008 Diploma Examination Application Pack 2013-2

7/28/2019 008 Diploma Examination Application Pack 2013-2

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PATRON HRH THE DUKE OF YORK, KG, KCVO, ADC

Dear Colleague

Thank you for your enquiry concerning the Colleges Diploma Examination.

I enclose copies of the current: Registration InformationAdmission ProcedureGuidance for Candidates with Additional NeedsPolicy on Allegations of Cheating in ExaminationsAppeals ProcedureLanguage RequirementsFees Schedule

Examination TimetableExamination StructureStandard SettingExamination SyllabusApplication FormEqual Opportunities Form

Candidates must hold a medical qualification approved by the General Medical Council of theUnited Kingdom or of Ireland for the purpose of registration.

Please note candidates are required to submit an attested copy of their medical degree or

details of their GMC registration in evidence of their eligibility to sit this examination. Medicaldegree certificates may be attested by a Fellow or Member ofthis College, the British Council oryour embassy, a solicitor or the university issuing the certificate.

Please note that from 1 August 2013, candidates will be permitted a maximum of six attempts inwhich to pass this examination. Examination attempts prior to August 2013 will not be includedwhen the new ruling is introduced.

The above information has been agreed by the Council of The Royal College ofOphthalmologists.

This information is subject to variation at the discretion of the Council.

Yours sincerely

Emily BeetHead of the Examinations Department

The Royal College of Ophthalmologists17 Cornwall Terrace, London. NW1 4QW.

Telephone: 020-7935 0702, Extension 213Facsimile: 020-7487 4674Email: [email protected]: WWW.RCOPHTH.AC.UK

FROM THE EXAMINATIONS DEPARTMENT


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REGISTRATION INFORMATION

Candidates wishing to confirm the eligibility of their medical degree for the purpose ofregistration with the General Medical Council may do so by the following means:

You can access the World Health Organisation (WHO) Directory of Medical Schools through theAVICENNA Directory at the below link:

http://avicenna.ku.dk/database/medicine/

Candidates who have yet to enter the Part 1 FRCOphth examination are required to submit anattested copy of their medical degree or details of their GMC registration in evidence of theireligibility to sit this examination.
http://avicenna.ku.dk/database/medicine/http://avicenna.ku.dk/database/medicine/http://avicenna.ku.dk/database/medicine/


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Regulations

The following notes on the regulations concerning applications for admission to the examinationsare published for the guidance of candidates:

1) Completed application forms for admission to an examination must reach theExaminations Department no later than 5.00pm on the closing date, namelyapproximately FIFTY-SIX days before the exam is held. It is not possible acceptapplications received after the closing date.

2) The application forms mustbe accompanied by the fee and such certification as isrequired by the regulations. If you cannot supply all the relevant information you mustcontact the Examinations Department or supply a covering letter as to the reasonswhy. All information must be sent within 14 days after the closing date, if not before,otherwise the candidate will be withdrawn from the examination and forfeit theirexamination fee.

3) Upon receipt of application the Examinations Department will send all candidates awritten receipt. Detailed instructions including written and clinical examination dates willbe dispatched to all candidates within ten days after the closing date for receipt of

applications.

4) Applicants wishing to withdraw or transfer their entry for an examination must notify theExaminations Department in writing by 5.00pm on the closing date for receipt ofapplications. Fees cannot be refunded or transferred after this time.

5) Applicants must apply for entry visas for the United Kingdom in good time prior to the dateof the examination. If a candidate is refused a visa after the closing date of receipt ofapplications they will forfeit their examination fee. If written evidence of the refusal of avisa is provided, the Examinations Committee will consider requests for candidates totransfer their examination entry subject to the receipt of a 20% administration charge.

6) Candidates unable to attend an examination will forfeit their examination fee. Inexceptional circumstances, the Examinations Committee will consider requests to transfera candidates entry to the next examination sitting subject to receipt of writtensupplementary evidence (e.g. a medical certificate, a death certificate for a close familymember) and subject to a 20% administration charge. Please note that lack ofpreparation is not considered a suitable reason to withdraw or transfer an examinationentry.

7) All candidates will receive feedback regarding their individual performance in theexaminations.

8) Results are posted by First Class Mail with the Pass List being displayed on the Collegewebsite. Results are only released upon approval of the Senior Examiner. We regret thatexamination results are not available by telephone or email.


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Written Examination Procedures

1. Unless notified, candidates are not permitted to use calculators in any section of theexaminations.

2. Candidates are only allowed to bring pens/pencils etc into the examination in a clearplastic pencil case or plastic bag. Candidates MUST use the pencil provided by theCollege for MCQ Paper.

3. Candidates are forbidden to communicate in any way with, seek assistance from, giveassistance to, or interfere with the work of other candidates or the invigilators in theexamination room or elsewhere during the period of the examination, or indulge in anyother form of unfair practice.

4. The Senior Invigilator has the power to expel a candidate from the examination room.

5. Candidates are advised to read the Policy on Allegations of Cheating in Examinationsregarding examinations.

6. Candidates are not allowed to use mobile phones. All mobile phones must be switchedoff and must not be kept on the candidates person. Clear instructions will be given tocandidates regarding the timing of the examination.

7. Photographic identification (such as a passport or photographic drivers licence) will bechecked before candidates are admitted to the examination hall. Candidates are alsorequired to sign a register when entering written examinations.

8. Candidates are NOT permitted to enter a written examination 30 minutes after theexamination has started. The clock to be referred to will be the clock in the examinationhall or the Senior Invigilators watch.

9. No candidate is allowed to leave the examination hall in the first 30 minutes of a writtenexamination. No candidate is allowed to leave the examination hall in the last 10 minutesof a written examination to avoid disruption to candidates completing their work.

10. Candidates deciding to leave the examination hall must submit their paper to theinvigilator. They will not be permitted to re-enter the examination hall.

11. Candidates are asked to raise their hand should they have a query regarding any part ofthe examination.

12. Candidates requiring a comfort break must raise their hand and wait to be escorted by aninvigilator. Only one candidate at a time is permitted outside the examination hall.

13.No books, written material or electronic equipment are allowed on the candidates desk.All references to the examination such as letters and individual timetables are notpermitted on the examination desk.

14. Candidates are not allowed to use scrap paper. All notes must be written on the answersheet and crossed through as appropriate.

15. Candidates are advised that no extra time will be given to transfer answers from thequestion paper to the answer sheet.


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Practical Examination Procedures

1. Unless notified, candidates are not permitted to use calculators in any section of theexaminations.

2. Candidates are only allowed to bring their own clinical equipment into the examination ina clear plastic pencil case or plastic bag.

3. Candidates are forbidden to communicate in any way with, seek assistance from, giveassistance to, or interfere with the work of other candidates or the invigilators in theexamination room or elsewhere during the period of the examination, or indulge in anyother form of unfair practice.

4. The Senior Invigilator has the power to expel a candidate from the examination.

5. Candidates are advised to read the Policy on Allegations of Cheating in Examinationsregarding examinations.

6. Candidates are not allowed to use mobile phones. All mobile phones must be switched

off and must not be kept on the candidates person. Clear instructions will be given tocandidates regarding the timing of the examination.

7. Photographic identification (such as a passport or photographic drivers licence) will bechecked before candidates are admitted to the examination.

8. For clinical examinations, candidates are required to present themselves in good time andare required to wear name badges throughout the examination period (these will besupplied by the Royal College of Ophthalmologists). The start of the examination cannotbe delayed for candidates arriving late.

9. For clinical examinations candidates must be appropriately dressed and should follow theDepartment of Health Bare Below the Elbows guidelines.

10. No books, written material or electronic equipment may be consulted during theexamination and are not permitted on a candidates person.

11. Candidates are not allowed to use scrap paper. All notes must be written on the answersheet and crossed through as appropriate.

12. Candidates are advised that no extra time will be given to complete their mark sheetsonce the end of the OSCE station has been signalled.


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Eligibility

A medically qualified candidate will be eligible to sit the examination provided that he/she:

a) holds a medical qualification approved by the General Medical Council of the UnitedKingdom or of Ireland for the purpose of registration;

b) has completed a pre-registration year (or equivalent) acceptable to the General MedicalCouncil;

All candidates are required to submit an attested copy of their medical degree or detailsof their GMC registration in evidence of their eligibility to sit this examination. Certificatesmay be attested by a Fellow or Member ofthis College, the British Council or your embassy, asolicitor or the university issuing the certificate.

Condition of the Examination

There is no formal minimum training period required for candidates to sit the Diplomaexamination but candidates are unlikely to pass this assessment without exposure toophthalmology at a postgraduate level.

Exemption

Candidates who have passed the Part 1 FRCOphth examination since October 2006 are exemptfrom the MCQ and CRQ papers of the Diploma examination.

Candidates holding the following historic examinations are also eligible to apply for exemptionsfrom the MCQ and CRQ papers:Part 1 and Part 2 MRCOphth (prior to November 2008)Part 1 and Part 2 MRCSEd (prior to August 2008)*

In order to apply for exemption from the written papers, candidates must indicate on theapplication form the date of their success in the appropriate examination for verification.

*Candidates applying for exemption on the grounds of success in MRCSEd examinations arealso required to submit:

An attested copy of their medical degree or details of their GMC registration

An attested copy of their success letter for the Part 1 and Part 2 MRCSEd Examinationresult


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Guidance for candidates with additional requirements

The Royal College of Ophthalmologists recognise that there may be some candidates whorequire additional arrangements when undertaking a Royal College of Ophthalmologistsexamination.

All candidates who require additional arrangements must adhere to the guidelines set out below.Candidates must note that upon receipt of sufficient evidence additional arrangements may not

necessarily be granted.

In awarding additional arrangements the Royal College of Ophthalmologists seek to:

1. Approve valid arrangements and access to written and clinical examinations.2. Give special consideration to candidates where specific circumstances have arisen

at or near to the examination time which have not previously been highlighted.3. Ensure that no additional arrangement gives an unfair advantage over another

candidate

When submitting their application form applicants must indicate if additional arrangements are

needed and supporting evidence must be provided at the time of application. Examples of thetypes of supporting evidence required are as follows:

Doctors note

Up to date literacy assessment

A Statement of Special Educational Needs

A Relevant diagnostic report regarding the learning disability

Historical evidence of the disability

Extra time award:

An additional allowance of up to and including 25% may be awarded to those candidatesrequesting special consideration for extra time and only on approval of the supplementaryevidence.

Specialist equipment:

The Royal College of Ophthalmologists will consider special requests from candidates forspecialist equipment such as:

Additional lighting

Larger desk to accommodate specialist equipment Separate room

Supervised rest breaks

All additional requirements will be considered by the Chairman of the Examinations Committee.


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ALLEGATIONS OF CHEATING AND MISCONDUCT IN EXAMINATIONS

FRCOphth, Refraction Certificate, DRCOphth Examinations and the Certificate in LaserRefractive Surgery

Candidates should note that by entering to sit an examination they are deemed to have read andunderstood and agreed to abide by all relevant examination regulations.

1.0 Introduction

1.1 Cheating and other misconduct, whether attempted or successful, will be penalised veryseverely by the Council of the Royal College of Ophthalmologists. Candidates found to be inpossession of unauthorised material or equipment, including mobile phones, during anexamination will be deemed to be guilty of misconduct whether the items have been used ornot. Cheating and misconduct includes, but is not restricted to:

Plagiarism (for the full policy please seewww.rcophth.ac.uk/examinations)

Taking unauthorised material into the examination

Taking unauthorised material from the examination

Copying from other candidates or unauthorised material

Talking to other candidates

Passing notes

Failure to respond to the instructions of an invigilator or examiner

Bribery

Unauthorised access to examination papers

Copying or alteration of certificates

Discussing clinical cases with other candidates (if either party has not yet sat theexamination)

Unacceptable or disruptive behaviour

1.2 Candidates may not take the following items into a written or practical examination:

Spare paper, including revision notes

Electronic equipment

Calculators

In addition:

All mobile phones must be switched off and not on the candidates person. Candidatesshould note that invigilators may employ the use of a device to detect the use of mobilephones. Candidates who have no other personal effects with which to store their switched offmobile phone, should surrender the device to the Senior Invigilator for the duration of theexamination.

Alarms on watches/clocks/mobile phones must be turned off Personal belongings should be placed at the back or side of the examination hall or

appropriate place, as advised by the invigilator. Valuables should not be brought to theexamination as the College cannot take responsibility for any loss of or damage to personalbelongings.

1.3 Candidates are not permitted to talk to, pass information to, or signal to another candidatewhilst the examination is in progress.

1.4 Candidates are reminded that it is a serious sanctionable offence to attempt to impersonateanother person or to have another person impersonate you during any part of the Collegesexaminations. Photographic identification will be checked by College Staff at the start ofevery examination.
http://www.rcophth.ac.uk/examinationshttp://www.rcophth.ac.uk/examinationshttp://www.rcophth.ac.uk/examinationshttp://www.rcophth.ac.uk/examinations


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2.0 Preliminary Procedure

2.1 In the event that a candidate is suspected of cheating or misconduct by an invigilator orCollege Examiner, the Senior Invigilator shall confiscate any unauthorised materials orequipment in the possession of the candidate. Candidates must, on request, surrender to theSenior Invigilator any materials or equipment reasonably suspected by the invigilator not to bepermitted. The Senior Invigilator shall include all such materials with their report and theymay be retained at the absolute discretion of the Chairman of the Examinations Committee.If candidates fail to surrender materials or equipment requested by the Senior Invigilator it willbe deemed that the alleged offence has occurred.

2.2 Details of the allegation will be made known to the Head of the Examinations Department.The following procedures will be followed:

i. The invigilator will submit a written report outlining the particulars of the allegation. If anallegation is made during a practical examination, the examiner concerned will note detailedinformation on the reverse of the candidates mark sheet.

ii. If the Head of the Examinations Department considers the suspicion of cheating ormisconduct to be well founded, he/she will submit a report to the Chairman of theExaminations Committee immediately following the examination.

iii. Upon receipt of the Head of the Examinations Departments report, the Chair of theExaminations Committee will undertake any further investigation that he/she thinksappropriate.

iv. If the Chair of the Examinations Committee believes there to be no grounds or insufficientevidence to support the allegation of cheating or misconduct no further action will be taken.

3.0 Investigation Procedure

3.1 If the Chair of the Examinations Committee believes there are grounds that require further

investigation, he/she will notify the candidate to inform them:

i. They are under investigation following an allegation of cheating or misconduct and that theresults of their examination will be withheld pending an investigation.

ii. The candidate will be sent a copy of the Head of the Examination Departments report andany further evidence obtained by the Chair of the Examinations Committee. The candidatewill be invited to submit a response to the allegations within a period of 28 days.

iii. The Chair of the Examinations Committee will call an Investigatory Board consisting of twoConsultant Fellows, who are not Senior Examiners or current Council Members, and one

member of the Lay Advisory Group who will review all the particulars of the case. Theinvestigatory process will be kept confidential.

iv. The Head of the Examinations Department will act as Secretary to the Investigatory Boardand will attend the Board as an observer. The Investigatory Board will otherwise conduct itsinquiry in private and will decide whether it finds the allegation of cheating or misconductproved on the balance of probabilities.

v. Where the Investigatory Board finds an allegation of cheating or misconduct proved on thebalance of probabilities, the Head of the Examinations Department shall notify the candidateof the outcome and inform them they have 28 days from the date of the outcome letter toappeal the Investigatory Board decision.

vi. If, after 28 days, no further communication has been received from the candidate, the findingsof the Investigatory Board shall be reported to the College Council at their next meeting. TheCollege Council shall impose penalties on the candidate as it sees fit. Penalties for cheating


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and misconduct include, but are not restricted to:a. Ruling the candidates examination attempt as invalidb. Referring the matter to the candidates employer and, if in Ophthalmic Specialist

Training, their deaneryc. Referring the matter to the General Medical Council or relevant Medical Board.

The candidate will be informed of the College Councils decision within 14 days after theCouncil meeting.

4.0 Appeal against the Outcome of the Investigatory Board

4.1 If the candidate wishes to appeal the findings of the Investigatory Board, a notice of appealmust be sent to the Chair of the Examinations Committee to arrive within 28 days of thedate of the outcome letter following the Investigatory Board. Included in the notice ofappeal must be the detailed grounds of appeal and all of the evidence that the candidatewishes to be considered.

4.2 A fee of 1000.00 must be received which will be refunded should the appeal be successful.

4.3 If reasonably practicable, the Chair of the Examinations Committee will convene an AppealPanel within 8 weeks of a notice of appeal being received. The Appeal Panel shall be

comprised of two Consultant Fellows and a member of the Lay Advisory Group who have notpreviously been involved in any aspect of the candidates examination or the InvestigatoryBoard and have no current or previous connection with the candidate. One of the members ofthe Panel shall be appointed Chair.

4.4 The Head of the Examinations Department will act as Secretary to the Appeals Panel andattend the Panel as an observer. He/she will agree the date of the hearing with the candidate.

4.5 The candidate will be invited to present his or her case in person to the Appeal Panel and isentitled to be accompanied by a friend whom the candidate shall identify in advance,providing 10 days notice. The friend may advise and counsel the candidate but will not be

allowed to make statements or take any part in the proceedings.

4.6 The Appeal Panel will review the findings of the Investigatory Board and may invite theInvestigatory Board or the candidate to produce further evidence prior to the hearing. TheAppeal Panel may summon any person to give evidence before it. Members of the Panel andthe candidate may question any person before it.

4.7 The candidate will be informed of the outcome within 28 days of the hearing by the Secretaryto the Appeal Panel. If the appeal is rejected, the Secretary to the Appeal Panel will informthe candidate of the reasons for the Panels decision.

4.8 If the finding of the Appeal Panel is that the decision of the Investigatory Board be overturnedno further action will be taken and the candidates examination result published.

4.9 If the finding of the Appeal Panel supports that of the Investigatory Board, the Panels findingsshall be reported to the College Council at their next meeting as per Regulation 3.1vi above.

The candidate will be informed of the College Councils decision within 14 days of the date ofthe Council meeting.

4.10 There is no further right of appeal.

4.11 Any question arising in connection with the conduct of an appeal shall be determined fully andfinally by the Chair of the Appeal Panel, who may take whatever steps he/she considersnecessary to ensure that the appeal is handled fairly and efficiently.


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Appeals Procedure

The Colleges appeal procedure is available online atwww.rcophth.ac.uk/examsadmission.

Language Requirements

All examinations run by the Royal College of Ophthalmologists are conducted in English.

Although candidates are not expected to undertake examinations such as IELTS or PLAB it isexpected that candidates should be equivalent to IELTS Level 7.

Preparing for the examinations

The Royal College of Ophthalmologists recommend that candidates preparing for examinationsshould:

Read the appropriate text, syllabi and curriculum for the relevant examination.

Gain clinical experience in ophthalmology in hospitals this may also includeworking within other specialties such and Medicine and Pathology.

Attend courses A list of courses for examinations can be found on the Collegewebsite (the College does not run or endorse any of the listed courses).

Be familiar with the Good Medical Practice documentation (from the GeneralMedical Council)

Candidates may also find useful information from the National Advice Centre for PostgraduateEducation. (http://www.nhscareers.nhs.uk/nacpme/)
http://www.rcophth.ac.uk/examsadmissionhttp://www.rcophth.ac.uk/examsadmissionhttp://www.rcophth.ac.uk/examsadmissionhttp://www.nhscareers.nhs.uk/nacpme/http://www.nhscareers.nhs.uk/nacpme/http://www.nhscareers.nhs.uk/nacpme/http://www.nhscareers.nhs.uk/nacpme/http://www.rcophth.ac.uk/examsadmission


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EXAMINATION FEES 2013

PART 1 FELLOWSHIP EXAMINATION

Fee to sit examination 485

PRACTICAL REFRACTION CERTIFICATE 585

PART 2 FELLOWSHIP EXAMINATION


Completion fee (to be paid by candidates 160who successfully complete the examination)

1Candidates who do not progress from the written component to the practical component will receive a rebate of

35% of the original fee. This is not available retrospectively for previous candidates.

DIPLOMA IN OPHTHALMOLOGY EXAMINATION


Completion fee (to be paid by candidates 160who successfully complete the examination)

FELLOWSHIP ASSESSMENT

Fee to sit examination (per attempt2) 850

Resit Fee3

275

Completion fee (to be paid by candidates 160who successfully complete the assessment)

2An attempt constitutes the submission of your casebooks and any subsequent amendments prior to the proposedinterview date. Candidates deemed as unsuccessful after the casebook stage shall not be permitted to attend forinterview. Candidates are required to submit payment of the fee for each attempt. For example, if a candidatescasebook do not proceed to interview and a new date is allocated, the full fee of 850 will be payable. Similarly, if acandidate fails three or more chapters at the interview stage, a new date must be allocated and payment of the fullfee must be submitted.

3The resit fee of 275 applies only to candidates re-sitting two chapters or less at the interview stage.

CERTIFICATE IN LASER REFRACTIVE SURGERY

Fee to sit examination (per attempt) 1150

An attempt constitutes the submission of Portfolio Assessment and any subsequent amendments prior to theproposed interview date.

Candidates deemed as unsuccessful after the submission shall not be permitted to attend the Portfolio Interview orStructured Vivas.

Candidates are required to submit payment of the fee for each attempt.

Additional Payments:Replica certificates 75 + VAT

4

Appeal procedure 200

Duke Elder5 15 (Undergraduate Prize Examination)

4From 1 January 2011 VAT is payable at the rate of 20%

5Payments for non-attendance


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DIPLOMA EXAMINATION

2013 TIMETABLE

Please note there will be only one sitting of the Diploma Examination in 2013. Numberswill be limited and allocated on a first come, first served basis.

September 2013

Closing Date for Receipt of Applications: 22 July 2013

16 - 18 September 2013 Hull Royal Infirmary

16 September 2013 Constructed Response Question Paper

Multiple Choice Question Paper

17 September 2013 Structured Viva Examination

18 September 2013 Multi Station Clinical Examination

Please note the exact schedule for the Structured Vivas and Multi-Station Clinical Examinationwill be confirmed once the number of candidates is known following the closing date for receiptof applications.


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Diploma Examination - Structure of the Examination

IntroductionFrom 1 August 2013 candidates will be permitted a maximum of six attempts in which to passthis examination. Examination attempts prior to August 2013 will not be included when the newruling is introduced.

The examination will comprise of theoretical papers, a structured viva and an objectively

structured multi-station clinical examination (OSCE) as follows:

A 3 hour Multiple Choice Question (MCQ) paper of 120, single best item stem, questionsrelating to basic sciences and theoretical optics

A 2 hour Constructed Response Question (CRQ) paper of 12 questions

A Structured Viva consisting of five stations, each will be timed for a precise period of 5minutes. Station 7 of the OSCE, Communication Skills, will not be conducted in a clinicalsetting and will be held at the same time as the Structured Viva, lasting for a preciseperiod of 5 minutes.

The stations are set out as follows:

Station 1: Patient Management 1Station 2: Patient Management 2Station 3: Patient InvestigationsStation 4: Ethics and Evidence Based MedicineStation 5: Public Health (including Health Promotion and Disease Prevention)

Two examiners will be present at each station for the duration of the cycle.

A Multiple Station Clinical examination (OSCE) consisting of a series of 7 stations. Eachof the clinical stations will be timed for precise periods 10 minutes. Station 7,Communication Skills, will not be conducted in a clinical setting and will be held at thesame time as the Structured Viva, lasting for a precise period of 5 minutes.

The stations are set out as follows:

Station 1: Posterior Segment 1Station 2: Posterior Segment 2Station 3: Anterior Segment

Station 4: Strabismus and Neuro-OphthalmologyStation 5: Pupils and Visual FieldsStation 6: External EyeStation 7: Communication Skills (takes place logistically with Structured Viva)


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Standard Setting

All examinations are standard set. The MCQ paper is standard set using the Ebel method. TheCRQ, Structured Viva and OSCE are standard set using the borderline candidate method.

Overall Result

Candidates are required to pass the clinical component. A marginal fail in one component can

be compensated if a candidate performs well in the clinical (OSCE) component.

If awarded a fail, candidates must re-sit the entire examination, even if a pass was previouslyachieved in any section.

Results

Results will be released four weeks after the examination, once verified by the Senior Examiner.Candidates are not permitted to telephone the College for examination results. All results will besent to candidates by first class post and the pass list will be displayed on the College website.


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Syllabus for the Diploma examination

The Diploma examination consists ofthree assessment formats:

written papers (single best answer multiple choice and constructed response question)

structured viva and

objective structured clinical examinations (OSCE).

Syllabus for the Written Papers page 14Syllabus for the Structured Vivas page 23

Syllabus for the OSCE page 26

Syllabus for the Written Papers

The written part of the DRCOphthexamination assesses understanding of patient investigationsand knowledge of basic and clinical sciences relevant to ophthalmology. The syllabus is based uponthe curriculum for ophthalmic specialist training (OST) in the UK.

Basic and clinical sciences

BCS1 Anatomy The Orbit and adnexae: Osteology, orbital foramina, eyelids, conjunctiva, lacrimal system,

extraocular muscles, intraorbital nerves, vessels, orbital fascia

Ocular anatomy: Conjunctiva, cornea, sclera, limbus and anterior chamber angle, iris andpupil, lens and zonule, ciliary body, choroid, retina, vitreous, optic nerve

The Cranial Cavity: Osteology of the skull, meninges, vascular supply, foramina, cranialfossae, pituitary gland and its relations

Central Nervous System: Cerebral hemispheres and cerebellum including microscopicanatomy of visual cortex, cranial nerves, spinal cord, vascular supply, visual pathways,control of eye movement, autonomic regulation of eye.

Head and neck: Nose, mouth, paranasal sinuses, face and scalp, pharynx, soft palate, larynx,trachea, major arteries and veins, lymphatic drainage of the head and neck

BCS2 Physiology

General principles including:

Maintenance of homeostasis: Characteristics of control systems - nervous and hormonal

Body fluids - volume, osmolarity, osmotic and oncotic pressure, and electrolyte (including H+)concentrations

Excitable tissues nerve and muscle: Structure and function of nerve cell, membranepotential, action potential, nerve conduction, synapse, the motor unit, muscle

Blood: Plasma composition and functions, cell types, immune mechanisms, blood groups,haemoglobin and red and white cell formation and destruction, anaemias, clotting andfibrinolysis

Cardiovascular system: Pressure resistance and flow in blood vessels, blood pressure

And blood flow, the activity of the heart and its control, cardiac output, control

Mechanisms within the CVS, transcapillary exchange, tissue fluid formation

Respiratory system: Structure, lung volumes, composition of respiratory gases, lungmechanics, gas exchange in the lung, carriage of O2 and CO2 in blood, ventilation perfusionrelationships, chemical and neural control of ventilation

Nervous system and special senses: Receptors, synapses, afferent pathways, efferentpathways, cerebral cortex, control of movement, hearing, pain and its control, autonomicnervous system, cholinergic transmission, adrenergic transmission

Endocrinology: Hormonal control, hypothalamus, pituitary, thyroid / parathyroid, adrenals,pancreas

Nutrition: Dietary requirements, absorption, vitamins

Kidney and adrenal cortex: Glomerular and tubular function, osmolality and pH of body fluids


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Ocular physiology including:

Physiology of tear production and control and the lacrimal drainage system

Physiology of aqueous production and drainage including principles ofintraocular pressure measurement

Physiology and biochemistry of the cornea

Lens metabolism

Physiology of the vitreous

Retinal physiology including phototransduction

Retinal pigment epithelium

Choroid Blood ocular barrier

Physiology of vision including:

Visual acuity

Accommodation

Pupillary reflexes

Light detection

Dark adaptation

Colour vision

Electrophysiology of the visual system

Visual fields Contrast sensitivity

Eye movements

Stereopsis

Motion detection

Visual perception

Magnocellular and parvocellular pathways

BCS3 Biochemistry and cell biology

Biochemistry of the cell: Organelles, plasma membranes, cytoskeleton, nucleus (DNA, RNA),transport mechanisms, cell-cell communications, cell-matrix interactions

Signalling: Growth factors, cytokines, hormones, eicosanoids, receptors, signal transduction,intracellular signalling pathways (e.g. second messengers)

Connective tissue and extracellular matrix: Extracellular matrix molecules, composition ofocular extracellular matrices, synthesis/degradation, cell-matrix interactions

Biochemistry and cell biology of ocular tissues: Cornea, sclera, ciliary body, lens, vitreous,retina, choroid.

Active oxygen species: Free radicals and H2O, scavengers, lipid peroxidation, phospholipaseA

BCS4 Pathology

Acute inflammation: Chemical mediators, cellular mechanisms

Wound healing

Chronic inflammation: Types, granulomata, immune mechanisms, ulceration, specificexamples

Immunological mechanisms: Types of hypersensitivity reaction

Graft rejection

Degenerations: Examples: amyloidosis, calcification

Ageing and atrophy

Hypertrophy, hyperplasia and metaplasia

Vascular disorders: Atheroma, thrombosis (and homeostatic clotting mechanisms, embolism(including pulmonary embolism), ischaemia and infarction, congestion and oedema,

angiogenesis, hypertension, aneurysms, diabetic microangiopathy Shock


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Neoplasia: Definition, terminology, concepts; benign and malignant tumours, carcinogenesis;gene control including regulation of apoptosis; oncogenes; geographical and environmentalfactors; pre-neoplastic conditions; effects of irradiation and cytotoxicdrugs

BASIC OCULAR PATHOLOGY, With an emphasis on:

Cornea endothelial dysfunction and corneal dystrophies

Glaucoma

Cataract

Diabetes

Age Related Macular Degeneration Retinal vascular occlusion

Ocular neoplasia

Retinal detachment and Proliferative Vitreo-retinopathy

MICROBIOLOGY:

The biological and clinical behaviour of the micro-organisms responsible for infections

Elementary principles of microbial pathogenesis: Concepts of colonisation, invasion,endotoxins, exotoxins, virulence and pathogenicity etc.

Gram staining and classification

Commensal eye flora

Viruses: Classification, structure and replication, antiviral agents, laboratory methods of viraldetection; viral infections of the eye.

Prions

HIV and AIDS

Fungi: Classification, factors which predispose to fungal infection, antifungal agents.

Toxoplasmosis, Chlamydia, Acanthamoeba, helminthic infections

Principles of sterilization: Disinfection and asepsis and the application of these to currentpractice and practical procedures

Antimicrobials: Spectrum of activity, mode of action, pharmacokinetics and resistance

IMMUNOLOGY

Principles of immunology e.g. non-specific resistance, genetic basis of immunity, cellular andhumoral mechanisms

Host defence mechanisms with particular reference to the eye

Mechanisms of immunologically-induced tissue damage with special reference to the eye

MHC antigens, antigen presenting cells and antigen processing

Transplantation immunology (with particular reference to the cornea)

Immunodeficiency and immunosuppression

Tissue regulation (with particular reference to the eye) of inflammatory responses)

BCS5 Growth and senescence

Embryology: General embryology especially at early stages; embryology of the eye, orbit,

adnexae and visual pathways; the embryological origins of congenital malformations of theeye.

Child development: key milestones in childhood development especially regarding the visualand central nervous systems.

Senescence: the process of ageing and degeneration.

BCS6 Optics

PHYSICAL AND GEOMETRIC OPTICS:

Properties of light: Electromagnetic spectrum, wave theory, particle theory, diffraction,interference, resolution, polarisation, scattering, transmission and absorption, photometry,

lasers Reflection: Laws of reflection, reflection at a plane surface, reflection at curved surfaces

Refraction: Laws of refraction (Snells Law), refraction at a plane surface, refraction at curvedsurfaces, critical angle and total internal reflection


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Prisms: Definition, notation of prisms, uses in ophthalmology (diagnostic and therapeutic),types of prism

Spherical lenses: Cardinal points, thin lens formula, thick lens formula, formation of theimage, vergence power (dioptric power), magnification, spherical decentration and prismpower, lens form

Astigmatic lenses: Cylindrical lenses, Maddox rod, toric lenses, Conoid of Sturm, Jacksonscross cylinder

Notation of lenses: Spectacle prescribing, simple transposition, toric transposition

Identification of unknown lenses: Neutralisation, focimeter, Geneva lens measure

Aberrations of lenses: Correction of aberrations relevant to the eye, Duochrome test

CLINICAL OPTICS

Optics of the eye: Transmittance of light by the optic media, schematic and reduced eye,Stiles-Crawford effect, visual acuity, contrast sensitivity, catoptric images, emmetropia,accommodation, Purkinje shift, pinhole.

Ametropia: Myopia, hypermetropia, astigmatism, anisometropia, aniseikonia, aphakia

Accommodative problems: Insufficiency, excess, AC/A ratio

Refractive errors: Prevalence, inheritance, changes with age, surgically induced

Correction of ametropia: Spectacle lenses, contact lenses, intraocular lenses, principles ofrefractive surgery

Problems of spectacles in aphakia: Effect of spectacles and contact lens correction onaccommodation and convergence, effective power of lenses, back vertex distance, spectaclemagnification, calculation of intraocular lens power, presbyopia

Low visual aids: High reading addition, magnifying lenses, telescopic aids - Galileantelescope

BCS7 Clinical Ophthalmology

The scope of contemporary clinical ophthalmology is broad and the following list is indicative ratherthan exhaustive.

Orbital diseaseo Clinical anatomyo Lacrimal problems secretory and drainage systems.o Orbital inflammationo Paranasal sinus diseaseo Orbital neoplasiao Orbital malformations

External eye diseaseo Clinical anatomyo Dry eye syndromeso Conjunctival infectiono Conjunctival inflammatory, degenerative and neoplastic diseaseo Scleral and episcleral diseaseo Allergic eye diseaseo Abnormalities of tear film

Eyelid disorderso Clinical anatomyo Blepharitis and Meibomian gland dysfunctiono Malpositions: entropion, ectropion and ptosiso Lid tumours

Corneal diseaseo Clinical anatomy, physiology and immunologyo Keratitiso Corneal dystrophies and degenerationso Corneal ectasias


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Lens and cataracto Clinical anatomy, physiology and biochemistryo Cataracto Abnormalities of lens shape and position

Uveal diseaseo Clinical anatomy, physiology and immunologyo Uveitiso Primary and secondary uveal tumourso Choroidal effusion

Medical retinal diseaseo Clinical anatomy, physiology and immunologyo Vascular retinopathieso Macular degenerationo Hereditary retinal diseaseo Retinal infection

Glaucomao Clinical anatomy, physiology and pharmacologyo Classification of glaucomas

Ocular motility and strabismuso Clinical anatomy and physiologyo Binocularityo Strabismuso Myopathieso Developmental anomalies of binocularity, including amblyopia

Neuro-ophthalmologyo Clinical anatomy and physiologyo Optic nerve diseaseo Visual pathway disorderso Pupil abnormalitieso Nystagmuso Headacheo Diplopiao Ptosiso Cranial nerve palsies particularly II

nd, III

rd, IV

th, V

th, VI

thand VII

th

Paediatric ophthalmologyo Clinical anatomy and embryologyo Child development and developmental delayo Congenital abnormalitieso Cataract, glaucoma and retinal disease in childreno Retinopathy of prematurityo Non-accidental injuryo Assessment of the apparently blind baby/childo Systemic syndromes

Intraocular tumourso Primary intraocular neoplasiao Secondary intraocular tumourso Non-metastatic effects of neoplasia

Surgical ophthalmologyo Anaesthesia local and generalo Surgical anatomyo Sterilization of instruments and equipmento Sutures and other materials used in ophthalmic surgeryo Principles of wound design, construction and healingo Principles of wound closure, appropriate use of different suture materials and needle

designo Intraocular lenseso Management of traumao Cataract surgery


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o Endophthalmitis


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Principles of surgery for: (not detailed knowledge of techniques)o Glaucomao Vitreo-retinalo Strabismuso Oculoplastico Cornealo Enucleationo Nasolacrimal surgeryo Laser surgery cornea, iris, vitreous, retinao Complications of surgery general and specifico Use of human tissue for surgery (eye banking)

Tropical ophthalmology

BCS8 Therapeutics

Pharmacokinetics and pharmacodynamics: General and specific to ocular tissues

Drug-receptor interactions

Mechanisms of drug actions (including receptor pharmacology and biochemicalpharmacology)

Mechanisms of drug toxicity

Specific classes of pharmacological agents: Examples include catecholaminergics,cholinergics, serotonergics and histaminergics, eicosanoids

Pharmacology of drugs used in inflammation and immunosppression

Pharmacology of drugs used in glaucoma

Local anaesthetics

Analgesics

BCS9 General Medicine and NeurologyKnowledge, to the level of a newly qualified doctor, is expected in the following areas:

Sexually transmitted diseases

Infectious diseases

Gastroenterology, hepato-biliary and pancreatic disease

Haematological diseases and medical oncology Rheumatology

Renal disease and basic fluid and acid-base balance

Cardiovascular and respiratory disease

Endocrinology and diabetes

Neurological disease

Dermatology

Emergency medicine ability to recognize the ill patient

Management of acute emergencies anaphylaxis, hypo/hyperglycaemia, the unconsciouspatient and cardiac and respiratory arrest

BCS10 Psychology Psychiatric disorders

Psychiatric aspects of ophthalmic diseases

Medically unexplained symptoms

Alcohol and drug misuse

Organic mental disorders

Dementia

Mental incapacity and consent

BCS 12 Lasers

The physics of light and lasers: coherence, laser physics, laser properties, types of

ophthalmic laser, tissue effects of laser, photocoagulation, photoablation, photodisruption,drug-enhanced laser absorption, OCT

BCS13 Epidemiology and evidence based medicine


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Scientific method: clinical measurement instruments, reliability and scales, definition ofepidemiological terms, definition of blindness, main causes throughout world,

Screening for ocular disease: principles of screening, evaluation of screening programmes,sensitivity and specificity

Evidence based practice: hierarchy of evidence, trial design, sources of information,interpretation of evidence

BCS14 Instrument technology

Direct and indirect ophthalmoscopes

Retinoscope Focimeter

Simple magnifying glass (Loupe)

Lensmeter

Automated refractor

Slit-lamp microscope

Applanation tomography and tonometry

Keratometer

Specular microscope

Operating microscope

Zoom lens principle

Corneal pachometer Lenses used for fundus biomicroscopy (panfunduscope, gonioscope Goldmann lens, Hruby

lens, 90D lens, etc.)

Fundus camera

Lasers

Fields machines (Goldmann, Humphrey)

Retinal and optic nerve imaging devices (OCT, SLO, GDx)

BCS16 Clinical Genetics

Organisation of the genome: Genes, chromosomes, regulation of transcription

Mendelian genetics: General principles

Population genetics: General principles Cytogenetics: Aneuploidy, deletions, translocations, mosaicism, chimerism

Genetic basis of eye conditions: Genes involved in ocular disorders or systemic disorderswith an ocular phenotype

Gene therapy: General principles

Patient Investigations (PI):

Candidates are expected to understand the basic principles underlying these investigations, when toorder them and how the results should be interpreted. These subjects can also be assessed inthe structured vivas.

PI1 Orthoptic assessment

Quantitative and qualitative assessment of vision

Cover-uncover test and alternate cover test

Assessment of ocular movements

Measurement of deviation

Assessment of fusion, suppression and stereoacuity.

PI2 Assessment of corneal shape, structure and thickness

Keratometry

Corneal topography

Pachymetry

Optical coherence tomography

Specular and confocal microscopy


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Wavefront analysis


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PI3 Retinal and optic nerve imaging

Retinal photography

Optical coherence tomography

Scanning laser ophthalmoscopy

PI4 Ocular angiography

Fluorescein and indocyanine green angiography

PI5 Ultrasonography

PI6 Radiology and other neuro-imaging

Plain skull and chest X ray

Orbital and neuro-CT scans

Orbital and neuro-MRI scans

Neuro-angiography

PI7 Ocular and neuro-physiology

Electroretinography

Electrooculography

Visually evoked potentials

PI8 Biochemistry

Liver and renal function tests

Blood glucose

Cardiac enzymes

Acid-base balance

Blood gases

Thyroid function tests

PI9 Haematology

Clotting screens

Blood count Blood transfusion

ESR. CRP and blood viscosity

PI10 Pathology

Types of biopsy

PI11 Microbiology

Collection of samples for virology, bacteriology, mycology, parasitology

Corneal scrapes

Conjunctival swabs

Intra-ocular samples

PI12 Biometry

Axial length measurement

IOL power calculation and A constants

Sources of biometric error

Choice of post-operative refractive error

Refractive error

PI13 Fields (automated, Goldmann)

Humphrey and other automated perimeters

Statistical analysis

Goldmann perimetry


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PI14 Immunology and allergy testing

Auto-antibodies

HLA antigens

Patch tests

PI15 Urinalysis

Proteinuria

Haematuria

PI16 Bone scans

Patient Management (PM)

PM13 Systemic implications

Medical retinal disorders including diabetic retinopathy and hypertensive retinopathy

AIDSrelated opportunistic infections

Cardiovascular disorders relevant to ophthalmology

Respiratory disorders relevant to ophthalmology

Rheumatological disorders relevant to ophthalmology

Skin disorders relevant to ophthalmology

Endocrine and metabolic disorders relevant to ophthalmology Chromosomal disorders relevant to ophthalmology

Phacomatoses

Ocular toxicology

Systemic associations with ophthalmic disease

Neurological disorders relevant to ophthalmology

PM14 Spectacle lenses

Correction of ametropia and presbyopia using spectacle lenses

Monofocal, mulitfocal and varifiocal lenses

Use of prisms

PM15 Contact lenses

Types of contact lenses

Contact lens solutions

Indications for contact lens use in ophthalmic practice

The basics of contact lens fitting

Management of contact lens complications

PM18 Diet and nutrition

Vitamin deficiency

Ocular consequences of alcohol, tobacco and drug abuse

Malnutrition Use of nutritional supplements in ophthalmology


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Syllabus for the Structured Viva

This aspect of the exam may explore competence in any of the learning outcomes from theRCOphth OST curriculum, therefore in addit ion tothe subjects assessed in the written papers,the following are subjects for assessment in the Diploma Structured Viva examination and OSCE:

Viva stations:PATIENT MANAGEMENT 1PATIENT MANAGEMENT 2

Patient Management

PM1 Management Plan

Differential diagnosis from clinical findings and patient investigation

Use of evidence based practice, protocols, clinical guidelines

Explanation of management plan to patient and carers

Involvement of patient in management decisions

Monitoring response, identification of complications

PM2 Triage/Prioritisation

Ocular and medical emergencies

Clinical leadership

PM3 Therapeutics

Good prescribing practice

Use of topical medication

Use of peri-ocular and intraocular medications

Use of oral and intravenous medications

Common side-effects of and contra-indications to ophthalmic therapeutic agents

Compliance

PM4 Select for surgery Indications for surgery in contemporary ophthalmic practice

Explaining surgery to patients and their carers

Reasons for withholding or delaying surgery

PM5 Prepare for surgery

Standards of consent for surgery (mentally competent and incompetent patients)

Pre-operative assessments and preparation

Intraoperative care of the patient

Postoperative care of the patient

PM6 Assess progress Natural history of ophthalmic disorders

Expected responses to treatment (therapeutic and side-effects)

Adverse incident reporting

Recognition of role and expertise of others in a multi-professional team

PM7 Complications

Recognised common complications of ophthalmic interventions

Communication of complications to patients and their carers

Normal reporting mechanisms for complications e.g. cataract complication audit

Prophylaxis/management of complications

Action when complication rates reach unacceptable levels

PM8 Emergencies/First aid

Hypoglycaemia


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Diabetic ketoacidosis

Severe haemorrhage and shock

Cardiopulmonary collapse

Anaphylactic shock

Vomiting

Severe pain

PM9 Anaphylaxis/resuscitation

Angiography anaphylaxis

Adverse reaction to local anaesthesia Basic adult life support

Basic paediatric life support

PM12 Referral

Recognition of professional limitations

Appropriate and timely referral

PM17 Select for laser

Types of laser in ophthalmic practice

Indications and contraindications for laser

Appropriate preparation of the patient, including information, consent and pre-laser treatment

Viva station:PATIENT INVESTIGATIONS(see patient investigations syllabus for the written papers)

Viva station:PUBLIC HEALTH OPHTHALMOLOGY (includes health promotion and disease prevention)

Health Promotion and Disease Prevention (HPDP)

HPDP1 Screening

Types of screening Sensitivity, specificity, likelihood ratio, predictive value, prevalence and incidence

Ethics of screening

Management of screening positives and negatives

Screening programmes for ophthalmic diseases e.g. ROP, diabetic retinopathy, neonatalexaminations

HPDP2 Contagion and cross infection

Hand hygiene

Management of MRSA and other hospital cross-infection risks

Management of highly infectious eye diseases e.g. epidemic conjunctivitis

Blood borne infections Needle stick injuries

HPDP3 Notification/contact tracing

Ophthalmic diseases that require notification e.g. ophthalmia neonatorum

Liaison with genitourinary medicine departments

HPDP4 Injury prevention

Eye protectors

At risk professions/activities

Eye disorders requiring particular protection

HPDP5 Disease risk reduction

Cardiovascular risk

Ophthalmic signs of systemic disease


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Contemporary strategies for risk reduction

Appropriate liaison with primary and secondary care

HPDP6 Contact lens care

Types of contact lens, storage and solutions

Common problems associated with contact lenses and their prevention

HPDP7 Care of laser and diagnostic contact lenses

Prevention of cross infection

Appropriate cleaning and storage Signs of damage

HPDP8 Avoidance of allergens

Common allergens

Simple strategies for reduction of allergen exposure

HPDP9 Immunisation

Management of tetanus prone injuries

BCG

Awareness of other vaccination regimes (The Green Book)

HPDP10 Investigations and therapeutics during pregnancy

Important teratogens

Risks associated with the use of medications and diagnostic agents during pregnancy

HPDP11 Bone protection

Assessing risk of osteoporosis

Simple prophylaxis measures

Indications for bone density scans and specific osteoporosis treatment

HPDP12 Prophylaxis

Prophylaxis for endophthalmitis and wound infections during surgery Best evidence/guidance on antibiotic use in prophylaxis

Other prophylactic measure relevant to ophthalmic practice e.g. migraine, IOP rises withsome procedures, herpes simplex infection

Viva Station: ETHICS AND EVIDENCE BASED MEDICINE

Decision Making, Clinical Reasoning and Judgment (DMCRJ)

DMCRJ1 Reasoning

Basis of clinical reasoning

Hierarchy of evidence for practice Evidence based practice

Attitudes, Ethics and Responsibilities (AER)

AER5 Confidentiality

Professional standards of patient confidentiality

Situations where confidentiality can be broken

AER12 Legal (Duties of a doctor)

Duties of a doctor and Good Medical Practice


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Syllabus for the OSCE

This aspect of the exam may explore competence in any of the learning outcomes from theRCOphth OST curriculum, therefore in addit ion tothe subjects assessed in the written papersand Structured Viva), the following are subjects for assessment in the Diploma OSCE:

OSCE Stations:POSTERIOR SEGMENT 1 78/90d lensPOSTERIOR SEGMENT 2 indirect ad direct ophthalmoscopy

CA10 Fundus examinationAll candidates must be able to examine the fundus of the eye using appropriate techniquesand interpret their findings. They must be able to use the direct and indirectophthalmoscopes. They must be able to use a variety of lenses for binocular fundusexamination with the slit lamp. They must be able to use appropriate indentation techniques.

Assessment of the vitreous, retina, choroid and optic nerve using;o the direct ophthalmoscopeo the indirect ophthalmoscope with a variety of lenses and indentation techniqueso the slit lamp with a variety of lenses

Interpretation of findings and recommendation for further testing

OSCE Station:ANTERIOR SEGMENT EXAMINATION - Slit lamp skills

CA9 Slit lampAll candidates must be able to examine the eye and adjacent structures using the slit lampand interpret their findings. They must be able to employ all of the functions of the slit lampand use accessory equipment when indicated. They must know how to care for theequipment properly and prevent cross infection.

Assessment of lids, conjunctiva, cornea, anterior chamber, iris, pupil, lens and anterior

vitreous Assessment of anterior chamber angle using a variety of lenses

Mastery of the slit lamp: illumination techniques, magnification, use of eye pieces

Familiarity with portable slit lamp systems

Assessment of the intraocular pressure


OSCE Station:STRABISMUS AND NEURO-OPHTHALMOLOGY

CA7 Ocular motility and cover test

All candidates must be able to assess ocular movements, interpret the findings andunderstand the technique and role of performing a cover test. They must be able to perform aprism cover test. They must also be able to recognise and describe nystagmus if present

Examination of eye position: cover test, alternate cover test, prism cover test

Examination of eye movements: ductions, version and vergence, smooth pursuits, saccades,dolls head, OKN

Assessment of concomitant and incomitant strabismus

Amblyopia

Nystagmus

Assessment of binocular function and Stereopsis



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CA13 Neurological examination

Proficiency in general medical and neurological assessment is tested at the level expected ofa foundation year 1 trainee (newly qualified doctor), including assessment of

o cranial nerveso motor function in limbs (tone, power, reflexes including plantar responses),o sensory function (light touch, vibration sense, proprioception)o coordination/cerebellar functiono brief mental state assessment


OSCE Station:PUPILS AND VISUAL FIELDS

CA6 PupilsAll candidates must be able to assess the pupil for abnormalities of shape, size, equality andreactions and interpret their findings. They must also be able to perform and interpretappropriate pharmacological tests for specific pupil abnormalities

Anisocoria

Direct and consensual reflexes

Swinging torch test

Near reflex

Light/Near dissociation

Pharmacological assessment of pupils

Dark reflex


CA3 Confrontation visual fieldsAll candidates must be able to make an assessment of normal and abnormal visual fieldsusing an appropriate confrontation method. They must then be able to interpret anyabnormality and the possible causes. They should be aware of the reliability of this method ofvisual fields assessment and know when to arrange for more detailed visual field analysis.

Appropriate confrontational technique

Appropriate use of coloured targets


OSCE Station:EXTERNAL EYE EXAMINATION

CA5 External eye examinationAll candidates must be able to perform an examination of the external eye, ocular adnexae,eyelids and orbits using appropriate equipment and illumination. They must be able to modifythe examination and utilise other techniques as indicated by the clinical findings

Observation using torch, palpation, auscultation

Exophthalmometry

Assessment of lid position

Lid eversion



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ALL OSCE STATIONS

Candidates may be required to perform the following in any of the OSCE stations, depending uponthe type of patient seen:

CA1 Clinical HistoryAll candidates must be able to take a clinical history from a patient, which is appropriate forthe clinical problem and the individual patient's needs.

Appropriate start to interview

Good listening skills

Appropriate use of open and closed questions

Relevant questioning e.g. drug, family history, systemic enquiry

Sensitive to patients needs

Aware of barriers to good communication

Able to summarise important negative and positive findings

Appropriate conclusions drawn from history

CA2 Assess visionAll candidates must be able to assess visual acuity for near and distance using an

appropriate method and interpret the results. They must be aware of and be able to interpretand apply newer methods of assessing visual acuity when they are introduced into clinicalpractice. They must be able to test colour vision using an appropriate method and interpretthe results. They should also know the principles of the assessment of contrast sensitivity.They must be able to assess vision in children and in adults who have language and otherbarriers to communication. They must be able to assess vision in circumstances outside theOPD environment.

Snellen and LogMAR acuities

Near acuity

Acuity testing in children, non-English speaking or reading individuals and those with mentalimpairment

Colour vision testing

Contrast sensitivity

Potential acuity in presence of cataracts

CA14 Examination of neckAll candidates must be able to perform a basic examination of the neck and recognise whenfurther referral is appropriate.

Examination of anterior and posterior triangles

Assessment of neck movement

Basic assessment of oral cavity and airway Interpretation of findings and recommendation for further testing

CA15 Examination of skin and joints

Examination of skin

Examination of joints, in particular hands and upper limb


CA16 Differential diagnosis

Summary of all relevant negative and positive clinical findings Justification of differential diagnosis

Strategy to refine diagnosis

Development of management plan


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OSCE Station:COMMUNICATION SKILLS OSCE (held during the Structured Viva examination)

C1 RapportAll candidates must be able to establish a trusting relationship with a patient, their carers andrelatives. They must be able to recognise when there could be problems with establishingrapport and make attempts to mitigate possible effects on the clinical relationship.

C2 ListeningAll candidates must be able communicate effectively and sensitively. They must be able todemonstrate active listening throughout a consultation. They must be sensitive duringquestioning and be able to draw the consultation to a satisfactory conclusion.

C3 Deliver informationAll candidates must be able deliver information clearly to a patient and, where appropriate,their carers and relatives; this must include including the explanation of a diagnosis and itstreatment options using appropriate terms. They must be sensitive to how the information isgiven and how it is being received. They must allow a patient to determine how much

information they want and how quickly it should be shared. All trainees must provideinformation using appropriate terms and be sensitive to issues of ethnic, gender and religiousdiversity.


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PATRON HRH THE DUKE OF YORK, KG, KCVO, ADC

Application form for the Diploma Examination

Last name:

Other names in full:

Address for correspondence:

Telephone number: Home Work

E-mail address: Date of Birth:

Name of Deanery (if in OST):

Medical Qualifications (with dates):

University or Medical College:

Country of qualification:

Please note candidates must submit an attested copy of their medical degree or details oftheir GMC registration in evidence of their eligibility to sit this examination.

GMC Number (if applicable):

If you are registered or anticipate being registered with the GMC then your personal data,including data about your examination results, will be passed to the GMC for quality assuranceand research purposes and to facilitate the awarding of certificates of completion of training

(CCT).

Have you at any time had (or do you have pending) any investigations, suspensions, limitationsor removal of medical registration in any country? (If yes, please provide details)

If you have sat this examination on a previous occasion please state the number of times youhave sat this examination: ____________

If applicable, date of Passing Part 1 FRCOphth (after 1 October 2006); or Part 1 and Part 2

MRCOphth (before November 2008) or Part 1 and Part 2 MRCSEd (before August 2008.Attested confirmation of MRCSEd exams required)

The Royal College of Ophthalmologists17 Cornwall Terrace, London. NW1 4QW.

Telephone: 020-7935 0702, Extension 213Facsimile: 020-7487 4674Email: [email protected]: WWW.RCOPHTH.AC.UK

FROM THE EXAMINATIONS DEPARTMENT


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I would like to request additional arrangements and include the required supplementaryevidence

I hereby apply to be admitted to the Diploma Examination of The Royal College ofOphthalmologists commencing Monday16 September 2013 at Hull Royal Infirmary (Closingdate Monday 22 July 2013)

The fee for sitting the Diploma Examination is 700.00. Please make cheques payable to TheRoyal College of Ophthalmologists. Alternatively, Visa and Mastercard are accepted. If youwish to use this method of payment, please give your details below.

This application form must be returned to the Examinations Department, The Royal College ofOphthalmologists, 17 Cornwall Terrace, London, NW1 4QW, together with the fee anddocumentation.

Please note it is not possible to accept application forms after the closing date for receiptof applications. Allocation will be on a first come, first served basis.

Applicants are advised to send applications forms by Special Delivery or Recorded Post toguarantee delivery.

Signature of Candidate:

Date of Application:

Details for Card Payment (this section is detached and destroyed once payment is processed)

Name of Cardholder:

Card Number: Security Code (CSV):

Expiry Date: Start Date: Issue Number:


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Monitoring of Equal Opportunities

The Council of The Royal College of Ophthalmologists would be grateful, although it is notcompulsory, if you would help the College to monitor equal opportunities within its Examinations byanswering the following questions and submitting the completed form with your ExaminationApplication. The ethnic groups used are those recommended by the Commission for Racial Equality

NAME OF EXAMINATION CANDIDATE:

SEX OF EXAMINATION CANDIDATE: MALE FEMALE

ETHNIC BACKGROUND OF EXAMINATION CANDIDATE:

Please choose one selection from (a) to (h) then tick the appropriate box to indicate your culturalbackground:

a) White British

English Scottish Welsh

Irish Any other white background, please specify

b) Mixed White and Black Caribbean White and Black African White and Asian Any other mixed background, please specify...

c) Asian, Asian British, Asian English, Asian Scottish or Asian Welsh Indian

Pakistani Bangladeshi Any other Asian background, please specify

d) Black, Black British, Black English, Black Scottish or Black Welsh Caribbean African Any other Black background, please specify

e) Chinese, Chinese British, Chinese English, Chinese Scottish or Chinese Welsh Chinese

Any other Chinese background, please specify

h) Other ethnic group Other, please specify

Decline to Answer

Do you consider yourself to have a disability according to the terms given in the DisabilityDiscrimination Act 1995 (DDA)? Yes No

FIRST SPOKEN LANGUAGE OF EXAMINATION CANDIDATE:

Documents

008 Diploma Examination Application Pack 2013-2