Ophthalmology ST1 Interview Preparation and Essential Reading

The Ophthalmology ST1 interview is one of the most competitive interviews in the country, with many excellent applicants and outstanding portfolios, so it’s important you prepare for it properly.

Here are some tips for your portfolio and the interview stations, which will hopefully optimise your application. We’ve also prepared a number of Ophthalmology ST1 Mock Interviews to help you prepare.

Ophthalmology ST1 Application

The pandemic has caused a major disruption to normal interview processes, so this year’s application is done purely online, and if you are shortlisted, there is an online interview on Microsoft Teams. You should closely refer to the official guidance for updates. You use the Oriel platform to apply for Ophthalmology ST1, as with all other specialty applications.

The overall ophthalmology application this year consists of your Evidence folder, the MSRA exam, and an online interview. These 3 components add up to an overall score and you are ranked on your score compared to other candidates. You will need to score above a certain cut-off mark in the MRSA exam to be invited to interview.

Proportionally, your Evidence folder gives you the largest weighting, but it also takes years to get the points here for publications, research, a PhD or PACES.

Doing well in the MRSA exam and the interview, which is structured much like an OSCE exam, are marks that you can attain with targeted revision over just a few months.

Evidence folder

Your portfolio is submitted to the panel of interviewers on the day of your interview, and is marked according to a set criteria divided into qualifications/prizes, commitment to ophthalmology (e.g. electives/taster weeks), publications, your best audit/QIP, presentations, and teaching. Some useful tips are outlined in our Portfolio blog post.

The official requirements are clearly listed on the Severn Deanery website.

Crucially, your portfolio should be clearly laid out, following the mark scheme to the letter, as you have no opportunity to explain or present your contents. A couple of interviewers will only have 20 minutes to flip through your life’s work, so it is vital that it is organised, and everything that is worth points is easily navigable and scored for your benefit. Everything that is unnecessary should be left out, as it detracts the interviewers’ attention.

Note that you can score most points even with presentations/ publications/ audits etc. that are not ophthalmology themed, and that there is only one section that requires some ophthalmology related experience.

There are also a few ways to gain some last-minute marks if you haven’t already got them. For example, you can “design an educational course” via an e-learning tool, which you can put together in your local hospital. Alternatively, you could publish a series of blog posts on a medical topic of interest. In “commitment to ophthalmology”, if you haven’t already, you can ask your friendly local ophthalmologist if you can spend time with them in eye casualty (with a letter as evidence for points). There are also marks for the use of the EyeSi programme, which is a microsurgical simulator that junior trainees use, for example in training for independent cataract surgery. Only a few units, such as Moorfields Eye Hospital, Western Eye Hospital and the Royal College of Ophthalmologists, have this simulator, and the best way to access these is to ask a friendly ophthalmology trainee.

For more advice on how to structure your portfolio and how to use what you already have to maximise marks, check out this e-book on Amazon.

You can also read more about preparing your portfolio.

Multi-specialty Recruitment Assessment (MSRA) Exam 

This is a multiple-choice exam that is also taken by GP, radiology and other specialty applicants. It consists of an SJT-type component, and a general medical questions component. Details of the exam can be found on the Severn Deanery website.

The best advice for this is to do as much practice as possible. It is not a difficult exam, but you need to do fairly well to simply get an interview. Furthermore, the higher you score in this exam, the higher your overall interview score. The cut-off score for interview will vary from year to year.

Remember to refer to the website regularly, especially with changing Covid lockdown guidelines, as to whether the exam is remote or at a test centre. The exams should be held between 6th January – 15th January 2022.

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Practice is especially important in the clinical component, and it can also be useful in your interview. It is usually based on generic, GP-tailored medical knowledge, which is a useful refresher for some basic interview questions.


This year, the interview is slimmed down to a patient consultation scenario online, on Microsoft Teams. You will be invited to book your online interview if you meet the required MSRA score. This is scheduled for 11th March 2022.

This is the second year that this is conducted online. Make sure you have a strong wi-fi connection, a good laptop camera and room lighting, and that you are familiar with Microsoft Teams. Ensure that you have tested this prior to your interview!

The interview comprises only one station, which involves a patient consultation with an actor. This should not take longer than 10-20 minutes. You are tested on your clinical knowledge and communication skills. As with previous face-to-face interviews, clinical scenarios and communication skills tend to be fairly realistic and based on real-life scenarios as an ophthalmologist that you would encounter in your clinic.

There could potentially be a wide range of different topics based on different themes. As a suggestion, do prepare to be familiar with the following scenarios as a starting point:

  • Patient with decreased vision, with diabetic retinopathy/maculopathy. You explain to them what the disease is, how it affects vision, treatment options, lifestyle advice and diabetic control.
  • Patient with glaucoma, with progressing visual field loss and inadequate eye pressure control. You need to advise them about treatment compliance, disease progression, and always remember to check a social history e.g. driving – do they meet the driving standards? What do they do for a living?
  • Angry patient: common scenarios involve previous misdiagnoses (or poorly explained diagnoses), cancelled/delayed appointments, treatments not working.
  • Refractive surprise: patient after cataract surgery noticing much worse vision – how would you approach this and what investigations would you instigate?
  • Breaking bad news: incidental finding of ocular metastasis, how would you begin a difficult consult like this? What does the patient know? What are your suggested next steps?

Although there are no specific QIPP/Audit, Clinical or specific Communication Skills stations this year, these are overlapping and very relevant themes in ophthalmology in general. You should read through our clinical, communication and even QIPP scenarios to familiarise yourself with cases like this and beyond.  It is always easier if you have encountered real-life situations like this in a clinical setting, so do try to gain some prior ophthalmology clinical experience if you can. Use your taster week wisely!

Final tips

  • Get started as early as you can! Get your portfolio in order, it takes a lot longer than you expect.
  • Read ALL official instructions carefully.
  • Practice for the MRSA exam and do lots of questions.
  • Prepare for the online interview as you would with real-life OSCE stations. Practise with a partner online on Microsoft Teams for familiarity.
  • Remember, you are scored stringently with a mark scheme, and almost half your battle is done when you submit your portfolio of evidence.
  • Coming across well-mannered and thoughtful is always important at any interview, and is especially important on a video-call. Good luck!

Professionally written Ophthalmology question bank

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Further reading

More tips on smashing your Ophthalmology interview.


Ophthalmology ST1 Interview Portfolio Preparation

The ST1 ophthalmology portfolio has strict criteria and a stringent mark scheme. The requirements are updated annually on the Severn Deanery website, four months in advance of the interview. Your portfolio is marked during the interview day in a separate room to you, so you do not get any opportunity to sell yourself or to explain the contents.

By Medibuddy — 12 November 2021