Refraction Certificate

The Refraction Certificate is an exam which assesses competence in practical refraction, an essential requirement for ophthalmologists. This exam is part of the Fellowship examinations.

New Hybrid Exams from November 2022

The Refraction Certificate Examination will adopt a new hybrid format beginning from November 2022.

After two years of running specially adapted examinations without real patients due to the COVID-19 pandemic, the Refraction Certificate examination will now adopt a new hybrid format from November 2022.

This new hybrid format will see the re-introduction of some patients into the exam, utilising a combination of patients alongside the retinoscopy simulators that were introduced in 2020.

This will mean that 2 of the 5 OSCE stations will still use the retinoscopy simulators that have been used over the past two years but stations 3-5 will once again use real patients and re-introduce subjective refraction.

Please note that the July 2022 sitting of the Refraction Certificate in Glasgow will still be the current COVID-era format. The first new hybrid exam will be the November 2022 sitting in Cairo followed by the December 2022 sitting in London.

For the new hybrid exam beginning in November, please refer to the 2022 Refraction Certificate Information Pack – New Hybrid Exams for full details.

FOR THE JULY 2022 EXAM ONLY, please still refer to the 2022 Refraction Certificate Information Pack as well as the COVID proof RefCert – FAQs

Who can sit the exam?

No previous experience is necessary to sit this exam however candidates who have not undertaken a large number of clinical refractions in a clinical setting are unlikely to pass the exam. Previous candidates will have completed 50 to 100 full refractions in preparation for the exam.

Anyone who is medically qualified is eligible to sit the exam if they hold a primary medical qualification which is approved by the General Medical Council or Irish Medical Council. If you hold a non-GMC or non-IMC approved medical degree certificate you must have your certificate attested before you can apply for the exam.

You can take the exam before, during or on a break from a GMC-approved training programme.

If you are a candidate in OST you must pass this exam before entering your fourth year of ophthalmic specialist training. If you have previously registered with the General Optical Council as an optometrist you are exempt from this certificate, however you must apply for exemption with the Exams Team.

Candidates are permitted a maximum of six attempts to pass this exam. Tests taken before August 2013 do not count towards the number of attempts.

Overseas Candidates

If you have an overseas medical qualification and you are not registered with the GMC already, you must submit an attested copy of your certificate when applying. You can provide this to the Exams team when they are setting up your booking.

If you are an overseas candidate and/or you are NOT registered with the GMC, you must email [email protected] for a physical application form and further instructions. You must do this the first time you want to book an exam.

Candidates with GMC registration or those on an official OST programme

If you don’t currently have an online account you must follow the instructions to create an account. All applications to sit exams are assessed by the Exams department. Once your eligibility has been assessed you will be emailed to confirm if your place has been reserved to sit the exam.

How do I book the exam?

Booking the exam will depend on whether you are already an RCOphth member or previous exam applicant  – or whether you are a first-time exam applicant:

If you have yet to sit the Part 1 FRCOphth exam or the Refraction Certificate you are required to submit attested proof of your medical degree certificates. If you are registered with the GMC or Irish Medical Council you must provide your number on your application form.

If you are re-taking the exam or have already sat the Part 1 FRCOphth Exam you will have an online login which you can use to book the Refraction Certificate exam via our Book an Exam page. Our exams open at certain times throughout the year. If you are unable to find the Refraction Certificate Exam in the list of tests to book this means it has not opened for booking yet. A full calendar of all exams and their open and close dates is available here.

Read the 2022 Refraction Certificate Information Pack for further information on eligibility and applying for the exam.

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 Refraction Certificate exam consists of an Objective Structured Clinical Examination (OSCE). Candidates will be assessed at 10 OSCE stations in five rooms. These include double retinoscopy stations where candidates will assess three patients and perform retinoscopy on each eye and rooms where subjective refraction is involved. Each station has a 10-minute time slot and timings will be strictly adhered to. Each OSCE station is worth 15 marks out of a total of 150 and examiners will be present throughout the cycle.

Read the Information Pack for further information on the structure of the exam.

Electronic Examination 

The examination became a fully electronic exam from December 2020 and instead of paper marksheets, candidates will be required to input their answers for each OSCE station into an iPad.

Candidates are strongly recommended to read this iPad Screenshots for Electronic Refraction Certificate Examination document and view the video below that details the look of the iPad marking system and how answers are inputted, how it is timed etc.

Refraction Certificate Examination – iPad Marking System Tutorial Video

We also have an online demo of the iPad exam, where candidates can practice a mock exam using the iPad software used which will be identical to the real examination:

To use the demo, click this link http://rcophthexams.org 

And then select Refraction from the top of the screem, which will launch the demo exam.

How will the exam be marked?

All examinations are pass mark set.  The Refraction Certificate OSCE is pass mark set using the Hofstee method. The pass mark setting methods quoted are subject to change at any time at the discretion of the College.

Candidates are required to pass the OSCE.  If awarded a fail, candidates must re-sit the entire examination, even if a pass was previously achieved in any station.

When will I receive my exam 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 email and the pass list will be displayed on the College website.

Please note that successful candidates do not receive a certificate for passing the Refraction Certificate. The only certificate issued is for completion of the whole FRCOphth qualification (Fellowship certificate), not for individual components.

Appeals information can be found on our Policies and Procedures page.

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 Refraction Certificate 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.

Frequently Asked Questions and other key information

Commonly asked questions about the Refraction Certificate can be found here.

Other key information

Find below a list of useful resources:

Explore this demo version of the Refraction Certificate iPad Exam, that candidates can practice with. Please select Refraction from the top of the screen when following the link below.

Demo Refraction Certificate iPad Exam