How to get your Ophthalmology Number * Updated March 2024*

Getting into Ophthalmology is becoming increasingly competitive- but with hard work and the right advice, you can get your dream job!

There are three key components which you will be scored on during the national recruitment process:

1. The MSRA

2. The Portfolio

3. The Interview

You can find more advice on each of these components below.

Before we get into the details, we want to dispel some myths:

1. Myth 1: You will do better if you know the right people or trained in the area you want to work in. The process is fundamentally objective. It does not matter which medical school you attended or where you trained. If you tick the box, you will score the point. Getting to know people might help you get some projects for your Portfolio, but if you're new to the ophthalmology world, it's not a deal breaker.

2. Myth 2: You will do better if you spend money on expensive courses. The best resources for all components of the process are free or affordable. We will do our best to explain when we spent money and whether it was worth it.

3. Myth 3: You need to pass the Duke Elder exam. You can score 1-2 points out of 100 by passing the Duke Elder Prize exam. It is not essential.

4. Myth 4: Everything in your Portfolio needs to be ophthalmology-focused. While there is a commitment to the Specialty section in the Portfolio, most areas, like publications and QIPs, do not need to be ophthalmology-focused for you to score full marks.

5. Myth 5: The MSRA is an easy exam and doesn't require much prep. Without a good MSRA score, the rest of your Portfolio will not be scored, and you will not progress to the interview. While many find the exam easier than finals, your score must be competitive.

Right, let's get to it. We have included a collection of advice below for each section, MSRA, Portfolio and Interview, to get you on track:

1. MSRA exam

As of 2023, only the top-scoring 300 applicants in the MSRA will progress to have their portfolios reviewed, and only those applicants scoring >40% in the portfolio will be invited to participate in the interview.

Exam Structure

The MSRA is 170 minutes in length, and there are 2 parts - a Professional Dilemmas (PD) paper and a Clinical Problem Solving (CPS) paper. The papers are time separately, so if you finish the PD paper early, you will not have extra time for the CPS paper.

1. Professional Dilemmas (PD) paper- The PD paper consists of 50 items, and there are 95 minutes in which to complete the test. Only 42 items account towards the final score, as 8 of the items in each test paper are being tested ('piloted') before use.

2. Clinical Problem Solving (CPS) paper- The CPS paper consists of 97 questions, and there are 75 minutes in which to complete the test. Only 86 items account towards the final score, as 11 items in each test paper are being tested ('piloted') before use.

More details on the exam blueprint can be found here, using the MSRA Test Blueprint & Information.

Booking / Sitting the exam

When you submit an application to ST1 Ophthalmology on Oriel, you will automatically be enrolled to sit the MSRA. The exam usually takes place in early January, and you will need to take the MSRA at a Pearson Vue centre:

All slots for all centres are released simultaneously, and you will receive a text/email from Oriel when they are released. Often, there are a limited number of slots in some popular areas like London, so you need to book early. In addition, some slots are one to two weeks later than others, and the later slots book up quickly.

The exam is generated by selecting a number of questions from a pre-approved question bank. The questions from previous years have been repeated.

Revision Advice

Currently, many resources are out there to help with MSRA prep. As this section of the application process is not ophthalmology-specific, we have included only the essential details. Other valuable resources are linked below, but please note that you don't need to spend much money. Many of us only used question banks and still received top scores. The best prep comes from using the sample exam papers certified by Health Education England and the GMCs Generic professional capabilities framework for the PD paper.

Resources for the MSRA

- Medibuddy- The free advice is great, and we have achieved top scores without paying for any additional courses or resources.

- Both Emedica and Passmedicine have question banks, which are useful for revising the clinical knowledge questions.

2. Portfolio

3. Interview