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Examination Application Pack September 2015 Diploma Examination 26 January 2015 Dear Colleague Thank you for your enquiry concerning the College’s Diploma Examination. I enclose copies of the current: Registration Information Admission Procedure Guidance for Candidates with Additional Needs Policy on Allegations of Cheating in Examinations Appeals Procedure Language Requirements Fees Schedule Examination Timetable Examination Structure Standard Setting Examination Syllabus Application Form Equal Opportunities Form Candidates must hold a medical qualification approved by the General Medical Council of the United 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. Medical degree certificates may be attested by a Fellow or Member of this College, the British Council or your embassy, a solicitor or the university issuing the certificate. Please note that from 1 August 2013, candidates are permitted a maximum of six attempts in which to pass this examination. Examination attempts prior to August 2013 do not count towards the number of attempts available. The above information has been agreed by the Council of The Royal College of Ophthalmologists.

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Examination Application PackSeptember 2015 Diploma Examination

26 January 2015

Dear Colleague

Thank you for your enquiry concerning the College’s Diploma Examination.

I enclose copies of the current: Registration InformationAdmission ProcedureGuidance for Candidates with Additional NeedsPolicy on Allegations of Cheating in ExaminationsAppeals ProcedureLanguage RequirementsFees ScheduleExamination TimetableExamination StructureStandard SettingExamination SyllabusApplication FormEqual Opportunities Form

Candidates must hold a medical qualification approved by the General Medical Council of the United 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. Medical degree certificates may be attested by a Fellow or Member of this College, the British Council or your embassy, a solicitor or the university issuing the certificate.

Please note that from 1 August 2013, candidates are permitted a maximum of six attempts in which to pass this examination. Examination attempts prior to August 2013 do not count towards the number of attempts available.

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

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

Yours sincerely

Emily BeetHead of the Examinations Department

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REGISTRATION INFORMATION

Candidates wishing to confirm the eligibility of their medical degree for the purpose of registration 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 the AVICENNA Directory at the below link:

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

Candidates who have not previously entered a College examination 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.

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Regulations

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

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

2. The application forms must be accompanied by the fee and such certification as is required by the regulations. If you cannot supply all the relevant certification you must contact the Examinations Department or supply a covering letter as to the reasons why. All outstanding certification must be sent within 14 days after the closing date, if not before, otherwise the candidate will be withdrawn from the examination and forfeit their examination fee. Applications submitted without the required fee will not be accepted.

3. Upon receipt of application the Examinations Department will send all candidates a written receipt. Detailed instructions including written and clinical examination dates will be 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 the Examinations Department in writing by 5.00pm on the closing date for receipt of applications. 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 date of the examination. In exceptional circumstances, if written evidence of the refusal of a visa is provided, the Examinations Committee will consider requests for candidates to transfer their examination entry, subject to the receipt of a 20% administration charge.

6. Candidates unable to attend an examination will forfeit their examination fee. In exceptional circumstances, the Examinations Committee will consider requests to transfer a candidate’s entry to the next examination sitting subject to receipt of written supplementary evidence (e.g. a detailed medical certificate, a death certificate for a close family member) and subject to a 20% administration charge. Please note that lack of preparation is not considered a suitable reason to withdraw or transfer an examination entry.

7. All candidates will receive feedback regarding their individual performance in the examinations.

8. Results are posted by First Class Mail with the Pass List being displayed on the College Website. Results are only released upon approval of the Senior Examiner. We regret that examination 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 the examinations.

2. Candidates are only allowed to bring pens/pencils etc. into the examination in a clear plastic pencil case or plastic bag.

3. Candidates are forbidden to communicate in any way with, seek assistance from, give assistance to, or interfere with the work of other candidates or the invigilators in the examination room or elsewhere during the period of the examination, or indulge in any other 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 and Misconduct in Examinations.

6. Candidates are not allowed to use mobile phones. All mobile phones must be switched off and must not be kept on the candidate’s person. Clear instructions will be given to candidates regarding the timing of the examination.

7. Photographic identification (such as a passport or photographic driver’s licence) will be checked before candidates are admitted to the examination hall. Candidates are also required to sign a register when entering written examinations.

8. Candidates are NOT permitted to enter a written examination 30 minutes after the examination has started. The clock to be referred to will be the clock in the examination hall or the Senior Invigilator’s watch.

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

10. Candidates deciding to leave the examination hall must submit their paper to the invigilator. 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 of the examination.

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

13. No books, written material or electronic equipment are allowed on the candidate’s desk. All references to the examination such as letters and individual timetables are not permitted on the examination desk.

14. Candidates are not allowed to use scrap paper, all notes must be written on the answer sheet and crossed through as appropriate.

15. Candidates are advised that no extra time will be given to transfer answers from the question 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 the examinations.

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

3. Candidates are forbidden to communicate in any way with, seek assistance from, give assistance to, or interfere with the work of other candidates or the invigilators in the examination room or elsewhere during the period of the examination, or indulge in any other 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 and Misconduct in Examinations regarding examinations.

6. Candidates are not allowed to use mobile phones. All mobile phones must be switched off and must not be kept on the candidate’s person. Clear instructions will be given to candidates regarding the timing of the examination.

7. Photographic identification (such as a passport or photographic driver’s licence) will be checked before candidates are admitted to the examination.

8. For clinical examinations, candidates are required to present themselves in good time and are required to wear name badges throughout the examination period (these will be supplied by the Royal College of Ophthalmologists). The start of the examination cannot be delayed for candidates arriving late.

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

10. No books, written material or electronic equipment may be consulted during the examination and are not permitted on a candidate’s person.

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

12. Candidates are advised that no extra time will be given to complete their mark sheets once 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 United Kingdom or of Ireland for the purpose of registration;

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

Candidates who are registered with the General Medical Council (GMC) should include their GMC number in the appropriate place on the application form for verification.

All other candidates are required to submit an attested copy of their medical degree in evidence of their eligibility to sit this examination. Medical degree certificates may be attested by a Fellow or Member of this College, the British Council or your embassy, a solicitor or the university issuing the certificate.

Condition of the Examination

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

Exemption

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

Candidates holding the following historic examinations are also eligible to apply for exemptions from 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 the application form the date of their success in the appropriate examination for verification.

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

An attested copy of their medical degree or details of their GMC registrationAn attested copy of their success letter for the Part 1 and Part 2 MRCSEd Examination result

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Guidance for Candidates with Additional Requirements

The Royal College of Ophthalmologists recognise that there may be some candidates who require additional arrangements when undertaking a Royal College of Ophthalmologists’ examination.

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 the types of supporting evidence required are as follows:

Doctor’s 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 candidates requesting special consideration for extra time and only on approval of the supplementary evidence.

Specialist equipment:

The Royal College of Ophthalmologists will consider special requests from candidates for specialist 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 Laser Refractive Surgery

Candidates should note that by entering to sit an examination they are deemed to have read and understood 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 very severely by the Council of the Royal College of Ophthalmologists. Candidates found to be in possession of unauthorised material or equipment, including mobile phones, during an examination will be deemed to be guilty of misconduct whether the items have been used or not. Cheating and misconduct includes, but is not restricted to:

Plagiarism (for the full policy please see www.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 the

examination) 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 candidate’s person. Candidates

should note that invigilators may employ the use of a device to detect the use of mobile phones. Candidates who have no other personal effects with which to store their switched off mobile phone, should surrender the device to the Senior Invigilator for the duration of the examination.

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 the examination as the College cannot take responsibility for any loss of or damage to personal belongings.

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

1.4 Candidates are reminded that it is a serious sanctionable offence to attempt to impersonate another person or to have another person impersonate you during any part of the College’s examinations. Photographic identification will be checked by College Staff at the start of

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every examination.

2.0 Preliminary Procedure

2.1 In the event that a candidate is suspected of cheating or misconduct by an invigilator or College Examiner, the Senior Invigilator shall confiscate any unauthorised materials or equipment in the possession of the candidate. Candidates must, on request, surrender to the Senior Invigilator any materials or equipment reasonably suspected by the invigilator not to be permitted. The Senior Invigilator shall include all such materials with their report and they may 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 will be 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 an allegation is made during a practical examination, the examiner concerned will note detailed information on the reverse of the candidate’s mark sheet.

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

Upon receipt of the Head of the Examinations Department’s report, the Chair of the Examinations Committee will undertake any further investigation that he/she thinks appropriate.

If the Chair of the Examinations Committee believes there to be no grounds or insufficient evidence 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 the results of their examination will be withheld pending an investigation.

ii. The candidate will be sent a copy of the Head of the Examination Department’s report and any further evidence obtained by the Chair of the Examinations Committee. The candidate will 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 two Consultant 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. The investigatory process will be kept confidential.

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

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

vi. If, after 28 days, no further communication has been received from the candidate, the findings of the Investigatory Board shall be reported to the College Council at their next meeting. The College Council shall impose penalties on the candidate as it sees fit. Penalties for cheating and misconduct include, but are not restricted to:a. Ruling the candidate’s examination attempt as invalidb. Referring the matter to the candidate’s 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 Council’s decision within 14 days after the Council meeting.

Appeal against the Outcome of the Investigatory Board

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

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

If reasonably practicable, the Chair of the Examinations Committee will convene an Appeal Panel 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 not previously been involved in any aspect of the candidate’s examination or the Investigatory Board and have no current or previous connection with the candidate. One of the members of the Panel shall be appointed Chair.

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

The candidate will be invited to present his or her case in person to the Appeal Panel and is entitled 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.

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

The candidate will be informed of the outcome within 28 days of the hearing by the Secretary to the Appeal Panel. If the appeal is rejected, the Secretary to the Appeal Panel will inform the candidate of the reasons for the Panel’s decision. If the finding of the Appeal Panel is that the decision of the Investigatory Board be overturned no further action will be taken and the candidate’s examination result published.

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If the finding of the Appeal Panel supports that of the Investigatory Board, the Panel’s findings shall be reported to the College Council at their next meeting as per Regulation 3.1vi above.

The candidate will be informed of the College Council’s decision within 14 days of the date of the 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 and finally by the Chair of the Appeal Panel, who may take whatever steps he/she considers necessary to ensure that the appeal is handled fairly and efficiently.

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Appeals Procedure

The College’s appeal procedure is available online at www.rcophth.ac.uk/examappeal.

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 is expected that candidates should be equivalent to IELTS Level 7.

Preparing for the examinations

The Royal College of Ophthalmologists recommend that candidates preparing for examinations should:

Read the appropriate text, syllabi and curriculum for the relevant examination.Gain clinical experience in ophthalmology in hospitals this may also include working within other specialties such and Medicine and Pathology.Attend courses – A list of courses for examinations can be found on the College website (the College does not run or endorse any of the listed courses).Ensure they are familiar with principles and values of the General Medical Council’s Good Medical Practice (http://www.gmc-uk.org).

Candidates may also find useful information from the National Advice Centre for Postgraduate Education. (http://www.nhscareers.nhs.uk/nacpme/)

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EXAMINATION FEES 2015

PART 1 FELLOWSHIP EXAMINATION Fee to sit examination £540

REFRACTION CERTIFICATE £640 (UK Centres)£915 (Kuching, Malaysia)

PART 2 FELLOWSHIP WRITTEN EXAMINATION

Fee to sit examination £390

PART 2 FELLOWSHIP ORAL EXAMINATION

Fee to sit examination £620

DIPLOMA IN OPHTHALMOLOGY EXAMINATION Fee to sit examination £775

CERTIFICATE IN LASER REFRACTIVE SURGERY

Fee to sit examination (per attempt) £1290

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

Candidates deemed as unsuccessful after the submission shall not be permitted to attend the Portfolio Interview or Structured Vivas. Candidates are required to submit payment of the fee for each attempt.

Additional Payments:Replica certificates £75 + VAT1

Appeal procedure £250 Duke Elder £10 (Undergraduate Prize Examination)

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

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DIPLOMA EXAMINATION

2015 TIMETABLE

Please note there will be only one sitting of the Diploma Examination in 2015. Examination places will be limited and allocated on a first come, first served basis.

September 2014

Opening Date for Receipt of Applications: 26 January 2015 Closing Date for Receipt of Applications: 20 July 2015

14 - 16 September 2015 James Paget Hospital, Great Yarmouth

14 September 2015 Constructed Response Question PaperMultiple Choice Question Paper

15 September 2015 Structured Viva Examination16 September 2015 Multi Station Clinical Examination

Please note the timetable slots for the Structured Vivas and Multi-Station Clinical Examination will be randomly allocated and confirmed once the number of candidates is confirmed, following the closing date for receipt of applications.

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Diploma Examination - Structure of the Examination

IntroductionFrom 1 August 2013 candidates are permitted a maximum of six attempts in which to pass this examination. Examination attempts prior to August 2013 do not count towards the number of attempts available.

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, questions relating 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 5 minutes. Station 7 of the OSCE, Communication Skills, will not be conducted in a clinical setting and will be held at the same time as the Structured Viva, lasting for a precise period 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. Each of 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 the same 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 SegmentStation 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. The CRQ is standard set using the Angoff method. The Structured Viva and OSCE are standard set using the borderline candidate method.

Overall Result

Candidates are required to pass the written and oral sections. If a candidate marginally fails one written paper (within one standard error of measurement of the pass mark) their total marks for both papers will be added together. If this mark exceeds the combined pass marks for both papers, they will be deemed to have passed the written section

If a candidate marginally fails the Structured Viva (within one standard error of measurement of the pass mark) their total marks for both the Viva and the OSCE will be added together. If this mark exceeds the combined pass marks for both papers, they will be allowed to pass the oral section. It is NOT possible to compensate a poor OSCE with a good Structured Viva result.

If awarded a fail, candidates must re-sit the entire examination, even if a pass was previously achieved 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 be sent 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 of three 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 16Syllabus for the Structured Vivas page 25Syllabus for the OSCE page 28

Syllabus for the Written Papers

The written part of the DRCOphth examination assesses understanding of patient investigations and knowledge of basic and clinical sciences relevant to ophthalmology. The syllabus is based upon the 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 and

pupil, lens and zonule, ciliary body, choroid, retina, vitreous, optic nerve The Cranial Cavity: Osteology of the skull, meninges, vascular supply, foramina, cranial

fossae, pituitary gland and its relations Central Nervous System: Cerebral hemispheres and cerebellum including microscopic

anatomy 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, membrane

potential, 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 and fibrinolysis

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, lung mechanics, gas exchange in the lung, carriage of O2 and CO2 in blood, ventilation perfusion relationships, chemical and neural control of ventilation

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Nervous system and special senses: Receptors, synapses, afferent pathways, efferent pathways, cerebral cortex, control of movement, hearing, pain and its control, autonomic nervous 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

Ocular physiology including: Physiology of tear production and control and the lacrimal drainage system Physiology of aqueous production and drainage including principles of

intraocular 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 of

ocular 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, phospholipase

A BCS4 Pathology

Acute inflammation: Chemical mediators, cellular mechanisms Wound healing

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Chronic inflammation: Types, granulomata, immune mechanisms, ulceration, specific examples

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 Neoplasia: Definition, terminology, concepts; benign and malignant tumours,

carcinogenesis; gene control – including regulation of apoptosis; oncogenes; geographical and environmental factors; 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

viral detection; 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 current

practice 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

and humoral 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)

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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 the eye.

Child development: key milestones in childhood development especially regarding the visual and 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 (Snell’s Law), refraction at a plane surface, refraction at

curved surfaces, critical angle and total internal reflection 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 the

image, vergence power (dioptric power), magnification, spherical decentration and prism power, lens form

Astigmatic lenses: Cylindrical lenses, Maddox rod, toric lenses, Conoid of Sturm, Jackson’s cross 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 of

refractive surgery Problems of spectacles in aphakia: Effect of spectacles and contact lens correction on

accommodation and convergence, effective power of lenses, back vertex distance, spectacle magnification, calculation of intraocular lens power, presbyopia

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

BCS7 Clinical Ophthalmology

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

Orbital disease Clinical anatomy Lacrimal problems – secretory and drainage systems.

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Orbital inflammation Paranasal sinus disease Orbital neoplasia Orbital malformations

External eye disease Clinical anatomy Dry eye syndromes Conjunctival infection Conjunctival inflammatory, degenerative and neoplastic disease Scleral and episcleral disease Allergic eye disease Abnormalities of tear film

Eyelid disorders Clinical anatomy Blepharitis and Meibomian gland dysfunction Malpositions: entropion, ectropion and ptosis Lid tumours

Corneal disease Clinical anatomy, physiology and immunology Keratitis Corneal dystrophies and degenerations Corneal ectasias

Lens and cataract Clinical anatomy, physiology and biochemistry Cataract Abnormalities of lens shape and position

Uveal disease Clinical anatomy, physiology and immunology Uveitis Primary and secondary uveal tumours Choroidal effusion

Medical retinal disease Clinical anatomy, physiology and immunology Vascular retinopathies Macular degeneration Hereditary retinal disease Retinal infection

Glaucoma Clinical anatomy, physiology and pharmacology Classification of glaucomas

Ocular motility and strabismus Clinical anatomy and physiology Binocularity Strabismus Myopathies Developmental anomalies of binocularity, including amblyopia

Neuro-ophthalmology Clinical anatomy and physiology Optic nerve disease Visual pathway disorders Pupil abnormalities Nystagmus

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Headache Diplopia Ptosis Cranial nerve palsies – particularly IInd, IIIrd, IVth, Vth, VIth and VIIth

Paediatric ophthalmology Clinical anatomy and embryology Child development and developmental delay Congenital abnormalities Cataract, glaucoma and retinal disease in children Retinopathy of prematurity Non-accidental injury Assessment of the apparently blind baby/child Systemic syndromes

Intraocular tumours Primary intraocular neoplasia Secondary intraocular tumours Non-metastatic effects of neoplasia

Surgical ophthalmology Anaesthesia – local and general Surgical anatomy Sterilization of instruments and equipment Sutures and other materials used in ophthalmic surgery Principles of wound design, construction and healing Principles of wound closure, appropriate use of different suture materials and needle

design Intraocular lenses Management of trauma Cataract surgery Endophthalmitis Principles of surgery for: (not detailed knowledge of techniques)

o Glaucomao Vitreo-retinal o Strabismus o Oculoplastic o Corneal o 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 biochemical

pharmacology) 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

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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 unconscious

patient 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 Scientific method: clinical measurement instruments, reliability and scales, definition of

epidemiological 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

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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 disorders

with an ocular phenotype Gene therapy: General principles

Patient Investigations (PI):

Candidates are expected to understand the basic principles underlying these investigations, when to order them and how the results should be interpreted. These subjects can also be assessed in the 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 Wavefront analysis

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

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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

PI14 Immunology and allergy testing Auto-antibodies HLA antigens Patch tests

PI15 Urinalysis Proteinuria Haematuria

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PI16 Bone scans

Patient Management (PM)

PM13 Systemic implications Medical retinal disorders including diabetic retinopathy and hypertensive retinopathy AIDS–related 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 the RCOphth OST curriculum, therefore in addition to the 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

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Prophylaxis/management of complications Action when complication rates reach unacceptable levels

PM8 Emergencies/First aid Hypoglycaemia 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, neonatal

examinations

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

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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 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 with

some procedures, herpes simplex infection

Viva Station: ETHICS AND EVIDENCE BASED MEDICINE

Decision Making, Clinical Reasoning and Judgment (DMCRJ)

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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 the RCOphth OST curriculum, therefore in addition to the subjects assessed in the written papers and 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 techniques and interpret their findings. They must be able to use the direct and indirect ophthalmoscopes. They must be able to use a variety of lenses for binocular fundus examination 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 lamp and interpret their findings. They must be able to employ all of the functions of the slit lamp and use accessory equipment when indicated. They must know how to care for the equipment 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 Interpretation of findings and recommendation for further testing

OSCE Station:STRABISMUS AND NEURO-OPHTHALMOLOGY

CA7 Ocular motility and cover testAll candidates must be able to assess ocular movements, interpret the findings and understand the technique and role of performing a cover test. They must be able to perform a prism 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

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Nystagmus Assessment of binocular function and Stereopsis Interpretation of findings and recommendation for further testing

CA13 Neurological examination Proficiency in general medical and neurological assessment is tested at the level expected

of a foundation year 1 trainee (newly qualified doctor), including assessment ofo cranial nerves o 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

Interpretation of findings and recommendation for further testing

OSCE Station:PUPILS AND VISUAL FIELDS

CA6 PupilsAll candidates must be able to assess the pupil for abnormalities of shape, size, equality and reactions and interpret their findings. They must also be able to perform and interpret appropriate 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 Interpretation of findings and recommendation for further testing

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

Appropriate confrontational technique Appropriate use of coloured targets Interpretation of findings and recommendation for further testing

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 modify the examination and utilise other techniques as indicated by the clinical findings

Observation using torch, palpation, auscultation Exophthalmometry Assessment of lid position

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Lid eversion Interpretation of findings and recommendation for further testing

ALL OSCE STATIONS

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

CA1 Clinical HistoryAll candidates must be able to take a clinical history from a patient, which is appropriate for the 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 patient’s 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 interpret and apply newer methods of assessing visual acuity when they are introduced into clinical practice. They must be able to test colour vision using an appropriate method and interpret the 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 other barriers to communication. They must be able to assess vision in circumstances outside the OPD environment.

Snellen and LogMAR acuities Near acuity Acuity testing in children, non-English speaking or reading individuals and those with

mental impairment Colour vision testing Contrast sensitivity Potential acuity in presence of cataracts

CA11 General medical examination

All candidates must be able to perform a basic medical examination and understand the importance of their findings so as to be able to know when a patient is ill and requires appropriate referral.

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

o Cardiovascular system: heart, carotid arteries, peripheral pulses, perfusion, blood pressure

o Respiratory system: breath sounds, cyanosiso Abdominal examinationo Lymphadenopathy

Interpretation of findings and recommendation for further testing Examination of anterior and posterior triangles

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Assessment of neck movement Basic assessment of oral cavity and airway Examination of skin Examination of joints, in particular hands and upper limb

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 and relatives. They must be able to recognise when there could be problems with establishing rapport 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 to demonstrate active listening throughout a consultation. They must be sensitive during questioning 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 its treatment options using appropriate terms. They must be sensitive to how the information is given 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 provide information using appropriate terms and be sensitive to issues of ethnic, gender and religious diversity.

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Application form for the Diploma Examination (DRCOphth)

Monday 14 – Wednesday 16 September 2015

Last name:

Other names in full:

Address for correspondence:

Contact Telephone number: E-mail address:

Date of Birth: Gender:

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 of their 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 assurance and 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, limitations or 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 you have 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)

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I would like to request additional arrangements and include the required supplementary evidence

I hereby apply to be admitted to the Diploma Examination of The Royal College of Ophthalmologists commencing Monday 14 September 2015 at James Paget University Hospital, Great Yarmouth (Closing date Monday 20 July 2015)

The fee for sitting the Diploma Examination is £775.00. Please make cheques payable to ‘The Royal College of Ophthalmologists’. Alternatively, Visa and MasterCard are accepted. If you wish to use this method of payment, please give your details below.

This application form must be returned to the Examinations Department, The Royal College of Ophthalmologists, 18 Stephenson Way, London, NW1 2HD, together with the fee and documentation.

Please note it is not possible to accept application forms after the closing date for receipt of applications. Late applications will not be accepted under any circumstance.

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

Allocation of examination slots will be on a first come, first served basis.

Signature of Candidate:

Date of Application:

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

Name of Cardholder:

Type of Card: Visa Electron Visa Debit Visa Mastercard(please circle)

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 not compulsory, if you would help the College to monitor equal opportunities within its Examinations by answering the following questions and submitting the completed form with your Examination Application. The ethnic groups used are those recommended by the Commission for Racial Equality

NAME OF EXAMINATION CANDIDATE:

GENDER 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 cultural background:

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 Equality Act 2010?

□ Yes □ No

FIRST SPOKEN LANGUAGE OF EXAMINATION CANDIDATE: