First FRCR exam

Learning resources, recommended books and tips for the First FRCR anatomy and physics exams


The First FRCR exam comprises of two modules:

  • Anatomy
  • Physics

Exams for both modules are held 3 times a year in March, June and September.  Exact exam dates can be found on the Royal College of Radiologists website.  Most ST1 radiology trainees will first attempt both modules in the March sitting of their first year of training.  Visit the RCR website to view the specialty training curriculum for clinical radiology and get information on exam dates, fees and venues.  Tips and links to useful resources for each examination are shown below.

 

 Contents


 

Anatomy module

Overview

The anatomy module covers radiological anatomy across all body systems and imaging modalities.  The exam consists of a computer based image viewing session of 100 images.  A single structure on each image is marked by one or more arrows and there will be a single question on that structure.  The majority of the questions will be 'What structure does the arrow point to?', however there will be a number of other questions such as 'What normal anatomical variant is demonstrated?' or 'At what age does the structure arrowed normally fuse during skeletal development?'.  The exam lasts 90 minutes.

 

Each examination paper aims to cover the curriculum and individual modalities are given roughly equal weight as follows:

  • 1/3 cross-sectional
  • 1/3 plain radiographs
  • 1/3 contrast studies

Similarly different body parts are given roughly equal weight as follows:

  • 1/4 head, neck and spine
  • 1/4 chest and cardiovascular
  • 1/4 abdomen and pelvis
  • 1/4 musculoskeletal

There will also be paediatric images and normal variants.  A list of normal variants to learn is provided here.  Fetal imaging and neonatal cranial ultrasound will not be in the exam.

 

How is the exam marked?

Marks are awarded for precision of anatomical description.  Each question is marked on a scale of 0, 1 or 2.  The maximum mark for a single question is 2.  As there are 100 questions, the examination is marked out of 200.  The following mark scheme is used for each question:

  • Answered with full accuracy = +2 marks
  • Answered with less accuracy, but still correctly (e.g. omits 'left' or 'right' for a paired structure) = +1 mark
  • Answered incorrectly = 0 marks

A vague or imprecise answer e.g. 'liver' when the fully correct answer is 'segment VII of the liver', will also be awarded 0 marks.

The exam utilises automated computer marking, which is programmed with acceptable answers.  These answers are provided by a group of UK consultant radiologists.  After the exam, the programmed answers are matched with candidate responses and marks awarded by the system automatically.  Any answers that do not exactly match those within the platform will be reviewed by examiners and awarded an appropriate mark.

The pass mark varies for each sitting, but usually lies around 75%.  If the paper is hard, the percentage pass mark can drop to around 60%, however if the paper is relatively easy, the pass mark may even rise to the mid 80's.

 

Normal anatomy - Left renal vein

Normal anatomy - Left renal vein

 

Top tips for the First FRCR Anatomy exam

 

  1. Do lots of practise exams

    • Practise exams are a great way to learn anatomy and are highly recommended.  They are particularly useful for improving your exam technique (see other tips below).  There are many good courses, books and online resources to help you including our own free mock anatomy exams here at radiologycafe.com.

  2. Left and right

    • The importance of writing the side of the patient cannot be understated.  If the structure can be clearly identified as left or right it is critical that you state the side, otherwise you will lose 1 mark for that question, even if you otherwise name the structure correctly.

    • CAUTION: There will be structures that you cannot identify as left or right so be sensible and logical with your answers.  If the side is not obvious from the radiograph, just write the name of the structure.  For example, if you are asked to name the angle of the mandible on a lateral facial radiograph and you put left (or right), then you will get 0 marks for that question.  Similarly do not be tempted to put left or right on cross-sectional images of the limbs.  Please also remember that there are many structures that do not require a side (e.g. splenic artery)!

  3. READ the question!

    • Not all questions are 'What structure does the arrow point to?'.  Some will ask you for a piece of information related to the structure.  Examples include: 'Name the structure that passes through the canal indicated by the arrow', 'Name the muscle group that attaches to the arrowed structure', 'What normal anatomical variant is demonstrated?', 'At what age does the structure arrowed normally fuse during skeletal development?' etc.

    • Some questions ask for a single answer.  If you write two pieces of information, you will be marked down.  Don't try to be clever, just answer the question!

  4. Do NOT use acronyms or abbreviations!

    • Always avoid these.  Many clinical errors have arisen from the use of acronyms and what is common in one institution may not be common elsewhere.  Always write LEFT and RIGHT in full.  Examples of what not to do are as follows: L, R, SMA, CCA, ACL, TP, CBD etc... the list is endless!

  5. Learn this list of normal variants

    • Whilst there are limitless variations of what might be considered normal, you will be tested on variations that are either common or have 'clinical significance' (i.e. may be mistaken for pathology or predispose the patient to certain diseases).  A list of normal variants to learn is provided here.

  6. Be specific, but not overly detailed!

    • The examiners are seeking a degree of detail that would be appropriate for a written radiology report.  The arrow placement is very specific and will indicate a single structure or a specific part of a larger structure.  For example if the arrow is pointing to the "neck of the left radius", just writing "left radius" will not be enough to score the mark.  Some questions will clearly indicate a relatively simple structure and hence excessive detail is unnecessary.  The best way to learn the level of detail required is to do lots of day-to-day radiology and do practise questions/exams.

  7. Watch this short instructional video from the RCR

  8. Practice on the RCR examination demo site

    • The RCR have developed their own software for the examination and you should practise using this software on their demo website prior to the exam.  You will require a PIN number to access the anatomy examination demo.  Unlike in previous exams, you will NOT have the opportunity to practice immediately prior to the start of the examination at venues, so practising on this demonstration site is essential to help you become familiar with the exam format!  Here are the links:

    • RCR exam demonstration site
    • Anatomy exam PIN access number

  9. Be careful with the spelling of similar sounding structures

    • The examination is not a spelling test and the examiners may overlook minor spelling mistakes, however certain structures have similar names (e.g. coronoid/coracoid and ilium/ileum) and care should be taken over these.  Confusion could arise in clinical practise, therefore mistakes over similar-sounding structures will be penalised.

  10. Write an answer for every question

    • There is no negative marking so if you are not sure of an answer then make a best guess!  If you are struggling to identify the structure marked, or know what it is but can't remember the name (very frustrating!), then write something and more on.  You can come back to it later.  Remember there is no negative marking.

  11. There is no pathology

    • If you see pathology, you probably need to spend more time reporting as the exam will only show normal anatomy and normal variants!  Occasionally minor age-related degenerative changes may be present on some images, however as the features of ageing are highly variable, this will not be tested.  Similarly, all arrows are only indicating anatomical structures.  The arrows will not be indicating artefacts, instruments, catheters or the contrast agent itself.

  12. Learn your paediatric radiology

    • Paediatric anatomy may include radiographs, fluoroscopy, ultrasound or cross sectional imaging.  It is important you know the anatomy of the growing skeleton on different imaging modalities.  You must be able to identify all the different parts of the growing bone and distinguish between epiphyses, apophyses and epiphyseal growth plates.  If you describe an epiphysis or apophysis as a secondary ossification centre, you will lose 1 mark as your answer will be only partically correct.  You should also be able to recognise common paediatric normal variants.

 

What are the best revision books for the First FRCR Anatomy exam?


Essential:

Imaging Atlas of Human Anatomy
Jamie Weir, Peter Abrahams, Jonathan Spratt, Lonie Salkowski

Imaging Atlas of Human Anatomy

There are some great books out there, however only one is essential!  This is it.  A comprehensive atlas for the FRCR anatomy exam.

 

Radiological Anatomy for FRCR Part 1
Philip Borg, Abdul Rahman Alvi

Radiological Anatomy for FRCR Part 1

Consists of 10 mock exams, with dedicated chapters on paediatrics and anatomical variants.  The mocks are comparable in difficulty to the actual exams.

 

Recommended:

First FRCR Anatomy Examination Revision (MasterPass)
Alexander King, Benjamin Hudson

First FRCR Anatomy Examination Revision (MasterPass)
 

 

 

First FRCR Anatomy: Practice Cases
Constantinos Tingerides, Ashley Uttley, David Minks, Claire Exley

First FRCR Anatomy: Practice Cases
 

 

 

First FRCR Anatomy: Mock Papers
Matthew Budak, Magdalena Szewczyk-Bieda, Richard White, Jamie Weir

First FRCR Anatomy: Mock Papers
 

 

 
 

 

What anatomy courses are there?


 First FRCR Anatomy Courses

  • Leicester FRCR Part 1 Anatomy Revision Course  
    4 x mock exams marked held in Leicester (1 day)
    Discount when attending both the anatomy and physics courses
  • Leeds FRCR Part 1 Anatomy Course  
    5 x mock exams marked held in Leeds (2 days)
  • Oxford FRCR Part 1 Anatomy Revision Course  
    Topics covered in exam format and 1 x mock exam held in Oxford (1 day)
    Early registrants will receive a free copy of Passing the FRCR Part 1: Cracking Anatomy
  • Imperial FRCR Part 1 Anatomy Course  
    Held in London
  • Peninsula FRCR Part 1 Anatomy Revision Course  
    Held in Plymouth
    Discount when attending both the anatomy and physics courses
  • Guys FRCR Part 1 Anatomy Course
    Held in London
    Contact This email address is being protected from spambots. You need JavaScript enabled to view it.

 

What are the best online resources?

 

 Recommended

Click here for Radiology Cafe's free mock anatomy exams

Free mock anatomy exams from Radiology Cafe
Free anatomy questions (1800 questions)

 Practice questions

 Useful websites


 

Physics module

Overview

The physics module covers UK ionising radiation legislation, patient safety and the physical principles that underpin diagnostic medial imaging.  The exam consists of 200 true or false questions.  There are 40 stems (question or statement) and five statements (answers) for each stem that must be marked true or false.  The paper lasts 2 hours.  The pass mark varies for each sitting, but is usually somewhere in the region of 70-75%.

The physics paper can be tricky, particularly if you didn't learn physics at school or university.  The key is to keep reading and learning until you have a good understanding of the key concepts.  There are many good resources out there including our own FRCR Physics Revision Notes here at radiologycafe.com.  The Radiology - Integrated Training Initiative (RITI) e-learning sessions are also particularly well thought out.  If you have structured physics teaching, make the most of these sessions by reading in advance and asking questions.

View the specialty training curriculum for clinical radiology.

 

FRCR Physics Notes Atom

Click on the atom to view our FRCR physics notes

 

 

Top tips for the First FRCR Physics exam

 

  1. Do lots of practice questions

    • After understanding the basic concepts, test yourself by doing lots of mock exam multiple-choice questions (MCQ).  Usually registrars in the years above have books that they no longer need and can be passed down.  Just a word of caution regarding accuracy - most books have a few questions with the wrong answer!  If you disagree with the book, it is always worth cross-referencing with a textbook as the book may be wrong!

  2. Use our FRCR Physics Notes for revision

    • At Radiology Cafe we have produced an incredible set of free FRCR Physics revision notes, which are based on, and cover, the entire scope of the RCR Radiology - integrated training initiative (R-ITI) e-learning upon which the first FRCR physics exams are based.  They are not a replacement for studying the R-ITI modules, but hopefully make things a little more structured and easy to understand, as well as provide a reference point when you quickly need to look something up.  The structured and organised nature of the notes makes them ideal for dipping into a specific topic for reference, although if you fancy reading the entire physics syllabus, you can do that!  They have been separated into chapters covering basic science, x-ray imaging, CT imaging, ultrasound imaging, MR imaging, nuclear imaging, and radiation dosimetry, protection and legislation.

       

  3. If you don't know the answer, make a logical guess

    • There is no negative marking therefore you should attempt to answer all questions!

  4. TTTTT or FFFFF

    • There is no restriction on the number of true or false items in a question.  It's possible for all five items to be true or all five to be false.  Tactics won't help you!

  5. Mark the answer sheet clearly

    • A computer is used to read the answer sheets so mark them clearly with a HB pencil.  If you place an incorrect mark, ensure you rub it out fully!
      Example of the physics exam paper marksheet

 

More information including sample physics questions can be found at the Royal College of Radiologists website.

 

What are the best revision books for the First FRCR Physics exam?


Essential:

FRCR Physics Notes
Sarah Abdulla, Christopher Clarke

FRCR Physics Notes: Beautiful revision notes for the First FRCR Physics exam

Written by radiologists for radiologists, and checked by physicists, these notes are concise but comprehensive covering the entire scope of the RCR Radiology - integrated training initiative (R-ITI) upon which the first FRCR physics exams are based.

 

Farr's Physics for Medical Imaging
Penelope Allisy-Roberts, Jerry Williams

Farr's Physics for Medical Imaging

The essential text for the FRCR physics exam.

 

Recommended:

MRI in Practice
Catherine Westbrook, Carolyn Roth, John Talbot

MRI in Practice
 

 

 

Get Through First FRCR: MCQs for the Physics Module
Grant Mair, Andrew Baird, Andrew Nisbet

Get Through First FRCR: MCQs for the Physics Module
 

 

 
 

 

What physics courses are there?


 First FRCR Physics Courses

  • Leicester FRCR Part 1 Physics Revision Course  
    Small group teaching, lectures and mock exam held in Leicester (3 days)
    Discount when attending both the anatomy and physics courses
  • Peninsula FRCR Part 1 Physics Revision Course  
    Held in Plymouth
    Discount when attending both the anatomy and physics courses
  • BIR Essential physics for FRCR  
    Lectures and workshops held in Sheffield (2 days)
  • Mersey FRCR Part 1 Physics Course
    Tutorials and mock exams held in Liverpool (2 days)
    Contact This email address is being protected from spambots. You need JavaScript enabled to view it.

 

What are the best online resources?

 

 Recommended

Click here for Radiology Cafe's free physics notes

Revision notes for the First FRCR Physics exam from Radiology Cafe
Free physics notes (covers the whole RCR syllabus)

 Useful websites

 Practice questions

 Apps


 

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!

 

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