Tips and Tricks on Passing the Exam FRCPath Part 1 Course 2022 Nikhil Ravikumar ST3 Histopathology Trainee
Exam Structure ●
3 hour long exam
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125 Multiple Choice Questions (MCQ)
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80 single best answer - out of 5 choices
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9 Extended Matching Questions (EMQs) ○
5 questions from one topic
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Pick the best choice out of the available 10-15 choices
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Each question may be accompanied by pictures
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At present you sit the exam at home via your computer ○
Invigilated on Webcam
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You are allowed one small-ish whiteboard 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 B. Anti-intrinsic factor antibodies C. Anti-mitochondrial antibodies D. Anti-neutrophil cytoplasmic antibodies E. 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 B. Anti-intrinsic factor antibodies C. Anti-mitochondrial antibodies D. Anti-neutrophil cytoplasmic antibodies E. Anti-smooth muscle antibodies
What the Exam is Really Testing ●
The exam is testing more than just your ability to recognise a pathological entity
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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
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70% of the exam will relate to entities that you should have come across in your day-to-day training ○
However, the exam will test your depth in terms of what you know
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E.g. common translocations
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Common situations where you might use immunohistochemistry
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Questions relating to the pathophysiology of the condition
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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
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At this stage, you should have seen most of the common entities across the ‘bread and butter’ specialities
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You should have a good idea of the commonly utilised datasets
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The way you approach the exam depends on the type of person you are
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Some people are suited to loads of consistent and wholesome reading
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Some people are more suited to directed reading
Remember, pathology is a vast (and highly interesting) domain of expertise ○
So reading is a must
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But for the exam, I suggested very directed and topical reading
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Ask your Consultants at work for advice when you get stuck
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When reading, it is very important to consider - how can they test me about this topic/entity?
How to Approach the Exam
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When studying ○
Focus on the clinical aspects e.g. age/gender, course
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Macro descriptions can often give you major hints to the condition
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Pathologists love to use descriptive terminology that is often ‘pathognomonic’ for a condition/pattern
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Focus on differentials where the diagnosis alters the management
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Read the datasets on the RCPath Website
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Focus on the topics that you have never had any knowledge of
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Try to get cases from archive/view digitally
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Discuss and learn from others you are training with
How to Approach the Exam
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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
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Focus on the topics that you have never had any knowledge of
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Practice on questions ○
Importantly practice on figuring out what the question is actually asking you
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You only have about 1min 45seconds per question
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Figure out what is going to be your strategy for the exam
Favorite topics of the exam
● Medical Renal ● Medical Liver ● Thyroid pathology ● Salivary gland neoplasms ● Soft tissue neoplasms ● Bone pathology - including radiological correlation ● Non-neoplastic skin conditions ● Haematopathology ● Interstitial Lung Disease ● Brain pathology ○
Usually relating either to things which may be seen in head and neck
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Or commonly things seen at post-mortem
● Translocations ● Paediatric pathology
Datasets that you MUST read ●
Skin Datasets - BCC, SCC and Melanoma ○
Pay attention to high risk and upstaging criteria
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Lung Cancer
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Head and Neck
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Pay special attention to the Oral Cavity and Pharyngeal datasets
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Use of p16 IHC
Gynae Datasets ○
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Make sure to read the sections on IHC
Soft Tissue ○
IHC section is a must
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GI
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All the urology ones - Renal, Urinary, Prostate and Testicular
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CUP
Datasets that you MUST read - Con’t ●
Don’t forget the Autopsy ones if you have time ○
Industrial/Occupational Disease related death
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Sudden death in cardiovascular pathology
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Epilepsy
Useful Resources ●
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Reading material ○
Robbins - especially the modules in the start of the digital edition
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Quick Reference Handbook for Surgical Pathologists by Natasha Rekhtman
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Kurt’s Notes
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Utah Webpath - Loads of basics covered and loads of tutorials on systemic pathology
Viewing Material ○
Youtube - Jared Gardner
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Youtube - Pathcast
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Youtube - Rajal Shah
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Youtube - Washington Deceit
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Youtube - 15 Diagnoses in Inflammatory Dermatopathology Every Path Resident Should Know
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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
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Loads of pictures and detailed explanations
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Robbin’s Review of Pathology
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Sternberg's Diagnostic Surgical Pathology Review
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FRCPath, Part 1: Examination Preparation Guide - By S. Steele ■
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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
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Focus on repetitive, easy methods to remember memory-test topics like translocations and staging
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Sleep well during revision period and especially the night before the exam
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Keep yourself physically active - will help your mental strength
Mental Preparation and Pro Tips ●
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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
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Book a suitable exam time
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Have a large desk if possible
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Use a single, large desktop monitor
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Have a working webcam and microphone
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Have a stable, high-speed internet connection
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Ensure the environment is quiet and peaceful
Have loads of snacks ready for the exam - I really mean it! ○
Water, coffee, energy drinks
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Chocolate bars, chocolate bags, sweets
Good Luck!