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 but can also be taken as a standalone examination for optometrists and other non-FRCOphth candidates.

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.

The Refraction Certificate examination is also offered as a standalone examination for candidates who are not intending to complete the whole FRCOphth. Each candidate who passes this exam will be given a digital certificate but no postnominal is awarded.

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 toward 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.

Optometrist Candidates

The Refraction Certificate examination is also offered as a standalone examination for optometrists worldwide who are not intending to complete the whole FRCOphth. Each candidate who passes this exam will be given a digital certificate but no postnominal is awarded. It should also be noted that for optometrists, the Refraction Certificate does not provide anything additional to practice in the UK.

Optometrists must have a medical degree/MCOptom or equivalent qualification from their home country to be eligible to apply for this examination.

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 already have a candidate number with log-in details or have sat the exam previously, you must book your exam here. Please DO NOT use the online application form below as this form is for first-time applicants only.
  • If you have NOT sat any of our exams before and are sitting our Refraction Certificate exam for the very first time, you MUST use this online application form:

Online Refraction Certificate Examination Application Form

IMPORTANT: Please do not use multiple email addresses to complete the application form, as this will delay the approval process. If you have been asked for further documents, please email them to [email protected]

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 are available here.

Please note that first time applicants must still submit their application BEFORE 5pm on the published closing date. They will then be sent a payment link and payment must be completed BEFORE 5pm the day after the published closing date.

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

Please note that candidate exam confirmations are sent within 10 working days of the closing date to the email address that the candidate registered with. If a candidate has failed to receive their exam confirmation email after this period, then they must contact the exams department immediately. Refunds will not be given if a candidate fails to let the College know in good time that they did not receive their confirmation email.

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.

The examination has a hybrid format, utilising a combination of patients alongside retinoscopy simulators.

Please refer to the Refraction Certificate Information Pack – New Hybrid Exams for full details.

Please also read the Hybrid Exams Refraction Certificate – FAQs

IMPORTANT NOTE: You will only be required to attend the examination on one of the days during the week that the exam is scheduled to take place.

Electronic Examination 

The examination became a fully electronic exam from December 2020, and instead of paper mark sheets, 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 

And then select Refraction from the top of the screen, 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.

Results will be released by the deadline in our published examinations calendar, and we only publish them early if they are ready and at our own discretion. Please do not contact the Examinations Department asking for when results will be released.

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 has 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


Exam Pass Lists

RCOphth Pass Lists are published online after all marks for an exam have been verified by the senior examiner. Click on the exam you sat to view the pseudonymised results based on candidate numbers.

Exam Reports

As per the General Medical Council’s (GMC) Standards for Curricula and Assessment Systems, abridged reports are provided for the Refraction Certificate examinations from 2009 as “the methods used to set standards for classification of trainees’ performance/competence must be transparent and in the public domain” [Standard 12, Standards for Curricula and Assessment Systems, July 2008].