It is anticipated that most trainees will sit the Paediatric Pathology Part 2 Examination after four years of training. Trainees must have completed at least 2 years training in a recognised Histopathology training programme and at least 18 months training in a recognised Paediatric Pathology training programme at Specialist Trainee or Registrar grade.

The examination takes place over at least two days, and usually over three days. It is held in the Pathology Department of one of the major Children’s or Women’s  Hospitals in England, Wales, Scotland or Ireland. The exam consists of:

• a full perinatal or paediatric autopsy, followed by a viva (2–3 hours)
• 20 surgical cases for which immunohistochemistry is not provided (3 hours); this may include anything that is not post-mortem material
• special techniques (2 hours);3–5 surgical or post-mortem cases in which the candidate will be provided with the H&E slides, and relevant histochemistry, immunohistochemistry electron microscopy and molecular biology
• 2–3 long cases (2 hours);
  autopsy cases on which a report including clinico-pathological correlation will be requested

• macroscopic examination, which may involve surgical cut-up or fixed specimens (1 hour)
• oral examination, which may include all aspects of provision of a paediatric or perinatal pathology service including laboratory management, health and safety and ethics (up to 1 hour).

The candidate should reach a minimum pass mark in all sections of the examination and be able to demonstrate competence in perinatal and paediatric pathology appropriate for an independent consultant paediatric pathologist and to enter the continuing professional development and external quality assurance schemes.

There is no written paper for the Part 2  examination.

Surgical cases: the cases are such as to be diagnosed on H&E section or at least have a narrow differential without resort to special stains. They are chosen over  time to cover the entire curriculum.

Special techniques: These are chosen to reflect current practice in paediatric pathology where special staining techniques are used diagnostically. Biopsies of kidney, muscle, liver or tumour may be included. Cases in the past have included Hirschsprung disease (with acetylcholinesterase), Duchenne muscular dystrophy (with muscle special stains, including dystrophins) and extra renal rhabdoid tumour (with immunohistochemistry).

Macroscopic Examination: any gross surgical specimen may be included. A placenta is frequently included, as are formalin fixed hearts with examples of the commoner forms of congenital heart disease.

Long cases: These are usually, but not exclusively perinatal cases. Cases in the past have included, skeletal dysplasia, acute perinatal asphyxia, infant of diabetic mother, neonatal Herpes simplex infection.