Candidate 184


FRCS Glasgow


Hi to all…

I am Dr. Yousaf Jamal from Pakistan. I passed my FRCS3 Glasgow in Delhi in Sep 2014 in first chance Alhamdulillah. I want to share my experience here so that in future it may help other candidates.

I will like to thank Almighty Allah who rewarded me. I want to thank my supervisor and my teachers who encouraged me to go for this exam. I also thank Prof. Chua for his wonderful website, Prof. Muthu virtual university whose weekly questions were guiding the path and FRCS Yahoo group where I found related material and experience for the exam.

My experience regarding study material….

1.      Must read Chua website thoroughly especially the past candidates experiences, Pathology slides and surgical instruments.

2.      Must enroll yourself with Prof. Muthu virtual university ( where his weekly questions give you the exact idea of exam. It’s very helpful.

3.      FRCS yahoo group is also good source.

4.      Books are… Kanski, Wong, Oxford handbook of Ophthalmology (last 100 pages), medical emergencies from Oxford handbook of medicine, AAO (for General medicine related to eye, cataract surgery in special situations, Squint surgery complications and Tx, Anophthalmic socket and Prosthesis) and Case reviews in ophthalmology (by Neil J. Freidman).

My advice to Pakistani candidates is that attempt FRCS3 after your FCPS exam bcz you will feel it easy. Also, India is good center for exam but only one problem of VISA, you get Indian visa just 2-3 Days before exam, so be ready for that. And try to go for exam with friend… it’s not necessary, I was all alone.

The examiners are really very nice and try to guide you. Mental blocks are natural and they understand it.

Now I will share my exam experience. I got visa just 3 days before exam but managed to reach Delhi on time.

First day was clinical examination.

STATION 1….Posterior segment:

I managed to see three cases.

1st case was young female with swollen disc. Examiner asked me the diagnosis; I asked to examine the other eye which was ok. He showed me her OCT which had CME but now resolved. I told it is posterior uveitis. He asked me the causes. Later I thought she may be case of Intermediate uveitis.

2nd case was male with CRVO. I was asked about causes, difference between ischemic & non-ischemic CRVO and investigations.

3rd case was female with round 1.5-2 DD rounded lesion inferior to disc with punched out pattern and hyperpigmented borders. I was asked about diagnosis, I said I have two differentials of either choroidal coloboma or toxoplasma scar. Examiner asked me about toxoplasmosis. However it was choroidal coloboma.


STATION 2… Neuroophthalmology and Ocular motility:

I managed to see three cases.

1st case was young female with left ptosis, down and out eye with dilated pupil. Was case of surgical 3rd nerve palsy. I was asked about causes, investigation and treatment.

2nd case was to examine pupil. Patient had total APD and was case of old ACG. I was asked to examine the disc and found pale cupped disc. Was asked about causes of unilateral sudden visual loss.

3rd case was again pupil examination of female. This time was RAPD and was asked about causes.


STATION 3…Oculoplastics and Lids:

Saw two cases.

1st case old female with cicatricial ectropion. Was asked about causes of watery eyes. What test you do for ectropion and demonstrate each one. Treatment options.

2nd case was complicated case of ptosis surgery following trauma. I was asked to do the relevant measurements and examination and was asked about the importance of each test. What is the principle of sling procedure?


STATION 4…Anterior segment:

Saw two cases.

1st case was old female with posterior synechiae and cataracts. Asked about evaluation and treatment. How to do cataract surgery in miosed pupils?

2nd case was old female with penetrating keratoplasty and aphakic eye. Was asked about possible sequence of events in this eye. Causes of graft rejection, types of suturing techniques and their advantages.


It was a good day and I was satisfied. There was one day gap for oral examinations. As I was alone I couldn’t study well, that’s why partner is good.


Oral examination.

STATION 1…General Medicine & Neurology:


1st examiner asked me in neuroophthalmology.

Case scenario… 26 with headache, B/L 6th Nerve palsy and normal neuroimaging. Diagnosis was IIH. Was asked in detail about risk factors, causes, investigation and treatment.

Causes of papilledema and disc findings in acute papilledema.

Color picture showing ciliary staphyloma. Was asked about diagnosis. I told necrotizing scleritis but examiner not satisfied, later he told me its scleromalacia perforans. Then asked me systemic associations. Some discussion on Wagner’s granulomatosis.

Another scenario of of old patient diagnosed of abdominal lymphoma presents with loss of vision and you see whitish patches in fundus with hemorrhages and vitreous haze. What is diagnosis. I told it can be PIOL or metastasis, but examiner not satisfied. He said do you think this patient will be immunocompromised; I said yes and told it may be viral (herpes, CMV, AIDS). He said yes but what’s the diagnosis? I couldn’t answer… he told me it’s ARN. But I didn’t understand bcz ARN occurs in immunocompetent person.


2nd examiner asked in general medicine.

Case scenario… you are examining fundus of a patient and suddenly he becomes cold and clammy. What’s your diagnosis? I couldn’t reach the diagnosis but I said these are signs of shock. He helped me by saying in which metabolic condition you examine fundus? I said Diabetes, and then he said now what it can be. Here I got the clue that patient had an attack of hypoglycemia, examiner was satisfied. He asked me treatment of hypoglycemia, how you differentiate between hypo & hyperglycemia clinically? Complications of hypoglycemia?

Another scenario… patient after head surgery 10 days back present with chest pain, what’s diagnosis? I said pulmonary embolism. He asked me other signs and symptoms of PE. He asked me about type of chest pain in PE which I couldn’t answer…its pleuritic. He asked me about other causes of chest pain. Asked me about signs/symptoms and only examination findings in pneumothorax. Then asked about treatment of pneumothorax. Again he came to PE and said which one investigation you will like to do. I said D-Dimers. Then he asked about other investigations in PE. Treatment of PE. Name three diseases with chest pain with falling bp and rising pulse.


STATION 2…Ophthalmic Medicine:


1st examiner…

Showed me fundus photograph of bergmiester papilla. Asked about cause of this?

Another picture of iris atrophy and glaucomflecken… was asked in detail about ACG. Acute and long term management.

Then was shown Humphrey visual field. But bell rang.


2nd examiner…

Asked about Aniridia in detail. Genetics, ocular and systemic association. Complications and treatment and follow-up.

Fundus picture of BRAO. Was asked about investigation and treatment.

Another picture of PUK. Just name it.


STATION 3…Ophthalmic surgery & Pathology:


1st examiner…

Showed me picture of swelling near medial canthus. Was CDC. Asked about treatment and complications.

Another picture of limbal dermoid. Asked about complications and treatment.

Another picture of PXF. Asked about complications and management.


2nd examiner…

Showed me picture of shallow AC after Trab. Asked about causes and detailed discussion on malignant glaucoma.

Management of traumatic subluxated and luxated lens.

Scenario with picture of ON glioma. Asked about the systemic association and other ocular presentations in NF-1.

My experience is that this exam is not very difficult but if you prepare with guidance. So best of luck .



More candidates' experience