If you’re an ophthalmologist aiming for international recognition and clinical excellence, the FRCOphth exam pathway can open up a world of opportunities. However, the journey can seem overwhelming without a clear structure.
Based on my personal experience, here’s a simplified, step-by-step guide to help you understand what to expect at each stage.
1. MCQ Part 1 – The Foundation
This is the entry point into the FRCOphth journey. It tests your understanding of basic sciences as applied to ophthalmology.
- Format: Two papers, each with 90 single-best-answer (SBA) questions
- Content: Covers anatomy, physiology, pathology, optics, and basic clinical knowledge
- Prep Time: 3–4 months on average
- Tips: Focus on high-yield topics, understand the concepts thoroughly, and practice lots of MCQs
📘 Resources I found helpful: Oxford book, Chua’s notes, and question banks like EFRCophth and EyeAcademy.
2. MCQ Part 2 Written– Clinical Application
This is the most knowledge-intensive part of the exam. It tests your ability to apply clinical reasoning to real-life ophthalmic scenarios.
- Format:Two papers, each with 90 single-best-answer (SBA) questions
- Content: Broad clinical ophthalmology, investigations, interpretation of data, management plans, and guidelines
- Prep Time: 4–6 months depending on your familiarity with UK-style exams
- Tips: Stay updated with RCOphth guidelines, understand common differentials and investigations, and practice structured answers
📘 Key resources: RCOphth curriculum, NICE/GMC guidelines, Oxford Handbook, OphthoQuestions, Eye Academy
3. Refraction Certificate – The Practical Must-Do
This is a hands-on practical exam and a prerequisite before appearing for the final oral.
- Format: Objective Structured Clinical Exam (OSCE) with multiple stations
- Stations include: Retinoscopy, lens neutralisation, sphere and cylinder refinement, focimetry, binocular balancing
- Tips: Attend a practical course or get access to trial lens sets and retinoscopes for practice
📘 Important: This is often underestimated but requires dedicated practice under timed conditions.
4. Oral Examination (Final Part 2)
This is the final and most comprehensive step in the FRCOphth pathway. It assesses your clinical reasoning, communication, and professionalism.
- Format: 5 structured viva stations + 6 stations (OSCE-style)
- Topics Covered: Retina, cornea, glaucoma, uveitis, neuro-ophthalmology, paediatrics, and more
- Tips: Practice with peers, attend mock exams, and focus on concise, structured, and safe answers
📘 Bonus tip: Record yourself, work on your communication, and always prioritise patient safety in your answers.
Summary at a Glance
| Step | Focus Area | Approx. Duration |
|---|---|---|
| MCQ Part 1 | Basic sciences + optics | 3–4 months |
| Written Part 2 | Clinical knowledge + application | 4–6 months |
| Refraction Certificate | Practical skills (OSCE style) | 1–2 months |
| Oral Exam | Clinical judgment & communication | 2–3 months |
- Estimated Timeline: 1.5 to 3 years (flexible depending on your pace)
- Estimated Cost: £4000–£6000 (excluding travel & accommodation)
- Benefits: GMC recognition, global credibility, and enhanced clinical skills
About the Author:
Dr. Hemali Kanabar, MBBS, MS Ophthalmology
