Tips and Tricks on Passing the Exam
FRCPath Part 1 Revision Course 2025
ST6 Histopathology Trainee
Nikhil Ravikumar
Exam Structure
● 3 hour long exam
● 125 Multiple Choice Questions (MCQ)
● 80 single best answer (SBA) - out of 5 choices
● 9 Extended Matching Questions (EMQs)
○ 5 questions from one topic
○ Pick the best choice out of the available 10-15choices
● Each question may be accompanied by pictures
● At present you sit the exam at home via your computer
○ Invigilated on Webcam
○ You are allowed one small-ishwhiteboard that must be wiped clean at the end
Example MCQ Question
A 45 year old woman has a skin disorder. A punch biopsy has histology showed in the image: Which auto-antibodies are most likely to be elevated?
A. Anti-endomysial antibodies
A. Anti-intrinsic factor antibodies
A. Anti-mitochondrial antibodies
A. Anti-neutrophil cytoplasmic antibodies
A. Anti-smooth muscle antibodies
Example MCQ Question
A 45 year old woman has a skin disorder. A punch biopsy has histology showed in the image: Which auto-antibodies are most likely to be elevated?
A. Anti-endomysial antibodies
A. Anti-intrinsic factor antibodies
A. Anti-mitochondrial antibodies
A. Anti-neutrophil cytoplasmic antibodies
A. Anti-smooth muscle antibodies
What the Exam is Really Testing
● The exam is testing more than just your ability to recognise a pathological entity
● The exam tests the breadth of your pathology knowledge as well as the depth of your knowledge in topics that may be difficult to test in the Part 2
● 70% of the exam will relate to entities that you should have come across in your day-to-day training
○ However, the exam willtest your depth in terms of what you know
○ E.g. common translocations
○ Common situations where you might use immunohistochemistry
○ Questions relating to the pathophysiologyof the condition
○ Quirks relating to a certain condition
● The exam serves as a benchmark of basic pathology knowledge which the Royal College believes every trainee pathologist should have obtained at this stage.
How to Approach the Exam
● At this stage, you should have seen most of the common entities across the ‘bread and butter’ specialities
● You should have a good idea of the commonly utilised datasets
● The way you approach the exam depends on the type of person you are
○ Some people are suited to loads of consistent and wholesome reading
○ Some people are more suited to directed reading
● Remember, pathology is a vast (and highly interesting) domain of expertise
○ So reading is a must
○ But for the exam, I suggest very directed and topical reading
● Ask your Consultants at work for advice when you get stuck
● When reading, it is very important to consider - how can they test me about this topic/entity?
How to Approach the Exam
● When studying
○ Focus on the clinical aspects e.g. age/gender, course
○ Macro descriptions can often give you major hints to the condition
○ Pathologists love to use descriptive terminology that is often ‘pathognomonic’ for a condition/pattern
○ Focus on differentials where the diagnosis alters the management
● Read the datasets on the RCPath Website
● Focus on the topics that you have never had any knowledge of
● Try to get cases from archive/view digitally
● Discuss and learn from others you are training with
How to Approach the Exam
● When studying
○ Focus on the clinical aspects e.g. age/gender, course
○ Macro descriptions can often give you major hints to the condition
○ Pathologists love to use descriptive terminology that is often ‘pathognomonic’ for a condition/pattern
○ Focus on differentials where the diagnosis alters the management
● Read the datasets on the RCPath Website
● Focus on the topics that you have never had any knowledge of
● Practice on questions
○ Importantly practice on figuring out what the question is actually asking you
○ You only have about 1min 45seconds per question
○ Figure out what is going to be your strategy for the exam
Favorite topics of the exam
● MedicalRenal
● MedicalLiver
● Thyroid pathology
● Salivary gland neoplasms
● Soft tissueneoplasms
● Bone pathology- including radiologicalcorrelation
● Non-neoplasticskin conditions
● Haematopathology
● InterstitialLung Disease
● Brain pathology
○ Usuallyrelating either to things whichmay be seenin head and neck
○ Or commonlythings seenat post-mortem
● Translocations
● Tumour and Familial Syndromes
● Paediatricpathology
● Infectious Diseases
Datasets that you MUST read
● Skin Datasets - BCC, SCC and Melanoma
○ Pay attention to high risk and upstaging criteria
● Lung Cancer
● Head and Neck
○ Pay specialattention to the Oral Cavity and Pharyngeal datasets
○ Use of p16 IHC
● Gynae Datasets
○ Make sure to read the sections on IHC
● Soft Tissue
○ IHC and Translocations sections is a must
● GI
● All the urology ones - Renal, Urinary, Prostate and Testicular
● CUP
Datasets that you MUST read - Con’t
● Don’t forget the Autopsy ones if you have time
○ Industrial/Occupational Disease related death
○ Sudden death in cardiovascular pathology
○ Epilepsy
Useful Resources
● Reading material
○ Robbins - especially the modules in the start of the digital edition
○ Quick Reference Handbook for Surgical Pathologists by Natasha Rekhtman
○ Kurt’s Notes
○ Utah Webpath - Loads of basics covered and loads of tutorials on systemic pathology
● Viewing Material
○ Youtube - Jared Gardner
○ Youtube - Pathcast
○ Youtube - Rajal Shah
○ Youtube - Washington Deceit
○ Youtube - 15 Diagnoses in Inflammatory Dermatopathology Every Path Resident Should Know
○ Johns Hopkins Bone Pathology Cases
Useful Resources - Con’t
● Exam Question Resources
○ Anatomic Pathology Board Review by Jay Lefkovitch
■ The online access to Elsevier Review Website is amazing
■ Loads of pictures and detailed explanations
○ Robbin’s Review of Pathology
○ Sternberg's Diagnostic Surgical Pathology Review
○ FRCPath, Part 1: Examination Preparation Guide - By S. Steele
■ Very useful full mock exams to test your pacing - lacks pictures though
○ Pathoutlines Board Review Questions (Free)
Mental Preparation and Pro Tips
● Ramp up your revision and revise intensely leading up to the exam - this is a marathon not a race
● Focus on repetitive, easy methods to remember memory-test topics like translocations and staging
● Sleep well during revision period and especially the night before the exam
● Keep yourself physically active - will help your mental strength
Mental Preparation and Pro Tips
● Ensure everything in your desk set-up is in order prior to the exam
○ Download the testreach app in advance and check your email for the login details
○ Book a suitable exam time
○ Have a large desk if possible
○ Use a single, large desktop monitor
○ Have a working webcamand microphone
○ Have a stable, high-speed internet connection
○ Ensure the environment is quiet and peaceful
● Have loads of snacks ready for the exam - I really mean it!
○ Water, coffee, energy drinks
○ Chocolate bars, chocolate bags,sweets
Good Luck!