An Overview of Ophthalomogy Training

Why choose Ophthalmology?

Ophthalmology is a branch of medicine dealing with the diagnosis, treatment, and prevention of diseases of the eye and visual system. Ophthalmology is unique amongst medical specialties. The eye, its surrounding structures and the visual pathways may be affected by a great variety of clinical conditions. Their successful management depends on the ophthalmology team combining the diagnostic and therapeutic abilities of a physician and technical skills of a microsurgeon with an understanding of the whole patient. Ophthalmology integrates with many other branches of medicine. The commonest cause of visual impairment under the age of 65 years is diabetes.

One of the fundamental properties of the eye is that many of its components are transparent. This enables the details of its structure and abnormalities to be observed directly, in a manner not possible for most other parts of the human body. Ophthalmologists are applying new discoveries from the basic sciences to clinical practice. Innovative technologies for imaging the eye have helped to diagnose and treat many conditions, and there have been numerous advances in microsurgical techniques that have improved surgical outcomes. Novel treatments for degenerative diseases of the retina give hope to patients with a previously poor prognosis. These developments make it a very exciting time for the specialty.

As a trainee what can I expect from my training programme?

The Ophthalmology programme is a 7 stage programme (ST1 to ST7), with each stage expected to last 1 year if you are in full-time training. The first 2 stages will be spent rotating through placements in the Newcastle Royal Victoria Infirmary (RVI), Sunderland Eye Infirmary (SEI), Darlington Memorial Hospital and the Cumberland Infirmary, Carlisle. Each placement will be for 6 months, and the aim of the ST1 and ST2 placements is to get a good grounding in General Ophthalmology. It is a requirement of the Royal College of Ophthalmologists that the FRCOphth Part 1 exam must be passed before you can progress into ST3. ST3-7 placements rotate through posts at the RVI, SEI, and James Cook University Hospital (JCUH) in Middlesbrough. Each of these placements after ST2 offers the opportunity for sub-specialty training. Usually, you will spend time in all 3 of these hospitals. It is a requirement of the Royal College of Ophthalmologists that the Refraction Certificate must be passed before you can progress into ST4. By ST5 level, most trainees will have been exposed to all sub-specialty areas and will have acquired most, if not all their Workplace-Based Assessments (WpBA). At the discretion of the School, this would be a good time to develop an area of sub-specialty interest, by choosing to study a sub-specialty area in far greater detail as part of a Trainee Selected Component (TSC) or you can apply for a period of Out of Programme (OOP). You must pass the Part 2 FRCOphth examination by the end of ST7.

Our programme provides training in all sub-specialties. Several of our units are tertiary referral centres giving exposure to basic Ophthalmology and also specialties. Our trainees get very good surgical training. There are local and regional teaching programmes weekly where we cover all areas of Ophthalmology and where we also invite world renowned speakers in their fields. We have a cataract simulator in the region and is available for trainees to access at all times. We also run Wet Labs in Corneas and Trabeculectomy. We run teaching programmes for trainees to assist them in their postgraduate exams and have a high success rate.

What our trainees say:

Ophthalmology is a unique blend of surgery and medicine. I particularly enjoy the fact that lateral thinking is a pre-requisite in my daily clinical practice. Many systemic diseases such as diabetes and thyroid disease can manifest through ocular problems. It is important therefore, to maintain a holistic approach to patient care even though most ophthalmic pathologies are directly visible on examination.

A typical day consists of two clinical sessions. On most days, this includes either seeing patients in an outpatient clinic or operating in theatres. Up to two clinical sessions per week are dedicated to research and audit while Wednesday afternoons are usually reserved for a regional teaching session attended by all Ophthalmic specialty trainees in the region.

Trainers in this deanery take a genuine interest in your training and development. I have always had the opportunity to discuss my goals and plans with my supervisors who then go on to ensure that these aims are met. Many also ensure that I receive sensible careers advice. As a result, I have been able to map out and follow a clear career plan from the outset.

This general culture of seniors taking an active interest in my development enabled me to build a solid foundation with which I was able to proceed confidently to the subsequent years in ophthalmic specialty training. The surgical experience was also exceptional as I was able to perform twenty four full cataract procedures as an ST1.