Candidate 154

Final FRCS

Centre:   New Dehli

   Date:    Sep 2011

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-

Kanski(the latest 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 illustrations.

Wills, Oxford 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 the book

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 Chua( a very important site for the pathology part, the examination videos , studies and other sections also-an essential  website for the aspiring candidate.

“FRCOphth”, “FRCS” 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 viva

Collins, Gladstone (Selected topics) - very important for the oculoplasty viva and clinicals

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 Bhattacharya)

Dr Bhattacharya 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 nice examiner)

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 Granulomatosis.

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 with management.

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.

Station 1- 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 

Station 2- 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 management options.

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  :

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