Ophthalmology ST1 (OST) Application Guide

Introduction

The Ophthalmic Specialty Training Programme is a competitive 7-year programme leading to a Certificate of Completion of Training (CCT) and eligibility to become a Consultant Ophthalmologist. With a competition ratio of 21.54:1 in the 2025 application cycle, this may appear daunting at first glance, but understanding the selection criteria for the application and preparing early are essential to a successful Ophthalmology ST1 application. The Severn Deanery traditionally leads the national recruitment process, so 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%).

What can Medset do to help?

Medset’s interview course is a comprehensive guide designed to help candidates with the Ophthalmology ST1 application. Let Medset help you prepare for the next step in your career with our interview course.

The MSRA Examination

The Multi-Specialty Recruitment Assessment (MSRA) was initially 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 outline 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.

Application Timeline (2025–2026)

Being aware of deadlines is crucial, as missing any date can disqualify you. Below is the official timeline for this cycle:

Note: Applicants from Northern Ireland may follow separate processes and deadlines. Always verify local guidelines before applying.

Top Tips For The MSRA

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 that require more revision. Most candidates start their revision 2 to 3 months before 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 then 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.

The Portfolio

The top-scoring applicants in the MSRA will be invited to upload a digital copy of their portfolio. Applicants will also have to provide a self-assessment score. The MSRA and portfolio scores will be equally weighted to produce a rank list. 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. The top-scoring 260 candidates will then be invited for an interview. 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, you may be awarded a lower score, which will be conclusive.

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 in 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 whopping 13 of 50 points allocated to the Portfolio section of your ophthalmology ST1 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 Medical Leadership and Management course or the Medset Train The Trainers course. Each course will count for a point within the ‘Education and Teaching’ domain of your portfolio.

The Interview

The interview 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. Medset’s 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 includes 17 unique patient consultation stations and 10 clinical 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 OST 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). Watching recordings of yourself can help you refine your consultation skills by picking up on body language such as eye contact and hand movements. Doing this may also 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.

Summary

Getting into Ophthalmology ST1 training may initially seem daunting, but with early preparation based on the official sources and past years’ questions, you will give yourself the best chance of excelling in your Ophthalmology ST1 training application. Ophthalmology is a fascinating and rewarding specialty (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! Check out our comprehensive OST Interview Course to boost your chances of securing a training post. Check out our other courses for doctors and health professionals here at Medset.