The RANZCR pathology examination is part of the RANZCR Phase 2 written examinations. It aims to assess both core and advanced knowledge of pathology, and its application to radiological practice.

The examination can be attempted as early as 12 months from the start of training if all the other Phase 1 training requirements have been met. Trainees have a maximum of three opportunities to complete the pathology examination. 

The passing standard is set by the relevant examination review panel using formal standard-setting procedures. As well as achieving the overall passing standard, candidates must achieve minimum standards in a determined number of examination components in order to pass.

Learning outcomes

The examination aims to assess a thorough knowledge of general pathology, particularly in relation to the identification of disease and conditions using imaging. This includes recognition of the pathological consequences of disease, as well as morphological changes associated with therapies and occupational exposures.

Clinical conditions are organized into three categories:

1. common conditions or conditions in which the radiologist plays a vital role in diagnosis

2. conditions that may have less urgency in diagnosis

3. rare conditions that a radiologist must broadly know of, but in enough detail to include them in a differential diagnosis

Format

The examination is 3 hours in duration and consists of:

• 100 multiple choice questions: each with a stem and five possible answers, worth 1 mark per question

• 10 short answer questions: two general questions and one question per topic area (see below), worth 6 marks per question (each question requires no more than 3-4 sentences)

All questions are text-based, i.e. no images are shown. There is also no negative marking.

Since August 2012, the examination has been delivered electronically. It is delivered on the Practique system at a local Cliftons venue.

Content

There are nine topic areas covered in the examination with the following approximate weightings:

• genetic syndromes / multi-system conditions (5%)

• brain (15%)

• head and neck (15%)

• spine (5%)

• cardiothoracic (15%)

• abdominal and pelvis (20%)

• musculoskeletal system (5%)

• breast (5%)

• obstetrics and gynecology (15%)

Specific topics include:

• cellular adaptations of growth and differentiation, including:

  • hyperplasia, hypertrophy, atrophy, and metaplasia

• cell injury and cell death, including:

  • necrosis and apoptosis

• intracellular accumulations and their relevance in pathological conditions, including:

  • lipids, proteins, glycogen, and pigments

• pathological calcification and associated morphological changes

• acute and chronic inflammation

• regeneration, repair and scar formation, fibrosis, and healing in specialized tissues (e.g. fracture healing)

• hemodynamic disorders, thromboembolic disease, and shock, including:

  • edema and effusions

  • hyperemia and congestion

  • hemorrhagic disorders (defects of primary and secondary hemostasis)

  • thrombosis

  • disseminated intravascular coagulation

  • embolism

  • infarction

• hypersensitivity reactions, autoimmune diseases, and immunodeficiency syndromes, including:

  • systemic lupus erythematosus

  • scleroderma

  • vasculitis

    • small vessel: granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis

    • medium vessel: polyarteritis nodosa, Kawasaki disease

    • large vessel: giant cell arteritis, Takayasu arteritis

  • IgG4-related disease

  • tissue transplant rejection

  • acquired immunodeficiency syndrome

  • amyloidosis

• neoplasia, including:

  • tumor nomenclature, tumor classification, and staging systems

  • benign and malignant tumors

  • clinical aspects (including local effects, hormonal effects, and paraneoplastic syndromes)

  • tumor markers

• infections

• tobacco, alcohol, and drug use

• adverse drug reactions

• radiation injury

• poisons

• nutritional deficiencies

• obesity

• diabetes mellitus

• occupational exposures

The examination questions are rewritten every year and are drawn directly from the latest edition of Robbins & Cotran Pathologic Basis of Disease.

Prize

Each year, RANZCR awards the most successful candidate in the pathology examination the MGF Donnan Prize, named in honor of Dr Gordon Donnan, a radiologist who was instrumental in the formative years of the college. The recipient is awarded a cash prize equivalent to the cost of their exam fee and complimentary early bird registration to the RANZCR Annual Scientific Meeting (ASM) that year ³.

NB: Details are correct at the time of writing. Please check with RANZCR for updated details.