FRCR 2B rapid-reporting

Dr Jeremy Jones et al.

The FRCR 2B rapid-reporting component of the FRCR part 2B is the final part of the FRCR examination.  It aims to assess the candidate's ability to accurately detect abnormalities in the type of plain films usually seen in a standard reporting pile.  Thus, it generally consists of chest and appendicular radiographs.

Radiopaedia.org Rapids is a set of free practice rapid reporting examinations.

The examination is 35 minutes long and 30 plain films are shown in soft copy using Osirix. The candidate must report them as normal or abnormal; where abnormal, they must record the abnormality.

The cases selected by the college examiners must only have one abnormality on them - age-related degenerative change and normal variants are considered "normal".

Of the 30 cases, approximately half will be normal.  It is generally considered that when the examiners select cases, they will be more likely to give more abnormal than normal, giving a range of approximately 15-17 abnormal and 13-15 normal.  That is just a guide though.

It would appear that there is no clearly defined pass mark. While it was rumoured previously that the pass mark was 27/30, that is less clear now.

The rapid-reporting exam was previously a test of the candidate's ability to work their way through a packet of hard-copy and much of the exam technique that is banded about relates to the difficult of man-handling hard-copy films and keeping track of the films that have been looked at.

What you must not do is spend too long ruminating about the film that is possibly abnormal.

One way of approaching the test
  • start with the first film
  • is it definitely abnormal?
    • yes: mark it on the marking sheet and write down what's abnormal
    • no: move on - don't spend long looking at the film, you will get the chance to do it later
  • move to the next film - repeat

Using this technique, you should be able to review all 30 films in about 10 minutes and have picked up all the obviously abnormal films.  Depending on the test, you might have picked out 10 abnormals in this first run.  However, it is worth noting that all radiologists who are not blind will have probably picked out these films too, so they are not discriminatory in the least!

The remaining cases (approximately 20) will contain the remaining 5 or so abnormal films. These will be more subtle and may include pathology located at the edge of the film:

  • shoulder dislocation on the chest radiograph
  • dens fracture on the skull radiograph
  • eroded apical rib
  • subtle paraspinal collection
  • fibular fracture only visible on the lateral ankle radiograph through the tibia
  • subtle paediatric distal radial fracture

The only way to be sure that a film is normal is to have checked it in a systematic fashion to ensure that you've not missed anything. That is where a checklist approach to reporting is helpful - the checklists offered are just a starting point and it will be likely that you will add your review areas.

https://radiopaedia.org/courses/Rapids: a selection of easy to use typical rapid reporting sets curated by our very own editorial team with FRCR exam experience.

www.frcracademy.co.uk: a revision resource with ten free sets of rapid reporting cases created by UK based radiology registrars and consultants.

www.frcrtutorials.com: a useful FRCR revision resource with the full range of Rapid Reporting, Long Cases and Viva sets. Created by a UK based Radiologist.


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rID: 16877
Tags: exam, frcr
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Cases and Figures

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    Case 1: typical CXR case
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    Case 2: lung cancer on a shoulder film
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    Case 3: pneumothorax on shoulder x-ray
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    Case 4: ACJ injury on CXR
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    Case 5: triqueteral fracture
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