Final FRCR Part B long cases examination

Last revised by Daniel J Bell on 4 Dec 2019

The Final FRCR Part B long cases examination is one of the three parts of the final Final FRCR Part B exam. It comprises six long cases that are viewed on the RCR digital examination platform (Practique) under exam conditions. The time allowed for the exam is 75 minutes (new from Autumn 2018).

Cases may comprise single or multiple modalities and may include ultrasound, plain film, fluoroscopy, CT, MRI, or nuclear medicine. In general, the six cases will cover a broad range of the curriculum.

Answers are typed. The structure is:

  • observations: recording of factual observations from the studies provided
  • interpretation: interpretation of the observed findings, for example, describing whether the process is aggressive or non-aggressive
  • main diagnosis: the most likely unifying diagnosis
  • differential diagnosis: if there are any differential diagnoses, these should be included here
  • relevant further investigations or management: this might include clinician notification, further investigations, referral pathway or appropriate multidisciplinary team (MDT) discussion

Exam technique

Until Autumn 2018, the long cases section of the FRCR 2B exam was allowed 60 minutes. Following the introduction of the new computed system, this was extended to 75 minutes.

Timekeeping however still remains one of the most important aspects of this exam. You must make sure you have time to answer all six questions. Being strict with timing is vital, taking eleven minutes per case leaves nine minutes contingency time to go back to any difficult or complex case at the end. After eleven minutes you should move on, even if you have not completed the case in full.

Marking schema

Individual cases are marked out of 8 as indicated below:

3  no answer offered

4  fail: significant observations missed; correct diagnosis not made 

5  borderline: appropriate if there are two main diagnoses in the case but only one is mentioned; some observations missed               

6  pass: most observations made correctly; principal diagnoses correct

7  good pass: additional relevant material included in a "pass" grade answer       

8  excellent: a perfect answer, clear and confident

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