Kraig Jamieson

As a Foundation Year 2 Doctor aspiring to continue training in Ophthalmology, passing the FRCOphth Part 1 examination is a rewarding and achievable milestone with the right preparation. Not only does it contribute valuable points to the inevitable portfolio, but the content itself covers the fascinating fundamentals of ophthalmic science – material that, dare I say, you might actually enjoy learning as a budding ophthalmologist.

Despite being early on in my medical career, I chose to take on what many in the field warned me is the most difficult and time-consuming exam in the entire ophthalmic training pathway. After sitting the exam, an honest reflection from myself is simple – I have to agree with them. FRCOphth Part 1 is daunting with its low pass rate (~40%), but in this written piece here, I’d like to share how I approached it — the strategies I used, the resources I relied on, and the vital importance of community along the way. I hope this helps other junior doctors (or registrars and medical students) who are considering sitting the exam.

Start Early: Respect the Scope of the Exam

One of the best pieces of advice I received from multiple ophthalmology trainees was simple: start early and be consistent. In hindsight, I can’t stress this enough.

The breadth and depth of knowledge required for Part 1 is unique among postgraduate exams. It demands familiarity with:

• High school-level physics and chemistry (e.g. optics, refraction, lens properties)
• Undergraduate biology and anatomy (some of which I hadn’t revisited since my first year at medical school)
• Registrar-level pathology and clinical sciences

This range is what makes the exam particularly tough. You could be answering questions on the biochemical pathways of phototransduction one question, and the optics of a thin lens the next — all while being expected to understand embryology, physiology, microbiology, and much, much more.

I gave myself around six months of structured preparation time, increasing the intensity in the final few weeks. Starting early gave me space to not just memorise facts, but to understand concepts, build connections, and feel genuinely prepared.

Choosing the Right Resources

With such a vast syllabus, I learned quickly that not every resource is necessary. Instead, I focused on a curated selection of high-yield materials that allowed me to work efficiently and confidently.

Textbooks I Used

One standout resource for me was Clinical Optics by Elkington. It’s readable, thorough, and very closely aligned with the optics questions in the actual exam – almost as if the questions were directly modelled from this textbook. I read it through multiple times, and each time I felt my understanding deepen. This became my go-to for one of the exam’s most heavily weighted topics, and I would consider it an absolute non-negotiable for the individuals who are keen on passing this exam!

For anatomy, I used Snell’s Clinical Anatomy of the Eye, which is a well-established classic. I also found Forrester’s The Eye: Basic Sciences in Practice very helpful, particularly for ocular embryology and physiology — topics I found difficult to grasp initially.

I also made a conscious effort to focus on investigations, especially when they appeared in the context of other subjects. For this, Kanski’s Clinical Ophthalmology was surprisingly useful. Whilst it is more clinically oriented, it offers great insights into the indications, methods, and limitations of investigations, helping me apply basic science in a more practical way.

Another key resource was Basic Sciences in Ophthalmology by Ferris, which presents content in an MCQ format. I used this for self-testing and revision across topics like microbiology, pharmacology, and statistics — all of which are easily overlooked but heavily tested.

Online Question Banks

Once I had a decent textbook foundation, I shifted to active practice through question banks. I started with the Royal College of Ophthalmologists’ sample questions, just to familiarise myself with the format.

Then I moved on to the Chua revision site, which still holds value — especially for investigations and pathology — despite being built for the old MRCOphth exam. I also used the MRCOphth optics site, which helped me test what I’d learned from Elkington.

However, the most valuable practice came from paid question banks. I trialled several and eventually settled on using a combination of different platforms. Exposure to varied question styles, content breadth, and answer explanations was vital to reinforcing knowledge.

A particular highlight was PassMedicine eFRCOphth question bank, which offers an extensive range of up-to-date questions with detailed explanations. Its user-friendly interface and progress tracking features helped me identify weaker areas and focus my revision more effectively.

Other Resources That Helped

Some extra tools I found helpful included:

• Professor Hunter’s optics video on YouTube — a concise and well-explained visual overview of key optics principles. I often returned to this after tackling more abstract sections in Elkington.
• EyeWiki — a reliable and accessible online resource when I wanted more clinical context or quick refreshers on specific conditions.
• “400 SBAs & CRQs in Ophthalmology” by Peden & Hall — a book with realistic MCQs and clear explanations. Although the CRQs are no longer used in Part 1, I still found them helpful for reinforcing clinical thinking.

Study Groups: The Secret Ingredient

Studying intensely for any exam by yourself is a one-track road to feeling isolated and experiencing burnout — and that’s exactly where I was heading just two months into my study prep.

Joining a study group genuinely turned things around for me. I was incredibly fortunate to be invited into a group led by two ophthalmology consultants along with five junior registrars. As an FY2, I was the most junior member. Rather than being a disadvantage, this pushed me to raise my game — I was determined to pull my weight and prove I belonged. Moreover, I was shocked to find out how common these senior lead study groups actually were, and just how important they are to push through the exam.

We met every two weeks on Microsoft Teams. Each session included a mix of didactic teaching, MCQ-style discussions, and a learning strategy based on a modified version of the Feynman Technique — a method built around active recall, simplifying ideas, and teaching them to others. (1)

The Feynman approach goes something like this:

1. Study a topic
2. Explain it out loud, as if teaching someone else
3. Identify what you don’t fully understand
4. Revisit resources to plug the gaps
5. Repeat

At the start of each session, I was expected to teach a topic I had covered since our last meeting. The group would then ask questions — sometimes quite challenging ones — ranging from applied optics to retinal development. The pressure to explain clearly and answer questions forced me to engage more deeply with the material and made my revision far more focused.

Why it worked:

• Active recall strengthens long-term memory retention (2)
• Spaced repetition across fortnightly sessions helped reinforce knowledge
• Peer teaching clarified my understanding through simplification and articulation (3)

This wasn’t just about exam prep — it helped me feel part of the ophthalmology community. Studying became collaborative, even enjoyable. It reminded me why I wanted to be in this field in the first place.

Lessons Learned & Final Tips

1. Don’t Wait for “The Right Time”

It’s tempting to delay this exam until you’re further into training, but taking the initiative early can give you a real edge. The exam is tough, but very doable with early planning.

2. Treat It Like a Marathon, Not a Sprint

Cliche but true. Trying to cram simply doesn’t work for this one. The syllabus is too broad. Spreading your study over months with regular revision sessions was key to avoiding burnout.

3. Join (or Start) a Study Group

If you don’t have access to registrars or consultants, gather FY colleagues or join online communities. Platforms like The Ophthalmology Book Club, Reddit’s r/MedicalSchoolUK, and Facebook groups can connect you with motivated peers.

4. Accept Not Knowing Everything

This exam will expose your knowledge gaps — and that’s okay. One of the best pieces of advice I received was to leave your ego at the door. Nobody knows it all, but being open about what you don’t know creates space to learn and improve.

Conclusion

Taking the FRCOphth Part 1 as an FY2 was a challenge — but a fulfilling one. More than just a tick-box exercise, it taught me how to learn better, how to manage time and pressure, and above all, the power of collaborative learning.

If you’re a junior doctor considering taking this step early — go for it. With the right resources, consistent preparation, and a solid support network, passing is entirely achievable.

And who knows? You might even enjoy the process as much as I did.

References

1. Feynman R. The Pleasure of Finding Things Out. New York: Basic Books; 1999.
2. Roediger HL, Butler AC. The critical role of retrieval practice in long-term retention. Trends Cogn Sci. 2011;15(1):20–27.
3. Bargh JA, Schul Y. On the cognitive benefits of teaching. J Educ Psychol. 1980;72(5):593–604.