My name is Tarek Ibrahim Badreldin ,from egypt ,working in Memorial institute of Ophthalmology in Egypt ,thanks  God I passed final part FRCS examination of Glasgow from first attempt by the help of Allah.

I Would like to thank all people who supported me especially my wife and my family.

My advice in this exam is to be confident , never to hesitate even if you  don't know just say confidently ( I can not recall sir ) not to lose time and to be able to reply more questions and be targetful by  starting  your answer with the most commmon or most serious or most related to the data given to you by examiner….this is what the examiner wants to hear. Also try to deal ,think and examine the cases as if you are in your clinic ,deal as a doctor not as a candidate ,give your opinion confidently and insist on it when you are sure as the examiner may try to hesitate you to test your confidence in your knowledge. In this examination, they mainly evaluate your performane in your practice and how you think and they try to make sure that you will not make a fatal or blinding mistakes ,so please take care of endophthalmitis , acute glaucome, GCA, ………..

Again the approach to this exam is not the amonunt of knowledge only but how to explain in a systematic way as an ophthalmologist in his own clinic.

MY READING SOURCES:

Kanski (main source),Will's eye manual (esp. work up),Oxford for emergency medicine and other notes for work up and ophthalmic surgery.

Chua web site is extremely useful esp. past candidate experience , vivas,pathology (more than enough for pathology).

Other books which I didn't go deely through as Wong.

1^st day:-

General medicine & neurology :-

1^st examiner:

-unilateral  disc swelling then discussion about causes , in young adult what will you think about ?   M.S  and then deailed discussion about  M.S  especially investigations? MRI……what if patient refused to do MRI ?....i said he should do it…..the examiner smiled..i really didn't know the exact answer.

-a photo of fundus with dense subretinal  hyperpigmentation invoving the macula…the examiner said it is a difficult case….i gave d.d  of flecked retina…the examiner smiled and said if this in a female with cancer breast….i said cancer associated retinopathy,he wanted metastasis ,however the lesion was flat.

^2nd examiner:

-unilateral headache…he wanted migraine..what will you ask in history? He wanted precipitating factors of migraine and aura…… What if in female receiving ocp? Hypercoagulability , hypertension  and ocp is a precipitating factor.

-ptosis ….causes ? then detailed discussion about myasthenia gravis …especially ice pack test in clinical examination and acetycholine receptor antibody titre in investigations.

Ophthalmic  medicine:-

1^st examiner:

-a photo of PDR with CSME and PRP laser marks…..there was active NVE , what will you do ? FFA and OCT …..then GRID laser followed by additional PRP…….. what else ?  systemic work up for DM.

-a photo of eyelid with lost lashes (partial madarosis )…d.d? he wanted  ocular cicatricial pemphegoid…what will you do? Systemic steroids…..the examiner wasn't satisfied…..he wanted  systemic immunosuppressive  after consulting immunologist or dermatologist.

-patient did wonderful phaco…after 6 weeks can't see ? I gave dd and when said steroid induced glaucoma..he said after 6 weeks…you give steroids after phaco for 6 weeks???????…I said no only 3-4 weeks so it's a remote possibility….. he wanted Irvin Gass..then detailed disscussion about treatment.

2^nd examiner:

-a photo of punctured cornea with a metallic object…..then detailed discussion about endophthalmitis.

-a photo of infective keratitis….detailed discussion……dose of fortified eye drops is very important.

-aphoto of lower follicular cojunctivitis….dd….then treatment of trachoma in a child.

Ophthalmic surgery:-

1^st examiner:

-Lid swelling...dd….then discussion about site and  treament of rodent ulcer and reconstruction of lid ….site of grafts (non hairy areas).

-A photo of choroidal melanoma…..treatment according to COMS (small-medium-large).

2^nd examiner:

-vitreous loss during ECCE …what will you do?..how to make sure that all vitreous has been removed….she wanted injection of triamcinolone acetonide.

-a photo of retionblastoma….detailed disscussion about treatment esp. chemotherapy.

-another photo of retinoblastoma after irradiation.

-pterygium….how to excise and prevent recurrence ?

2^nd day:-

Posterior segment:-

-1^st case: a case of NPDR with CSME….ttt?  FFA and OCT…then focal or grid laser treatment ( according to ETDRS).

-2^nd case:  a child pseudophakic with pale disc and subretinal hematoma……I said post-traumatic…the examiner was happy.

Oculoplasty and lid disorders:-

-1^st case: ptosis  in young female…..i did complete examination for ptosis….there was aberrant 3^rd nerve regeneration ????i'm not quite sure.

-2^nd case: blind painful eye in old lady…..dd….discussion about evisceration and types of implant.

Ocular motility and neuro-ophthalmology:-

-1^st case: RAPD  in old male with optic atrophy…dd …discussion about AION.

-2^nd case: Duane syndrome in a child with right over left.

Anterior segment:-

-1^st case: glaucoma drainage device in a child with failed trabeculectomy and posterior embryotoxon…..discussion about causes of congenital  glaucoma esp. iridocorneal dysgenesis.

-2^nd case: macular dystrophy in one eye and discussion about options  of treatment…then examiner asked me to examine other eye…there was corneal graft  of deep lamellar keratoplasty.