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Faculty Focus with Dr Nehal Singla: The most important is to be confident and have a systematic approach...

Revise Radiology

Revise Radiology

May 9th, 2023

An interview with FRCR 2B Rapid Reporting Course lead examiner, Dr Nehal Singla

This article is a transcript of an interview with Dr Nehal Singla, lead course examiner for the FRCR 2B Rapid Reporting Course. Dr Singla passed the FRCR 2B examination using the Revise Radiology subscriptions and courses for her preparation and is currently working with the NHS at Bart's Trust, Whipps Cross Hospital.

Q. Please could you tell us a bit about yourself and your career to date?

Hi, I'm Dr Nehal Singla. I completed my radiology training in India, from one of the top medical institutions in Dehli. Then I got married. I had to move to the United Kingdom. I sat the FRCR 2B exam in October 2021. At that time, I was doing an MSK fellowship in Birmingham, at Queen Elizabeth Hospital. It's one of the main trauma centres in the UK. I completed my fellowship. Then I moved back to London because that's where my husband stays. I joined King's College London as a senior clinical fellow with MSK. I also got to touch on some bits of acute reporting there. I’m currently working as a consultant at Bart's Trust, Whipps Cross Hospital. Altogether, I have been a practising radiologist for four to seven years.

Q. What are your specialisations and interests and why did you choose them?

My specialisations in India were cardiac imaging and neuroimaging. But when I came to the UK, I decided to get a fresh start and I went on to pursue MSK radiology. I did an observership at Royal National Orthopaedic Hospital, Stanmore for two months. I then got into the fellowship here.

I like MSK the most. It’s challenging and that's what inspires me. It's tough and challenging.

Q. What is your association with the FRCR 2B Rapid Reporting Course?

I figured during my 2B exam preparation that the rapid reporting exam is the deal breaker or maker in the exam. If you're thorough with your rapids, you have a 90-95% guarantee to pass the exam. The longs are easy and almost everyone can get through it. But in the rapids, if you do two X-rays wrong or two X-rays right, it makes a massive difference to your score. So while studying for the exam, my strategy was, to focus on the rapids 80 % of the time. The viva bits were pretty much covered along with that. Then during the last week, I practised the longs. After sitting the exam, I found out that a lot of trainees focus more on the longs rather than the rapids. They then struggle with the rapids at the exams. A lot of trainees fail because they lack just a little bit of refining in the rapids.

They're not confident about their normals. They're not confident about what they're calling abnormals. About whether they are calling the right pathology or not. Sometimes, most of the time, they overcall the normals.

So I thought, someone needs to do a specific rapid reporting course. There are plenty of rapid reporting courses in the market. I also did the Northwick rapid reporting course for my exam preparation. That course really inspired me to have more of these courses. And that's how I got in touch with Dr Koshy and we came up with the idea for the rapid reporting course.

Q. Could you tell us a little bit about the FRCR 2B Rapid Reporting Course?

Right now, we're starting with a 2-day course. we'll be focusing on 80% of the rapid reporting curriculum. We'll be doing 14 packets organised according to subspecialties. We will divide the body into different parts, like the upper limb into the shoulder + elbow and wrist. The lower limb will be divided into two parts. We will go over the skull and chest areas on day 2.

We also plan to further extend the course to a three-day course in the future with some mixed packets as well. The full extensive course will be a four-day course. The course in June will be a two-day course. By next year, we'll probably have a four-day course.

Q. What is the most important thing a registrar needs to know when they sit the FRCR 2B exam?

The most important is to be confident and have a systematic approach to all the radiographs. During the course, we'll focus on how you look at a normal shoulder radiograph. How you draw the cortical lines and diagnose fractures. We will also look at other common conditions like vascular necrosis and dislocations. We will do this for all the X-rays that are common in rapids. I will draw them live, on the course material. So the candidates can have a systematic approach. They can be confident about what they are calling a pathology or what they're calling normal.

Q. Any particular advice to Radiologists from abroad trying to sit the FRCR?

I was also one of them and so I feel they are too scared of the exam considering the skills they have. It's just a matter of confidence. I would say the first-year exam is like a puzzle to me. You have to understand the strategy, how and what they are asking you and answer according to that format. It's easy to pass once you’ve mastered the strategy of the exam. Be confident in yourself and try to practice more and more rapids. For the overseas candidates, parts 1 and 2A are easy because they are more theory-based. But 2B is where most of the candidates are struggling because they feel they don't know the system or the NHS. The 2B exam is more about filtering the safe radiologists. You shouldn’t miss anything in the emergency setting where a patient could die, and that's it. You all have the training in your own country. It's not that different in the UK. Radiology is the same everywhere.

Q. How does joining an FRCR course help a registrar?

Joining a course helps with your nerves on your exam day. You don't go thoughts like, how will I do 30 radiographs in 25 minutes? or how do I answer the vivas? or how many cases will I be able to answer? You're more prepared for the exam because you know the structure of the exam. You're not struggling because you know how to load the images, how to window them, and what the correct answer is. Everyone can point out that there is a fracture. But what are the specific words that you need to write to get the whole mark in the rapids? That makes a lot of difference. When you practise on your own, you may not know what you’re supposed to write. The more practice you do, the better you score in the courses, and the more confident you are during the exam day.

Click here to read about Revise Radiology's FRCR 2B Rapid Reporting Course