Usman Raja
Ophthalmology is a run-through training programme that doctors can typically apply for after completing the foundation programme. A run-through programme allows trainees to be given the training that covers what is expected from them in a specialty after one selection process as opposed to uncoupled training that typically requires a total of two stages of an application and selection process (1).
Ophthalmic Specialist Training (OST) is a seven-year surgical training programme. The Royal College of Ophthalmologists (RCOphth) have created a curriculum that will lead to certificate of completed training (CCT) (2). Year on year, the competition for OST training spots is increasing, with the latest figures from 2023 showing the ratio of applicants to places was approximately 10:1 (3). Due to the increased competition, medical students may start feeling the need to decide about their specialty of choice during medical school in order to prepare an adequate portfolio and become competitive at the application process.
This article is targeted towards medical students and will provide 5 top tips for medical students who are interested in ophthalmology.
Tip 1: Shadowing and early exposure
When picking a specialty, it is important to consider what a typical day can involve. Making use of shadowing opportunities will provide students the chance to immerse themselves in the specialty and gain experience in the variable nature of the specialty. It is also important to gain experience in all aspects of ophthalmology including eye casualty, theatres and clinics. This will provide valuable insight into aspects of patient care and will help students understand the processes involved in the management of common conditions.
As well as this, shadowing is great for students who want to learn skills in patient interactions. Ophthalmologists in clinics take histories and also examine patients, often providing detailed instructions in order to thoroughly examine them on a slit-lamp microscope. Students would be able to observe how ophthalmologists effectively communicate and empathise with the patients they review.
Tip 2: Speak to those in the specialty
Those currently working in the specialty can provide personal experiences to medical students that are interested in ophthalmology. Firstly, they can provide a realistic perspective in the specialty by advising on the pros and cons which can help students make a more informed decision on their career. They would be able to provide some perspective into the future of the specialty especially on evolving technologies. As well as this, they can give medical students an insight into their reasons for choosing their specialty and answer any questions or misconceptions.
The majority of a doctor’s career will be as a consultant and therefore speaking to consultants about their job is also important.
Tip 3: Attend Ophthalmology conferences and events
Attending ophthalmology conferences and events will provide opportunities for students to network and meet like-minded individuals. This could lead to mentorship and project opportunities which would be useful for medical students interested in ophthalmology.
Conferences will showcase the latest research and advancements in the field and this will provide students a good insight into the future directions of ophthalmology.
Most conferences and events offer workshops where attendees can attend and practice surgical techniques and using innovative equipment. This is useful for medical students as it provides an opportunity to gain experience in practical skills.
Conferences also allow students to present their work and allows them to gain experience in sharing their work and receive feedback.
Tip 4: Engage in projects
Engaging in projects is good for any medical student. It will teach vital research skills such as reviewing literature, collecting data and statistical analysis. These skills can be used in any future projects and are vital throughout a medical career.
Projects can lead to further opportunities such as presenting them at conferences or publication in journals. This will enhance portfolios and will strengthen future applications.
Tip 5: Look at the ophthalmology portfolio requirements
For OST1 2024 entry (4), the portfolio contributes to 50% of the final mark. There are a few aspects of the portfolio that medical students can start on in order to score highly in the portfolio.
Students can sit the Duke Elder examination. This exam is produced by the RCOphth and can only be sat once a year. The content is at a level that is slightly higher than what is expected for medical student final examinations. Scoring in the top 10% gains 2 marks in the portfolio, top 20% leads to 1 mark and top 60% leads to 0.5 marks.
Undertaking an elective and also an ophthalmology-related project also gain 1 mark respectively which medical students can also do.
In summary, ophthalmology is a competitive but very rewarding specialty. This article provides some guidance for medical students interested in ophthalmology.
References
- Garg M, Collyer J, Dhariwal D. “Run-through” training at specialist training year 1 and uncoupled core surgical training for oral and maxillofacial surgery in the United Kingdom: a snapshot survey. Br J Oral Maxillofac Surg. 2018 May;56(4):327-331. doi: 10.1016/j.bjoms.2018.03.008. Epub 2018 Apr 5. PMID: 29628171.
- The Royal College of Ophthalmologists (2016) Curriculum for Ophthalmic Specialist training, The Royal College of Ophthalmologists. Available at: https://curriculum.rcophth.ac.uk/curriculum/ost/
- Health Education England. (2023) 2023 Competition ratios, NHS England. Available at: https://medical.hee.nhs.uk/medical-training-recruitment/medical-specialty-training/competition-ratios/2023-competition-ratios
- Health Education England. Severn Postgraduate Medical Education Ophthalmology: Evidence Folder [online]. 2024 available from: https://www.severndeanery.nhs.uk/recruitment/vacancies/show/oph-st1-24/evidence-folder-lib