Please enter your full name in this format - Lastname Firstname
Please provide your GMC number
Are you a resident doctor or a doctor in a non-training post?
Please indicate your ST (stage of training) year if you are a resident doctor, or your status if you are a doctor in a non-training post.
Have you sat the Refraction Certificate before? (NOTE: the Pilot is only for those who have never sat the Refraction Certificate)
Do you intend to sit the Refraction Certificate in May 2026? (NOTE: the Pilot is only available for those who intend to sit the May 2025 exam)
Please indicate the name of your deanery
Please supply your email address
Are you happy for your contact details to be shared for the purposes of the Pilot?