Advanced FEBOS-CR Exam/ Diploma (Cataract and Refractive Surgery) The FEBOS-CR Examination

FEBOS-CR has been developed by the EBO and ESCRS to certify the expertise and advanced knowledge of experienced cataract and refractive surgeons. Successful candidates earn the right to use the post-nominal title FEBOS-CR to show they:

  • hold a superior theoretical and practical knowledge
  • can deal with more challenging cases and a complex case mix
  • appreciate the importance of evidence-based medicine, and its purpose in developing scientific knowledge and clinical practice of the subspecialty
  • are, or have the ambition to become, trainers and leaders in the cataract and refractive surgery subspecialty
Candidates must therefore be independent surgeons with a varied case mix who regularly deal with complex situations, and who are willing to be challenged by having their expertise and theoretical knowledge tested by a rigorous theoretical examination and interviews with some of the opinion leaders in European and worldwide ophthalmology.

The 2020 examination will take place immediately before the 38th Congress of the ESCRS in Amsterdam, on 2nd October, 2020. The 2020 examination fee is €850.

Overview of the process

It is important for those applying to understand and carefully follow the application process:

  1. Applicants must read the curriculum for 2020, to confirm that they meet the eligibility criteria (listed below, and in the curriculum)
  2. Supporting materials must be submitted by March 27, 2020:
    1. The EBO-ESCRS CV/ Application (download here)
    2. EBO-ESCRS Examination Letter of Recommendation (download here) signed by the Head of Department/ Clinical Director/ Director of Training (If the applicant holds one of these roles, and there is no one in one of the other suitable roles, the practice manager can sign and stamp the letter)
    3. 5-minute MP4 video of one of your complex surgeries, which should include 7 key steps (see here, surgeries will be judged based on the steps listed). ”Complex” is not to be confused with “complicated” or recovery from an initial mistake. The video should showcase your advanced skill and knowledge. If your video is not considered to be complex by the Examination Board you will not be invited to sit the examination.
  3. Applications will be reviewed, and candidates will have one opportunity to rectify any issues with their application or supporting materials by June 1st 2020
  4. Selection will take place in June 2020, and candidates will be invited to sit the examination by early July 2020. Candidates must confirm they intend to sit the examination and pay the examination fee (€850) by July 31st 2020.
  5. In August/September 2020, candidates will be sent between 2 and 4 articles to read for the literature analysis section of the examination. They will be interviewed on one of these articles. A candidate handbook will also be sent, which includes the examination details and rules.
  6. On October 2nd, the examination will take place.
  7. Results of the examination will be released as soon as practicable after the examination (usually next day, but this is no guarantee)

Examination Deadlines

  • December 2019 application process opens
  • 1 July 2020 confirmation for eligible candidates to sit the examination
  • 31 July 2020 deadline for candidates to confirm intent to sit examination, and pay examination fee (€850).
  • 2 October 2020 Date of Examination

    Eligibility Criteria

    Those selected to sit the FEBOS-CR examination will be experienced surgeons, who are active in the community (local, national or international), as demonstrated by a commitment to teaching, research and/or publication. Those awarded FEBOS-CR will be (or have the ambition to be) leaders in the cataract and refractive subspecialty, and will be running centres, training fellows, publishing research and continuing to contribute to the scientific knowledge and clinical practice of cataract and refractive surgery.

    Please note: the FEBOS-CR is open to cataract and refractive subspecialists who have completed an ophthalmology residency program in a country member of the UEMS as well as cataract and refractive surgery fellowship training – ESCRS membership is not required.

    To be accepted to sit the FEBOS-CR examination, applicants must:

    • have at least 5 year’s experience operating without supervision, having completed a minimum of 4 year’s general ophthalmology training. This training should be documented by a recognised fellowship programme (FRCOphth, EBOD, etc.)
    • have completed 1,000 cataract surgeries, without supervision
    • be able to demonstrate superior knowledge of cataract and refractive surgery
    • already be involved with/ have experience of supervision of trainees programs
    • have practiced without supervision in an institution that offers adequate capacity and the appropriate infrastructure for high quality, diverse exposure to cataract and refractive surgical cases and their management. The institution should have a sufficient number patients as well as an area fully equipped with access to current diagnostic, therapeutic and surgical equipment

    Full eligibility criteria and curriculum is available to download here

    Supporting Materials Required by the Candidate

    • A letter (using this template) from a Director/Head of Department/other senior figure in your Institution that recommends you as a surgeon of advanced experience and expertise. If the applicant holds one of these roles, and there is no one in one of the other suitable roles, the practice manager can sign and stamp the letter. Please click here to download the recommendation letter template.
    • Completed CV/ Application (using this template), which lists surgical, teaching and publication experience. A section of this form also asks for information on the complex video you submit.

    Please note: The ESCRS reserve the right to audit an applicant’s declared surgical experience, by requesting further details. This may be a registry report (e.g. EUREQUO, EMS report, etc), accounts statement (IOLs implanted by the applicant) or an appropriately anonymised log book for the applicant. In all aspects of your application, it is your responsibility to ensure proper data protection and patient confidentiality in the process.

    • One video of one complex case you operated, which demonstrates your current skillset. This video should meet the following criteria (failure to do so will lead to rejection of the video and thus the application):

    Video Submission Requirements:

    • MP4 format, of at least 800 x 600 resolution (1024 or better is preferred)
    • Titled as follows: “LAST NAME_FIRST NAME_CASE TYPE.mp4”
    • Maximum 5 minutes. Editing should not obscure or alter the core surgical procedure.
    • The video must be the sole work of the candidate, and must state that this is the sole work of the candidate
    • There must be no music, narration, or credits on the video
    • Include the following steps (which will be judged to determine suitable candidates for the examination): incision, capsulorhexis, hydrodissection, nuclear dissassembly, irrigation/aspiration, IOL implant and closure. More information is available in the curriculum
    • No FLACS, the surgery must demonstrate your current manual skill set in a complex situation
    • No patient-identifiable information should be included/ remain in the video.
    • Provide the following information about the complex surgery video in the CV/ Application document: Background case data and a short description of what makes the surgery complex for you

    This process will not be considered complete until you have submitted all the information listed above. Failure to submit these documents automatically excludes you from consideration to sit this examination.

    All eligible candidates will be invited to sit the examination no later than July 1st 2020. The Examination Board reserves the right to accept or refuse any applicants based on their eligibility. Their decision is final. Applicants who are found to submit false materials (letter of recommendation, or videos) will be automatically excluded from the process.

    Format of the Examination

    Please note: this examination will be conducted in English only. The examination has 5 parts, divided into two broad sections:

    1. Multiple choice (written) section (2.5 hrs). This is composed of 50 questions formatted as follows:
      • A stem provides a context for the subsequent statements
      • 5 independent statements are provided. Each statement must be marked True, False or Don’t Know
      • A correct answer will score 1 point. An incorrect answer is negatively marked -0.5 points. “Don’t Know” gives a score of 0. Unanswered questions, or “double marked” (e.g. marking 2 or all of True/ False and “Don’t Know”) are negatively marked -0.5 points
    2. Oral exam (1 hour), consisting of four 12-minute stations:
      • In Literature analysis, candidates will be asked to discuss an article, sent in advance of the examination (between 2 and 4 articles are sent earlier in the year). Candidates should be able to discuss the article or identify considerations they would make if they were reviewing the article for a peer-reviewed journal.
      • In Case Study, candidates will be given clinical data and imagery, and asked to discuss the case with their examiners.
      • In Candidate Video, candidates will discuss the video they submitted with their examiners, covering why they chose the technique they did, as well as the complexities of the case
      • In Unseen Video, candidates will take the role of trainer, discussing a video they have not seen, as if the examiners were their trainees. They will provide an ongoing narrative of the surgery, including the likely outcomes of certain surgical steps, as well as alternative approaches and procedures.

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