combined to give a single mark. It is, therefore, not possible to pass one paper at a time.

The exam is mapped to the competencies of Years 1-3 of the Clinical Radiology Curriculum, which is available on the RCR website. The questions for the new exam will initially be taken from the existing question banks used to create the old modular papers.

The exam is marked using a modified Angoff method where a cut-off score is defined as the score a minimally acceptable candidate is likely to achieve. One standard error of measurement will be added to the cut-off scores to calculate the required final pass mark for the paper.

The Final FRCR Part A question style:

The questions in the Final FRCR Part A exam are single best answer (SBA) questions. These require the candidate to select the correct answer from five (or sometimes more) options based on the information given in the question.

Within each question, there is usually a clinical scenario with a variable level of detail to aid or abet the candidate. There follows a question for the candidate to answer and then the answers available. Usual questions include:

• What is the most/least likely diagnosis?
• Which of the following findings would be most/least in-keeping with a diagnosis of '....'?
• Select the correct combination of findings/features.
• What is the next most appropriate treatment for this patient?
• What is the most likely associated finding with '....'?
• What is the name of this finding/sign?

Questions are often based on one of two formats: common presentations of uncommon problems or uncommon presentations of common problems. Additionally, rare diseases, the likes of which you may never encounter in your professional careers, are over-represented in exams.

Preparing for the Final FRCR Part A exam

Building up a good knowledge base from which to answer the questions takes a great deal of time, and candidates should start preparing at least six months before the exam. A robust textbook covering each of the areas should be used and should form the basis of your initial revision. Some of the more commonly used textbooks in the UK are:

• Weissleder - Primer of Diagnostic Imaging
• Brandt & Helms Fundamentals of Diagnostic Radiology
• Grainger and Allison’s Diagnostic Radiology Essentials
• The Requisites series

It is important to realise that by this level, textbooks alone are insufficient to provide a complete reference on which to base your learning. Candidates should be reading around subjects in topical journals to supplement their learning. Some of the better journals for this purpose are:

• RadioGraphics – Radiological Society of North America
• American Journal of Roentgenology
• European Radiology
• Journal of the American College of Radiology

Once you have started to get to grips with the basics of each topic, it is a good idea to start to supplement your learning with regular SBA practice using resources such as our site and any of the various question books available. Try to isolate areas of weakness and concentrate on these areas and spend less time on your areas of strength.

Many candidates struggle with the vast size of the syllabus and often need to focus on a module with which they are less content. It is a good idea to use your performance in SBAs as a benchmark of your knowledge base in each area of the curriculum and use this as a means to support your revision planning. By the time each of you has qualified as a doctor, you will already have sat numerous exams and developed your own methods for preparing. It is a good idea to keep using the revision methods that you are used to when preparing for this exam. It is very important not to underestimate the amount of work that is required and spend plenty of time preparing!

The FRCR exams are well matched to work that you may come across during any day in your Radiology department, so it is a good idea to read around interesting and relevant cases that you or your colleagues come across in day-to-day practice as this will help you achieve a better grasp of the current understanding of topics.

Best of luck with your preparation for the FRCR and the actual exam!

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