Also known as the Final FRCR (Part B) exam
The final FRCR 2B exams are held four times a year, in January, March, June and October. Exact exam dates can be found on the RCR website. Candidates are permitted to enter the 2B examination once they have passed the Final FRCR Part A (also known as the 2A exam) and have been in formal clinical radiology training for at least 34 months.
The FRCR 2B exam consists of three components: short case reporting, long case reporting, and an oral examination. All components are taken at the same sitting. Here’s some help for each component:
Just remember, although these exams will likely be a stressful experience, revising for them is often said to be one of the most enjoyable and rewarding parts of radiology training!
You’ll see a huge variety of cases in a short period of time. Your consultant colleagues will have piles of cases to show you so you need to quickly get used to sitting in the ‘hot seat’. Practise is key here. It should be second nature to present whatever is thrown up in front of you by the time you get to the exam. See as much as you can from as many different consultants as you can. Quite a few of the cases I was shown actually turned up in the exam so don’t underestimate the importance of seeing a large variety of cases.
Lastly, don’t doubt yourself. You can’t know everything, but you got this far and after all the written exams in the past, this one will feel much more natural. You’ll be doing what you do every day. Good luck!
FRCR 2B scoring system
The 2B marking scheme is complex so here’s an overview to give you a good understanding for the FRCR 2B exam.
The FRCR 2B exam consists of three components:
Each of the exam components are marked individually and have their own set pass mark. Candidates must reach the pass mark in at least 2 of the 3 exam components. Candidates who fail two or more of the three exam components will automatically fail overall. Candidates who pass all of the three exam components automatically pass overall.
For those who meet the pass mark for 2 of the 3 exam components, a pass overally is given provided that the following criteria are met:
- If candidates fail either the long case reporting or short case reporting, but meet the pass mark for the oral and for one reporting component, they will pass overall if they have scored within one standard error of measurement (SEm) below the pass mark for the failed exam component.
- If the candidate has failed the oral exam but met the pass marks for the long case reporting and short case reporting components, they will pass overall if they have scored within half a SEm below the pass mark for the oral exam.
What is the standard error of measurement (SEm)?
Source: https://www.rcr.ac.uk/exams-training/rcr-exams/clinical-radiology-exams/frcr-part-2b-radiology-cr2b/june-2025-frcr-part-2b-radiology-cr2b-scoring-system/
It will not be possible to carry forward a pass in any single componenet from a previous sitting. If candidates fail the 2B then they must re-sit the whole exam again.
Key points:
- There is no concept of passing one part (e.g. oral) only
- There is no ranking of candidates (other than for awarding the Gold Award)
The mark schemes are slightly different for each component of the exam and are described in more detail below along with top tips and links to useful resources. More information from the Royal College of Radiologists.
What is the scoring system for the short cases?
There are 25 questions in 2 hours with up to 5 marks per question. The exam is marked out of 125. No half marks are allocated. Candidates are independently double marked and the final score is averaged from the two examiners. The marking framework permits a difference of up to 1 mark per question. Any question with a difference in score of 2 or more will be flagged for discussion.
Each question has specific guidance for marking to indicate key findings, diagnosis and recommended onward management.
Here is the mark scheme examiners will use alongside the question specific guidance:
| Marking descriptors | Score |
|---|---|
| Detects all major findings and most minor observations. Makes correct diagnosis or differential diagnoses using clinical information provided. Makes safe further management plans with clear recommendations (including MDT or specialist referral if appropriate). Demonstrates a clear understanding of likely further management required by different MDTs. Report is clear, logical and concise. May demonstrate knowledge beyond the core curriculum. | 5 |
| Detects most major findings (including those marked essential) and most minor observations. Makes correct diagnosis or differential diagnoses using clinical information provided. Makes safe further management plans with clear recommendations (including MDT or specialist referral if appropriate). Report is clear, logical and concise. | 4 |
| Detects most major findings (including those marked essential) and some minor observations. May or may not reach the correct diagnosis but demonstrates sensible clinical reasoning. Safe differential diagnoses offered. May not know full management plan but demonstrates enough knowledge not to compromise patient safety. Report is clear although it may not be ideally structured. | 3 |
| Major/critical observations missed. Undue significance placed on irrelevant or minor findings. Limited understanding of pathology. Fails to make correct diagnosis or provide reasonable differential diagnoses. Failure to refer to appropriate MDT/clinical team or inappropriate over-investigation e.g. MRI and orthopaedic referral for benign bone lesions. Unstructured, scattergun report. | 2 |
| Major/critical observations missed. Undue significance placed on minor or incidental findings. Demonstrates no understanding of pathology. Inappropriate patient management (including over-investigation). Incoherent, rambling report. | 1 |
| No answer provided or answer is entirely incorrect or inappropriate/unsafe patient management. | 0 |
A standardised setting process will be used to set the pass mark for each sitting. This will be based on the content/cases used.
(Source: Final Examination for the Fellowship in Clinical Radiology (Part B) Scoring System. Published by: The Royal College of Radiologists)
What is the scoring system for the long cases?
The long cases consists of 6 cases in 75 minutes.
The long cases component of the exam is marked out of 30. There are six cases and candidates can get up to 5 marks per case. No half-marks are awarded.
All cases are independently double marked. The final score is the average of the two examiner marks. The marking framework allows for a difference of up to 1 mark between the two examiners. If the difference is 2 marks or more, the case is flagged for review asnd discussion.
There is specific marking guidance for each question which indicates key findings, diagnoses and recommended management. Examiners will use the following mark scheme descriptors alongside the individual question mark schemes to allocate marks:
| Marking descriptors | Score |
|---|---|
| Detects all major findings and most minor observations. Makes correct diagnosis or differential diagnoses using clinical information provided. Makes safe further management plans with clear recommendations (including MDT or specialist referral if appropriate). Demonstrates a clear understanding of likely further management required by different MDTs. Report is clear, logical and concise. May demonstrate knowledge beyond the core curriculum. | 5 |
| Detects most major findings (including those marked essential) and most minor observations. Makes correct diagnosis or differential diagnoses using clinical information provided. Makes safe further management plans with clear recommendations (including MDT or specialist referral if appropriate). Report is clear, logical and concise. | 4 |
| Detects most major findings (including those marked essential) and some minor observations. May or may not reach the correct diagnosis but demonstrates sensible clinical reasoning. Safe differential diagnoses offered. May not know full management plan but demonstrates enough knowledge not to compromise patient safety. Report is clear although it may not be ideally structured | 3 |
| Fails to detect most major/critical (essential) observations. Fails to make correct diagnosis or provide reasonable differential diagnoses. Inappropriate further management or failure to refer to appropriate MDT. Unstructured, scattergun report. | 2 |
| Fails to detect major observations or places undue importance on minor or incidental observations. Makes an incorrect or inappropriate diagnosis, failing to consider clinical information. Incoherent, rambling report. | 1 |
| No answer provided or answer is entirely incorrect or inappropriate/unsafe patient management. | 0 |
A standardised process is used for setting the pass mak for each sitting based on the content/cases used. Therefore the pass mark may be different for different sittings depending on performances and difficulty of the questions.
(Source: Final Examination for the Fellowship in Clinical Radiology (Part B) Scoring System. Published by: The Royal College of Radiologists)
What is the scoring system for the oral?
The oral (‘viva’) component consists of 2 x 30 minute viva sessions. Candidates are scored on images shown by two pairs of examiners. Each pair of examiners will examine for 30 minutes. Each case is independently marked by both examiners looking at the following domains:
- Radiology knowledge
- Observation
- Clinical reasoning
- Clinical safetly and management
Each examiner will assess and rate the candidates performance in each domain for each case using the following scale:
| Marking Description | Score |
|---|---|
| Display positive domain characteristics at a level well above that expected. | Excellent |
| Display of positive domain characteristics is predominant overall. Some minor negative characteristics are displayed. Competence is clearly demonstrated. | Clear pass |
| Display of positive domain characteristic is predominant by a small margin. Should be able to provide some of the positive characteristics without the need for prompting, i.e. not require prompting for all of them. Some negative characteristics are displayed but they are not in the majority or decisive with a potential to be dangerous or harmful to patients. A minimum level of competence is achieved. | Just pass |
| No predominance of positive or negative domain characteristics displayed. Negative characteristics displayed not potentially harmful to patients. A barely adequate level of competence is achieved. | Borderline fail |
| Display a majority of negative domain characteristics. Negative domain characteristics displayed are potentially harmful to patients. The required level of competence is not achieved. | Fail |
Communication domain
At each station, examiners will also assess communication skills. This is a rating based on the performance across all six cases in the station. The same scale as above is also used for this.
Calculating the score
Following the examination, all ratings are converted to a number (0-4) as follows:
Excellent (E) = 4
Clear pass (CP) = 3
Just pass (JP) = 2
Borderline fail (BF) = 1
Fail (F) = 0
As the communication socre is only assessed once per station, the communication score is multiplied by 6 to ensure it has the same weighting as the other four skill domains. Scores are then totaled from all 4 examiners across both stations to give the candidates final score out of a maximum of 480.
The marking framework allows for a difference of up to 5 marks between two examiners per case. Any score difference of 6 or more per case is flagged for review and discussion.
The pass mark for the oral is 281 (58.5%).
(Source: Final Examination for the Fellowship in Clinical Radiology (Part B) Scoring System. Published by: The Royal College of Radiologists)
The Gold Award
The Gold Award is awarded to an outstanding candidate, based on their performance, at each sitting of the exam. Candadates can only be considered for the award on their first attempt at the exam and if they achieved the highest score overall. In the event of a tie, the candidate with the highest score in the oral component will receive the award.
More information: https://www.rcr.ac.uk/career-development/awards-honours/awards-for-achievement/the-gold-award/
If you have anything you would like to add to this page or know of any useful tips/resources for future exam candidates, then please contact us and we will consider adding to this page!