First FRCR exam - Radiology Cafe (2024)

Contents

• 1. Anatomy module
  1a. Overview
  1b. Marking
  1c. Top tips
  1d. Books
  1e. Courses
  1f. Online resources
• 2. Physics module
  2a. Overview
  2b. Top tips
  2c. Books
  2d. Courses
  2e. Online resources

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 examshere at radiologycafe.com.

2. Remember to say left or 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 youstate 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 writeLEFT 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 exampleif 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. Practice on the RCR examination demo site

   • The RCR have developed their own software for the examination and you should practice 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

8. 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.

9. 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.

10. 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.

11. Learn your paediatric radiology

    • Paediatric anatomy may include radiographs, fluoroscopy, ultrasound or cross sectional imaging, and comes up more frequently than expected in the examination. 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.

12. Watch this short instructional video from the Royal College of Radiologists (RCR)

    • This short instructional video from the RCR is excellent and demonstrates how to select, view and move through examination cases using the image viewing software. Alternative link to the short instructional video.

1. Do lots of practice questions

   • After understanding the basicconcepts, test yourself by doing lots of mock exam multiple-choice questions (MCQ). Usually trainees 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 alwaysworth 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 theRCR 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-ITImodules, 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 idealfor dipping into aspecific 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, molecular 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 youplace an incorrect mark,ensure you rub it out fully!

Further resources

• Examination hints and tips from the RCR
• First FRCR Examination