List of resources

This is a list to help you prepare for the examination, but I do not say that this is a comprehensive list. There are many other excellent resources out there to help you. Please let me know if you feel there is something which should be mentioned here.
 Many of these books are costly and you may want to check your departmental/institutional library first.
  1. Curriculum – Most important resource. Go throught the curriculum and do a gap analysis. Check what are the areas you feel you need to read more. You can develop a traffic light system to help you (green – you are confident, amber – you need to read more, red – you must read about this topic. For example ‘typing in microbiology’ How confident are you?)
  2. A standard textbook: Patrick Murray/ Greenwood.
  3. Oxford Handbook of Infectious Diseases and Microbiology
  4. Microbiology & Infectious Diseases Flashcards, Third Edition (Lange Flashcards)
  5. The emphasis on clinical aspect of the infection has increased now. Hence, I believe preparing from a USMLE book (infection related questions) will be helpful. However, please be aware that this exam is for the UK, so you have to think about the UK scenario when you are preparing. (For example – the coccidioidomycosis is endemic in some parts of  the USA but not in the UK, MRSA is more prevalent in the USA,  teicoplanin is not available in the USA, Group B universal screening in pregnancy is not done in the UK etc).
  6. Critical appraisal:
    Book –How to Read a Paper: The Basics of Evidence-Based Medicine: Trisha Greenhalgh
    Practice writing abstract. Make a list of different statistical terms (e.g Sensitivity, specificity, NNT) and learn how to apply them.
  7. Vaccine: Greenbook
  8. Greenbook MCQ
  9. SOP: National SMI
  10. Sensitivity testing – EUCAST
  11. Mycology: Identification of Pathogenic Fungi  (- A book to help with mycology identification. If you have any other resource and comfortable with it – please use that. )
    Dividing the fungi based on clinical features might help. For example, if the sample is an ear swab – you should be able to think what are the common fungus that we can isolate from there. Make sure you are familiar with microscopy, germ tube test, API, E-test, corn meal agar. Learn different methods of identification and sensitivity. You must read about clinically relevant fungi and antifungal drugs.
  12. Virology: Read the virology from any standard textbook. I read Kudesia’s Clinical and Diagnostic Virology, but I couldn’t find any updated version after 2009. I do not recommend using a reference book like Fields Virology as a textbook (it is not time effective).
    I suggest you collect a list of common virology problems (e.g. management of rash contact in pregnancy) and prepare answers for those scenarios. Ask your virologist for help.
  13. Parasitology: Usually short answer questions, spotters etc. Please remember UK not being a tropical country we do not see a lot of parasitology. You need to balance your effort and gain here. I also found it useful to keep google image open when I read parasitology. Search the image of whatever you are reading. It will help you if you get a spotter.
  14. Cowan and Steel’s Manual for the Identification of Medical Bacteria (Reference, most likely you will get it in your laboratory)
  15. Health technical memoranda (relevant ones only – water, ventilation, decontamination)
  16. Subscribe to Public Health England (PHE) RSS feed or
    Subscribe to Health Protection report
  17. Journals – Read UK microbiology journals
    Journal of Antimicrobial Chemotherapy
    The Journal of Hospital Infection
    Journal of Infection
    The Lancet Infectious diseases
  18. Guideline from different UK organisations – NICE, BTS, BSAC, BASHH, BHIVA, CHIVA, HIS, BIA, SIGN, IPS,  RCOG, BOA, BSR etc.
  19. Infection control: Check NHS Trust guidelines – many of the NHS trust guidelines are available in the internet. If you are from the UK – read your trust infection control and antibiotic guideline. If you are in a DGH – find out the guidelines of a university hospital, as you may not find all the guidelines in a DGH – like transplant related guidelines.

You can also supplement your knowledge from an infection control book (some of them are very costly and old – choose a new one, if you can)
Communicable Disease Control and Health Protection Handbook (2012)

Manual of Infection Prevention and Control

Ayliffe’s Control of Healthcare-Associated Infection Fifth Edition: A Practical Handbook (2009)


Unfortunately I am not aware of any preparatory course for part 2 FRCPath Microbiology. (If you are aware of any -please let me know).

For UK trainees local hospitals might organise a mock test for you. I recommend you speak to your ES and TPD.

Past questions:

RCPath do not allow storing of the past papers, but you can look at some sample papers here.

You should speak to trainees who has recently appeared in the examination for guidance.

Commonly asked questions about FRCPath Microbiology

Here are some topics that I get asked frequently. Many of these questions are answered in the RCPath website - please read this first -RCPath FAQ for the examination .

Please note I am neither involved in the examination process nor hold any position in RCPath. These answers are from my own experience.
How much time you should give yourself to prepare?

It is difficult to say how long you need as it very much depend upon the you – your method and speed of study, whether you are preparing while working or not, whether you are trained in the UK or familiar with UK system etc.

For UK trainees – I would suggest you discuss with your educational supervisor. He is the best person to advise you if you are ready.

For International trainees – if you have already done post-grad, probably you have enough knowledge of Microbiology. However, you need to get used to or learn the UK system. You might need 6 months least, if not a year, to prepare for either part of FRCPath.

Collect your materials first, then assess how much time you might need to cover that.

Is there any syllabus/curriculum?

RCPath provides the trainees with the curriculum.

Is there any MCQ book/Question bank available for the examination.

I have not seen any book specifically written for FRCPath examination. The questions are often based on clinical scenario. So if you find similar questions in any book (USMLE prep), please use that.  RCPath provided us with some sample papers.

You should also speak to the trainees who has recently appeared in the examination for guidance.

My understanding is that the FRCPath part 1 looks for a breadth of knowledge rather than depth. For Part 2, however you need an extensive knowledge of all aspects of microbiology and infection (and also areas like infection control, decontamination etc.) as you will be expected to work unsupervised as a consultant soon.

Resources for FRCPath part 2 by Dr Katherine Watson

Dr Katherine Watson, StR, Microbiology has kindly let us know the resources that she used to prepare for FRCPath part 2.
Thanks Katherine.
Here are some of the resources that I used in preparation for FRCPath part 2, April 2016 Bristol. One of the most useful things to do is speak to anyone you know who has already sat the exam and ask for all their past questions and tips.
Mycology – A Canadian microbiologist’s blog, has some really great photos of fungi, very useful for familiarising yourself with organisms for spotters and the practical. I printed quite a few out and stuck them around the house, after seeing them every day I felt confident at quickly recognising organisms.– Website set up by the University of Adelaide, lots of useful mycology information, the mould virtual assessment section is particularly good for testing yourself.– Suggest read the EORTC/MSG definitions of invasive fungal disease. – Recent review article published in the Lancet, update on topical issues surrounding diagnosis and investigation of invasive fungal infection that can come up in many sections of the exam.$FILE/Etest%20AFST%20Reading%20Chart.pdf – Useful pictures and guidance on how to interpret etests for fungi, useful to have in the lab folder.
Parasitology – CDC website has 18 years’ worth of monthly case study quizzes and A-Z of parasites, excellent practice for spotters, this is the resource I used for most of my parasitology revision.
The Green Book! Suggest reading this a few times, the virology paper is only an hour long, but the questions were all very specific questions that you either knew or you didn’t, for example, we had to give dosing schedules for Hepatitis B and rabies and specific regimen for HIV post exposure prophylaxis. Thankfully, we didn’t get any questions about the new Hepatitis C drugs. – Screening for Hepatitis E in blood products is a topical issue that we got asked about in the virology paper. Make sure to read all the latest guidance on the PHE website about the Zika virus, this is very topical so likely to come up in the next exam. We had to write a short note on the laboratory diagnosis of Zika virus.
Bacteriology – Quite time consuming, but I suggest reading all of the SMIs. I printed the flow charts from the identification section to put in my practical folder. I would suggest learning by heart the 2 SMIs under the protocol section which cover identification of ESBLs and CPEs as there were lots of questions and spotters on these topics.
Also, don’t forget to read the quality-related guidance, you can pick up useful information to include the essay question if it is anything about a laboratory service and also in my exam one of the groups of 4 short notes were all about laboratory quality assurance.
Look out for new SMIs, for example, in the autumn 2015 exam there were questions relating to the new ectoparasite SMI. – I would suggest printing out the BSAC endocarditis guidelines for the lab folder, so if one of the cases is about endocarditis you will have the guidelines to refer to for treatment advice.
Infection Control and Public Health
PHE website has some really good training slides for healthcare professionals with up-dates on specific vaccines, would definitely recommend reading since the vaccination programme seems to have changed quite a bit in recent years.
Must read documents for infection control of CPE
If you have time before the exam I would suggest completing Dundee University’s 6 week online course on antimicrobial stewardship, which is such a topical issue that can come up in the exam. You can sign up for free:
General – Another great website for practicing spotters, clinical cases with high quality pictures of clinical conditions, radiology, histology and organisms then multiple choice questions on diagnosis. You have to sign up to the website, but it’s free to do so. – Federation of Infectious Diseases Societies of Southern Africa website, has a case of the month section where you can guess the diagnosis, quite a lot of rare tropical infections. – American Academy of Dermatology, has a number of quizzes including some on infectious causes of rashes.
iTunes U – If you search microbiology or virology you can find some series of lectures from American universities, some good basic parasitology and mycology lecturers that you can listen to when walking or driving to work. -A well written article advising how to write an abstract, which is something that you always have to do for each of the critical appraisals. I suggest reading journal articles with the abstract covered and practice writing abstracts, pay careful attention to word counts, you are normally given a 250 word limit.
The Doctor’s Guide to Critical Appraisal Paperback – 14 Jul 2006 by N. Gosall, G. Gosall – I am terrible at critical appraisal and read a lot of books to try to improve, this was the one I thought was most useful with straightforward explanations of statistical tests and study designs. Other trainees told me that the written paper is where most people fail the exam, I have to agree and would definitely recommend doing a lot of preparation for critical appraisal. I read this book and also Trisha Greenhalgh’s How to Read a Paper: The Basics of Evidence-Based Medicine several times.

New format of part 2 FRCPath Microbiology examination

Source: RCPath website

From Autumn 2017 onwards, the format of the FRCPath Part 2 Medical Microbiology examination has changed. The changes, which have been approved by the General Medical Council, are designed to make the exam more accurately reflect the role of the consultant microbiologist in modern NHS practice; to be in line with new, revised curricula in Medical Microbiology specialty training; and to strengthen the reliability of the examination.

The new-format examination will last two days and be structured as follows:

Structured essay paper and Short-Answer Questions (SAQs): 2 ½ hours

1 essay (from a choice of 2) followed by 10 SAQs.

SAQs to be based on clinical and laboratory scenarios and to include:

  • Data interpretation
  • Report validation
  • Laboratory management, including quality assurance, laboratory error/incidents, lab safety
  • Clinical investigation and management
  • Infection prevention and control
  • Anti-microbial stewardship

Critical Appraisal Paper and SAQs: 2 ½ hours

1 journal article to critically appraise (from a choice of 2) followed by 10 SAQs (as described above).

Practical Scenarios: 3 ½ hours

  • A series of images, data and other laboratory-based material will be presented with clinical scenarios for which candidates provide interpretation and construct management plans.
  • Clinical scenarios and laboratory material evolve with additional information during the exam to simulate day-to-day clinical practice

Objective Structured Practical Examination (OSPE): 3 hours

At least 15 stations.

FRCPath part 2: virology questions for practice

These are some scenario’s that we encounter in our day to day practice. You can practice these as a part of your preparation. I suggest you should also read the associated topics. For example, if you are preparing the answer for HBV, read about HCV, HIV as well. Most of these problems can be answered from relevant UK guidelines.

  1. Management of a child found with scratch marks on his face in the morning. A bat was found in the same room in the morning. What should be the management?
  2. A lady had a normal delivery. Some herpetic lesions were noted in the perineal region during delivery. What would you advice to the clinicians regarding the management of mother and baby.
  3. 16 weeks pregnant school teacher had contact with a boy in her class with suspected Parvovirus B19 infection. What would you advice to the clinicians? What test would you perform?
  4. 20 weeks pregnant lady had a tick bite. The GP is asking you for advice.
  5. 28 weeks Pregnant lady had contact with chickenpox. What would you advise the clinicians? What additional information would you need to make a decision?
    If this lady was 39 weeks pregnant with an imminent delivery, what should be the management?
  6. 39 weeks pregnant lady with chicken pox presented to labour ward and she was in a bay with three other patients before the clinical team came to know about chicken pox. The consultant contacted you for advice immediately. What advice would you give?
  7. A baby born of hepatitis B positive mother (serological status unknown). Describe the tests you would do and management.
  8. A renal transplant patient presents with deteriorating renal function? What are the possibilities? What serology/molecular test you would consider? What should be the management?
  9. A pregnant lady presented to the midwife. Her son developed a rash the day before. What information would you ask for? What tests would you do? What advice would you give? Your laboratory informed you that there is no booking blood, what changes would you make in your management plan?
  10. A young boy presented to the A&E after having a needlestick injury from a discarded needle in a playground. This playground is in an area known to have problems with IV drug abusers. What should be your advice?
  11. A nurse presented with a needlestick injury. The source is an IV drug abuser, who refused test for blood borne virus. What advice would you give?
  12. A patient presented after a pub brawl. He suffered from a human bite on his face. What advice would you give?
  13. You have received a call from a doctor in accident and emergency. She has a patient, brought in by police, with a history of sexual assault. What advice would you give? What tests would be required? What precaution should be taken when a specimen being taken and being transferred to the laboratory and after that.
  14. How would you do the work up for renal transplant?
  15. An immunosuppressed patient presented with colitis. The gastroenterologist is asking for your advice. What investigations would you recommend?
    He reported back to you after a couple of days that some inclusion bodies have been found in HE stain. What would be your management strategy?
  16. Patient presented with hepatic impairment. What virology tests would you recommend? Patient had a complaint of sore throat few days before this episode – what test would you ask for?
  17. GP is requesting a Zika virus test for a patient recently returned from Cuba. She is planning for a pregnancy. What other information you should ask to assess the case? What advice would you give?
  18. Your A&E consultant has called you out of hours that a suspected MERS-CoV patient is going to be admitted within the next hour. What would be your course of action?
  19. A GP is asking for your advice regarding investigation of chronic fatigue syndrome. What would be your advice? Explain.
  20. GP is investigating a patient with a possible history of tick bite. Your result C6 – reactive, Immunoblot IgG: P41, ospC reactive. IgM P41, ospC reactive. What would be your advice?


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.