How the ophthalmology ST1 self-assessment is scored

Scoring is a ladder, not a judgement

Each domain has a list of item types, and each type carries a fixed number of points. You are not making a case for how impressive something was. You are identifying which rung of a published ladder it sits on, and the rung decides the number.

This is good news and bad news. The good news is that it is completely predictable: you can work out what your portfolio scores today, exactly, before anybody else looks at it. The bad news is that effort does not enter into it. A piece of work that took a year and a piece of work that took a weekend score the same if they sit on the same rung.

The presentations ladder, which catches people out

Presentations are capped at six points and the ladder is steep. What matters is the level of the meeting and whether you presented orally, not how much work went into the underlying project.

• International, oral, first author: 3 points
• National, oral, first author: 2 points
• Regional, oral, first author: 1 point
• International, poster or video: 1 point
• National, poster or video: 1 point
• Regional, poster or video: 0 points
• Second author, national or international oral, where you did the presenting: 1 point
• Second author, regional oral, where you did the presenting: 0 points

Authorship position is worth two points

Publications cap at six. First or joint-first author scores three points. Second through fourth author scores one. That is a three-fold difference for the same paper depending on where your name sits, and it is the single largest per-item swing on the form.

The practical consequence is about which projects to take on rather than about writing. Two first-author papers reach the cap. Six mid-list authorships do not, and represent far more work.

Audit scores on how far you took it, not how many you did

Quality improvement and audit caps at five, and the ladder measures depth rather than count. Turning up to somebody else's audit is worth one point. Closing the loop is worth four.

• Participation only, no clear role or format: 1 point
• Initiated and designed, with some format: 2 points
• Initiated, designed and written up to full format: 3 points
• As above, plus implemented change or closed the loop: 4 points
• Published audit, or a QI guideline implemented supra-regionally: 5 points

The teaching entries that score nothing

Education and teaching caps at five, and this is the domain where the gap between effort and points is widest. Six common activities score zero on their own:

• Helping with an educational course, two or more sessions: 0 points
• Helping with mock OSCEs, two or more sessions: 0 points
• Designing an e-learning tool: 0 points
• Writing an e-book: 0 points
• Completing a teaching-the-teachers course: 0 points
• Formal undergraduate examining: 0 points
• Three or more formal teaching sessions on different topics, over three months or more, with feedback: 1 point
• A higher teaching qualification, 60 credits or eight months full-time, separate from your primary degree: 2 points

Nothing scores without third-party evidence

This is not a scoring rule so much as the precondition for all of them. A claim you cannot prove with a document somebody else wrote scores zero, regardless of whether it is true and regardless of which rung it would otherwise sit on.

Peer-reviewed work needs a PubMed citation and the first page, or an acceptance letter if it is in press. Courses need certificates showing type and duration. Clinical and project claims need a supervisor letter with dates, setting and duration. And no document you upload may carry patient-identifiable data.

Working out whether you are competitive

The honest answer is that the number you can calculate is your own self-assessment score, and it is worth calculating early rather than late. Everything on these ladders is historical by the time the form opens, so the value of scoring yourself is in the months it leaves you to change the answer.

The one thing worth saying plainly: a low score a year out is a different situation from a low score a week out, and the ladders above tell you which rungs are still reachable.