Histopathology training in the UK – a guide to the pathway

Are you a doctor who wants to learn more about the histopathology training pathway in the UK? This guide covers entry requirements, training, exams, and career progression from trainees to consultant-level. We also outline the career opportunities available to you after completion of histopathology training for general histopathology, forensic histopathology, diagnostic neuropathology, paediatrics, perinatal pathology, and cytopathology.

How to become a histopathologist

Entry requirements

If you want to apply for histopathology specialist training, you will need to meet the requirements below for a chance to be accepted onto this training pathway:

  • Qualify as a doctor
  • Register with the General Medical Council (GMC)
  • Complete the UK Foundation Training Programme or equivalent

According to Health Education England (HEE), 380 doctors applied for 109 histopathology training posts in 2023, giving it a 3.49 competition ratio. More than 46% of specialties had a higher competition ratio, but that doesn’t mean securing your histopathology training post will be easy.

Doctors applying for ST1 histopathology posts will need to complete a self-assessment, submit supporting evidence, and if shortlisted, complete an interview which lasts 30 minutes and covers two stations. HEE anticipates the number of UK training posts for the ST1 histopathology intake in August 2024 to be between 53 and 89.

Training pathway

Histopathology offers a run-through training programme where you apply once after foundation training, and you’re recruited for the duration of the specialty programme. The first year of run-through specialty training is called ST1, the second is called ST2 and so on.

Once you have completed the first two years of histopathology training, you can decide to stay in general histopathology or move into one of the related subspecialties:

  • Forensic histopathology
  • Diagnostic neuropathology
  • Paediatrics
  • Perinatal pathology
  • Cytopathology

A doctor training full-time to become a consultant histopathologist would need to complete 5 years of specialty training and need to complete two exams before being awarded a Certificate of Completion of Training (CCT) that allows entry into the GMC specialist register.

Stage of trainingGrade
Foundation TrainingFY1
Specialty TrainingST1
FRCPath Part 1
General Histopathology or Subspecialty TrainingST3
ConsultantFRCPath Part 2


You will need to pass the Fellowship Examination of the Royal College of Pathologists (FRCPath) before you can be awarded a CCT in Histopathology. The FRCPath is broken down into two parts and they can be attempted at different stages during histopathology training in the UK.

The only requirement which is mandatory with the FRCPath exams is that they are sat in sequence of FRCPath1 followed by FRCPath2. The rest of the advice is indicative of the Royal College of Pathologists based on the training undertaken and the knowledge needed to be able to pass the exam. Doctors should check with their educational supervisor as to when is best to sit the exam. The Part 1 and Part 2 examinations are held twice a year in Spring and Autumn.

FRCPath Part 1

Experience in histopathology training is crucial to be able to pass the first exam. Doctors will usually have undertaken at least one year of speciality training and be in ST2 before attempting FRCPath Part 1.

This three-hour online exam consists of 125 single best answers (SBA) questions and extended matching format questions (EMQ). Your overall knowledge and understanding of histopathology and cytopathology will be assessed through a full range of autopsy practices expected in a district general hospital in the UK and the basic sciences which underpin pathology.

The next FRCPath Histopathology Part 1 exam is on Wednesday 27th March 2024. For future dates, please visit the FRCPath examination news and dates calendar.

FRCPath Part 2

The Royal College anticipates that most doctors will attempt FRCPath Part 2 after a further two years of histopathology training. You should not take this exam until at least 12 months after passing FRCPath Part 1.

This two-day practical and in-person exam includes writing and interpreting reports on histopathological slides and non-gynaecological cytopathology. Some cases will include a specific diagnosis and others without, so you will need to demonstrate proficiency to practice and outline the steps to pursue a diagnosis.

You will be assessed in the following six sections of the examination:

  • Surgical histology
  • Cytopathology (non-gynaecological cytopathology)
  • Objective structured practical examination (OSPE)
  • Macros
  • Frozen sections
  • Long cases

Each section assesses a distinct set of professional skills and is awarded a pass or fail. You must pass all six sections to pass the exam. An immediate failure will occur if you fail to distinguish something that affects a patient’s outcome, such as benign/malignant boundary in 15%-25% of cases in any single section of the exam. This is because of the special place of cellular pathology only a certain level of inaccuracy is allowed.

The next FRCPath Histopathology Part 2 exam is on Tuesday 9th April and Wednesday 10th April 2024. For future dates, please visit the FRCPath examination news and dates calendar.

The 2021 Histopathology curriculum is assessed by High-level Outcomes in the form of Capabilities in Practice (CiPs), which is relevant work completed during your training. Please review the latest curriculum and syllabus for a full understanding of the aspects of learning covered in specialty training in histopathology.

Progression in histopathology

After completion of core training, consultant histopathologists will usually progress to work in hospitals alongside other medical staff. Most histopathologists never have direct contact with patients but their role in patient care is vital.   

Your work environment can vary greatly if you’re trained in a related subspecialty. Forensic histopathologists might find themselves working in mortuaries, hospitals, courts or even crime scenes. Some histopathologists work at specialist hospitals where their subspecialty expertise is required such as children’s or cancer hospitals.

A substantive NHS consultant in histopathology will earn a basic salary between £93,666 and £126,281. Histopathologists working outside of the NHS or on temporary contracts may earn more. To learn more about NHS consultant salaries, read our guide on the NHS consultant pay scale in England.

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