I am Dr Rudra Prosad
Ghosh working in a teaching hospital in Kolkata, India, passed the
final FRCS held at New Delhi, at September 2011 with blessings from my
well wishers, support and sacrifice from my family and co-operation
from my colleagues. I would like to share with you some of my
experiences and suggestions that may be useful for this exam.
Firstly, the choice of
study material is very important, my preferences are-
edition, obviously)-the single most important book for
the preparation, you have to go through it several times,
line by line with an indepth understanding of a single word and the
handbook of Ophthalmology, and Dr Muthu’s site (MVUPGO)- These are
must for passing the part 2 exam and also helpful for part 3
Wong (OER) -
the approach should be followed, but not always the answers written in
AAO (book on
general medicine and partly book on paed ophth)
Book by Dr C N
Chua( Marudi Publications, Singapore)- Very helpful for the
clinicals, especially the examination techniques-a must read book
before the clinics exam
Website by Dr C N
a very important site for the pathology part, the examination videos ,
studies and other sections also-an essential website for the aspiring
group of Yahoo Website- another must see site for an aspiring
candidate, specially the FILES section
Oxford handbook of
clinical medicine (selected topics including full of the emergency
section), and AAO (update on gen med)-must for the Gen medicine
(Selected topics) - very important for the oculoplasty viva and
Ready Reckoner (a
compilation published by the AIOS), “DOS Times” Journal ( published by
DOS New Delhi)- selected topics from these journals and reckoners
are very helpful for the viva(specially the recent advances)
Next for the Clinical
part - practicing, practicing and only practicing is the core of
success, the examiners for the FRCS exam are very competent in
diagnosing whether you are doing a procedure specially learned for the
exam purpose or you do it on a regular basis on your day to day
practice. Some of the procedures you should practice regularly are
everything of Slit Lamp examination, 78D, 90D, I/O, D/O, Ptosis Exam
including measurements, Proptosis Exam including measurements( if
possible with Hertels), Pupil exam, Ocular motility, Cover-Uncover
with and without Prisms, Visual field testing, Cranial Nerves
testing, Nystagmus testing etc.
Now I would like to
share my experiences in the New Delhi Exam
My viva was on 26th
Sep and started with Ophthalmic Surgery and Pathology Table
( One British examiner and another Indian examiner-Dr
started with Ectropion, pathogenesis, diagnostic clinical tests and
some surgical procedures-it was a very detailed discussion.
The next topic started
with a clinical picture of a traumatic cataract-with detailed
discussions about the effects of ocular trauma.
The British Examiner
started with complications of Trabeculectomy with special focus on
shallow ac, its d/d and management
My next topic was a
case of Refrac Accom Esotrpia with residual deviation-a detailed
discussion regarding the types of surgeries and complications, with
management of scleral perforation.
My second table was on
General Medicine and Neuro-ophthalmology (One Indian
Physician-Dr Duggal and one Arabian Lady who is an Ophthalmologist-a
Dr Duggal started with
a scenario-2 day post op. 70 yr lady pt with H/O of Osteoarthritis
with blood vomiting, bp-100/60-details management with drugs and doses
The Second Scenario
was a pt complaining of increasing waist circumference and shoe
size-d/d and management- discussions revolving around Pituitary
Adenomas and Thyroid including medical and surgical management.
I was not very happy
with my performance in this part
The Arabian Examiner
started with questions on post chiasmal visual field defects, defects
of higher visual function and effects of ICA and VBA strokes.
Next was a picture of
Anisocoria with detailed discussions on Horners including
Pharmacological testing .
Last was a picture of
PUK with H/O of Nasal bleeding with discussions on Wegener
This table was very
satisfactory for me.
My Third table was on
Ophthalmic Medicine (One Indian Examiner-Dr S Mohan-One
of the best Examiners for the FRCS Exam, another Lady Examiner from
UK-An equally nice Examiner)
Dr Mohan started with
a picture of a angle closure Glaucoma with detailed discussions on it,
next case was a picture of NPDR with CSME with detailed management
with special emphasis on ETDRS and Anti-VEGFs including, dosage,
procedures and complications
The lady examiner
started with a picture of proptosis with discussions on D/D ,
investigations and detailed discussions on Orbital Cellulitis and
I.O.I.D. with special emphasis on steroid and Anti metabolites, Her
next picture was of an Angioid Streak with discussions on D/D ,
systemic associations, complications with special emphasis on CNVM
Her third question was
about Myaesthenia along with diagnostic procedures (including
procedure of Edrophonium Test in details with complications and
management) and management of MG.
After one day gap
on 28th Sep I had the Clinical Exam.
Anterior Segment (One African Examiner, the other one was the
Arabian examiner whom I faced in my Neuro Table). The first case was a
case of Fungal corneal ulcer with hypopyon with discussions about dx
and tx. The second case was a young male patient with inferonasal Iris
coloboma with nystagmus, and the third case was a complicated one with
a young pt with circumferential limbal abnormality with stromal
corneal opacity, pupillary membrane and some patches on the Iris.
The whole procedure in
the ant seg station was mainly focused on the use of the Slit lamp
with different filters, demonstration of sclerotic scatter and
specular reflection etc
Posterior segment (One Indian Examiner- Dr Grover-again one of
the best FRCS examiners another British Lady Examiner –Equally nice
one). The first case was a middle aged lady( SL with 78D Lens) with an
ST-BRVO with macular edema with Pre retinal Hge-discussions revolved
around the systemic investigations, special diagnostic procedures and
management( lasers anti anti-VEGF). The second case was a young lady
(I/O with 20D lens) with a old traumatic choroidal rupture with the
The third case was a
young male (SL with 78D) with a traumatic Macular hole, with
discussions about staging, clinical diagnosis (Watzke-Allen, and He-Ne
Test) and management.
Station 3- Neuro-Ophthalmology
and Ocular Motility disorders (Two British Examiners)
The first case was a
young male for gross torchlight examination ( anisocoria) and then
Ocular Motility-he had Inverse Duane Sign-I was very happy to diagnose
it as aberrant Regeneration of Traumatic third Nv palsy.
The second case was an
Optic Disc anomaly-? Optic Disc coloboma and I was asked to perform a
confrontational VF testing-I did it with a white and a red pin and the
examiners were happy.
The Third case was an
Alternating Exotropia and I was asked to perform a cover –uncover
testing and to comment on the vision of the patient.
Station 4 –
Oculoplasty (One Indian Examiner-Dr Bhattacharya another
British examiner) The first case was a middle aged male pt with
Bilateral Ptosis-I was asked to perform a detailed Ptosis examination
and I diagnosed it as a MG pt. The discussions revolved around the
diagnostic procedures and the treatment options for the patient.
The second was a young
girl with a prosthetic eye with contracted socket, discussions were
about the causes for these contraction, preventive measures and
detailed surgical options for the patient.
Results came on the
evening of 3rd Oct and my i.d. number was on the top-I was
so excited that I could not believe my eyes initially and called my
wife to recheck it-it was one of the happiest day of my life, at last
my hard work and dedication was paid-off.
If anyone wants to
take any suggestions from me please feel free to contact me at :