Competition for ophthalmology ST1 has intensified steadily over recent cycles, rising from ~9:1 (2022) to ~10:1 (2023), ~14:1 (2024) and ~22:1 (2025) [1]. Against this background, applicants benefit from a structured approach: mapping achievements to portfolio domains early, identifying gaps and planning targeted activity well ahead of deadlines. The 2026 round introduces candidate self-assessment of the portfolio, while the final offer stage retains an equal balance between portfolio and interview [2].
What is new in 2026?
Self-assessment has been introduced. Candidates self-score their portfolio against the published framework. This score is combined with the Multi-Specialty Recruitment Assessment (MSRA) [3] (equal weighting) to inform the initial ranking prior to panel verification.
Shortlisting pathway
- MSRA for all → Initial rank: MSRA and self-assessment are equally weighted to create an initial rank list.
- Top 350 → Panel verification: the top 350 candidates undergo portfolio review, where claims are checked and scored against the guidance.
- Top 260 → Interview invitations: following verification, the top 260 are invited to the virtual interview.
Interview format
The interview remains as two stations, each structured and marked against set criteria:
- Clinical consultation: applied clinical knowledge and communication.
- Difficult communication / ethics: judgement, professionalism and clarity under pressure.
How offers are determined
At the offer stage, the MSRA is not included. Final ranking is a 50:50 combination of:
- Interview score (50%), and
- Verified portfolio score (50%).
Posts are allocated in rank order via Oriel (offers issued by 24 March 2026).
Portfolio: Preparing effectively
The portfolio domains are broadly unchanged. Qualifications; Prizes / Awards; Publications; Presentations; Quality Improvement / Audit; Teaching; Professionalism / MSF; Commitment to Specialty, with minor reweighting (e.g., MSF 3→2, Commitment to Specialty 12→13). These are incremental adjustments rather than a redesign [3].
How to prepare
- Establish a roadmap. Map intended activities to specific domains across the cycle (e.g. completing QI / audit loops, submitting abstracts / manuscripts, scheduling teaching) and align them to key dates. Start planning this well ahead of time and treat progress as cumulative over months, not weeks.
- Align claims to criteria. The scoring framework is precise. Cross-check each prospective claim against the published descriptors; avoid duplication across domains; ensure each item is supported by clear, accessible documentation (merged per domain where required).
- Prioritise clarity. Present concise, well-structured evidence with explicit roles, dates and outcomes to facilitate panel verification and reduce the risk of missed credit.
- Be rigorous in self-assessment. Score conservatively and ensure every point is mapped to any proof you upload. The panels will verify and may adjust scores.
SmartOST: An intelligent portfolio companion
To comprehensively address these points and to support candidates, we have created SmartOST (smartost.co.uk), a tool that helps applicants maximise ophthalmology specialty application points with a dynamic score that updates as you add evidence.
The built-in calendar maps your portfolio roadmap, showing where points are likely to come from and helping applicants to plan ahead. Most importantly, rule-aware scoring enforces caps and prevents duplicates across domains, which is often the trickiest part of preparing the portfolio.
References
1. https://medical.hee.nhs.uk/medical-training-recruitment/
medical-specialty-training/competition-ratios/2025-competition-ratios
2. www.severndeanery.nhs.uk/recruitment/vacancies/
show/oph-st1-26/applicant-guide-lib
3. https://medical.hee.nhs.uk/medical-training
-recruitment/medical-specialty-training/multi
-specialty-recruitment-assessment-msra
[All links last accessed November 2025]
Key dates timeline
23 October – 20 November: Oriel Application
15 December: MSRA Booking
6–19 January: MSRA Exam
16 January – 2 February: Portfolio submission
16–17 March: Interviews
24 March: Feedback and Offers release
Declaration of competing interests: Mertcan Sevgi and David Merle are the creators of smartost.co.uk.
