RCPA Anatomical Pathology Fellowship Examination Format Explained
Overall structure
Two-part single-discipline exam after a minimum 5 years training. No MCQ.
Components and structure
The RCPA Anatomical Pathology Fellowship Examination is assessed across the following components:
- Part I Written (mixed-format) — 195 min. Criterion-referenced Pass/Fail. Both Part I components must be passed within 5 years of first attempt.
- Part I Histopathology Digital Slides (digital slides) — 255 min. Practical.
- Part II Histopathology Digital Slides (digital slides).
- Part II Small Biopsy & Special Techniques (practical) — 210 min.
- Part II Cytology Digital Slides (digital slides) — 135 min.
- Part II Oral (oral). All-day structured oral.
Part I (Written + Digital Slides) must be passed before Part II. Part I has no Oral in the 2026 structure. No MCQ.
Attempt limits: Part II within 5 years of passing Part I.
Exam format glossary
Key assessment formats used in the RCPA Anatomical Pathology Fellowship Examination, defined. Each definition is general and applies across colleges.
- Viva voce
- A structured oral examination in which examiners question the candidate in real time, assessing reasoning, justification and depth of understanding under pressure.
- Digital slides (virtual microscopy)
- Whole-slide pathology images interpreted on screen, replacing the glass-slide microscope station in modern pathology examinations.
What the format means for your preparation
The single most common preparation mistake is studying as if the examination only had an MCQ component. Format-aware preparation looks like this:
- MCQ components reward high question volume and pattern recognition. Read explanations, not just answers, and revisit weak domains with spaced repetition.
- Short answer / SAQ components reward a prioritised, structured response under time pressure. Practise writing complete answers in the available time, not just outlining points.
- Viva or OSCE components reward verbalised structured reasoning. Practise aloud, ideally with feedback, rather than rehearsing silently.
- Practical or image-based components reward repeated exposure under time pressure. Build a routine that includes timed slide or image interpretation.
What separates pass from fail under this format
Across multiple sittings, these failure modes recur:
- Cytopathology underprepared - a dedicated practical component requires systematic slide-based preparation, not just reading.
- SAQ answers that describe rather than diagnose and manage: examiners want clinical context integrated with pathological findings.
- Rare tumour entities: uncommon variants and diagnostic pitfalls are reliably tested and require explicit study.
- Insufficient microscopy practice - slide interpretation is a perishable skill that degrades without regular use.
How PRIMEX maps to the format
- Written and SAQ practice mapped to the RCPA Anatomical Pathology curriculum.
- Image-based practice for histopathology and cytopathology slide interpretation.
- Curriculum-mapped study notes across surgical, cytological, and forensic pathology.
Start your 7-day free PRIMEX trial for the RCPA Anatomical Pathology Fellowship Examination and practise in the format you will actually sit.
Start free trialFrequently asked questions
What is the format of the RCPA Anatomical Pathology Fellowship Examination?
Two-part single-discipline exam after a minimum 5 years training. No MCQ.
How many components does the RCPA Anatomical Pathology Fellowship Examination have?
The examination has 6 assessed components, examined and weighted as the examining body specifies. The structured breakdown above reflects the official examination materials.
Which component is hardest?
Difficulty varies by candidate. Most fail-tier outcomes trace back to underprepared structured-answer technique or insufficient question practice volume rather than to one specific component.
How should the format change how I prepare?
Match your practice mode to the format. SAQ paper means write structured timed answers; viva or OSCE means rehearse speaking aloud under time pressure; MCQ means build pattern recognition through high-volume practice.
Does PRIMEX cover every component?
PRIMEX covers each component of the RCPA Anatomical Pathology Fellowship Examination with format-specific practice: MCQ banks, AI-graded SAQ practice, and viva or OSCE simulation as the format requires.