There’s something daunting about FRCR Part 2A – not just because of the volume, but because of what it represents. It’s the point where radiology moves from theory to decision-making. Six hours of questions. Two papers. Every subspecialty in the mix.
But most people don’t struggle because they’re underprepared. They struggle because they prepared in the wrong way.
If you’ve spoken to people who’ve sat Part 2A recently, you’ll probably hear the same things come up: it’s long, it’s tiring, and it tests how well you can stay focused across a huge range of topics. Not just what you know – but how you apply it under pressure.
It’s not the hardest content, but the scale and format catch people out. The ones who get through it comfortably? They usually didn’t do anything fancy. They just started early, chipped away at it, and didn’t leave big gaps.
This is what they tend to get right, and what they often wish they’d done differently.
Start with a Real Foundation
If your plan is to read a few notes and blast through questions, you’ll probably find yourself hitting a wall. Because without a strong base, you’ll struggle to recognise patterns, connect clues, or apply knowledge under pressure.
Most candidates who pass start by reading a core textbook. Not a 1,000-page reference manual – but something readable. Concise, focused, and something you can realistically get through twice.
Your first read builds the scaffolding – anatomy, pathology, key signs, differentials, and imaging features. It’s where you learn things properly. What does a phaeochromocytoma actually look like on MRI? How do you stage rectal cancer? If you don’t know that yet, practice questions won’t help.
Plan to finish this first pass 6 to 8 weeks before the exam. That gives you time to shift into full-on question mode without feeling like you’re leaving gaps behind.
Use Questions to Learn – Not Just to Test
Some people make the mistake of holding back on question banks until they’ve “revised everything.” But that’s backwards.
You don’t need to know everything to start questions. You need to read a bit and then start using SBAs to figure out what’s stuck and what hasn’t. That’s the point.
The best approach? Read a section. Then do questions on it. Not to pass a quiz, but to help things settle. SBA questions are where understanding gets tested, refined, and corrected.
They also teach you how the exam is written. What’s asked. How options are phrased. What “safe registrar-level” really looks like in a question. You’ll notice a theme: the exam often tests either common presentations of uncommon conditions or uncommon presentations of common conditions. Keeping that in mind can help you rule in or rule out options more decisively.
Set a target. 4,000 questions across your prep is realistic. Twenty to thirty a day is enough to keep momentum, and if you miss a day, don’t panic. Just keep going.
Every error is a lesson. If you get something wrong, don’t just note the right answer –ask why you missed it in the first place.
Make FRCR Exam Prep Your Home Base
FRCR Exam Prep is widely used for a reason – it feels close to the real thing.
The platform mirrors the tone, structure, and pacing of the exam well. But it’s not just useful for the final few weeks. The earlier you start using it, the more natural the format feels.
You can use it in short bursts early on – maybe after finishing a chapter or when reviewing a system. But in the last month, it should be your go-to. Timed blocks. Full-length papers. Sessions where you’re sitting for an hour or more without stopping.
That’s how you build stamina. That’s how you learn to stay focused even when your brain’s tired, and you’re three hours in. Because in the real exam, that matters more than you think.
Know the Guidelines You’re Expected to Know
This is a UK exam. That means NICE guidelines, RCR recommendations, and national protocols are all fair game.
Don’t assume you’ll be tested only on textbook knowledge. You’ll need to know how real-world decisions are made – what happens next in a stroke or how to manage an incidental adrenal lesion.
High-yield areas include:
- Stroke imaging pathways
- Adrenal incidentaloma work-up
- Management of renal and testicular masses
- Trauma CT protocols
- Lung nodule follow-up (especially BTS guidelines)
You’re not expected to recite algorithms. But you do need to know what’s reasonable and appropriate in context. Candidates who skim over guidelines often regret it.
Don’t Go It Alone the Whole Way
Some people prefer solo revision. And if that works for you, great. But more than a few candidates have said they got more value than expected from small group study.
Having someone else to:
- Ask questions
- Challenge your understanding
- Explain that one topic you keep dodging
- Keep you honest about your progress
…it all helps.
You don’t need a full study group. Even one session a week with a colleague can keep you sharper than working entirely in isolation.
The Mistakes People Regret
There are a few patterns that come up again and again when candidates reflect on what they’d do differently:
- Leaving prep too late – Even if you feel relatively well-read, this exam is different. Six hours of recall and reasoning under pressure is not something you can cram for.
- Only reading, never applying – Reading feels productive. But unless you practise applying what you know, you don’t actually know how to use it.
- Avoiding weak subspecialties – Everyone has favourites. But the exam is balanced. MSK, paeds, gynae – if you don’t study them, you’re handing marks away.
- Trying to cover everything – You don’t need to know zebras. You need to know core radiology solidly, across the board.
The plans that actually work tend to be the ones people can stick to. Nothing fancy –
just steady progress without burning out. You don’t need to get everything right. You just need to be good enough, across enough topics, to pass.
What Candidates Say Afterwards
Here’s what comes up most often in feedback from people who passed:
“Start questions as early as possible. I learned more from SBA questions than anything else.”
“Read your core textbook twice. The first pass is slow. The second one sticks.”
“Simulate the full exam. Six hours of SBAs is mentally brutal if you haven’t practised.”
“It’s not about obscure trivia. It’s about recognising common patterns and making safe decisions.”
How to Structure Your Time
You don’t need a rigid daily schedule. But having a loose framework can keep you grounded:
Months 1–2:
Start reading a core textbook. Take notes on tricky topics. Begin slow SBA practice after each section.
Months 3–4:
Ramp up the question work. 20–30 per day during the week, more on weekends if you can. Review errors. Revisit weak areas. Read guideline summaries – oncology, trauma, lung nodules etc.
Final 2–3 weeks:
At this stage, it pays to focus on one platform. For most people, FRCR Exam Prep is the closest match to the real exam, so using it as your main resource is a sensible way to build stamina and exam rhythm. Sit at least two full mock papers under timed conditions.
Final Thoughts
FRCR 2A isn’t about being the smartest person in the room. It’s about showing that you can work across the full range of radiology in a sensible, consistent, registrar-level way.
It’s not a trick exam. It doesn’t reward cramming or panic. It rewards planning. Practice. Steady effort.
A few days before the exam, I remember thinking, “I’m nowhere near ready.” There were still whole topics I hadn’t gone over properly and certain questions I just kept getting wrong no matter how many times I tried. It felt like too much. But it turned out that feeling was pretty normal. Most people don’t feel fully ready – they just reach a point where they’ve done enough and sit it anyway. If you’ve been showing up, learning from your mistakes, and not ignoring the bits you don’t like, you’ve probably done more than you think.
Thank you to the joint editorial team of FRCR Exam Prep for this ‘Exam Tips’ post.
