FRCPath part 2: Essay questions for practice

Please note these are not past papers. These questions are made by me based on the common issues in the NHS. These questions are intentionally not formatted like a proper long question you will find in the examination. These will however will give you an idea of the type of question you are likely to encounter in your part 2 FRCPath Microbiology.


  1. There is a plan for consolidation of pathology services in your region. Your hospital might lose its laboratory in the consolidation process. Please write a report to the trust board explaining its impact on the service you are providing to your users.


You are the clinical lead of the microbiology service of a large university hospital. Your hospital is due to become a hub in a consolidation process. Please write a report to the trust board how your laboratory is going to provide the expanded service. What are the challenges the laboratory might face? What support you might need from the trust management?


  1. Your hospital had a large number of C difficile cases last year. Please write a report on your plan for the next year. How you are planning to reduce the C difficile rate?


  1. You have been asked to deliver a cost improvement program to reduce the cost by 10% for Microbiology-virology service. Please write a report to trust board how you are going to provide a lean cost effective service without affecting the patient care.


  1. You have been approached to provide a result only service. Please write a report to the users about its merits/demerits.


  1. You have been notified of an error in the processing of the genitourinary medicine specimen over a week. The internal quality control was not properly monitored and it failed several occasions. A very junior member of staff was involved in monitoring of the process, who failed to recognise and report the problem. How are you going to investigate? Write a report for the board and a report to the users. What steps are you going to take to assure the users?


  1. Your surveillance has shown an increase in the number of VRE cases in renal unit. Write a letter to the renal consultants about the issue and any action that you might want to take. Explain about VRE and its implication.


  1. Your laboratory needs a system of screening for carbapenemase producing organisms. Discuss various options – their advantage and disadvantages.


  1. A GP surgery in your area has failed to meet the antibiotic prescribing reduction criteria (QP). They have asked you to deliver a lecture on how they can improve their antibiotic prescribing. Describe the points that you are going to discuss.


  1. Draft a 3 year  antimicrobial stewardship strategy and action plan for your region – aiming towards community practice mainly.


  1. You have been asked to consider a proposal for providing more active support to the community/GP practice as a microbiologist. At present you only offer telephone based advice to the GPs and community practitioners (Like multiple sclerosis nurse). Suggest a plan how a community based microbiologist improve the service. Will it be a cost effective model? Or discuss the advantages and disadvantages of such a practice model.


  1. You have been asked to provide a plan to reduce the hospital acquired gram negative bacteraemia rate by 50% by 2020. Please discuss and draft a plan how are you going to achieve the target.


  1. You are the microbiologist in a large university hospital. The rate of Staphylococcus aureus prosthetic joint infection is higher than the national average in your hospital. The surgical site infection group has asked your opinion on the universal Staphylococcus screening programme as opposed to the targeted Staphylococcus screening programme. Please write a report with your recommendations.


  1. You are a microbiology consultant in a district general hospital. You have to provide a plan for developing a molecular service for your laboratory. Please outline your strategy for the next 5 year period. Please list what measure you would take to achieve quality control/accreditation.


  1. Your laboratory is due for a UKAS visit for ISO 15189. How are you going to prepare your laboratory for this visit.


  1. You are the clinical lead of the microbiology laboratory. Your laboratory is due for a renewal of the managed service contract. Please prepare a report how you envisage the microbiology and virology service to evolve over next 10 years.


  1. Your laboratory is using an old unix based LIMS, with limited technical support from the manufacturer. Please write a business case for a new LIMS.


  1. You are the infection control doctor of your hospital. You have received a report of a Legionella pneumonia in a patient who has been in hospital for 2 weeks. Please describe how you are going to investigate and manage this case.


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