What happens in the FRCOphth exam
The Part 2 FRCOphth Oral is the final exam on the route to Fellowship of the Royal College of Ophthalmologists, taken after Part 1, the Refraction Certificate and the Part 2 Written exam. It has two parts and you must pass both: a Structured Viva of five 10-minute stations, each with two consultant ophthalmologist examiners, and an OSCE of five 20-minute clinical stations using real patients and/or video excerpts, plus a 10-minute Communication Skills station with a simulated patient. Every marking section or element is scored 0 to 3, giving maximum totals of 120 for the viva and 198 for the OSCE, and each part has its own pass mark, set by the borderline candidate method (or the Hofstee method for smaller cohorts).
Checked against the official sources on 27 September 2026.
The parts, in order
Case-based interpretation of investigations and data, which may include biometry, ocular and neuro-imaging, Hess charts, electrophysiology and working with uncertainty.
Two separate stations of case-based patient management, including complex and less common presentations. Topics may include endophthalmitis, ocular trauma, intraocular and orbital neoplasia, emergency presentations (neurological, ophthalmic and those needing medical referral) and complex cases.
Case-based discussion of professional judgement, ethics, duties and responsibilities, which may include suspected child abuse, consent, confidentiality, duties of a doctor, appraisal and revalidation, complaints, critical incident reporting and poor performance in a colleague.
Case-based discussion which may include the principles of audit and research, use of published evidence and clinical guidelines, screening for eye disease, prevention of cross infection, hospital-acquired infection and drug side effects.
Five 20-minute stations of short cases: anterior segment; glaucoma and lid; posterior segment; strabismus and orbit; neuro-ophthalmology. Each uses real patients and/or video excerpts: one examiner gives a brief scenario and asks you to examine the patient or watch the video, you describe your findings, and a short discussion of investigation and management follows; the second examiner then presents the next patient or video.
Held alongside the Structured Viva. You read a GP letter or case scenario first and may take your notes in, then have a 10-minute consultation with a simulated patient, which may involve history taking, consent for surgery, counselling or advising. An ophthalmologist and a trained lay examiner assess you, and you are told when one minute remains.
How it is marked
In the Structured Viva, examiners follow pre-agreed questions, and each station is divided into four marking sections scored 0 to 3 (0 is poor, 3 is good), so each of the two examiners gives up to 12 marks per station and the viva total is out of 120. In the OSCE, both examiners score every element 0 to 3 independently: in the clinical stations they judge examination, and diagnosis and management, for up to 18 marks per examiner per station; in Communication Skills the lay examiner judges rapport and information gathering, understanding of information given and patient input on overall communication skills, and the ophthalmologist judges rapport and information gathering, information delivery, and appropriateness of advice and accuracy of information, for up to 9 marks each. The OSCE total is out of 198. Examiners can raise a red flag for unsafe practice or inappropriate behaviour.
Passing
The Structured Viva and the OSCE have separate pass marks and you must pass both. At each station you also receive a global score of pass, borderline or fail, which is used only to set the pass marks by the borderline candidate method (Hofstee is preferred for smaller cohorts, such as overseas sittings). In the College's report on the November 2025 York sitting, one standard error of measurement was added to the borderline figure, giving pass marks of 75 out of 120 for the viva and 128 out of 198 for the OSCE. If you pass the OSCE and reach the combined pass mark but fail the viva by no more than one standard error of measurement, you still pass; a poor OSCE result cannot be made up by a good viva.
Worth knowing
- You can sit it once you have passed Part 1 FRCOphth, the Refraction Certificate and the Part 2 Written exam, and a Written pass is valid for seven calendar years.
- It is aimed at doctors in level 3 of Ophthalmic Specialist Training (OST), or with equivalent training and experience, and assesses whether you can apply your knowledge and clinical judgement at the standard expected of a general ophthalmology consultant. OST trainees must pass both the Written and the Oral exams by the middle of ST6.
- The OSCE is held outside a hospital, in a mocked-up clinical environment in a hotel or conference venue. At the November 2025 York sitting the five clinical stations were held on different days from the vivas.
- A viva station may finish before its 10 minutes are up; the College says early completion is not a sign of how you did.
- If you fail, you re-sit the whole Oral exam, even if you passed one part. You are allowed four attempts; after that you must show additional educational experience, and the College may allow one more attempt.
- Results are usually released four weeks after the final day of the exam, and all candidates receive details of their performance.
Sources
- RCOphth: Part 2 FRCOphth oral exam
- RCOphth: Part 2 Oral FRCOphth Exam, candidate information pack (updated June 2026)
- RCOphth: Examination report, Part 2 FRCOphth Oral Examination, York, November 2025 (public report)
- RCOphth: Pass lists and exam reports
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