One of the most exciting and rapidly advancing specialties within medicine is Clinical Radiology. That’s why many International Medical Graduates (IMGs) are interested in joining specialty training in clinical radiology in the UK. The Royal College of Radiologists (RCR) maintain the training and their website would be the primary source of information and guidelines.

Clinical Radiology in the UK is a run-through training for 5 years. The recruitment happens at ST1 level only. A further ST6 can be taken for specializing in Interventional Radiology.

Even-though Interventional Radiology is the only officially recognized sub-specialty, but radiology trainee can have “special interest” in the following major areas:

  • Paediatric radiology
  • Musculoskeletal
  • Vascular
  • Neuroradiology
  • Head & Neck
  • Gastrointestinal
  • Oncology
  • Cardiac
  • Chest
  • Breast
  • Radionucleotide Radiology

Let’s have a look at the statistics

The statistics above are for the Round 1 fill-up rate for the CT1/ST1 specialties. We can clearly see a few important points:

  • The number of available posts for training in clinical radiology is very small compared to other specialties (234 in 2018, 236 in 2019) like GP, Internal medicine training even core surgical training. This small number makes this training very competitive.
  • And as you can see almost 100% posts got accepted in both the years, that means it’s cut-throat.

Prior to joining specialty training for an international doctor

If you are an International Medical Graduate (IMG), the very FIRST target is to obtain the GMC registration with a license to practice. If you are unsure in what ways you can get that, please read how to get registered with the GMC UK.

The following discussion will require a basic understanding of how the training pathway for doctors are structured in the UK. This video will help:

This video is part of an extensive free course in RoadToUK academy regarding Post-graduation training pathway in the UK.

The structure of Clinical Radiology Training

As mentioned already, it is a 5 years run-through training with an option of taking an additional year to sub-specialize. So there is no separate core and specialty training modules.

Run-through Radiology Training

The five years of training is divided into:

  • General Radiology training (3 years) (ST1 – 3)
  • Special Interest Training (2 years) (ST4 -5)

Different special interests are has already been outlined above. The progression through the training is assessed via workplace-based assessments and via the FRCR exam.

You can’t apply for ST1 level if you already have more than 18 months of experience in radiology in any country. Please read the person specifications for ST1 radiology training here.

Fellowship of Royal College of Radiologists (FRCR) Exam

The exam is divided as follows:

  • First FRCR Exam
    • Physics Module
    • Anatomy Module
  • Final FRCR Exam
    • Part A
    • Part B

First FRCR examination

Applicants need to hold a formal clinical radiology training post (UK or non-UK) in which they are actively receiving clinical radiology training (or to have held such a post in the past) in order to enter the First FRCR examination. No minimum period of clinical experience or clinical radiology training is required in order to enter. No confirmation of course attendance is required.

No exemption is granted from the First FRCR examination on the basis of success in any other examination.

Final FRCR Examination

Applicants must have acquired 24 months in a formal clinical radiology training post by the month which the examination is taken and to have passed the First FRCR Examination in order to enter the Final FRCR Part A Examination.

The Final FRCR Part A Examination comprises of six modules:

  • Cardiothoracic and Vascular
  • Musculoskeletal and Trauma
  • Gastro-intestinal (including liver, biliary, pancreas and spleen)
  • Genito-urinary, Adrenal, Obstetrics & Gynaecology and Breast
  • Paediatric
  • Central Nervous and Head & Neck (including spine, eyes, ENT, salivary glands and dental)

There are two papers (each paper is three hours in duration) examined by the single best answer (SBA) covering all imaging modalities, and including some anatomy and techniques. Candidates need to pass both papers at one sitting in order to be deemed to have achieved overall success in the Final FRCR Part A Examination.

The Final FRCR Part B Examination comprises:

  • a reporting session
  • a rapid reporting session
  • two oral examinations

The three components of the Final FRCR Part B Examination are held during a single week twice a year, normally in April and October. In the oral examinations, each candidate is examined by two pairs of examiners, all of whom are clinical radiologists. Candidates who have passed the Final FRCR Part A Examination are permitted to enter the Final FRCR Part B Examination upon completion of 34 months in a formal clinical radiology training post.

Sub-specialty Training

A further one year of ST6 is available for those who are interested in taking “Interventional Radiology”, after completion of their 5 years of clinical radiology training.

What an IMG (non-UK, non-EEA, without a settled visa) can do to join the Radiology training?

I assume that you know that the first target is always to get GMC registration. After getting GMC registration, the initial approach should be to acclimatize yourself with the NHS by way of doing a non-training job.

Obtain GMC registration with a license to practice

If you have read the article how to get GMC registered already, you know in detail. To reiterate, if you already have the any of the following acceptable non-UK PG qualifications, then you don’t need PLAB for GMC registration, you can take the accepted PG pathway:

Please note that the following qualifications gets you GMC registration, they DO NOT make you exempt from taking the FRCR examination.

  • FRANZCR in radiation oncology (Australia/New Zealand)
  • FRANZCR in radiology (Australia/New Zealand)
  • FC Rad Diag(SA) (South Africa)
  • Royal College of Physicians and Surgeons of Canada diagnostic radiology examination
  • ABR in diagnostic radiology (USA)
  • FFR RCSI in clinical radiology (Ireland)

Getting the CREST form signed

This form marks the competencies equivalent of a foundation level doctor. The following individuals can sign your Certificate of Readiness to Enter Specialty Training form:

  • Consultants
  • GPs
  • Clinical Directors
  • Medical Superintendents
  • Academic Professors
  • Locum Consultants with CCT/CESR

The person who signs it must have worked with you for a consecutive 3 months within the last 3.5 years from the start date of the post in question. They do not have to personally witness your completing all of the professional capabilities listed; if there is sufficient alternative evidence at hand that you have demonstrated these capabilities, they can sign you off. Please note that clinical attachments/unpaid rotations WILL NOT count towards the 3-month requirement.

Click this photo to take a free course on CREST & Portfolio guidance

If the individual signing your competencies is registered overseas, it is your responsibility to provide the necessary evidence proving their registration. You must attach proof of their registration along with your CREST form and translate any part of the document as needed. If they have had GMC registration but no longer hold it, it will not be considered.

More information regarding Internship and UKFPO can be found here.

Specialty Recruitment Assessment (SRA)

SRA stands for the Specialty Recruitment Assessment. It is a computer-based assessment introduced by RCR and London Recruitment and has been part of the ST1 clinical radiology application process since 2016. There are two parts to the SRA;

  • Professional Dilemmas (PD) paper,
  • Clinical Problem Solving (CPS) paper.

The SRA is very important for two reasons:

  1. Candidates need to achieve a score high enough to be offered one of the limited numbers of interview slots (600) as the ranking for interview slots is directly based on your SRA score. If you do not perform well in the SRA, you will not be offered an interview.
  2. Once you are through to the interview stage, your SRA score is then weighted to contribute to 33% of the final selection centre score in order to determine appointability for the available Clinical Radiology ST1 posts.

This is the same MSRA exam that GP trainees have to take for their selection process but the mark is weighed differently for ST1 radiology posts.

The application timeline below gives you an idea, around what time of the year the SRA and the ST1 interview will take place:

Doing well in the ST1 Clinical Radiology interview

Apart from being well rounded in various common interview stations like clinical stations, prioritization of tasks – you also need to have a good portfolio put together. Your time in doing a non-training job in the NHS should be spent gathering all or some of the following if and when possible:

  • Postgraduate degrees and qualifications and additional degrees
  • CPD courses
  • Additional Achievements
  • Quality Improvement (clinical audit)
  • Teaching experience
  • Training in teaching
  • Presentations
  • Publications
  • Leadership and management
  • Commitment to radiology
  • Taster week in Radiology (Signed off by the consultant)
  • Organization of your CV

Specialist Registration via CESR

If you already a non-UK trained consultant radiologist but wish to work in the UK, you can take the process to obtain a Certificate of Eligibility of Specialist Registration (CESR).

Training application process

Recruitment and selection into Clinical Radiology training posts in England, Scotland and Wales are carried out through a nationally coordinated process run by HEE London and South East Recruitment.

All information about the process, including access to the application portal, interview structure and applicant guidelines, will be published on the ORIEL recruitment system.

Frequently Asked Questions

That’s all about training in clinical radiology in the UK. If you are interested in other specialties check our blogroll and look for “Specialty training in the UK” tab under Professional Development.

Need further explanation?

Tap the photo to book a one-to-one guidance session with Ibreez and Ibrahim!

41 thoughts on “Specialty Training in Clinical Radiology in the UK”

  1. Dr saqib Ahmed

    Hi
    I have completed my 3 years post graduate training/degree program( MD Radio diagnosis) in India
    1.) How and at what level can I get into NHS training/job after passing FRCR final exam?
    2) After obtaining CESR will I be eligible for training job(eg ST4-ST6) or for consultant level job?(As my post graduate training duration is 3 years
    Please guide . I want to pursue my career in UK.
    Thank you .you guys are doing really great work .May Almighty bless you

    1. 1. If you complete FRCR, you are almost a consultant in the UK, you should be able to get into senior clinical fellow or radiology registrar posts after obtaining GMC registration.
      2. If you obtain CESR recognition, you can work as a consultant. Now whether you will get CESR straight away with 3 years of training that is the question.

      You can complete FRCR > Obtain GMC registration > look for senior fellow posts in the NHS > work for a year or two and then with your consultants’ guidance apply for CESR. Radiology only takes trainee at ST1 level.

      1. Thank you Dr Ibrahim and ibreez for your response.
        I came across with one of my seniors who is working as a consultant n NHS. He told me the same. actually he followed the same path as you told.
        A big thanks and blessings .
        You are guiding the people with great efforts and research.

  2. Hello,

    Is it possible to get in a non training job as a img without experience in radiology at the nhs?
    What chance can you get 1 year later to get a ST1 job in clinical radiology?

  3. As you mentioned earlier that MRCS is not got clinical radiolgy, but i wanted to ask, will taking the MRCS improve my chances of getting in to radiology training?

    1. No. Please check person specifications of clinical radiology and google ‘application scoring for radiology training in the UK’ to see what increases your chances.

  4. Thanks for your great clarifications. I want to know is it possible for an IMG to get a non-training job related to radiology? And is it necessary to proceed in this pathway? I mean if we found a job in internal medicine we would lost our chance for radiology application?

  5. Hi, you guys are doing suoerb job,
    I wanted to ask , what is the job prospect of a Md radiology with 5 plus yr of experience, n Gmc registration,
    What kind of job are they eligible for.
    Please guide.

    1. In radiology? none. To my knowledge, radiology doesn’t employ non-training doctors straight away. You will be eligible to apply for any other branches non-training job. And then will have to work towards choosing in which subject you want to train in.

      1. Hi Ivan ,
        Thankyou for the reply , any thing like sas or clinical fellow post if u have any idea
        Thankyou.

        1. Yes there are some senior fellow posts available but that is mostly for doctors who have already completed FRCR. You can have a look at the NHS jobs website yourself.

    1. No. MSRA is part of the application process, and you can’t apply if you are not eligible. Without GMC registration you will not be eligible to apply.

  6. Hammad Akhtar

    Hi guys. Thanks for doing a wonderful job. I have a question about path to work in radiology for someone who has completed 03 years of radiology training from India. If such a person cant get into training is it possible for them to get a non-training junior levels jobs for them while they complete their FRCR ? What I means is that are there non-training registrar levels job abailable and publicised? Your guidance will be appreciated.

    1. To be honest, I haven’t heard of any non-training junior level radiology registrar posts. You can look for them on the online job ad websites.

  7. Are the 2020 competition ratios out yet?? How good are the odds for an above average medical graduate without PG from India now in his (my) early thirties , pursuing ordinary government house job in home country,if he wish to pursue radiology training in UK via PLAB route…thanks in advance… greetings from a super fan of you two ❤️

      1. Thanks for the reply Ivan…by telling ‘above average’ my intention was to communicate my fairly good exam scores in medical school (but not excellent scores) and my willingness to work hard ,forget about it being very subjective.
        Will it be helpful in anyway if I do modules in eIntegrity when I try for residency

        1. Skill matters more than your score. Online learning will not add to your application much.

  8. Fabiha Tasnim

    Assalamualaikum,thank u for ur detailed post.I just want to know that do I have to pursue MRCP/MRCS to add up to my portfolio?

  9. Had a few doubts
    1. After getting the CREST form signed if I couldn’t be able to rank well on the sra exams what should I do ?
    Do I get another non training job on ct1 level?
    Do I get to try next year ?
    2. If I get a rank but couldn’t get a place on clinical radiology what should I do ?
    Take what I get or wait for another attempt ?

    1. If you don’t fare well in the recruitment process that means you have to try again in the re-advert round (if there is any) or try next year.
      If you already had a non-training job while you were in the training recruitment process, your job doesn’t go away untill and unless you resign (which you do when you get selected for a training post).
      If you did not have a job and applied for training directly and was not successful, that’s it. Now you either have to find a non-training job in the NHS or wait until next training advertisement.

      When apply for a specialty, you either get it or don’t. All the specialties are not under one recruitment process, each has there own. Core surgery training, GP, pediatrics, Internal medicine training, clinical radiology etc all run separate application, shortlisting, interview and ranking.

      If you applied for radiology training, and was not successful, that doesn’t mean you will automatically get something else. Each specialty, separate process.

      1. Thank you so much doctor Ivan for clarifying the doubts and another thing I wanted to know that on clinical radiology person specification there’s a desirable criteria of mrcp full is it something that most candidates have ?
        Or its just to improve my chances of getting selected?

  10. Hi I want to pursue clinical radiology in UK.As you mentioned that we should work in a non traniee job for a year to get the NHS experience and side by side improving our CV and portfolio.My question is how will we get into the non training job and after that how can we improve our portfolio through teaching and other methods.(I mean to whom should we apply for the same )

    1. Once you get GMC registration you just apply for job this way. and while in the job speak to your post graduation medical education center and your consultants for the opportunities to improve your CV. Every NHS trust has post graduate medical education center.

      1. Thank you for your kind reply Dr.
        One more doubt I am coming with is can we do non training job in any department or it depends on what we want to chose further in our training?

        1. You can do the non-training job in any dept you get the job in, but it only makes sense to accept job which is related to your specialty of choice. But if you can’t find no problem, your non-training job doesn’t negatively influence your training application.

  11. EBRAHIM ABDIKARIM EBRAHIM

    Hi I am interested in pursuing a career in clinical radiology. I have managed to get certificate in radiological interpretation and a certificate in radiology through eintegrity website. My question is how are the certificates going to help me in this carrier path. Other than that I don’t have any background training in radiology. Thank you.

    1. By looking at the website, I feel like the courses you can do it for free as an NHS employee at e-LfH is being sold to the non-UK doctors through this website. These courses will add to your CV as training courses attended.

  12. Morgan Ikponmwosa

    I have two questions.
    1. Can an IMG who has 18 months training in another country and FRCR 1 apply for ST2?
    2. And can another person with 12months training with FRCR 1 apply for ST1?
    If yes what are the routes?

    1. 1. There is no application round for ST2 unfortunately.
      2. The overqualification for ST1 is 18 months of experience in radiology, anything less than that can apply.

  13. raj manavadariya

    How competitive will it be in the future to get into clinical radiology as an IMG keeping fact in mind that an IMG can apply for round 1 because of changed rules? I am aware of the numbers that roughly 1 out of 4 gets the place. But how does it looks like in the real-life situation for an IMG?

    1. What do you mean by the real-life situation?
      As the round 1 application has opened for everyone now, the competition ratio portrayed so far will be skewed a lot I think. It remains to be seen what is what after the 2020 competition ratios are out.

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