The FRCOphth Part 1 is the first written examination set by the Royal College of Ophthalmologists. It is required for progression to ST3 ophthalmology training. However, many doctors now choose to sit it much earlier, including during foundation training, because of the advantages it offers when applying for ST1.
With the updated ophthalmology portfolio scoring system, passing Part 1 scores 3 points in the commitment to specialty section. Even sitting the exam now scores 1 point. In a competitive specialty where you can score a maximum of 13 points for commitment, these points are valuable.
There is already an excellent article on Mind the Bleep by Dr Akshatha Daniels explaining the structure and breakdown of the exam, so I will not repeat that here. Instead, this article will focus on something more practical: a step-by-step guide on how to prepare for the exam, specifically from the perspective of a Foundation Year 1 doctor.
For context, I sat the exam in January 2026 during my FY1 year and managed to score 80%. I gave myself five months of preparation. The first three and a half months were during a psychiatry rotation with a 9–5 rota and no on-calls or nights. The final six weeks of revision were during general surgery, which included long days and on-calls but no nights.
Depending on how demanding your rota is, I would recommend allowing five to six months of preparation to give yourself the best chance of passing, particularly if you are balancing full-time clinical work.
Before going into the step-by-step structure, it is important to highlight what I believe is the single most important factor in passing this exam: doing as many practice questions as possible!
The FRCOphth Part 1 is a breadth-heavy exam. The volume of examinable material is vast, and for most foundation doctors working full-time, it is simply not realistic to read multiple large textbooks cover to cover. I certainly did not have the time to work through the heavy reference books that are often recommended.
In fact, the only textbook I read properly was Clinical Optics by Elkington. This is the one book I would strongly advise you to read. Optics carries significant weighting in the exam, and having a clear conceptual understanding early on makes a huge difference when tackling question banks.
For the rest of the syllabus, I relied primarily on question banks and MCQ books. The exam rewards pattern recognition, familiarity with common themes, and the ability to apply knowledge in single-best-answer format. These skills are best developed through active question practice rather than passive reading.
If you are balancing revision with a full-time rota, your time is limited. In my experience, that time is most effectively spent answering questions, reviewing explanations thoroughly, and identifying weak areas early. In the next section, I will explain how I structured this question-focused approach over five months.
Step 1: Build your base (Months 1-2)
For the first one to two months, your goal is to build a strong foundation, particularly in optics, while immersing yourself in question practice from the very beginning.
Start by working through Clinical Optics by Elkington. This is, in my opinion, the only textbook you must read. Optics is heavily weighted in the exam, and having a solid conceptual understanding early on will make everything else easier.
After finishing each chapter in Elkington, immediately complete the corresponding optics questions from the Chua MCQ book. The chapters align well, and this reinforces understanding while the material is still fresh. Optics becomes far more manageable when you combine reading with targeted questions rather than passively reading alone.
At the same time, and this is important, begin the Eyedocs question bank from your very first week of revision.
Do not wait until you “know enough.”
Do not worry about getting questions wrong.
You will learn through the process.
The FRCOphth Part 1 rewards exposure and repetition. Early mistakes are not a problem, they are the mechanism through which you improve.
As you go through Eyedocs:
- Create flashcards for questions you get wrong.
- Read around unfamiliar topics briefly to consolidate gaps.
- Keep a record of weak areas.
It is entirely possible to complete the Eyedocs question bank, including reviewing incorrect questions, within one month if you are consistent.
Once you have finished it, reset the bank and go through all the questions again. The second pass will be significantly quicker, and you will notice patterns emerging. This repetition is where confidence builds.
While doing this, you should still be:
- Reviewing incorrect questions regularly
- Continuing your optics revision
- Strengthening weaker topics
During your second month, I would also recommend purchasing the eFRCOphth question bank. It contains over 2000 questions. Your aim should be to complete 20–50 questions per day and maintain that consistency until the exam.
Do not worry if you do not finish the entire bank. In my view, it contains some lower-yield material. However, its optics and anatomy questions are excellent and worth prioritising.
By the end of month two, your ideal position is:
- Elkington completed
- Chua optics questions completed
- Eyedocs completed twice
- eFRCOphth started and ongoing
At this stage, you will have built a strong base of knowledge. You will not feel “ready” yet, that is normal, but your foundations will be solid.
In the next step, the focus shifts from building knowledge to refining exam technique and consolidating high-yield areas.
Step 2: Increase Volume and Refine Technique (Months 3–4)
By months three and four, you should have a solid foundation from repeated question exposure and optics consolidation. Now the focus shifts towards increasing volume, improving exam technique, and exposing yourself to different question styles.
The first resource to introduce at this stage is FRCOphth Part 1: 400 SBA and CRQ by Nikki Hall. This is an excellent book with detailed explanations that help consolidate understanding.
Do not worry about your scores while working through it. At this stage, performance is less important than learning. Continue the same process you established earlier:
- Write down questions you get wrong
- Identify recurring weak areas
- Read around those topics briefly to consolidate knowledge
After starting or alongside this book, move on to the OphthoQuestions (OphthoBank) question bank. It contains approximately 900 questions. In my experience, this bank has the closest style and level of difficulty to the real exam.
Again, the approach remains the same:
- Attempt questions in timed or semi-timed blocks
- Carefully review explanations
- Record incorrect questions
- Read around weaker topics
This repetition is deliberate. The FRCOphth Part 1 rewards familiarity with patterns and commonly examined themes. By this stage, you should start recognising how topics are repeatedly tested.
Completing Nikki Hall’s book and finishing OphthoBank should take you towards the end of month four.
As you approach the end of month four, introduce another MCQ book: MCQs for FRCOphth Part 1 by Sohaib R. Rufai. This book contains five full papers. Aim to complete one paper per week. This pacing will take you into month five and begins to shift your preparation towards exam simulation.
At this point, you are no longer just learning content. You are building exam stamina, improving timing, and strengthening pattern recognition.
In the next step, we will focus on the final months, where consolidation, repetition, and exam conditioning become critical.
Step 3: Consolidation and Exam Conditioning (Months 5–6)
The final one to two months are not about learning large amounts of new content. They are about consolidation, repetition, and sharpening exam technique.
At this stage, you are repeating everything you have already done.
Go through Eyedocs one more time to consolidate your base knowledge. By now, you should recognise most questions and feel much more confident with common themes. This pass is about reinforcing pattern recognition and eliminating lingering weak spots.
You should also systematically review all incorrect questions from every question bank you have used. These are your highest-yield revision points. The topics you repeatedly get wrong are the topics most likely to cost you marks on the day if ignored.
Aim to go through Clinical Optics by Elkington at least one more time to consolidate optics knowledge. By this stage, the concepts should feel significantly clearer than when you first read it. Optics carries heavy weighting, and being strong here gives you a real advantage.
Continue working through the five papers in MCQs for FRCOphth Part 1 by Sohaib R. Rufai. These should now feel more like exam simulations rather than learning exercises. Focus on timing, concentration, and consistency.
Around two weeks before your exam, complete the online FRCOphth MCQ mock paper (this is a paid mock exam and, at the time I sat it, cost approximately £15). It is a very accurate representation of the real exam, both in style and difficulty, and contains a few questions that feel very similar to the actual sitting. If possible, go through it twice, once under timed conditions and once reviewing thoroughly.
To summarise, my preparation consisted of:
- Three question banks
- Two MCQ books
- Elkington read at least twice
- Chua optics questions
- One realistic mock exam
- Consistent daily question practice
I cannot stress this enough: the more questions you do, the better you will perform. This exam rewards exposure, repetition, and familiarity.
Finally, plan early. Giving myself five to six months meant I could revise consistently while still going to the gym, running, and seeing friends. The exam did not completely take over my life, apart from the final few weeks, which is inevitable. Sustainable preparation is far more effective than short bursts of burnout. I hope this article has made it clear on how to prepare for this exam and I wish you all the best of luck when sitting it. Thanks!
References
- How to pass the FRCOphth part 1 as a Foundation Doctor by Dr Akshata Daniels. Available at https://mindthebleep.com/how-to-pass-the-frcophth-part-1-as-a-foundation-doctor/
- Severn Deanery NHS. Ophthalmology ST1 Recruitment 2026 – Evidence Folder. Available at: https://www.severndeanery.nhs.uk/recruitment/vacancies/show/oph-st1-26/evidence-folder-lib
- The Royal College of Ophthalmologists. Part 1 FRCOpth Exam. Available at: https://www.rcophth.ac.uk/examinations/rcophth-exams/part-1-frcophth-exam/
Written by Dr Ali Alseneid, FY1 Doctor
