FRCS Ophthalmology Part 1: Is It the Same as FRCOphth Part 1? What International Candidates Should Know

Key Takeaways (At a Glance)

• No, they are different exams. FRCS Ophthalmology Part 1 is set by the Royal College of Physicians and Surgeons of Glasgow (RCPSG). FRCOphth Part 1 is set by the Royal College of Ophthalmologists (RCOphth). Both test basic sciences, but the format, entry rules and syllabus differ.
• The formats differ. FRCS Part 1 is one 2-hour paper of normally 160 questions with five options each. FRCOphth Part 1 is two 2-hour papers of 90 questions each with four options each. That is about 45 seconds per question against about 80.
• The entry rules differ. FRCS Part 1 needs a GMC-acceptable degree plus at least two years of post-qualification experience, including one year of pre-registration training. FRCOphth Part 1 needs a GMC- or Irish Medical Council-approved degree and no ophthalmology experience. Candidates who have not yet accumulated two years of post-qualification experience cannot sit FRCS Part 1 and should confirm their eligibility against the closing date of their target sitting, not the exam date itself.
• Passing one does not exempt you from the other. FRCOphth Part 1 is not on RCPSG’s September 2026 list of exempting qualifications, and RCOphth’s route to Fellowship requires all four of its own components.
• The ICO exemption route for FRCS Part 1 stops working for exam diets from 1 January 2028. If your plan depends on an ICO qualification exempting you from FRCS Part 1, your target sitting must fall before that date. Qualifications from Pakistan, South Africa, Singapore, Sri Lanka, Ireland, Edinburgh and the Ophthalmology Foundation may also exempt you, check RCPSG’s current list before paying for any exam.
• One revision plan covers most of both exams. Build the shared base, anatomy, physiology, pathology, pharmacology, genetics, biochemistry, embryology and optics, once. Then add what is specific: for FRCOphth, add statistics, evidence-based medicine and patient investigations; for FRCS, weight revision toward anatomy, physiology and pathology, which carry roughly 75% of the paper.
• RCPSG charges a 20% administration fee for withdrawal before the closing date and forfeits the entire fee for withdrawal after it. Confirm eligibility, exemption status and the closing date before paying the FRCS Part 1 application fee, not after.

Both are called Part 1. Both are taken online. Both test basic sciences.

Beyond that, they diverge.

FRCS Ophthalmology Part 1 and FRCOphth Part 1 lead to two different fellowships, awarded by two different Royal Colleges under two different sets of rules. Candidates who treat them as interchangeable, a pattern PrepMedico’s faculty observe consistently among international applicants, tend to make three costly mistakes: they assume one pass exempts them from the other, they pace the wrong paper, and they discover an eligibility rule after the closing date.

This guide compares the two exams using the facts the Colleges themselves publish: format, content, entry requirements, exemptions, cost and what a pass leads to. It then covers what international candidates should plan for, and how to prepare for both without doubling your workload. For a comparison of the full pathways, including every later part of both fellowships, see our FRCOphth vs FRCS Ophthalmology (Glasgow) guide.

This guide is written by Ms Shruthy Vaishali Ramesh and Ms Swetha Ravichandran, FRCOphth-qualified consultant ophthalmologists and PrepMedico’s lead faculty for the FRCOphth and FRCS Ophthalmology programme. Both have completed the FRCOphth examination pathway and have since prepared candidates through both the FRCOphth and FRCS Ophthalmology routes. The factual comparisons in this article are drawn from each College’s own published documents, supplemented by PrepMedico’s faculty experience of where candidates most commonly make planning errors between these two pathways.

The Short Answer: Different Exams With Overlapping Content

FRCS Ophthalmology (Glasgow) is awarded by the Royal College of Physicians and Surgeons of Glasgow. It has three parts, and RCPSG describes Part 1 as an assessment of knowledge of basic sciences in relation to ophthalmology. FRCOphth is awarded by the Royal College of Ophthalmologists. According to the RCOphth exams page, you must complete Part 1 FRCOphth, the Refraction Certificate, Part 2 Written and Part 2 Oral to be awarded Fellowship.

The difference between FRCS Ophthalmology and FRCOphth starts at Part 1, and it shows in where each pass takes you. For UK Ophthalmic Specialist Training (OST) trainees, the RCOphth Part 1 information pack states that Part 1 must be passed before entering year three, and by the end of the second year of run-through training. RCPSG states that the FRCS does not provide direct entry to higher specialist training in the UK, although the Fellowship is recognised as part of the registration process with the General Medical Council (GMC).

The two exams do share ground. Both test basic sciences. Both use single best answer questions. Both are delivered online. Both allow a maximum of six attempts. That overlap is real, and it is why one revision plan can cover most of both exams. It is not complete, as the next sections show.

FRCS Ophthalmology Part 1 vs FRCOphth Part 1: Side by Side

The table uses each College’s own documents. RCPSG’s Regulations are the July 2021 version, its Candidate Guidance is the May 2022 version, and its exemption list is dated September 2026. Fees and dates change, so confirm them on the College pages before you apply.

Source documents used for this table: RCPSG FRCS Ophthalmology Candidate Guidance (May 2022), RCPSG FRCS Ophthalmology Regulations (July 2021), RCPSG Exempting Qualifications list (September 2026), RCOphth Part 1 Information Pack. Fees and sitting dates change, confirm current figures on each College’s examinations page before applying.

FRCS vs FRCOphth Part 1: Format and Pacing

The headline difference is shape. FRCS Part 1 is one paper: normally 160 questions in 2 hours, which leaves about 45 seconds per question. FRCOphth Part 1 is two papers of 90 questions, 2 hours each, which leaves about 80 seconds per question. FRCS rewards speed. FRCOphth rewards speed and endurance, with 180 questions across four hours of exam time.

The option count also differs. Each FRCS question has a stem and five options. The RCOphth information pack describes single best answer questions with four options. In FRCS Part 1, each correct answer scores one mark, an unanswered question scores zero, and marks are not deducted for incorrect answers. Leaving a question blank never helps you.

Results also differ in what you receive after a fail. FRCS Part 1 is awarded as a pass or a fail, and unsuccessful candidates receive a breakdown of marks for each section, which means you can see exactly where marks were lost and target those areas for a resit. RCOphth sets the pass mark in advance using the Ebel method, a standard setting process in which examiners rate question difficulty to determine a fair pass threshold before results are calculated. This means the pass mark can vary slightly between sittings. If you fail FRCOphth Part 1, you resit the entire examination.

FRCS Ophthalmology vs FRCOphth Part 1: What Each Exam Covers

RCPSG publishes a rough split for FRCS Part 1. Anatomy, physiology and pathology each account for roughly 25% of the paper. The remaining 25% is shared across embryology, pharmacology, cell biology and biochemistry, genetics and optics. On 160 questions, that is roughly 40 questions each for the first three subjects and roughly 40 across the other five subject groups combined.

The syllabus itself lists anatomy, embryology, physiology, pathology (including microbiology), pharmacology, cell biology and biochemistry, genetics and optics. Optics in the FRCS syllabus includes lasers, biometry and the optical principles of ophthalmic instruments.

The RCOphth information pack organises Part 1 by learning outcome rather than by percentage, and it gives no split. Beyond the core sciences, it lists epidemiology and evidence-based medicine, biostatistics, instrument technology, lasers, and a block of patient investigations that includes optical coherence tomography, angiography, electrophysiology, perimetry and blood tests.

Put the two together. Anatomy, physiology, pathology, pharmacology, genetics, biochemistry, embryology and optics appear in both syllabuses. Statistics, evidence-based medicine and patient investigations are listed for FRCOphth Part 1 but have no heading in RCPSG’s Part 1 syllabus. RCPSG’s regulations place evidence-based ophthalmology and the interpretation of investigations in the Part 2 and Part 3 syllabus instead.

If you are sitting FRCOphth Part 1, our guide to high-yield topics for FRCOphth Part 1 covers how to divide revision time across the subjects, including statistics.

Does Passing One Part 1 Exempt You From the Other?

This is the question that costs candidates money. RCPSG’s FRCS Ophthalmology Exempting Qualifications document, published September 2026, lists the qualifications that may be used for exemption from FRCS Part 1. Exemption may be granted, not assumed. You must hold the qualification and provide documentation, such as an attested copy of a certificate or result letter, by the closing date of the sitting you apply for. Documentation requirements are listed on the [RCPSG FRCS Ophthalmology exemptions page].

Qualifications that may exempt you from FRCS Part 1 (September 2026 list):

• College of Physicians and Surgeons of Pakistan: Fellowship in Ophthalmology
• Colleges of Medicine of South Africa: FC Ophth (SA), or Diploma in Ophthalmology
• International Council of Ophthalmologists: Basic Sciences or Visual Sciences, and Optics and Refractions or Optics, Refractions and Use of Instruments
• National University of Singapore: M.Med (Ophthalmology)
• Ophthalmology Foundation: Visual Sciences, and Optics, Refraction and Instruments
• Royal College of Surgeons of Edinburgh: FRCSEd Ophthalmology Part A, MRCSEd Ophthalmology Part 1, or FRCSEd Ophthalmology Part 1
• Royal College of Surgeons in Ireland: FRCSI (Ophthalmology) Part 1 or MRCSI (Ophthalmology) Part 1
• University of Colombo: MD (Ophthalmology) Module IV, M.Med (Ophthalmology), or MD (Ophthalmology) Part II

FRCOphth Part 1 is not on the list. Neither is MRCOphth Part 1. RCPSG states that no other qualifications will be accepted for exemption. Some older guides online still list FRCOphth Part 1 as an exempting qualification. The College’s current document does not, so use the College list as your only source.

The ICO Cut-Off

The International Council of Ophthalmologists (ICO) entry carries a footnote. The specific qualifications — ICO Basic Sciences or Visual Sciences, together with ICO Optics and Refractions or Optics, Refractions and Use of Instruments, are valid for exemption only for exam diets held before 1 January 2028, and after that date they will no longer be valid. If your plan depends on an ICO exemption, make sure your target sitting falls before that date.

Does FRCS Part 1 Exempt You From FRCOphth Part 1?

RCOphth’s route to Fellowship requires you to complete Part 1 FRCOphth, the Refraction Certificate, Part 2 Written and Part 2 Oral. The page lists no FRCS qualification as a substitute for any of them. If you plan to hold both fellowships, expect to sit FRCOphth Part 1 in full, and FRCS Part 1 unless you hold a qualification on RCPSG’s list.

Timing matters too. If you apply for a sitting and then request an exemption after the closing date, RCPSG states you are not entitled to a refund of the examination fee.

FRCS Ophthalmology for International Candidates: What to Plan For

Eligibility and Documents

FRCS Part 1 requires a primary medical qualification acceptable to the GMC and at least two years of post-qualification experience, including at least one year in pre-registration training. You must meet this by the closing date, and RCPSG states that applicants who do not will not be accepted under any circumstances. RCPSG’s FAQ says the additional year of clinical experience can be in any field, not only ophthalmology.

RCPSG also asks for supporting documents, in English, as attested copies of the originals, uploaded with your application. The full document list is available on the [RCPSG FRCS Ophthalmology application page]. Places are allocated on a first-come, first-served basis, and late applications are not accepted.

FRCOphth Part 1 requires a medical qualification approved by the GMC or the Irish Medical Council, and no previous ophthalmology experience. If you are not registered with either regulator, RCOphth asks for an attested copy of your degree. According to the RCOphth’s application guidance, it can be attested by a Fellow of the College, your embassy, a solicitor or the university that issued it.

Sitting the Exam Online

Both exams are delivered online, so neither Part 1 requires travel. RCPSG delivers Part 1 through an online exam system with remote proctoring, and candidates must complete a mandatory trial exam beforehand. The RCPSG application portal sets out the delivery arrangements for each sitting.

RCOphth’s Part 1 is an online proctored exam taken at home or work. The rules include a live proctor, photographic ID, a smartphone connected as a second camera, one sheet of paper for rough work and no calculators. Complete each College’s trial exam or system check as soon as it is offered.

Language

RCPSG advises English equivalent to IELTS 7.5, as stated in its Candidate Guidance. RCOphth expects English equivalent to IELTS 7, as stated in its Part 1 information. Neither requires you to take IELTS or another language test to sit Part 1.

Costs, Sittings and Withdrawals

RCOphth lists a 2026 fee of £725 for Part 1 FRCOphth. RCPSG listed £495 for its September 2026 sitting. Both fees are subject to change, confirm the current fee on each College’s examinations page before applying. Its Part 1 page now shows applications open for March 2027, so check the fee for that sitting. RCPSG normally holds Part 1 twice a year.

Withdrawal terms matter before you pay. RCPSG charges a 20% administration fee if you withdraw before the closing date, and you forfeit the whole fee if you withdraw after it. RCPSG also does not let you apply for another sitting while you are awaiting a result from a previous attempt.

What a Part 1 Pass Leads To

A pass in FRCOphth Part 1 is the first requirement of RCOphth’s route, and OST trainees must have it before year three. Passing Part 1 and Part 2 Written together also earns the Certificate of the Royal College of Ophthalmologists (CertRCOphth). A pass in FRCS Part 1 (or an accepted exemption) is required before you can apply for Part 2, which has its own experience requirements.

Which fellowship fits your plans depends on where you want to work. Our [FRCOphth vs FRCS Ophthalmology (Glasgow) guide] covers the full pathway comparison, including career implications, recognition in different countries, and the complete route to each Fellowship.

Preparing for Both Without Doubling Your Workload

1. Build the shared base first. Anatomy, physiology, pathology, pharmacology, genetics, biochemistry, embryology and optics are in both syllabuses. Our complete FRCOphth Part 1 preparation guide covers core texts and a study timeline.
2. Add what is specific to your exam. For FRCOphth Part 1, add biostatistics, epidemiology and evidence-based medicine, patient investigations, instrument technology and lasers. For FRCS Part 1, weight revision towards anatomy, physiology and pathology, which carry roughly 75% of the paper between them.
3. Practise at the right pace. For FRCS, work towards one full 160-question paper in 2 hours. For FRCOphth, practise two 90-question papers in one day with an hour between them.
4. Match the question format. Use five-option questions for FRCS practice and four-option questions for FRCOphth practice, and answer every FRCS question because wrong answers lose no marks.

PrepMedico’s FRCOphth and FRCS Ophthalmology Part 1 course covers both exams in one programme. It runs six live weekly sessions of about three hours: Optics; Statistics; Physiology and Biochemistry; Pharmacology, Genetics and Investigations; Pathology, Microbiology and Immunology; and Anatomy and Embryology. It includes an SBA question bank and an end-of-course mock exam. The course page states that where the emphasis differs between the two exams, those areas are highlighted during the sessions.

Before You Apply: Five Checks

1. Decide your destination first. FRCOphth Part 1 sits inside RCOphth’s route and is required before OST year three. FRCS does not give direct entry to UK higher specialist training.
2. Check the entry rule. FRCS Part 1 needs two years of post-qualification experience by the closing date. FRCOphth Part 1 needs none.
3. Check the current exemption list. Read RCPSG’s September 2026 document, not a summary, and note the ICO cut-off of 1 January 2028.
4. Prepare attested documents early. Both Colleges ask for attested copies in some cases, and RCPSG will not accept late applications.
5. Check the closing date, fee and withdrawal terms. RCPSG charges 20% to withdraw before closing and 100% after it.

Conclusion

FRCS Ophthalmology Part 1 and FRCOphth Part 1 are not the same exam. They share a scientific core and an online format. They differ in College, pacing, option count, entry rules, exemptions and the route each pass opens.

Build the shared core once. Add what is specific to your exam. Check the exemption list before you pay for anything twice.

International candidates have one extra job: read the College documents, not summaries of them. Treat this article as a starting point and confirm every detail with the College before you apply.

Preparing for FRCOphth Part 1, FRCS Ophthalmology Part 1, or both? PrepMedico’s Part 1 course covers both exams in one six-week programme, with live sessions, a question bank and a mock exam. Explore PrepMedico’s FRCOphth and FRCS Ophthalmology Part 1 Course, six live weekly sessions covering both exams in one programme, with SBA question bank and full mock exam. [View the course and upcoming dates →]

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