Introduction

Congratulations on getting to the final stage of the FRCOphth examinations! The oral examination is a purely practical exam held in the UK usually twice a year, consisting of a VIVA and OSCE component which are done on separate days. This puts to test your day to day clinical/communication skills, therefore the suggestion is to wait until you’ve had a few years of clinical practice under your belt before tackling it, although there’s no reason why it can’t be done earlier! The aim is to demonstrate a depth of knowledge and understanding expected of an independent specialist (consultant) not sub-specialising in the field being tested. The exam can only be sat after completing the part 2 written examination and, as of 2014, can only be attempted a maximum of four times. The pass rate is higher compared to the other examinations, at around 75% and slightly higher for those in training.

The Exam

The exam is extremely fast-paced, and despite extensive revision, most candidates rely heavily on the knowledge and skills developed through repeated clinical practice and placements. Once registered, you will receive an information pack outlining the OST curriculum learning outcomes, any of which may be examined.

Exam structure

OSCE

Each station lasts 20 minutes and includes three patient videos. You will be asked to discuss your findings and outline a management plan. Two examiners are usually present and will aim to cover as many questions as possible.

  • Station 1: Anterior segment

  • Station 2: Glaucoma and lid

  • Station 3: Posterior segment

  • Station 4: Strabismus and orbit

  • Station 5: Neuro-ophthalmology

  • Station 6: Communication (assessed during the VIVA)

VIVA

Each station lasts 10 minutes and is divided into four sections, each scored 1–3 points. Two examiners will work through the sections to maximise scoring opportunities.

  • Station 1: Investigations and data interpretation

  • Station 2: Patient management 1

  • Station 3: Patient management 2

  • Station 4: Attitudes, ethics and responsibilities

  • Station 5: Audit, research, evidence-based practice, health promotion and disease prevention

  • Station 6: Communication

Preparation

If you’ve recently completed the Part 2 FRCOphth written exam, you’re in a strong position to start practising for the oral. If it’s been a while, start early with regular practice to refresh your knowledge and fill any gaps. Practising stations is the most valuable preparation, so connect with colleagues in your department or training group and aim for 2–3 scenarios per session. Keep stations “prepared” where possible to ensure meaningful feedback and complete run-throughs. Regular practice over a few months allows you to cover a wide range of scenarios and topics.

Balancing work and personal commitments can be challenging, but flexibility helps. Practice on your commute, during lunchtimes, or short study sessions, and use online videos to practise descriptions and sign recognition. Closer to the exam, consider creating a “mock” OSCE/VIVA with a partner, using slides or videos to simulate different scenarios — this consolidates knowledge and can be shared for collaborative learning.

You may also wish to supplement your practice with interactive platforms like iPrepBuddy, which allow you to tackle a variety of clinical and communication OSCE/VIVA scenarios, receive personalised feedback, and repeat stations with slightly different patient responses each time.

Resources

In terms of resources to use, the Royal College of Ophthalmologists has an official document to outline which online/paper tools in addition to examination courses are available (see link below). Commonly used/essential resources include the below:

1) RCOphth Guidelines

2) NICE guidelines

3) Oxford handbook of Ophthalmology, Denniston & Murray – great quick overview of everything but very few images hence slightly boring to read. Good for on-the-go reading/quick access to read up on things while at work.

4) Clinical Ophthalmology: A Systematic Approach, Kanski & Bowling – great to cover gaps in reading/go into more depth (please remember that the exam largely is focussed on identifying what is important and discussing your management as you would plan in clinic, as opposed to as a specialist in that field therefore very in depth reading is arguably not necessary

5) Viva and OSCE Exams in Ophthalmology: A Revision Study Guide, Timothy H.M. Fung, Winfried M.K. Amoaku

6) http://www.mrcophth.com/chua1.html

7) http://webeye.ophth.uiowa.edu/eyeforum/atlas/quiz/index.htm

8) http://www.eyerounds.org

9) https://www.youtube.com/@sharjeeleye – great for quick practice at describing short (sometimes poor quality!) videos

Visit https://www.rcophth.ac.uk/examinations/rcophth-exams/part-2-oral-frcophth-exam/ for more information, exam tips, to make a booking and to review previous years exam reports (worth having a look through).

Overall try to study concisely with a focus on spotting key features and, most importantly, ensuring safe practice. Speak to others to get an idea of study techniques and utilise your time in clinic/theatre wisely i.e. asking if your consultant can quiz you/show you key signs (time-permitting!). Practice makes perfect and is really the key to tackling this exam! Having a clear systematic approach to your history, examination and managements is key to helping you get through the exam, especially if your mind should go blank (which can easily happen!).

Most importantly, it is important to look after yourself in the lead up to the exam! Lean back on family/friends/Deliveroo to support in the lead up to the exam, particularly during the busiest periods at work. Make sure you are well rested to provide your best performance on the day. Good luck!

Written by Binita Panchasara — ST5 East of England and Clinical Lead, Women in Vision UK