The FRCOphth (Fellowship of the Royal College of Ophthalmologists) Part 1 exam is a significant milestone for those pursuing a career in ophthalmology. The incentive of doing the exam early is it is worth 3 points if you pass and 1 point for attempting it as per the 2025 ST1 recruitment portfolio. As an FY1/FY2, it might feel daunting to attempt a membership exam, especially in a specialty that generally had limited exposure at medical school. This might be the first time attempting an exam while also juggling clinical responsibilities.

However, with the right resources, planning and approach, passing the FRCOphth Part 1 is entirely achievable. This article aims to assist candidates to provide guidance on how to prepare for this exam.

Let’s start by understanding the exam structure and syllabus. The FRCOphth part 1 is a requirement before starting ST3. It is based on the learning outcomes from the curriculum for the first two years of specialty training.

It consists of two MCQ papers of 90 questions each (2 hours for each paper). Pass marks vary but in 2024 the January and April sittings were 60.9% and 63.8% and the pass rates were 39% and 32% respectively.

Although it is an ophthalmology exam, it emphasises heavily on basic science knowledge like physiology, biochemistry, immunology and pathology. The material goes beyond knowledge of what was learned in medical school and so requires learning a lot of new material, beyond just ophthalmology.

The pie chart below gives the exam contents by subject area:

Source: Royal College of Ophthalmology April 24 examination report

Optics and pathology form the majority of questions in most sittings. The 26 miscellaneous questions cover biostatistics and epidemiology which plenty fail to prepare adequately for but are easy marks to obtain. The only tricky bit is calculators are not allowed in the exam so it might be beneficial to start practicing your long division. 

How to prepare

It is recommended to prepare for 3-4 months and intense revision for 2 weeks prior to the exam. It is difficult to pass if you do not have a strong understanding of concepts. It is easy to get overwhelmed, concepts are challenging particularly in optics which is why it is essential to start early.

Tips:

• Pick a rotation where you are likely to have more time to revise
• Burn-out is real so sometimes earlier might not be better
• Use the suggested reading list given in the study guide
• Spatial repetition, likely to forget things over 3-month period
• Find a buddy to study with

Resources:

1. Basic Sciences in Ophthalmology, Myron Yanoff – good summary of Forrester chapters
2. Elkington Optics – the only book I would recommend reading front to back
3. Snell’s Clinical Anatomy of the eye – a little heavy but recommended if you have time and want to solidify concepts prior to ST1
4. Forrester – useful for more in-depth reading but a lot of information and can get overwhelmed
5. American Academy of Ophthalmology – expensive, great if you can get access

Questions banks:

1. eFRCOphth – similar to passmed, with questions, explanations and high-yield textbook
2. Eyedocs – standard but some outdated questions

Question books:

1. FRCOphth part 1: 400 SBA and CRQ by Nikki Hall
2. MCQs for FRCOphth part 1 by Sohaib R. Rufai

Courses:

At this stage you might be the only one taking the exam out of your friends/colleagues. Courses are recommended not just for the teaching/material but also to be part of a bigger group who are all taking the exam with you. It is likely that you will be added to a group chat where you can ask questions, discuss and share learning material.

Miscellaneous:

1. Eyewiki by AAO
2. YouTube – Insight Ophthalmology for crystal clear basic concepts
3. Dr Hunter’s 2020 Optics and Refraction Review is a six-hour video lecture by Professor David Hunter focusing on the basics of optics and refraction.
4. Do a taster week, familiarise yourself with investigations and devices such as slit lamp, Humphreys visual fields, OCT etc.
5. Embryology is tough – least is to remember the origin of structures in the eye
6. Loads of calculations to my surprise and you are not allowed to bring a calculator – practice not using a calculator while revising

In summary, the FRCOphth part 1 is no small feat, especially as a foundation year doctor. If you are motivated enough to start the exam, you need to be disciplined throughout the revision period. Many people require multiple attempts, including those in training so do not feel disheartened if you do not pass the first time. Hopefully this article acts as a guide for starting exam prep. Good luck!

References:

1. Severn Deanery NHS. Ophthalmology ST1 Recruitment 2025 – Evidence Folder. Available at: https://severndeanery.nhs.uk/recruitment/vacancies/show/oph-st1-25/evidence-folder-lib

2. 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 Akshatha Daniels (FY2)