Should I include everything in my ophthalmology portfolio?

No. The instinct is to submit everything you have ever done, on the theory that an assessor will find the good parts and ignore the rest. That is not how the portfolio is read, and acting on it can cost you points you had already earned.

The useful version of the question is narrower: given a specific piece of work, does it belong in the portfolio? This post is about answering that, item by item. The rules it draws on come from the portfolio webinar SmartOST ran for this cycle's candidates, and they sit alongside the sixteen unwritten rules, which cover the whole picture in less depth.

First, read the evidence folder properly

Every decision below is a decision about one document. The recruiter's evidence folder guidance sets out each evidence type and the conditions attached to it, and those conditions are what an item has to meet. Read it before you sort anything, rather than after.

Read it for wording rather than for gist. A national meeting and a regional meeting are separate lines with separate point ladders, and a quality improvement project that has to fall within three years of the interview excludes a project from four years ago however good it was. One of the webinar's presenters says almost every portfolio they have looked at has some mistake in it, and a mistake of this kind is a point lost to reading rather than to achievement.

The domains and the rules that decide whether something counts are published in full. Very few candidates have read them as closely as the person marking has.

The cheapest points are in work you have forgotten

Before you go looking for new work to do, go backwards. An audit you ran in a first foundation post. A student project nobody has asked you about since. A teaching session you gave once and never thought about again. An essay prize from medical school.

Most of the form carries no time limit, so work you stopped counting years ago is still claimable. Two parts of it do carry one, and they are worth checking before you spend an evening digging: a quality improvement project has to fall within three years of the interview, and multi-source feedback within eighteen months if you are currently in a clinical post. Everything else is fair game however old it is.

That makes an afternoon of remembering the best rate of return available this late. It produces items you already hold the evidence for, which is not true of anything you start now.

Push a little on borderline work

Between the work that obviously scores and the work that obviously does not sits a third pile: work that would meet an evidence type if somebody explained how. Claim that work, and do the explaining.

A supervisor letter is how you do it. A letter naming the evidence type, the dates, the setting and what you actually did leaves an assessor nothing to infer. Without one they have to decide against you, because they cannot award points for a version of events they have had to invent. What to ask a supervisor for has a template you can send.

Push on that pile. Pushing on everything is a different move, and what it costs is two sections below.

Take out what clearly will not score

An item that matches no evidence type does not sit there harmlessly. An assessor works through a portfolio in order, and every page that cannot score is time spent away from the pages that can.

Two kinds of work qualify for removal. The first is work that meets no evidence type at all. The second is work that is already redundant: one piece of work counts once, and each domain it could go in has its own cap, so a fifth presentation in a domain you have already filled is not a small gain but no gain, and it is not free either. Before cutting a redundant item, check whether it can legitimately be claimed somewhere you are short. Where it can, the question is which domain has room rather than which is the better fit.

What overfilling actually costs

Two different things, and they are worth separating, because one is published and one is not.

The published one. The recruiter's guidance for the 2026 cycle gives each domain a list of contents, and then says it is important to follow that list "as precisely as possible as marks may be deducted for including unnecessary information" (archived copy, since the live page has gone; the 2027 guidance is not out yet).

Read that closely, because it is narrower than it first looks. The published penalty is for putting in material the list does not ask for. It is not a penalty for the portfolio being thick. Padding a domain with things nobody asked to see is the stated risk; holding a lot of work that the list does ask for is not.

The one that is not. The webinar's presenters go further and say that excess shows up specifically as a poor result in overall portfolio layout and quality. That is their reading of how portfolios are marked rather than anything the guidance states. The published description of that domain is one sentence, "How the portfolio is presented in layout and organisation will be assessed", and it says nothing about how much you include. Weigh it as experience, which is worth having, but do not treat it as a rule you can look up.

Either way the conclusion is the same. Surplus is not free, so it has to earn its place like everything else.

A test for each item

Three questions, in this order, all three answerable from the published domains, caps and evidence rules. If an item fails the first, the others do not matter.

1. Does it match an evidence type? Not "is it impressive", not "did it take a long time". Does it meet the stated conditions of a line you can point to?
2. Is the domain it belongs in already at its cap? If it is, the item scores nothing wherever you put it, unless it can legitimately go somewhere you are short.
3. Can you prove it? No points without third-party evidence. If the certificate is lost and the supervisor has moved on, the honest answer may be that the work does not go in.

Anything that passes all three goes in. Anything that fails the first should come out. The middle ground, work that passes one and two but has thin proof, is where a supervisor letter earns its keep.

Where to go next

The sixteen unwritten rules cover the rest of what the webinar taught, including how to present what you have decided to include. For the domains, the caps and the evidence rules themselves, see what the ophthalmology ST1 portfolio actually requires.