Candidate 187



Centre:   Dundee / passed


Date:   November,  2014

My name is Ahmed AbdelwahabSaad. I am currently working as a Lecturer of ophthalmology, ZagazigUniversity, Egypt. I have passed the final FRCOphth exam which was held in Dundee in the period 12-15/11/2014.


Although I have already FRCSEd and FRCSG since 2012, I decided to take the RCOphth exam to support my CESR (article 14) application to get a permanent consultant post in UK. With the help of Allah, I have passed all parts of the exam (Part 1, Refraction and part 2) in single attempt. I only started this process 8 months ago.


I would like to share my experience stressing on the difference that distinguishesRCOphth exams making it currently the only qualification considered towards the CCT or CESR in UK.


RCOphth exams are based on the OST (ophthalmic specialty training in UK). It is very difficult to pass the exam specially its final parts without working before in UK. I have spent a year in James Cook hospital in Middlesbrough as a specialty doctor. I think this was very important to get through this exam.


Part 1 (May 2014, Sheffield)

This exam is composed of 2 parts; the first part is MCQ on basic sciences and optics. It was more or less similar to ICO,Edinburgh& Glasgow part 1exams.The other part is the 12 CRQ questions in optics (including drawings) and in investigations (FFA, ERG, CT…) and this part needs some clinical ophthalmology experience.


Refraction certificate (April 2014, Birmingham)

12 stations (2 cycloplegicretinoscopy, 4 Non cycloplegicretinoscopy, 1 focimetry, 1 cyl refining, 1 binocular balancing, 1 trial frame/VA, 1 near add, 1 subjective sphere refine).

This exam is different from Edinburgh part b refraction station which you get only on patient to do everything on.


Part 2 written exam (September 2014, London)

180 MCQs divided in to 2 sessions each 2 hours.

Only those who passed the written exam were legible to sit for oral/clinical exam 8 weeks later.


Part 2 oral/clinical exam (November 2014, Dundee)


Oral exam


Station 1: Ophthalmic investigations and data interpretation:

·         Picture of dacroscintigraphy. Questions about name, technique, finding.

·         CT dacrocystography.Questions about findings.Work up of watering eye.

·         DD of filling defect in the lacrimal sac.. Questions about lacrimal sac tumors.

·         CT orbit showing tumor extending from lacrimal fossa to nose.


Station 2: Patient management one

·         Case history of asthmatic child with itchy watering eyes DD VKH. Questions about c/p. , side effects& treatment. Questions about cyclosporine &tacrolimus in details


Station 3: Patient management two

·         Case history about narrow pupil with phaco(with management).

·          Picture of PXS. Questions on intraoperativeZonulolysis(signs & management in details).


Station 4: Attitude, ethics and responsibility.

·         Questions on conflict of interest. (2 case problems about a new drug produced by a company for which you are a consultant... the other about new IOL to be introduced to the hospital.

·         Levels of scientific evidence.

·         Clinical governance

·         Scenario: you are in the interview panel of a new fellow post you know one of the candidates has psychiatric disorder but he didn’t declare in his application. (Discussion about confidentiality).


Station 5: Research,AuditScreening in details.

·         Role of ophthalmologists in diabetic retinopathy screening program.

·         Eye retrieval. Protocol, consent rules, precautions.


Communication skills (Held on the Viva day but counted with the clinical).

Scenario: Businessman was told by his optician that he has macular hole… OCT small hole 200um VA 6/9 no reading… Worried about operation, posturing… has to fly to Copenhagen in 8 weeks. The actor was very friendly. Discussed with him the no urgency of his problem. All details of vitrectomy and posturing. Gas and flying restriction. Some suggested Ocriplasmin as an option.

Patient happy at the end.


Clinical exam


Anterior segment:

Case 1: KCN

Case 2: Tremulous iris, PXS

Case3: PDS


Glaucoma and Lid

Case 1: ACG (bilateral PI and pseudophakia)

Case 2: Bilateral pseudophakia +GFS + cupped disc.

Case 3: Ptosis + Blepharospasm (detailed questions about Botox).


Posterior segment

Case 1: Dry AMD (questions about AREDS)

Case 2: Vitreous wick. With inferior chorioretinal scar (break!?).

Case 3: Buckle + cryomarks.


Motility+ orbit

Case 1: TED

Case2: Duanne syndrome type 1(old man).

Case3: Consecutive exotropia.



Case 1: RAPD + Facial palsy + pale disc.

Case 2: Left Inferior quadrantanopia (where is the lesion).

Case 3: Left INO with mild left abducent palsy (fasicular not nuclear ie not One and half syndrome.)

For any colleague preparing for exams, I am ready to help.


Dr Ahmed Abdelwahab Ali Saad


Lecturer of ophthalmology, Zagazig University, Egypt.



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