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 is extremely fast paced and no matter how much reading you do, the tendency is for you to fall back on the knowledge and skills that you have gained from repeated practice during your placements/clinical practice. Once you register for the examination you should receive an information pack which includes learning outcomes for the OST curriculum, any part of which you could technically be tested on.
The structure of the exam is as follows:
OSCE – 20 minutes per station with 3 patient videos shown in each. You will generally be asked to discuss your findings and the subsequent management plan. The examiners (usually 2) will try to push you to do as many questions as possible in the time allocated.
VIVA – 10 minutes per station with each station divided into 4 sections. Each section is scored 1-3 points. Again, the examiners (usually 2) will try to get you through all of the sections in order to score as many points as possible.
If you have recently completed your part 2 FRCOphth written exam, then you’re in a pretty good place knowledge-wise to begin tackling practice for the oral. On the other hand, if it’s been a while don’t worry! It’s worthwhile starting early with regular practice sessions to get into the flow of things and brush up on gaps in your knowledge. Practicing the stations is perhaps the single most useful thing to do, so reach out within your department/training groups to see who else might be sitting the exam. Try to do at least 2-3 scenarios each per session and keep your respective stations “prepared” if possible so that you have the feedback necessary to ensure a complete run through of each scenario. Through regular practice you can get through a significant number of scenarios and topics over just a few months!
We all know that it can be a juggle with work/personal commitments so try to be flexible - practicing over the phone during a commute to work is certainly an option that has helped some! In addition, lunchtimes/study sessions are useful periods to use at work to practice with others. Simply taking the time to run through a few short videos on YouTube to practice descriptions and sign recognition will serve you well! Closer to the exam, you might consider creating a “mock” OSCE/VIVA to practice with a partner, which could include creating a set of slides with different images/videos on power point. This is a great way of consolidating your own knowledge and can easily be shared.
If you feel like supplementing your learning with another form of practice you might consider using a recently developed interactive platform to practice doing a range of clinical and communication OSCE/VIVA scenarios in your own time. The feedback received is personal to your performance and each station can be tackled numerous times, with the responses from the virtual examiner/patient being slightly different each time. Head to www.iPrepBuddy.come to find out more!
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
