Dr. Mohammad Ihsan Fazal (BMBS, BSc)
Foundation Year Two Doctor, Watford General Hospital, West Hertfordshire Hospitals NHS Trust, UK
Introduction to the Duke Elder Exam
This article is a guide to help you prepare for the Duke Elder exam. The Duke Elder Exam is an undergraduate award exam available to medical students in the UK and Ireland. If you are even slightly considering ophthalmology as a career you should sit the exam because it is worth application points which you simply cannot get after graduation. This is especially important when considering how competitive the application process is.
If you are not familiar with the Duke Elder Exam format or content then a great starting point is the Royal College of Ophthalmologists website. There they have a comprehensive summary of the exam logistics and registration. Additionally, they link to a Duke Elder exam handbook which goes into more detail on the curriculum tested. The handbook gives you a list of topics which you can use as a guide to organise your revision.
Where to start
In many medical schools you only get a token 2 week placement in opthalmology and have little exposure to the field. Considering this, it is important to start your revision with the basics. Learn the anatomy of the eye in detail. Doing so will give you a better understanding of the diseases and will allow you to answer the straightforward anatomy questions.
There are many useful resources to do this. One that is particularly good is Dr Najeeb Videos – free on youtube. If you have never heard of him, he will teach you from the absolute basics to an expert level. The videos can be lengthy but it is well worth the time investment (and watching at double speed is always an option). Here is a playlist of his ophthalmology series – get a pen and paper ready!
Which books are best for the Duke Elder Exam?
If you prefer book work, there are several good options. I will start with basic texts for the beginning of your revision before exploring the more advanced books.
Ophthalmology: An Illustrated Colour Text
Firstly, there is the Ophthalmology volume of the well known ‘Illustrated Colour Text’ series. This will give you a good overview of the subject without being overwhelmed by the details. However, you might find that the less detailed approach will not give you the same level of confidence.
The book does a good job at covering common diseases and investigations. However, it has two chapters about history taking, which although useful for real-life, is not relevant for the exam (we also have an article covering history taking if you are interested).
Ophthalmology at a Glance
Secondly, another good starter text that you are likely familiar with is the Ophthalmology book from the ‘At a Glance’ series. Similar to the illustrated colour guide it provides a basic overview of the field with several chapters useful for working in clinic (such as how to document examination findings).
In addition to this it has very good sections on pathology, well suited for people who prefer lists. The book has headings of a condition’s name followed by bullet point facts alongside high quality photos of pathology (this is incredibly useful for the Duke Elder exam as you may be asked to recognise a condition from a photo).
Ophthalmology (Lecture Notes)
Third, this text is a step up from the previous two. Lecture notes is more detailed and has less focus on professional / clinical skills. It is packed full of images and covers a wide range of conditions making it an excellent primer for the Duke Elder Exam. However, it does not quite reach some of the niche conditions you come across in the harder questions.
Kanski’s Synopsis of Clinical Ophthalmology
The world renowned Kanski’s Synopsis is an excellent book and very useful for the Duke Elder Exam. It covers a huge range of conditions and has a plentiful supply of high quality photos. The great thing about it is that it is a synopsis so it has condensed lists of facts perfect for exam revision. However, it does require prerequisite knowledge of anatomy as this is not really covered. Personally, I used this heavily in the weeks leading up to the Duke Elder Exam and I found it invaluable.
Question Banks for the Duke Elder Exam
When it comes to revising for medical exams we are all familiar with doing question after question for hours on end. Unfortunately when revising for the Duke Elder exam, good quality questions are harder to come by. The main places to look are Professor Chua’s website (link) and EyeDocs.
Chua has a few question papers including questions reported from previous candidates but they do not all have answers and the website in general is quite dated. It is a good starting point as the questions are fairly representative of the style of the actual exam and it is completely free!
Eyedocs is good but costs £60 for a 6 month subscription. Helpfully they do have a set of free questions which you can find here but you will need to sign up for a free EyeDocs account first. There a lot of questions to learn from and they cover the entire range of the curriculum. If you do buy the premium subscription start revising early and get your money’s worth!
Fantastic Post!
We completely agree with your point about the question banks. That’s why we developed prepdukeelder.com. With over 1200 MCQs and an integrated textbook, we hope it will make preparation much easier for new candidates!
Great guide! There’s also a few hidden gem secret resources that no one seems to be talking about but they helped me get in the top 10%.
The first is the book 180 MCQs for the Duke Elder. A few top scorers wrote this one and it’s really representative on the Duke Elder questions.
The other is the STInterview Duke Elder course which is also run by top 10 scorers. It’s a bit more pricey but you get what you pay for