The 2025 Ophthalmology ST1 Portfolio Scoring Criteria and Key Changes from 2024

Upamanyu Nath

Securing a place in Ophthalmology training has become increasingly competitive, with the most recent competition ratio for ST1 in 2024 soaring to 14:1 (compared to 9:1 in 2023), as per statistics from Health Education England (1). This shows a significant rise from the 3:1 ratio recorded in 2019 (2). This growing demand underlines the importance of a well-prepared portfolio, as applicants strive to stand out in an increasingly crowded field.

This article highlights the key differences between the 2024 and 2025 scoring criteria for the portfolio evidence section, which remains a critical component of the Ophthalmology ST1 application. Applicants typically begin assembling their portfolios based on the previous year’s criteria, available on the Severn Deanery website (3), until the updated 2025 criteria are released in mid-October, shortly before applications open.

Application Overview

While there have been some changes to the portfolio scoring criteria for 2025, the overall application process remains largely unchanged. After taking the Multi-Specialty Recruitment Assessment (MSRA), the top 300 applicants move forward to the interview stage. Scoring well in the MSRA is crucial, as it carries a 20% weight in the final selection score.

Following the MSRA, candidates’ evidence folders are evaluated, with only those scoring above a 40% threshold advancing to the interview. The evidence folder remains the most significant part of the overall application, accounting for 50% of the final score. Once at the interview stage, candidates have a relatively good chance of securing a training spot, with odds of more than 1 in 3.

This article breaks down the section-by-section changes in the 2025 portfolio scoring criteria:

Key Changes in the 2025 Scoring Criteria

Overall Change:

  • An important adjustment for 2025 is the introduction of a rule that any score within a domain ending in x.5 will now be rounded up. However, no rounding will be applied within sections of a domain.

1. Qualifications (Max 5 points)

Qualifications with certificates or letter of proofCUMULATIVE SCORING (Maximum 5 points) Please note that a cross-specialty requirement that intercalated one-year degrees taken during a primary medical degree are not scored has been imposed. Please state explicitly if any additional degrees to your primary degree are intercalated or not intercalated. Any degree designations not mentioned below must have supporting evidence signed by a senior administrator or supervisor stating that degree’s equivalence to one of the categories below. 1 point – per qualification taken as a separate course separate from the primary degree for at least 8 months full-time or equivalent- MSc, BSc, PG Cert (including Optometry degrees but NOT intercalated degrees). 3 points- for an MD or MPhil degree taken as a separate course before or after the primary degree. If you gained your medical qualification in a country where all students are automatically awarded an MD without additional study you cannot claim points for that MD. You may only claim points for an MD/ MPhil where you have undertaken a period of 2 years full time additional study and research and you must present a supervisor’s letter confirming this. 4 points – for a completed PhD or DPhil. You must have undertaken full-time research involving original work, usually of at least three years’ duration, and ideally resulting in one or more peer-reviewed publications. You must present a supervisor’s letter confirming this. MRCP and MRCS are not scored.
  • Changes: No changes for 2025.

2. Prizes/Awards (Max 5 points)

Prizes/Awards with proofCUMULATIVE SCORING (Maximum 5 points) 3 points – for Crombie Medal (1st place in FRCOphth part 1 exam) 2 points – 1st in final undergraduate degree or equivalent e.g. Honours or Distinction where < 15% of the year achieve this. Evidence explicitly demonstrating this must be presented. Achievement in intercalated degrees is not scored. Degrees preceding or following a primary medical degree can be scored on this basis where evidence explicitly demonstrates < 15% of the year achieve this. National Undergraduate prize through competitive examination (in any specialty), e.g. The Duke-Elder prize: 2 points for coming in top 10% of entrants, 0.5 points for being in the top 60% (40th centile or a pass in 2016 or earlier Duke-Elder sittings). For any other prize please indicate the number of entrants and your position. 1 point will be awarded for being in the top 20% of entrants. 1 point each- for each successful research grant application where the candidate was lead author and the application led to substantial peer-reviewed published research. Travel and other bursaries will not be scored unless there are exceptional circumstances/ achievement demonstrated. 0.5 points each- for Best presentation or poster at a national or international meeting (may also be used in evidence for Presentations section). Being highly commended or any other designation will not be scored. 0.5 points each (maximum 2 points within this section) for each prize / distinction/ merit related to substantial parts (i.e. more than 4 weeks full-time) of the medical or dental course or Foundation Programme awarded to no more than the top 20% of students and doctors. Evidence explicitly demonstrating these criteria must be presented. For any other prize please indicate the number of entrants (must be more than 400) and your position.
  • Changes:
    • The 2025 criteria award 1 point for each successful research grant application that leads to a “substantial” peer-reviewed publication, compared to 0.5 points in 2024.
    • A new definition has been added for “substantial” involvement in medical courses or the Foundation Programme, clarifying that it must equate to over 4 weeks of full-time work.
    • Applicants can now also earn points for other prizes, provided they can document that there were over 400 entrants and the candidate’s ranking is specified.

3. Ophthalmology Specialty Links and Career Commitment (Max 12 points)

Ophthalmology specialty links and commitment to date as a careerCUMULATIVE SCORING (Maximum 12 points) Refraction Certificate (or exemption as fully-qualified post-registration optometrist):   2 points   FRCOphth part 1:  3 points or 1 point for attempting the part 1 FRCOphth on at least one occasion. Non-peer reviewed publications (0.5 point each) & case reports in ophthalmology or other peer-reviewed (Pubmed-cited) research publications in ophthalmology not included in other sections (1 point each): 2 points max. within this section (points only awarded if candidate is first author). Please indicate clearly impact of non peer-reviewed publications. Ophthalmic elective and/or separate undergraduate project:  2 points max., 1 point per achievement. Please provide evidence of reflection on achievements. If electives were cancelled due to COVID and evidence is provided that an elective was planned then this can be scored. Undergraduate projects must have supervisor support explicitly stating the project was equivalent to 2 weeks’ full-time work. Taster week: 1 point max. (or evidence presented of a Foundation year attachment in Ophthalmology). Attending ophthalmology clinics and theatre sessions outside of a formal taster week and spaced out over more than 3 months (minimum 10 sessions with dates & supervisor-signed evidence): 1 point max. Evidence of ophthalmology simulation training (including EyeSi experience): 1 point for each activity of at least 4 hours, max. 2 points Meetings attended: 3 points maximum, from which 3 points max for National / International Ophthalmology educational meetings attended (1 point per meeting) and 1 point max for Regional Ophthalmology meetings (including Royal Society of Medicine Ophthalmology Section) attended (0.5 points per meeting). Meetings included in this section must not be included in Presentations section. Evidence not included above- discretionary: 2 point max. (not including taking Duke-Elder, logbook of surgical cases or WBAs).
  • Changes:
    • Being exempt from the Refraction Certificate as a fully qualified Optometrist will also earn 2 points in 2025.
    • Candidates will now earn 1 point for attempting the FRCOphth Part 1 exam.
    • Undergraduate Ophthalmology projects must be explicitly supported by a supervisor, confirming that the project involved at least 2 weeks of full-time work.
    • Both a Foundation year attachment in Ophthalmology and a Taster Week now provide equivalent points.
    • Evidence of ophthalmology simulation training, including EyeSi experience, has been expanded: 1 point for each 4-hour session, up to a maximum of 2 points (up from 1 point in 2024).
    • Meetings included in this section must not be included in Presentations section

4. Multi-Source Feedback (Max 3 points)

Multi-Source Feedback (MSF)(Maximum 3 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 unless including a standard Team Assessment Behaviour Form (TAB) printed from E-portfolio which 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 appropriate good comments 3 points – satisfactory scores with a large number of superlative positive comments, e.g. “best trainee I have ever worked with”.
  • Changes: No specific changes noted for 2025.

5. Publications (Max 6 points)

Publications(Maximum score 6 points) Candidates cannot place the same work in both presentations and publications domains. Please choose which domain to include the work in. Duplicate work in different publications will not be scored. List peer-reviewed original research publications or high-quality systematic review articles (not letters to a journal) with the pro forma information detailed below and then after each pro forma information in turn, upload 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 “in press” paper and in the latter case evidence of final acceptance for publication must be presented. On the pro forma 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 4th author. 3 points for each publication where you are 1st author or joint first author and 1 point for any other publications up to 4th author (unless > 8 authors in total for article when 1st author only counted). If you are one of three or more joint first authors then you will be scored as a second author. If there are more than 6 joint first authors then no score will be given. No points will be awarded in this section if you are 5th author or lower in the citation. No points will be awarded in this section 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. Quality of the work presented and impact of the journal may be taken into account when scoring. Click to download: Publication Pro forma
  • Changes: No specific changes noted for 2025.

6. Quality Improvement/Audit Projects (Max 5 points)

Quality improvement / Audit projects(Maximum score 5 points) A copy of your best QI project or audit, performed within the last 3 years of the interview date, must be uploaded with either presentation slides or a text document showing standards, methods, outcomes and recommendations.  An additional covering letter signed by the supervising consultant explicitly confirming your specific role in the project / audit must be uploaded. This is especially important to confirm the points to be awarded as below. 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 (not to be added to Publications section) 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. 
  • Changes: No specific changes noted for 2025.

7. Presentations (Max 6 points)

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 must be uploaded through an abstract book or signed letter from supervisor. Presentations must be of original work and not didactic lectures. Presentations duplicating work will not be scored. Explicit evidence detailing that all the preparatory work was completed for presentations cancelled due to COVID will be accepted. 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. Regional designation includes specifically English, Scottish, Welsh meetings). Local hospital or university-specific meetings are not scored. 2 Points – National presentations (For example, RCOphth Congress, 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, etc or equivalent international non-ophthalmology meetings.) Meetings in non-UK countries where explicit evidence is not presented as to the international nature of the meeting are scored as national or regional meetings. NB: The same paper presented at different meetings will only be counted once e.g. the highest-ranking meeting. Also: 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 or video 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. Candidates cannot place the same work in both the presentations and publications domains. Meetings included in this section must not be included in Ophthalmology Specialty Links section. Please choose which domain to include the work in.
  • Changes:
    • For 2025, evidence of preparatory work for presentations cancelled due to COVID-19 will be accepted, a clarification not explicitly stated in the 2024 criteria.
    • The 2025 scoring system now provides detailed guidelines on how points are awarded for presentations that have been accepted but not yet presented.
    • Meetings included in this section must not be included in Ophthalmology Specialty Links section.

8. Education and Teaching (Max 5 points)

Education and TeachingCUMULATIVE SCORING (Maximum Score 5 Points) Scores will be awarded as follows; 0.5 points each – for helping with an educational course (more than one session), designing an e-learning tool, writing an e-book, completing a “teaching the teachers” course and/or undertaking a formal role in examining undergraduates. 1 point – for contributing to at least three teaching sessions on different subject areas over a period of at least 3 months with formal feedback uploaded. 2 points – for a Higher teaching qualification e.g. a Diploma, Certificate in Medical education. 2 points – for writing a chapter in a postgraduate-level academic book (not an e-book or self-published book). Specific evidence of the publisher and impact of the book must be shown. 3 points – for writing a postgraduate-level academic book (not an e-book or self-published book). Specific evidence of the publisher and impact of the book must be shown. All evidence must come with either 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 or other teaching achievements must be presented. Specific evidence of impact of e-books in numbers downloaded or otherwise accessed must be presented. No points will be awarded solely for being a teaching fellow or anatomy demonstrator. Any educational activities as above undertaken in those roles will be scored.
  • Changes:
    • In 2025, applicants must contribute to three distinct teaching sessions across different subject areas, whereas the 2024 criteria did not specify this requirement.
    • A clarification has been added stating that points will not be awarded solely for holding positions like Teaching Fellow or Anatomy Demonstrator without documented teaching activities.

9. Overall Quality (Max 3 points)

Overall portfolio layout & quality(Maximum Score 3 Points) Layout, organisation and quality of how the portfolio is presented will be assessed.
  • Changes: No changes noted for 2025.

The 2025 Ophthalmology portfolio scoring criteria introduce subtle, yet impactful changes that prospective applicants must be aware of when preparing their applications. While the overarching process remains similar to previous years, the nuanced adjustments in areas such as prizes, specialty links, and presentations will require careful attention. As competition continues to rise, understanding these changes and tailoring your portfolio accordingly will be critical to securing a spot in this highly sought-after specialty.

References

  1. Health Education England, 2024. Competition Ratios. Available at: https://medical.hee.nhs.uk/medical-training-recruitment/medical-specialty-training/competition-ratios [Accessed 15 October 2024].
  2.  Specialty Applications, 2024. Ophthalmology ST1 Competition Ratios. Available at: https://www.specialty-applications.co.uk/competition-ratios/ophthalmology-st1-competition-ratios/ [Accessed 15 October 2024].
  3. Severn Postgraduate Medical Education, 2024. Evidence Folder. Available at: https://severndeanery.nhs.uk/recruitment/vacancies/show/oph-st1-25/evidence-folder-lib [Accessed 15 October 2024].

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