Importance of FRCOphth Part 2 Orals

The FRCOphth Part 2 oral examinations represent the final and most demanding component of the Fellowship of the Royal College of Ophthalmologists (FRCOphth). For many candidates, this stage determines not only the completion of their fellowship but also the transition into independent clinical practice.

Unlike written exams, the orals assess your ability to think aloud, reason clinically, and communicate your approach under real-time pressure. The format mirrors high-stakes consultant discussions and patient encounters, making the Part 2 oral assessments both professionally relevant and uniquely challenging.

While some candidates may have a strong foundation in theory, the oral test assesses how well that knowledge is applied across diverse scenarios, including rare cases, ethical dilemmas, and surgical complications.

Structure and Scoring: Viva and OSCE

According to the Royal College of Ophthalmologists, the Part 2 oral assessment comprises two key components: the Structured Viva and the OSCE (Objective Structured Clinical Examination). These are conducted separately and scored independently.

Structured Viva

• Duration: Approximately 45 minutes
• Format: Typically four or five oral stations, each lasting 10–15 minutes
• Topics Covered:
  • Posterior Segment (e.g. retina, vitreous)
  • Anterior Segment (e.g. cornea, lens, glaucoma)
  • Neuro-ophthalmology and Paediatrics
  • General Medicine related to ophthalmology

Viva stations are designed to assess a candidate’s clinical judgement, investigative reasoning, consent processes, interpretation of imaging (e.g. OCT, fundus photos), and diagnostic prioritisation.

OSCE (Refraction & Clinical Examination)

• Format: 10–12 clinical skill stations
• Types of Stations:
  • Slit-lamp technique and finding interpretation
  • Communication scenarios (e.g. consent, breaking bad news)
  • Instrument recognition and safe usage
  • Visual acuity testing, retinoscopy, and orthoptics
  • Image-based diagnosis (e.g. fundus, CT, fluorescein angiography)

Each OSCE station is individually assessed. Candidates must pass both the Structured Viva and OSCE independently, as no compensation is allowed between the two.

To be eligible for the Part 2 Oral, candidates must have passed both the Refraction Certificate and the Part 2 Written Exam. A maximum of four attempts is allowed for the Oral component.

Daily and Weekly Study Plan

Structured preparation is essential, particularly for candidates managing hospital duties or preparing outside the UK system. Below is a suggested 6-week plan.

Week 1–2: Foundation and Content Familiarity

• Revise the FRCOphth syllabus: RCOphth Blue Book or OST Curriculum
• Identify weak subspecialties
• Begin reviewing common viva themes (e.g. diabetic retinopathy, cataract complications)

Week 3–4: Practice Scenarios and Time-Bound Responses

• Introduce timed daily viva practice with a colleague or mentor
• Review recent exam case banks
• Watch and simulate past clinical OSCE stations

Week 5–6: Full Mock Simulations

• Engage in at least 3 full mock viva rounds
• Practice OSCE circuits (including refraction and image-based scenarios)
• Revise ethics, consent, and UK guidelines (NICE, GMC)

Daily Micro Tasks

• 30 mins: Review key images (OCT, fundus, fluorescein angiography)
• 20 mins: Subspecialty viva flashcards
• 10 mins: Consent framework or communication script

Role of Mock Vivas and Real Case Exposure

The structured viva format can feel unfamiliar, especially for international candidates who may not routinely train under UK-style oral assessments.

Mock vivas help candidates:

• Understand what level of depth is expected in responses
• Learn to structure answers logically under time pressure
• Gain exposure to how questions are sequenced and scored
• Identify gaps in knowledge or communication clarity

Candidates who perform well in the orals often attribute their success to practising how to think aloud, not just studying the correct answers.

Real case exposure, whether through clinical duties, webinars, or case banks, enhances your ability to provide examples, explain risks, and link symptoms to investigations during the exam.

PrepMedico’s Format: One-on-One Mentoring for Orals

Preparing for FRCOphth Part 2 is not just about content, it’s about communication, confidence, and clarity under pressure. PrepMedico’s approach focuses on these elements through:

• One-on-one viva drills tailored to your weak areas
• Live feedback from FRCOphth-qualified mentors
• Mock OSCE walkthroughs, including refraction technique and slit-lamp stations
• Subspecialty focus (e.g. retina vs glaucoma) to simulate full-viva day experiences

Unlike standard prep courses, their emphasis is on interactive practice, helping candidates become comfortable with case-based discussion, especially valuable for those preparing without UK hospital exposure.

For more details, visit the PrepMedico FRCOphth page.

Frequently Asked Questions (FAQs)

What’s included in the FRCOphth Part 2 orals?

The oral assessment includes:

• Structured Viva: 4 oral stations across ophthalmic subspecialties
• OSCE: Clinical skill stations covering communication, instruments, slit-lamp use, and image interpretation

What does each viva station contain?

Each station focuses on a theme:

• Posterior segment: Retinal conditions, OCT interpretation
• Anterior segment: Cataract, glaucoma, surgical management
• Neuro-paediatrics: Strabismus, optic neuritis, visual field loss
• Systemic links: Diabetes, hypertension, neurology

Questions progress from basic to complex over ~15 minutes.

What does every OSCE part contain?

The OSCE includes:

• Refraction tasks (retinoscopy, lens interpretation)
• Communication stations (explaining procedures, managing concerns)
• Clinical skills (use of slit-lamp, eye drop technique)
• Diagnostic imaging (fundus images, CT, MRI)

What study resources should I use?

• RCOphth exam reports and past question banks
• Oxford Handbook of Ophthalmology
• Kanski’s Clinical Ophthalmology
• NICE and GMC guidelines for consent, ethics, and communication
• Image repositories (e.g. EyeWiki, RCOphth sample images)

How does PrepMedico structure the mock viva experience?

Mock vivas are structured around:

• Subspecialty scenarios tailored to the candidate’s background
• Timing-based simulations with scoring feedback
• One-on-one mentorship to refine answer delivery and communication

Is one-on-one mentoring available for FRCOphth?

Yes. PrepMedico provides personalised mentorship focused on interactive discussion, not passive content review. Candidates are paired with mentors based on subspecialty needs and exam history.

Can I pass Part 2 without UK clinical exposure?

Yes. Many international candidates clear the exam through targeted preparation. The key is understanding UK standards, protocols, and practising UK-style case discussions through mock vivas and mentorship.

Where are FRCOphth orals conducted?Most FRCOphth Oral exams are conducted at designated centres in the UK. However, international centres,  including India, Egypt, Malaysia, UAE, and Pakistan, may be made available based on demand and regional arrangements. Always check the latest exam calendar for updated venues.