How did I prepare for part 2 FRCPath?

What I read was a mix of

• Mandell

• SMI

• PHE documents

• Kucer’s (skimmed with notes)

• various test-type instruction booklets (i.e., E-test)

• Andrej Spec’s “Comprehensive Review of Infectious Diseases” was helpful as a broad cover for parasites and fungi.

• ECMM micro-guidelines

• EUCAST fine print on testing tables, etc.

No place has adequate questions. However, if you save up the questions from the NEQAS monthly question bank, they cover many topics. Some of the topics do come up in the exam (as I imagine the exam writers are either writing the same questions for NEQAS or are influenced by themselves doing the questions!

Aside from the usual topics of clinical microbiology and infection prevention and control, reference laboratory type investigations are not off-limits—be aware at least of the Cardiff Toxo unit and dye test/PCR/ISAGA Ig method, and the various specialist labs such as Porton, HTLV goes to London I think. Having awareness of what is done in local labs and what is done in ref labs may also help, but would not be critical to answering a question.

The main thing is time – there was so much for me to digest. When looking things up in reference-type books, they are unlikely to ask about specific non-landmark studies – so can skim past some sections, e.g., Kucers, where they try and show the ambiguity from various trials about an antibiotic (even if the book is interesting – time and energy are precious!)

Reinforcement – I used a spreadsheet, which I then transformed into an Anki deck (Anki – powerful, intelligent flashcards (ankiweb.net)). This meant that I could quiz myself using spaced repetition of weaknesses, to try and remember all the facts I thought that I needed. Making the spreadsheet was a learning process in itself, so whilst I can share what I made – half the benefit is not there, since I have made them in a way that helps me to learn.

Succinct notes: since some topics draw from many sources (i.e., there are many GAS guidelines in the UK depending on setting and publishing organisation), we need to draw them together and make them easy to read in 2-3 weeks down the line, when the freshness of reading the source document has gone. There is a fine line to be drawn between noting too little or too much. Some documents then branch out into other guidelines – such as the rash in pregnancy document, which then goes into specific infections. Having some way of managing that so that it makes sense is important. It’s otherwise easy to waste time re-reading the initial document on each learning of a single branch.

There are also a lot of non-clinical aspects. Awareness of how the NHS works, how medical units/ED work, may help dilemmas where someone has gone home and has a positive blood culture s(i.e. who is responsible for the result, what routes for review are available). Additionally, being able to manage complaints and investigate incidents in an NHS/UK lab setting is important. – this may be different around the world even if accreditation is to an ISO standard.

Knowledge of quality improvement is also important; – worth skimming but not necessarily reading in full: Improvement Hub » Service Improvement in Microbiology: Why, What and How (england.nhs.uk), Being able to look at a run chart/process control chart has been assessed before also-A-guide-to-creating-and-interpreting-run-and-control-charts.pdf (england.nhs.uk). Questions have also been asked on calculating sens/spec/NPV/PPV.

BNF alone is not the only resource for antibiotic monitoring/levels – check Antimicrobial Reference Laboratory Resources | North Bristol NHS Trust (nbt.nhs.uk) instead. Leeds also has an excellent (but far too wordy) antibiotic guideline website, that explains some concepts and starting points for further reading: – Leeds Infection Resource Page (leedsth.nhs.uk).