Radiology Specialist Training Overview, Induction and Exams

Programme Overview

This page provides some details of the day-to-day for each year of training along with details of the FRCR exams. If you have joined us as a new registrar then you are very welcome. If you have found this page whilst looking into regions for an application to radiology then the information below is a rough outline of what 5 years in Edinburgh looks like.

 
 

Expectations for each year and exams

ST1


Welcome to the Edinburgh Radiology department!

You will attend induction on the first Wednesday of August together and will spend the rest of that week learning the ropes. From the next monday some of you will be based at the Royal (RIE) and some at the Western (WGH). During your first year you will spend time at both of those main sites and also at one of the nearby district general hospitals, the main focus of the year being general radiology. Your working day will be 0830-1700 , although often little happens until 0900 (with the exception of inpatient CT at RIE and weekly MDTs).

Your main objectives for ST1 are to pass the FRCR part 1 (anatomy and physics), prepare to start on the ultrasound on-call rota from the start of ST2 and become independent at reporting appendicular trauma radiography. Aside from this, you should start to become comfortable producing a provisional report for other common radiographic and CT studies and these will always be checked.

In your first few weeks you will feel like you know very little but this comes with time. In your first year you will be predominantly supernumerary but first impressions count so do your best to be hard-working and enthusiastic. It doesn't matter if you get things wrong - in fact it is far better to have a go and get something wrong and learn, than to shy away, sit on the fence or not try.

You are expected to complete work-based assessments throughout the year in the form of DOPS (observation of a practical skill) and IPX (image reporting and interpretation) - you are required to have 10 of each of these by the end of May, attained at approximately one of each per month. A DOPS should be directly observed, ideally for a whole list, and should include a debrief on what went well and what could be improved. Similarly, an IPX should be for a whole list and should include same-session feedback. See ARCP section for more details.

Each year you will be expected to complete a quality improvement project (audit), but the projects in 1st and 4th years are presented at the Edinburgh Radiology Society (ERS) audit evening at the end of the year. Make sure you find a good audit that answers a clinical question and changes current practice. Ask some consultants whether they have any ideas, or if you have an idea yourself, approach someone with that specialist interest.


Books for ST1

  • Anatomy at a glance - don't buy this, but do get it from the library and give it a read
  • Weir's Imaging Atlas of Human Anatomy - the gold-standard for passing the anatomy exam
  • eAnatomy at IMAIOS.com - a good web/app based anatomy resource (many consider to replace Weir's)
  • Farr's Physics for Medical Imaging - a horrible book but you'll need a copy
  • Practical Ultrasound, Alty - give this a good read before the end of the year
  • Accident & Emergency Radiology - try not to buy this as you may get it free if you go to the Glasgow course
 

ST2


As each year goes by there is a new level of responsibility; thankfully in radiology, trainees tend to feel ready for the challenge when they come around. This year is the start of the ultrasound on-call rota at weekends. This consists of two 12 hour days 0900-2100 with booked inpatient lists until 1630 and on-call scans thereafter. See the on-call handbook for further information.

As the year moves on you will start to feel the prospect of ST3 CT on-call looming. Spend the year trying to build up experience in CT: reporting common pathology, understanding what 'normal' looks like and trying to build on your reporting speed and decision making. Most trainees will be ready to take this step when they come to the end of ST2 and will pass the required on-call test without trouble.

Over the next 2 years you will start your specialist blocks: these are Paediatrics, Neuroradiology, Breast, MSK/Nuclear Medicine. You will get the most out of these by doing background reading before you start and getting stuck in. It is a good opportunity to see new pathology and learn new skills. You won't finish all of these by the end of ST2 and some will be in ST3.


FRCR 2A Exam

The FRCR 2A exams will also be on the horizon and the ST2 year is pivotal. You will take these exams just before Christmas of your ST3 which might seem like a long way away but in fact will most likely require an 18 month run-up - most of the ground work for the 2A exam should be done in your ST2 year. Most trainees will use a combination of textbooks and question books and you must leave yourself enough time to read and digest everything you want to use (primary-learning) before you turn to actual revision. Here are three approaches from different past registrars:

Registrar 1

I used Primer as my main learning resource. This book contains all the core detail but does miss some of the finer points - I figure that if you know everything in primer like the back of your hand and get nothing in the book wrong then you'll pass the exam. I then used Grainger & Allison along with some of the specialist module books to fill in the gaps. Finally I did all the question books twice - the first time I was still learning, but by the second time through I was confident I was doing well.

Registrar 2

Check back soon

Registrar 3

Check back soon


Books for FRCR 2A

  • Notes
    • Primer of Diagnostic Imaging - easy to read, contains the main things but lacks the fine detail
    • Dahnert Radiology Review Manual - lots of extensive lists; some love it, some hate it
    • Revision Notes for the final FRCR Part A
  • Resource Textbook
    • Grainger & Allison: Diagnostic Radiology
    • Brant & Helms: Fundimentals of Radiology
  • Specialist books
    • Lane Donnelley: Fundamentals of Pediatric Imaging
    • Helms: Fundimentals of MSK Radiology (The Pink Book)
  • Question Books
    • Get-Through (two versions on the go; one recently updated to the new exam format but different Qs still in the old one!)
    • Masterpass
    • Oxford
    • Cambridge
    • Grainger & Allison
    • BIR: Imaging SBA - App
 
 

ST3


By now you'll be getting the hang of things. You should be moving onto the CT on-call rota at WGH and starting night-shifts covering RIE and paediatrics - see the on-call handbook for details.

You should also be nearly finished your learning-phase for the FRCR 2A and moving on to proper revision and consolidation. Take the run-in to the exam carefully as you don't want to burn out before you get there, but equally make sure you have covered all the ground you need to.

If you haven't already, start thinking about picking up some more management type roles. Try to find a committee to sit on or a rota to arrange. Try to organise teaching for junior registrars or take a bigger role in hot topics or journal club. Also consider attending conferences, submitting articles and posters - see dedicated section. It will be noticed if you are happy to put effort in and lead others and it's never too early to start thinking about your CV.

 

ST4


The main focus of this year is to get your 2A exams out of the way if you haven't already and to begin to focus on your FRCR 2B exit exam. This exam is a lot of hard work but most consider it to be more enjoyable than the 2A as it is more practical and similar to day-to-day practice. Focus your day-to-day work on gaining as much experience in all areas of radiology as possible, treating CT lists as long cases, plain film lists as rapids and seeking viva-style teaching where possible.

You will have been performing audit projects each year but your 4th year project should be something a little more special. Try to move towards research rather than audit and try to produce something that you can publish. You will present this at the ERS audit evening along with the ST1 projects but aim for something you can take to an international conference either as a poster or presentation.

You will now be able to choose your blocks for the 4th and 5th years in order to develop skills and experience in areas of sub-specialist interest. It is usually a good idea to have a general block at around the time of the 2B exam as this is really useful for preparation.


FRCR 2B Exam

This exam consists of three components with marks collated to give an overall score. The rapid-reporting exam involves 30 images in 35 minutes with a pass mark of 27. The written exam involves 6 multi-modality cases and tests identification, interpretation and decision making. The viva involves four 15 minute hot-seat style sessions, reporting films orally to an examiner, incorporating multiple cases, modalities and specialities.


Books for FRCR 2B
  • O'Brien: Top 3 Differentials in Radiology
  • Long Cases for the Final FRCR 2B, Hanlon
  • Final FRCR 2B Long Cases: Aw
  • Get Through: FRCR 2B, Sharma
  • FRCR 2B Viva: A Case Based Approach, Sidhu
  • Final FRCR 2B Viva: A Survival Guide, Tan
 
 

ST5


Your final year is all about consolidating your knowledge, your sub-specialist interests and your CV. By the end (or possibly sooner) of this year, you may well be applying for and interviewing for consultant posts, so aim to attain that level of practice. Work closely with your consultant colleagues, learning as much as you can about radiology but also learning how the department works, how job-plans are structured and how to manage a busy workload.

 

Further Training

Interventional Training

Check back soon


Neurointerventional Training

Interventional neuroradiology is a demanding but exciting specialty dealing with vascular pathology of the brain and spine. It is currently expanding to face the demands of delivering mechanical thrombectomy for stroke patients. When available, applications for interventional neuroradiology take place in the third year of clinical radiology, for an ST4-6 training number.

Training is spent developing the diagnostic, technical and clinical skills required to practice as an interventional neuroradiologist. There are also opportunites to get involved with audit, teaching and research. If you're interested in interventional neuroradiology, speak to one of the consultants and spend some time in the angio suite during your placement at the DCN.


Paediatric Training

There is no formal sub-specialist training program for paediatric radiology. However, the 4th and 5th years of training are relatively flexible and extended periods working at the Royal Hospital for Sick Children (RHSC) are usually possible.

Another option for further training is a post-CCT fellowship within the UK or abroad. These are not mandatory but do provide excellent experience.


Post CCT Fellowships

Check back soon
 
 

Local & National Societies

 
Edinburgh Radiology Society (ERS)

Small fee to join as a trainee. Monthly (approximately) evening meetings at one of the Edinburgh sites. Topics are wide-ranging and include guest speakers, radiology hot-topics, local practice, career advice and many in-between. Nibbles are usually provided and there is sometimes a meal afterwards.

Scottish Radiology Society (SRS)

Biannual meetings, with a strong focus on clinical practice and often with a half day trainee conference before the main event. SRS is independent from Scottish radiology management.