FCCOphth Part 1: An Introduction

The FRCOphth Part 1 examination is an examination that encompasses basic sciences pertinent to Ophthalmology and is offered in the United Kingdom and internationally. The exam is taken virtually and consists of two separate 120 minute papers of 90 multiple choice questions (MCQs) with single best answers.

In the United Kingdom, the exam is a requirement to progressing beyond the third year of specialist training (OST). However, passing the exam early can help foundation doctors show commitment to the speciality and gain strategic portfolio points for the OST application. Candidates who attempted the exam prior to OST training were shown to be more likely to obtain a training number at first attempt according to a cohort study published in 2021 (Das A, Smith D, Mathew RG. Predictors of ophthalmology career success (POCS) study. BMJ Open Ophthalmology 2021;6(1):e000735).

While the exam is known to be difficult to pass (pass rate of 30-40% over the past 2 years according to the released RCOphth reports), here are some helpful hints to guide you there.

Prioritising what you cover:

There is a broad range of topics to cover for the Part 1 exam, most of which you will not have covered before during undergraduate studies or even during the first 2 years of specialty training. Start with looking at the Part 1 syllabus available on the RCOphth website for the comprehensive list. From published exam information regarding previous MCQ breakdown, the majority of the questions (50-60%) pertained to optics, pathology and anatomy/embryology. The remainder (40-50%) were divided relatively equally between investigations, physiology, pharmacology and genetics, and miscellaneous (statistics/epidemiology).

Resources available:

With this in mind, there are a wide array of resources candidates can utilise to obtain this knowledge. Officially, there is a list of recommended reading on the RCOphth’s part 1 syllabus, but ultimately what you find most useful will depend on what suits your study style best. Some recommendations (please note this is not a comprehensive list) that may help you include:

Textbooks

  • For Optics: Clinical Optics by A.R. Elkington and H. J. Frank
  • For Anatomy: Clinical Anatomy of the Eye by Richard S. Snell
  • For a high yield review of ophthalmic basic sciences: Eye Yield: Ophthalmology Basics for Board and FRCS Part 1 by Exams by S. A. S. AlRyalat
  • For a high yield review of general basic sciences and miscellaneous topics: First Aid for USMLE Step 1 by T. Le et.
  • Practice questions (new and old format):
    • FRCOphth Part 1: 400 SBAs and CRQs by N. Hall
    • MCQs for FRCOphth and ICO Basic Sciences Examinations by S. Trikha et al.

Online Resources

  • RCOphth official practice questions
  • Question banks: eyedocs.co.uk, efrcophth.com, ophthoquestions.com
  • Pathology, Investigations, practice questions: Dr Chua’s mrcophth.com
  • Flashcards: Eyeguru (based on AAO basic sciences curriculum)
  • Notes: eye-notes.com

How long do I need?

As there is a breadth of, perhaps unfamiliar, topics and concepts to cover, the amount of time needed for revision will depend on the individual. A general guidance would be to make sure you have enough time to study for the exam and to ensure that you optimise your chances of success by structuring your revision effectively and 2-3 months prior to the exam you should be practicing questions, emphasising high yield points and identifying gaps in your knowledge.

What else?

Stress and anxiety has been shown to have a detrimental impact on cognitive function, so ensuring you look after yourself during this process should not be overlooked. Ensure that you leave plenty of time to balance your studies, your clinical work, and your personal wellbeing. Throughout this process, the knowledge you gain from this exam will provide a strong foundation to your future as an Ophthalmologist.

Written by Rynda Nitiahpapand — ST5 East of England