FRCPA · RCPA Anatomical Pathology

RCPA AP / diagnose it.

305 sourced study notes across the RCPA Anatomical Pathology curriculum (356 LOs, 7 domains). AI essay-written grading with RCPA examiner-style marking, plus a digital-slide viva simulator covering IHC panels and tumour grading. 10,163 LO-aligned spaced-repetition flashcards. Built for the precision the fellowship demands.

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Pass rate

Not published

RCPA releases individual results only

Sittings per year

1–2

Part I and Part II annually

Format

Written + Practical + Viva

Part I: Written + Digital Slides · Part II: Digital Slides + SBST + Cytology + Oral

Study notes

305

across 356 curriculum LOs · 7 domains

Organising college

RCPA

Not affiliated with PRIMEX

· 2026 dates ·

RCPA Anatomical Pathology Exam Dates 2026

Published dates for the upcoming sittings. Always confirm against the official RCPA examinations page before scheduling, I refresh this section quarterly as new windows are announced.

Part I, WrittenFri 15 May 2026 (online, 3h 15m)
Part I, Histopathology Digital SlidesSun 17 May 2026 (online/local, 4h 15m)
Part II, Histopathology Digital SlidesSat 16 May 2026 (online/local, 4h 15m)
Part II, Small Biopsy & Special TechniquesSat 13 Jun 2026 (online/local, 3h 30m)
Part II, Cytology Digital SlidesSun 14 Jun 2026 (online/local, 2h 15m)
Part II, Oral ExaminationSun 23 Aug 2026 (local, all day)
Part II Repeats, all written componentsFri 31 Jul 2026 (online/local)
Part II Repeat, OralFri 20 Nov 2026 (local, all day)

Written exams delivered online via the College's risr/assess + Proctor Exam platform. 2026 applications closed Sat 28 Feb 2026; the 2027 application window typically opens late in the prior year, so confirm dates on the official RCPA examinations page.

· Exam domains ·

Topics tested in the RCPA Anatomical Pathology exam

~30%

Surgical Pathology & Tumour Classification

Lung IHC panels (adenocarcinoma TTF-1/Napsin A vs SCC p40/CK5/6 vs SCLC synaptophysin/chromogranin), colorectal carcinoma MSI/MMR testing and Lynch syndrome, breast biomarkers (ER Allred, HER2 3+ or FISH ratio ≥2, Ki67), prostate Gleason/ISUP Grade Groups (GG1=6 → GG5=9-10), WHO 2021 CNS classification (IDH wild-type GBM: TERT/EGFR/+7/-10), endometrial TCGA molecular subtypes.

TTF-1 vs p40 · ER Allred scoring · Gleason/ISUP · IDH wild-type GBM criteria · TCGA endometrial · GIST (CD117/DOG1)

~25%

Immunohistochemistry & Molecular Diagnostics

IHC panel construction (minimum 3-marker panels with positive and negative controls), FISH indications (HER2 dual ISH, MDM2 liposarcoma, ALK/ROS1, MYC/BCL2/BCL6, 1p/19q glioma, ploidy for POC), PCR for somatic variants (BRAF V600E, IDH1, EGFR, KRAS), HPV genotyping, NGS, and MRD monitoring.

HER2 FISH dual ISH · ALK/ROS1 FISH · BRAF V600E IHC/PCR · MMR panel (MLH1/MSH2/MSH6/PMS2) · IDH1 R132H IHC

~25%

Organ System Pathology

Skin (melanoma: Breslow depth, mitotic count, Clark level, BRAF V600E reflex for pT1b+), liver (HCC: HepPar-1/Arginase-1/GPC-3, FNH vs hepatocellular adenoma), mesothelioma (calretinin/WT-1/CK5/6/D2-40 positive; CEA/CD15/MOC-31/BerEP4 negative), thyroid (TIRADS, papillary carcinoma nuclear features), lymphoma IHC (DLBCL vs Hodgkin vs metastatic; CD20/CD3/CD30/CD15/AE1-AE3/SOX11 minimum panel).

Breslow + mitotic count · Mesothelioma vs adenocarcinoma · HCC vs FNH · Lymphoma minimum panel · Papillary carcinoma nuclei

~20%

Laboratory Management, Frozen Section & Reporting

RCPA structured synoptic reporting protocols (cancer), frozen section limitations and intraoperative communication, cut-up and block selection, specimen management (FNA adequacy, SNOMED CT/LOINC coding), QA and digital pathology/AI integration, medicolegal reporting obligations, cultural safety in pathology practice.

Frozen section limitations · Synoptic reporting · FNA adequacy · SNOMED CT · Complete vs partial mole (p57) · Intraoperative communication

· What's inside ·

How candidates prepare for the RCPA Anatomical Pathology

· Written Exam Grader

RCPA Anatomical Pathology written grader: a marked extended-response answer on immunohistochemistry, graded with an examiner mark scheme and strong, partial and missing annotations

Essay written feedback at RCPA examiner standard.

The RCPA Anatomical Pathology Part I Written is an essay-style written paper (3 hr 15 min, online) on general pathology principles, organ system pathology, IHC interpretation, and tumour classification. There is no MCQ component. PRIMEX grades extended written responses for specific IHC marker combinations, IHC reasoning (positive and negative markers), numerical staging thresholds, and correct tumour classification, the elements RCPA examiners most commonly penalise.

Part I essay written grading with IHC marker combination feedback
Extended written response feedback: histological description → differential → IHC panel → diagnosis → management
Common errors flagged: p63 vs p40 confusion (p40 is superior for squamous), missing synchronous carcinoma in adenoma, FAB vs WHO terminology
Numerical thresholds checked: Gleason/ISUP grade groups, Breslow depth cut-offs, Nottingham grade elements

· Flashcards

10,163 LO-aligned flashcards across the 356 LOs.

10,163 spaced-repetition flashcards aligned to the curriculum's learning-objective structure across the 356 LOs. Card types include morphology, IHC patterns, classification systems, grading thresholds, and molecular markers. Each card ID is linked to an RCPA AP LO so cards surface alongside the relevant study note.

Rebuilding per learning objective from the study notes pipeline
Planned card types: IHC panels (primary lung, mesothelioma, metastatic carcinoma, lymphoma minimum panels), tumour grading (Gleason/ISUP, Nottingham, Breslow, WHO CNS 2021), molecular markers (MSI, IDH1/2, 1p/19q, POLE)
Staging cards planned: AJCC 8e pT/pN across the major sites
One click from card to full study note when the deck lands

· Viva Simulator

Digital slides. Frozen sections. The full RCPA AP oral.

The RCPA AP oral components present histological descriptions (digital slide scenarios) and expect a systematic report approach: specimen type → macroscopic → microscopic → IHC → molecular → integrated WHO-classified diagnosis → clinicopathological correlation. PRIMEX's viva simulator replicates this exactly, presenting histological descriptions and probing at every step.

Systematic viva structure: specimen → macroscopic → microscopic → IHC → molecular → diagnosis → correlation
High-yield scenarios: lung biopsy (primary vs metastatic), lymph node biopsy (DLBCL vs Hodgkin vs reactive vs metastatic carcinoma), prostate needle core (systematic Gleason grading per core), frozen section thyroid (when to defer vs proceed)
Examiner probes: "What additional stain would you perform and what result would confirm your diagnosis?"
Frozen section communication: how to report findings to surgeons and communicate limitations

· Study Notes

RCPA Anatomical Pathology study note: a cell-injury learning objective with an embedded interactive necrosis versus apoptosis pattern trainer

305 study notes. One per LO. Linked from every result.

305 sourced study notes across the RCPA AP curriculum, one for every covered learning objective. Each follows a structured format: pathophysiology, WHO classification, IHC panel with specific markers, molecular features, staging criteria, and reporting implications. Each maps to its RCPA Trainee Handbook 2025 curriculum LO.

305 sourced notes, one per covered LO; surgical pathology, IHC/molecular, organ systems, laboratory management
WHO classification criteria with specific numerical thresholds in every relevant note
IHC panel tables: markers, expected results, and positive/negative controls
References to WHO Blue Books (CNS 2021, Digestive System 2019, Thoracic Tumours 2021), RCPA structured reporting protocols, and AJCC 8e staging

· RCPA Curriculum Tracker

RCPA Anatomical Pathology curriculum tracker: 356 learning objectives across seven domains with per-section progress counts

356 learning objectives. Progress across all 7 curriculum domains.

The RCPA Anatomical Pathology Trainee Handbook (January 2025) defines 356 LOs across 7 domains including discipline-specific (Sections 1.1–1.6), laboratory management (2), research (3), and professional qualities (4). PRIMEX maps every LO with per-domain progress tracking.

All 356 RCPA AP LOs mapped across 7 curriculum domains
Appendix 13 Molecular Competencies tracked separately (FISH, IHC for oncoproteins, PCR for somatic variants)
Checkbox completion persisted to localStorage
Per-domain progress bars showing Part I, Part II, and viva coverage

· About this exam ·

RCPA Anatomical Pathology format and structure

The RCPA Anatomical Pathology Fellowship Examination is conducted by the Royal College of Pathologists of Australasia. Part I comprises an essay-style Written examination (3 hr 15 min, online) and a Histopathology Digital Slides examination (4 hr 15 min, whole-slide imaging). Part II comprises a Digital Slides examination, a Small Biopsy and Special Techniques (SBST) paper, a Cytology Practical, and a multi-station Oral (criterion-referenced; durations and station structure per the current trainee handbook). Each component must be passed individually. There is no MCQ paper in either part. RCPA publishes no aggregate pass rate; it releases individual candidate results only.

The Viva presents histological scenarios with clinical context and requires candidates to demonstrate a systematic reporting approach; from specimen type and macroscopic description through microscopic features, IHC construction, molecular testing, and WHO-classified diagnosis to clinicopathological correlation and management implications. The 2025 curriculum explicitly includes Appendix 13 Molecular Competencies covering FISH, IHC for oncoproteins, and PCR for somatic variants. PRIMEX is built by Dr Jay Marshall, an anaesthetics registrar in Taree, NSW.

OrganiserRoyal College of Pathologists of Australasia (RCPA)
Part I WrittenEssay-style written paper, 3 hr 15 min, online; general and organ system pathology, IHC; no MCQ
Part I Digital SlidesHistopathology digital slide (whole-slide imaging) interpretation, 4 hr 15 min; systematic reporting with RCPA structured synoptic protocols
Part II Digital Slides + SBST + CytologyThree separate practical components: digital slides, small biopsy and special techniques, cytology
Part II OralMulti-station, criterion-referenced; case-based discussion format (durations and station structure per the current trainee handbook)
CurriculumRCPA AP Trainee Handbook January 2025; 356 LOs across 7 domains including Appendix 13 Molecular Competencies

· FAQ ·

Common questions about the RCPA Anatomical Pathology exam

What are the components of the RCPA Anatomical Pathology examination?

The examination has no MCQ component. Part I consists of: an essay-style Written paper (3 hr 15 min, online; general pathology, organ system pathology, IHC, tumour classification) and a Histopathology Digital Slides examination (4 hr 15 min, whole-slide imaging). Part II consists of: Digital Slides, Small Biopsy and Special Techniques (SBST), Cytology Practical, and a multi-station Oral (criterion-referenced; durations and station structure per the current trainee handbook). Each component must be passed individually.

What is the correct IHC panel for a lung biopsy with glandular and solid areas?

The minimum panel is TTF-1, Napsin A, p40, and CK5/6. Adenocarcinoma: TTF-1 positive/Napsin A positive/p40 negative/CK5-6 negative. Squamous cell carcinoma: p40 positive/CK5-6 positive/TTF-1 negative/Napsin A negative. For SCLC: synaptophysin, chromogranin, CD56/INSM1 positive. If metastasis is suspected, add CK7/CK20 and site-specific markers (CDX2 for colorectal, ER/GATA3 for breast). A common RCPA examiner error is using p63 instead of p40; p63 can also stain myoepithelial and urothelial cells and is therefore less specific.

How does Gleason/ISUP Grade Group grading work?

The ISUP Grade Group system replaced Gleason scoring: GG1 = Gleason 6 (3+3), GG2 = Gleason 3+4=7, GG3 = Gleason 4+3=7, GG4 = Gleason 8 (4+4, 3+5, or 5+3), GG5 = Gleason 9–10. Critical reporting elements per RCPA protocol: Grade Group per core, percentage of core involved, percentage of Gleason pattern 4 (for GG2/3), tertiary pattern if >5% of cancer, presence of perineural invasion, extracapsular extension. RCPA examiner reports note candidates who report Gleason 3+3=6 as "well differentiated"; the grade simply indicates the lowest ISUP group, not true well-differentiation.

What are the frozen section limitations I need to know?

Frozen section limitations include: (1) Follicular thyroid lesions; capsular invasion is difficult to assess on frozen, defer to paraffin; (2) Lymphoma classification; cannot be made on frozen alone without flow cytometry and IHC; (3) Small biopsies; freezing artefact may obscure diagnostic features; (4) Fatty tissue; fat artefact on frozen is severe. When reporting frozen sections to surgeons (RCPA curriculum Section 1.5.4), candidates must communicate both the diagnosis and its limitations; "consistent with" versus "confirmed"; and indicate when a deferred diagnosis is necessary.

What does the Appendix 13 Molecular Competencies cover?

Appendix 13 (RCPA AP Trainee Handbook 2025) specifies the molecular tests candidates must know how to order, interpret, and act on: IHC for MMR proteins (MLH1/MSH2/MSH6/PMS2), BRAF V600E, IDH1 R132H, ATRX, TP53, p16, SDH; Dual ISH for HER2 (MBS 73332/73342), ISH for MDM2 in liposarcoma (73374), FISH for ALK/ROS1 (73341/73344), FISH for MYC/BCL2/BCL6/CCND1 in lymphoma, ISH for 1p/19q in glioma (73371), ploidy ISH for products of conception (73389); PCR for BRAF V600E, IDH1 R132H, EGFR, and KRAS somatic variants; HPV genotyping (73070-73075).

How should I approach the diagnosis of a complete vs partial mole?

Complete hydatidiform mole: androgenetic diploid (46,XX or 46,XY), no fetal tissue, diffuse villous hydrops, diffuse trophoblast proliferation, p57 immunostaining absent (p57 is a paternally imprinted, maternally expressed gene; absent in complete mole). Partial mole: typically triploid (69,XXX or 69,XXY), fetal tissue present, focal villous changes, p57 positive. FISH for ploidy (73389) confirms triploidy in partial moles. A common error is failing to perform p57 as part of the initial workup for a suspected molar pregnancy; the RCPA examiners note this explicitly.

Is RCPA Haematology content also available?

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