Requirement to Pass Ophthalmology Foundation (OF) Examinations
for Eligibility to Apply for an OF–IOFF Fellowship
–Effective for Applications for the September 2027 Fellowship Intake
In our mission to provide high-quality training and education to ophthalmologists around the world, we wish to encourage a lifelong journey of continuous learning, especially for those early in their careers.
Taking and passing the Ophthalmology Foundation (OF) Examinations is an important first step that may later lead to the opportunity of pursuing a fellowship abroad. To this end, we have made the following policy decision.
Purpose
From the September 2027 OF–IOFF Fellowship intake onward, applicants will be required to have successfully completed Ophthalmology Foundation (OF) Examinations, either via the standard pathway (Visual Sciences and Optics, Refraction & Instruments) or via the exemption plus Clinical Ophthalmology pathway, as a prerequisite for submitting a fellowship application, according to one of the defined routes below.
This requirement aims to:
- Ensure a standardized baseline of ophthalmic knowledge among fellowship applicants.
- Support high-quality subspecialty training by confirming core theoretical and clinical competence.
- Complement, not replace, local specialist examinations and residency training.
- This change is being announced well in advance to give potential applicants ample time (approximately 20 months) to prepare and complete the required examinations.
Scope
This policy applies to:
- All OF–IOFF subspecialty fellowship positions offered in the September 2027 intake and thereafter. It does not change other existing eligibility criteria (e.g. completion of ophthalmology training, local specialist certification, references, and institutional support), which remain in place.
OF Examination Requirement
To be eligible to apply for the September 2027 OF–IOFF Fellowship intake and thereafter, a candidate must meet the OF examination requirement via one of the following routes:
Route A – Standard Pathway
The candidate has passed both of the following Ophthalmology Foundation Examinations before submitting the application:
- Visual Sciences
- Optics, Refraction & Instruments
Passing both examinations is required to meet the OF exam prerequisite under Route A.
Route B – Exemption + Clinical Ophthalmology Pathway
The candidate:
- Holds a formally recognized exemption from the OF Visual Sciences and Optics, Refraction & Instruments examinations, as granted by the Ophthalmology Foundation Examinations Office; and
- Has passed the OF Clinical Ophthalmology Examination before submitting the fellowship application.
Under Route B, a candidate is not required to take the OF Visual Sciences and OF Optics, Refraction & Instruments examinations, provided that:
- The exemption is formally documented by the OF Examinations Office; and
- The candidate has successfully completed OF Clinical Ophthalmology.
The Clinical Ophthalmology examination remains a more advanced, clinically focused assessment and is recognized here as an acceptable alternative route for those whose prior qualifications have already been accepted by OF as equivalent to Visual Sciences and Optics, Refraction & Instruments.
For the purposes of OF-IOFF Fellowship eligibility, Route A and Route B are considered equivalent.
Recommended Examination Pathways (Optional Guidance)
While eligibility can be achieved via Route A or Route B as defined above, the following staged pathway is recommended when feasible:
Early in training:
- Take Visual Sciences to consolidate basic science and systemic knowledge related to ophthalmology.
Mid-training:
- Sit Optics, Refraction & Instruments to ensure competence in optics principles, clinical refraction, and use of key ophthalmic instruments.
Later in training (optional but strongly encouraged):
- Attempt Clinical Ophthalmology, which assesses broad clinical knowledge and decision-making and may represent a capstone of the OF examination pathway. For those with OF-recognized exemptions from Visual Sciences and Optics, Refraction & Instruments, Clinical Ophthalmology will also serve as the qualifying examination for OF–IOFF fellowship eligibility (Route B).
This pathway is advisory, but compliance with Route A or Route B is mandatory for OF–IOFF fellowship eligibility from the September 2027 intake onward.
Timing and Transition
Applications for Fellowships Before the September 2027 Intake
- The OF Examinations are encouraged but not compulsory.
- Any OF exam passes may be included as added strength in the application.
- Points are awarded for successful completion of OF Examinations.
Applications for the September 2027 Intake (and any later intakes covered by this policy)
At the time of application, candidates must already satisfy Route A or Route B:
Route A – Standard Pathway
The candidate has passed both:
- OF Visual Sciences
- OF Optics, Refraction & Instruments
Route B – Exemption + Clinical Ophthalmology Pathway
The candidate:
- Holds official OF exemptions from both Visual Sciences and Optics, Refraction & Instruments; and
- Has passed OF Clinical Ophthalmology.
It is the candidate’s responsibility to:
- Register for the examinations in good time.
- Sit and pass the relevant examination(s) as required by the chosen route.
- Obtain all necessary certificates and exemption confirmations before the relevant application deadline.
Documentation Required with the Application
Applicants must upload, as part of the September 2027 fellowship application:
1. Proof of OF Examination Passes
Depending on the route:
Route A – Standard Pathway
Official certificates or formal confirmations of pass for:
- OF Visual Sciences
- OF Optics, Refraction & Instruments
Route B – Exemption + Clinical Ophthalmology Pathway
Official OF exemption documentation confirming recognized exemption from both:
- OF Visual Sciences
- OF Optics, Refraction & Instruments
Official certificate or confirmation of pass for:
- OF Clinical Ophthalmology
All certificates must clearly show:
- Candidate’s full name
- Name of the examination passed
- Date of the examination
2. All existing standard OF–IOFF application documents, for example:
- Curriculum vitae
- Evidence of completion of residency or specialist training in ophthalmology
- Copies of relevant degrees or certificates
- Letters of recommendation
- Statement of career goals and fellowship objectives
- Any additional documents specified in the call for applications
If any OF certificates or exemption letters are not in English, a certified English translation should accompany the originals.
Verification and Integrity
- The OF–IOFF Fellowship Office reserves the right to verify the authenticity of any OF examination certificate or OF exemption letter with the OF Examinations Department.
- Submission of falsified or altered documentation will result in immediate rejection of the application and may be reported to the appropriate professional or regulatory authorities.
- The OF office may provide the IOFF office with a list of successful candidates’ examination outcomes and exemptions for verification and quality assurance.
Appeals and Exceptions
- Routine exceptions will not be granted.
- In truly exceptional circumstances (e.g. examination cancellations in a particular region, major disruptions), applicants may submit a written request for consideration of an exception, with full supporting documentation.
- Any exception is at the sole discretion of the Fellowship Committee and applies only to the specific application cycle in which it is granted.
Preparation and Support
Applicants are encouraged to:
- Consult the official OF Examination syllabi and guidance materials.
- Align exam preparation with their ongoing clinical work and academic program.
- Seek support from training supervisors and local educational bodies where available.
Successful completion of the required OF examinations—whether via Route A (Visual Sciences + Optics, Refraction & Instruments) or Route B (Clinical Ophthalmology with recognized exemptions)—not only fulfills the fellowship requirement but also builds a strong foundation for further examinations, subspecialty training, and a career of lifelong learning.