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The FRCOphth Part 1 is one of the most difficult exams in ophthalmology training, with an exam pass rate of 39.6% over the last 12 months (compared to 60.8% for FRCOphth Part 2 oral [60.8%] and written [68.7%]). Stack the odds in your favour by preparing well.

The exam consists of a three-hour, 120 multiple choice question (MCQ) paper and a two-hour constructed response question (CRQ) paper. The paper has a very heavy focus on basic clinical sciences and investigations.

A useful starting point would be to look at the college recommended reading list. Check at your hospital library or borrow them from a friendly ophthalmologist. Set aside at least three months to go through one book each for anatomy, basic clinical science and optics. I used Clinical Anatomy of the Eye – Snell, The Eye: Basic Sciences in Practice – Forrester, and Clinical Optics – Elkington. It might seem like a huge ask but set aside a little time on a regular basis to work through these books, as a lot of the exam questions seem to come from them. I read about 30 minutes to an hour everyday on my commute to work, over three months.

I looked at previous candidate advice and exam topics on over the last 10 exams, and made a list of which topics recurred (i.e. which light diagrams were frequently tested, locating visual pathway lesions according to field defects, histopathology etc.)

I set aside a week of annual leave before my exam to practice multiple choice questions and learn light diagrams by rote. Aim to do at least 1000 practice questions. The website is great for practice MCQs. Although dated, is also a useful resource for free practice questions. I used a couple of free MCQ apps on Android and IOS. After getting through the bulk of questions, start timing yourself on MCQs to simulate exam conditions.

Basic Sciences in Ophthalmology: A self assessment by John Ferris and FRCOphth Part 1: 400 SBAs and CRQS by Nikki Hall and Robert Penden have also been recommended for practise questions. Do as many of these questions as you can to improve your chances.

On the day try and be as well fed and rested as possible. It’s a five-hour marathon with a lunch break in between! Good luck.




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Hari Kaneshayogan

West of England Eye Unit, Exeter.

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