CertLRS Exam

The CertLRS is a practical examination that tests your ability to perform safe laser refractive surgery. You must take this examination to enter independent practice in the field of laser refractive surgery.

The Certificate in Laser and Refractive Surgery examination leads to the award of ‘The Certificate of Laser Refractive Surgery’ and the postnominals CertLRS. Success in this exam is an entry requirement to independent practice in the field of laser refractive surgery and can be used towards the GMC requirement for satisfactory annual appraisal as part of the revalidation process. This examination is not part of the FRCOphth examinations set.

Who can sit the exam?

There are two routes of eligibility to take the assessment:

1. Applicant is on the GMC’s Specialist Register for Ophthalmology.
2. Those without specialist registration in ophthalmology must have evidence of substantive experience in ophthalmology:

i. FRCOphth OR
ii. MRCOphth as awarded from 1 January 1997 to 31 December 2008 OR
iii. FRCSEd(Ophth)  OR
iv. FRCSI(Ophth)  OR
v. FRCSGlas (Ophth) OR
vi. FEBO OR
vii. FICO OR
viii. FRANZCO.

Evidence of relevant post-graduate certificates must be provided to demonstrate eligibility.

All doctors are subject to undertaking Continued Professional Development (CPD) and annual appraisal as set out by the General Medical Council (GMC) as part of a system of revalidation.  Their appraisal should provide evidence to their employer, and if required by the GMC, to include all aspect of their practice including surgery in terms of Audit and Outcomes thus showing their competency to continue in practice.

Allegations of Cheating and Misconduct

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. Cheating and other misconduct, whether attempted or successful, will be penalised very severely by the Council of the Royal College of Ophthalmologists.

Policy on Allegations of Cheating and Misconduct May 2016

Additional Examination Attempts

GMC policy states: “No candidate will normally be allowed more than six attempts at an examination.”

“After six failed attempts, a candidate must provide evidence of additional educational experience to the royal college or faculty for each re-sit.”

The GMC have confirmed that the expectations around national professional examinations allow flexibility for colleges to make exceptions to the guidelines or to apply more stringent rules if they see fit, meaning they are permitted to implement their own limit to the number of additional exam attempts permitted.

The RCOphth will allow only ONE additional attempt after the limit on previous attempts has been reached.

NB: For the CertLRS examination, the maximum number of attempts is 6.

For RCOphth examinations, candidates who have had the maximum number of attempts will not be eligible to attempt an examination again unless evidence of additional educational experience is provided. To be considered for a maximum of one additional attempt only, please read the following Additional Examination Attempt Information Pack and complete the Additional Examination Attempt Application Form only if you have exhausted your maximum number of exam attempts.

How do I book the exam?

You can book the exam online by logging into the member’s area or creating an account. Visit the Book an Exam page to reserve your place.

How much is the exam fee?

We update our examination fees each year.

Click here to find the latest list of fees.

What is the structure of the exam?

The exam content is based on the following syllabus:

  • Basic anatomy, physiology and optics
  • Pre-op Assessment for Cataract and Refractive Surgery
  • Theory of Laser Refractive Surgery
  • LASIK
  • PRK/LASEK/Epi-LASIK
  • SMILE
  • Refractive surgery for keratoconus
  • Technology and theory of lens based refractive surgery
  • Cataract / Lens surgery and intra-operative complications
  • Correction of Regular and Irregular Astigmatism
  • Phakic IOLs
  • Presbyopia
  • High Ametropia
  • Post operative complications of lens based refractive surgery
  • Post operative complications of laser refractive surgery
  • Retreatments
  • Good Medical Practice
  • Audit

For a detailed syllabus please see CertLRS Syllabus.

MCQ

There is a written MCQ component and five structured vivas which take place across two days. The MCQ component consists of 100 questions in an open-book format. The five structured vivas each last 10 minutes and will include:

  1. Good Medical Practice/audit
  2. Pre-op assessment
  3. Laser treatments
  4. Non-laser procedures
  5. Post-op assessment/ complications

Similarly to the Part 2 FRCOphth exam the vivas are intended to allow in-depth discussion on a wide variety of topics, with the opportunity for examiners to explore answers, seek clarification and assess analytical skills.

The Ebel method will be used to pass mark set the written component and to determine a pass mark.  This is the same pass mark setting method as that used by the College for Part 1 and Part 2 FRCOphth MCQ examinations.

MCQ Online Delivery

From September 2021, the CertLRS MCQ examination will be taken as an Online Examination, where the candidate will sit the exam at their home or their workplace, without the need to travel to a testing centre or examination venue. The examination will be taken online by being delivered over the internet to the candidate’s computer at a pre-agreed examination date and time.

Candidates are recommended to thoroughly read and familiarise themselves with the Important information: CertLRS MCQ online examination.

Candidates are also advised to read the CertLRS MCQ Online Written Exam FAQs.

Structured vivas

There will be five structured vivas each lasting 10 minutes.  There will no longer be a Portfolio assessment. The viva stations are as follows:

  1. Good Medical Practice/audit
  2. Pre-op assessment
  3. Laser treatments
  4. Non-laser procedures
  5. Post-op assessment/ complications

Vivas will be of the same structure as those used in the College’s Part 2 FRCOphth and are intended to allow in depth discussion on a wide variety of topics, with the opportunity for examiners to explore candidates answers, seek further clarification, and assess their analytical skills in ways which are often not possible in MCQs.  Each will be marked independently by two examiners working from pre-defined scripted questions and structured into 4 marking points with a clear marking guide.  Viva questions and required answers will be written and agreed in advance by experts in the field.

The structured viva component will be pass mark set using the Hofstee method.  This approach to pass mark setting is widely used, is approved by the GMC, and is a significant advancement on the previous criteria applied to pass the exam.

How is the exam marked?

The MCQ part of the exam is pass mark set using the Ebel method and the structured viva will be pass mark set using the Hofstee method. Each viva will be marked independently by two examiners working with pre-defined scripted questions and structured into four marketing points with a clear marking guide. Viva questions and answers will be written and agreed in advance by experts in the field.

Key resources for the CertLRS