Ophthalmology Specialty Training (OST) Portfolio Criteria (2022 changes)

Ahmed Elsaadawy

Over the years, most specialty training programs slowly change their acceptance criteria to become more challenging. This can be attributed to different factors including the number of applicants increasing each year across all specialties.

This year, there has been few changes specifically to the OST (Ophthalmology specialty training) criteria compared to last year, which was met with both positive and negative reactions. For instance, in 2022, you can get 1 extra point for attending 10 clinic/theatre sessions outside of the main taster week. On the other side, MSF remains one of the easiest points counting towards your overall portfolio score but this year MSF was reduced from 5 to 4 points only as maximum (see table below). Details of the most recent criteria is found below, as well as the new changes in 2022 (in red).

Evidence Folder

Until the time of writing this article, candidates are allowed to submit their portfolio evidences on-line in the first half of February. This follows your submission of the main OST application in November and attempting the MSRA in January (please see Oriel in the year you are applying for accurate dates). Further information about the on-line evidence portal is usually sent to candidates just before the portal opening.

Below are the main domains (as per the official “severndeanery.nhs.uk” website)

 Domain Headings Guidance
List of Previous postsPlease include a list of all your previous posts (your most recent post first). If you are not currently working within a clinical post please specify. This will not be scored. 
Qualifications with certificates or letter of proofCUMULATIVE SCORING (Maximum 4 points)    1 point – per qualification – MSc, BSc (including Optometry degrees but NOT intercalated degrees)   [2022 change: Intercalated degrees are no longer awarded points]   2 points- for an MD thesis as part of a degree taken after the primary degree   3 points – for a completed PhD or DPhil.    MRCP, MRCS, Diploma in Child Health are not scored.  
Prizes/Awards with proof CUMULATIVE SCORING (Maximum 5 points)   1 point each- for Best presentation or poster at a national or international meeting, successful research grant application   2 points – for Crombie Medal (stood 1st in FRCOphth part 1 exam)   2 points – 1st in final undergraduate degree

National Undergraduate prize through competitive examination (in any specialty) e.g. The Duke-Elder prize:   2 points for coming in top 10% of entrants   1 point for being in the top 60% (or a pass in 2016 or earlier exam sittings)

Ophthalmology specialty links and commitment to date as a careerCUMULATIVE SCORING (Maximum 12 points)  Refraction Certificate:  2 points     FRCOphth Part 1: 3 points    Non-peer reviewed publications & case reports in ophthalmology or other research publications in ophthalmology not included in other sections: 2 points max (1 point per piece if first author otherwise half the points awarded)     Ophthalmic elective and/or separate undergraduate project:  2 points max (1 point per achievement)    Taster week: 1 point max.    Attending ophthalmology clinics and theatre sessions outside of a formal taster week (minimum 10 sessions with dates & supervisor-signed evidence): 1 point max [2022 change: 1 point can be awarded for attending additional sessions OUTSIDE of the taster week]

EyeSi assessments (minimum 4 hours): 1 point max    Evidence of other ophthalmology simulation training: 1 point max  [2022 change: Potentially referring to the Royal College introduction to Ophthalmic surgery course, but this is not specified]   Meetings attended: 3 points max 2 points max for National / International Ophthalmology educational meetings attended (1 point per meeting) and1 point max for Regional Ophthalmology meetings attended (0.5 points per meeting)    Evidence not included above- discretionary: 1 point max. (not including taking Duke-Elder or WBAs) [2022 change: NEW]

Multi-Source Feedback (MSF)(Maximum 4 points)    The MSF must have been taken place within 18 months of the interview date if the candidate has been in clinical posts for this period. Candidates not currently within a clinical post who do not have an MSF within the timeframe (e.g. undertaking a longer period of research or an extended period of leave) should include the MSF from their most recent clinical post.    The MSF should include feedback from a minimum of 5 respondents if in a general practice post or 7 respondents if in a hospital post.  Your educational supervisor or equivalent supervisor should collate this information and summarise it in a report. The report should include the period the MSF covered.    The report must be signed by the educational supervisor or department lead and stamped with a departmental stamp.  If including a standard Team Assessment Behaviour Form (TAB) printed from E-portfolio it does not require a signature or departmental stamp.    For candidates without access to an on-line portfolio or unfamiliar with the MSF process information can be accessed from the link below.  Click for:  Multi Source Feedback Guidance  Points will be awarded as follows:  0 points – for significant negative comments  1 point – minor negative comments or non-satisfactory scores  2 points – satisfactory scores with limited good comments  3 points – satisfactory scores with appropriate good comments 4 points – satisfactory scores with multiple superlative positive comments  [2022 change: Points awarded for MSF has been reduced to 4 points instead of 5 last year. Also some clarifications were added to the criteria]
Publications(Maximum score 6 points)    Evidence: List of peer-reviewed original research publications with a photocopy of the first page of each paper   No marks will be given without a copy of the first page of either a published or accepted for publication paper and in the latter case evidence of final acceptance for publication must be presented.    Please use the standard pro forma to list each piece of evidence including the citation of the journal (author’s name(s), article title, journal name/title, volume of journal, issue number of journal, page or range of pages, year of publication and DOI or URL) and indicate whether you were 1st, 2nd, 3rd or 4thauthor.    3 points – for each publication where you are 1st author or joint first author   1 point – for any other publications up to 4th author (unless > 8 authors in total for article when 1st author only counted)    0 points – if you are 5th author or lower in the citation   0 points – for case reports. This evidence can be included in “Ophthalmology specialty links and commitment to date as a career” if the work is in Ophthalmology  [2022 change: 5th author or lower is no longer awarded points] [2022 change: Some clarification about case reports not being awarded points in this section]
Quality improvement / Audit projects(Maximum score 5 points)    Copy of your best QI project or audit, performed within the last 3 years of the interview date, with a short summary of your specific role in the project / audit.  The audit should have standards, outcomes and recommendations and be signed by the supervising consultant.    Note: covering letter or certificate are necessary for proof of presentation    Points will be awarded as follows:  0 points – if no evidence of QI / audit work in portfolio   1 point – for participation but no specific roles documented or specific format followed.    2 points – for initiation and design of the QIP / audit and some evidence of specific format.    3 points – for initiation, design and writing up the QIP / audit and specific format followed.    4 points – as above and was personally involved in implementing the QI strategy / completing the audit loop and implementing change   5 points – for published audit or QI guidelines implemented supra-regionally.    Note: Some modification of these marks may be made dependent on quality of project and impact of the work. If you are not clearly lead on the project then the maximum score is 1 point    [2022 change: Harder to score full points in this section compared to previous years]
PresentationsCUMULATIVE SCORING (Maximum score 6 Points)    List of presentations and copies of abstracts or posters, stating whether it is a poster presentation or oral presentation.  Proof through abstract book or signed letter from supervisor.    1 Point – Regional presentations (For example regional ophthalmology society meetings or other specialty equivalents in the UK or regional ophthalmology meetings of other countries or equivalent non-ophthalmology meetings)

  2 Points – National presentations (For example British Oculoplastic Surgery Society, or other specialty equivalents in the UK or national ophthalmology meetings of other countries or equivalent non-ophthalmology meetings)     3 Points – International meetings – (For example Association for Research in Vision and Ophthalmology, American Academy of Ophthalmology, RCOphth Congress etc or equivalent non-ophthalmology meetings)    NB: The same paper presented at different meetings will only be counted once e.g. the highest-ranking meeting.  Accepted presentations, but not yet presented, will be awarded points

Oral presentations score points as shown above, e.g. 2 points at national meeting

Poster presentations score half points shown above, e.g. 1 point at national meeting

Second author or lower scores a half of the oral presentation or poster points, e.g. 0.5 points for a poster at national meeting

Education and TeachingCUMULATIVE SCORING (Maximum Score 5 Points)    Scores will be awarded as follows;    1 point each – for designing an educational course or e-learning tool, writing an e-book, completing a “teaching the teachers” course, formal role in examining undergraduates

2 points – for writing a chapter in a textbook (not an e-book)

3 points – for writing a book (not an e-book)

3 points – for a higher teaching qualification e.g. a Diploma, Certificate or Masters in Medical education

All must come with photocopies of a chapter index, attendance certificate or a signed letter from a supervisory Consultant/ Educator etc. as supporting evidence. Specific evidence demonstrating impact of e-learning projects must be presented. Specific evidence of impact of e-books in numbers downloaded or otherwise accessed must be presented.   [2022 change: e-books are now awarded less points and points now include and consider download numbers]    
Overall portfolio layout & quality(Maximum Score 3 Points)  Layout, organisation and quality of how it is presented will be assessed. 


There are some points that can be more easily awarded, especially in the commitment to speciality section. Additionally, different points are rewarded for research and presentation, however, this section requires more time and effort and might be best planned well ahead application time to find appropriate senior support and allow time for submission/presentation.

Further Reading



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