The Ophthalmic Specialty Training programme is a competitive 7-year training programme towards a certificate of completion of training (CCT) to become a Consultant Ophthalmologist. With a competition ratio of 9.91, this may appear daunting at first glance, but understanding the selection criteria and early preparation is key to a successful application. The national recruitment process has traditionally been led by the Severn deanery and you should regularly check their website for updates on the evidence folder requirements and the recruitment timeline.
Applicants are assessed through three main components: the multi-specialty recruitment assessment (MSRA), the portfolio (50%) and the interview (50%).
Step 1: The Multi-Specialty Recruitment Assessment (MSRA)
The MSRA was originally designed to be an assessment for general practice and covers a wide breadth of medicine. The assessment consists of 50% clinical questions and 50% situational judgement questions. The scope of examination closely resembles the curriculum for UK medical schools. For candidates who have sat the Situational Judgement Test (SJT) for the Foundation Programme, the SJT questions in the MSRA closely resemble these.
If you have a primary medical qualification from outside the UK, you should refer to the NICE Clinical Knowledge Summary (CKS) Guidelines, which outlines the clinical guidelines used in primary care. The situational judgement test assesses key attributes outlined in the GMC’s Good Medical Practice, including patient focus, commitment to professionalism, coping with pressure, effective communication and teamwork. Candidates are presented with a series of work-related dilemmas and rank/select the most appropriate responses in each scenario.
For both the clinical and situational judgement aspects of the MSRA, there are multiple online question banks available to help you familiarise yourself with the examination material and format.
Top Tips For The MSRA Exam
- Start practising early with question banks! The breadth of the curriculum may initially seem overwhelming but you can use the questions to guide your revision and identify key areas which require more revision. Most candidates start their revision 2 to 3 months prior to the examination; you may need to alter this depending on your other commitments and work schedule. If you are applying outside the UK, you may need more time to familiarise yourself with the CKS guidelines.
- Set up your Pearson Vue account early. There is often a rush to book the MSRA when registration opens to secure a good date and location. To minimise the stress of this, register for your Pearson Vue account before this and make note of your username and password! The last thing you want to do on the day of registration is to stress about setting up an account or trying to reset your forgotten account password.
- Use the official MSRA preparatory material for the SJT section. After the MSRA registration period closes, you will be sent an ‘MSRA preparatory materials’ email with a full MSRA paper included. This will include an answer bank and an explanation for each question. This is particularly important for the SJT section as it gives you a guide to what responses the official examiners are looking for. Use this to guide your revision for the SJT.
Step 2: The Portfolio
The top-scoring 300 applicants in the MSRA will be invited to upload a digital copy of their portfolio on a separate website to Oriel. The portfolio is scored according to the Evidence Folder uploaded on the Severn deanery’s website. Your portfolio will be scored by 2 independent examiners and you will be awarded the average of the 2 scores.
Please note that at the time of writing this article (10/9/2023), the evidence folder shown is for the previous year’s application cycle (OST 2023). The evidence folder is highly prescriptive in the scoring criteria and you should use this to guide your portfolio. Don’t worry if your portfolio is not currently geared towards Ophthalmology. Peer-reviewed publications and presentations in all other fields will count towards your evidence.
After the portfolio scores are released, you will have 48 hours to appeal your score if you wish to. Please note that following a review of your appeal, there may be a chance that you may be awarded a lower score and the final score will be awarded.
Top Tips For Portfolio
- Format your portfolio according to the Evidence Folder. You can score 3 points just for the layout and organisation of your portfolio! (For context, the mark awarded is equivalent to passing the FRCOphth Part 1 examination.) Include a clear contents page for each domain of the portfolio and try to follow the sequence of items in the evidence folder as this will help the examiner navigate and award you the correct marks. If you are including a letter as evidence, try to include the exact wording on the portfolio in the letter to minimise any ambiguity during scoring.
- Aim to score full marks in the ‘Commitment to Specialty’ domain. Whilst it can be challenging to score full marks in domains such as ‘Qualifications’ and ‘Prizes’, you should be able to maximise your points in this section with some organisation and planning. This domain makes up a whooping 12 of 50 points allocated to the Portfolio section of your application. Some straightforward ways to score in this section include attending local ophthalmology meetings (such as the Midlands Ophthalmology Meeting) and writing bulletin articles or meeting reviews for EyeNews.
- Attend relevant courses. Other time-efficient ways to score points for your portfolio include attending courses such as the Medset Train The Trainers course, which will count for a point within the ‘Education and Teaching’ domain of your portfolio.
Step 3: The Interview
There has been a major change to the interview format for the 2024 application cycle, which now consists of a patient communication station and a clinical station, both running up to 10 minutes. Applicants who have achieved a minimum score of 40% in their portfolio will be invited to the interview.
The Medset Ophthalmology ST1 Interview Course takes you through the interview process and offers a structure and breakdown of the themes of the most examined patient consultation and clinical stations, based on previous years’ interview stations. It also includes 17 unique patient consultation stations, each complete with a candidate’s brief, an actor’s brief and a mark scheme. Whilst the clinical station is in a new format, the course uses pre-COVID clinical stations to guide the mock stations.
Applicants who score a minimum of 40% in the interview will then be ranked based on their final score, which consists of 50% interview and 50% evidence folder scores.
Top Tips For The Interview
- Start practising early! A common mistake for many applicants is to leave practice until the last minute after getting an invitation to interview. The invitations are sent out very late in the interview process and leave approximately 1 to 2 weeks for you to prepare for the interview. A good rule of thumb is to start around the time of your Oriel application in November (weekly/fortnightly), then increase the frequency of your practice sessions towards the interview date.
- Practise with different groups of people. By switching up your practice buddies, you learn different communication techniques and approaches. It may feel uncomfortable to practise with people you are not familiar with, but this best mimics the actual interview scenario and will prepare you well for the day itself.
- Record yourself (both on video and via transcript). It is very helpful to watch recordings of yourself when you practise your interview as this can help you to pick up things you may not have noticed during the actual practice session. This can help to refine your consultation skills by picking up on body language cues such as eye contact or hand movements and can help you to refine how you might phrase a particular diagnosis or plan. (Was it unclear? Too long? Too much jargon?) Use Teams if you have access to this via the NHS as this is the actual interview platform, and you can also activate the ‘Transcript’ function to look back on what you say and how effectively you say it.
In the Ophthalmology ST1 Interview Course, we will explore other tips and advice on how to prepare for the interview station to give yourself the best chance of scoring well in the interview.
Summary
Getting into Ophthalmology ST1 training may initially seem daunting, but with early preparation based on the official sources and past year questions, you will give yourself the best chance of excelling in your application. Ophthalmology is a fascinating and rewarding speciality (the author makes no apology for being biased about this!) and is well worth investing your time, energy and resources into securing a training position!
Footnote:
The new 2024 Curriculum provides a pathway for trainees to complete their training and CCT after 5.5 years of training
