How to pass the FRCOphth Part 1 Exam
What, When & Why?
FRCOphth Part 1 is the first of the trio of fellowship exams, refraction certificate aside, within ophthalmology specialty training. It is an online-proctored exam made-up of two papers each lasting two hours and with 90 MCQs. With a more theoretical focus on the core science underlying ophthalmology instead of clinical practice, Part 1 can be daunting with its low pass rate (~40%).
The question of when to sit the exam is more nuanced. There are three yearly sittings in January, April and October. Passing Part 1 is a requisite by the end of the second year of run-through ophthalmology training. However, many eyeball-aspiring doctors take the exam earlier than this, such as during their foundation years.
Why you may do this is for a few reasons. It adds significant points to the application portfolio within the commitment to specialty domain, establishes a knowledge base beneficial for OST interviews, and it facilitates concentration on other skills and competencies during the first two years of training. Additionally, Part 1’s content is the interesting fundamentals of ophthalmic science that you might daresay enjoy learning as a blossoming ophthalmologist.
Anatomy, Optics, Investigations & Statistics
The bulk of the exam is centred around these four topics. The key is to understand the core concepts and be able to apply these to the detailed questions rather than rote learning. This rings especially true for optics where understanding the principles of light, ray diagrams and instruments is essential to answer a broad array of questions. Similarly, a firm anatomical understanding of the orbit, eyeball and adnexa is crucial, alongside a reasonable appreciation of head and neck anatomy and neuroanatomy. Grasping the principles of investigations and statistics is also an advisable approach to handle the array of potential questions. There are other topics that comprise a smaller proportion of the questions, namely embryology, physiology, pathology, pharmacology and genetics, which are more amenable to memorising the facts.
Helpful Resources
Textbooks: Clinical Optics by Elkington is a must. It is eminently readable, crammed with high-yield information and very closely matches the content of Part 1’s optics questions. Reading through it a couple times is very beneficial for truly understanding the core principles of optics. Snell et al.’s Clinical Anatomy of the Eye is a staple but other books, such as Forrester’s The Eye: Basic Sciences in Practice, cover ocular anatomy and embryology in sufficient detail. Focusing in on investigations when they appear within other topics is imperative, and Kanski’s Clinical Ophthalmology is useful for more detail on their workings, indications and complications. Getting your hands on a copy of Basic Sciences in Ophthalmology by Ferris is also highly recommended because its multiple-choice format enables you to test your learning through a range of subjects including microbiology, pharmacology, physiology and statistics.
Online question banks: There are some valuable free resources out there. The Royal College of Ophthalmologists website features a small number of sample MCQs. Albeit devised to aid revision for the old MRCOphth exam, the Chua webpage has practice questions especially beneficial for investigations and pathology. Additionally, there is an MRCOphth optics site that tests your knowledge acquired from Elkington. These resources are useful, but you will need at least one paid-for question bank to work through too. There is a wide range of options available, and it is worth considering reviews, pricing, bank size and exam question realism. Do check out Eye Academy’s new Part 1 question bank with over 500 questions based on recent exam material, in-depth answer explanations and adaptable learning features!
Other: There is a wealth of resources out there. Some particularly helpful extras are Professor Hunter’s optics summary video on YouTube, and Eyewiki is an excellent place to read about conditions in more detail. Another must-have in the revision armamentarium is 400 SBAs & CRQs by Peden & Hall; the MCQs are realistic to the exam with informative explanations, and, although no longer representative of Part 1’s question format, the critical-reasoning questions are great to work through.
Revision Timeline
No two budding ophthalmologists see exactly eye-to-eye when it comes to revision techniques and strategies. The following timeline is only a suggestion, and some may prefer more time to prepare, others less. This also needs to be balanced against work/rota commitments and finding time to enjoy yourself outside of medicine and the world of fellowship exams.
· 3 months before: Start getting your head around the core topics, particularly optics and anatomy.
· 2 months before: Consolidate this essential material, especially from Elkington, and start testing yourself with a question bank.
· 1 month before: Hone any of the smaller topics you are struggling with as flagged by practice MCQs.
· Final week: This is a great time to utilise those realistic papers in Peden & Hall.
Final Thoughts
We have all ultimately already successfully gone through lots of exams at medical school and beyond. With a focused revision schedule and the right resources, FRCOphth Part 1 need not be any more intimidating, especially because as a future ophthalmologist you will likely find the content interesting. Happy revising and wishing you success for the exam!