Brief ‘definition’ of specialty
Medical ophthalmology is the diagnosis of eye disorders and the treatment of eye disease and multi-system disease involving the eye, orbit and visual pathways with mainly pharmacological approaches.
Brief run-down of training programme content and duration
Core Medical Training, then four years Higher Specialist Training (HST) in Medical Ophthalmology (Certificate of Completion of Training [CCT] after ST6) comprising one year of general ophthalmology then subspecialty eye clinics combined about half of the weekly sessions rotating through relevant medical specialties.
Exam requirements
MRCP (UK).
Other requirements
Good stereoscopic binocular corrected visual acuity.
Opportunities/expectations for out of programme/research
There is a lot of research going on in eye departments, particularly in the medical sub-specialties. Dedicated time out of programme for research (OOPR) is not a requirement but there are a lot of opportunities for this if trainees wish to pursue it. I am currently a Clinical Fellow in Multiple Sclerosis at the University of Oxford, working in clinical research on patients with optic neuritis.
A day in the life of a Registrar/Consultant
For a Registrar, depending on the stage of training, time spent either in the eye clinic or medical clinics. In some medical clinics you are supernumerary but in others you are expected to take part in the clinical workload. Registrars also get one research and administration session per week and attend postgraduate teaching in ophthalmology.
A Consultant’s day is also varied throughout the UK; some do six or more clinics per week but others mix fewer clinics with other commitments such as running diabetic retinal screening programmes.
Pros and Cons of working in this specialty
Pros and Cons
- Interesting and challenging to move from medicine to ophthalmology and straddling the two very different worlds
- Often have to be an ambassador for the specialty as it is small and not everyone has heard of it, again this can be rewarding but sometimes a challenge
- Busy clinics
- Get to see a lot of rare disease with interesting and challenging cases
- Often long follow-up periods with patients over many years
- I find it very rewarding working with patients of working age whose livelihood is threatened by a visual problem and helping to restore their vision
How this specialty differs to others and what made me choose it
There is very little of the ward round and inpatient structure that a lot of medical specialties have. Ours is very much an outpatient specialty and this requires an organised approach. The specialty is very small which has both positive and negative aspects. Despite being focused on such a specific organ, trainees actually develop and maintain quite a holistic knowledge of medicine.
I chose medical ophthalmology after being very open-minded going into core medical training as I was fascinated by the eye and wanted to develop highly specialist knowledge and skills. I think this specialty basically mixes the interesting bits of medicine with the interesting bits of ophthalmology.
Tips for success in applying for this specialty
- As with any specialty, an audit, poster or publication that relates to it helps.
- The main thing is to be enthusiastic and find out about the specialty by talking to Consultants who work in it.
- In Scotland there are Consultants in Aberdeen and Glasgow and they are always happy to be approached by prospective trainees both locally and beyond.
For more information
British Medical Journal Careers Advice (article by Drs Guly, Williams and Olson giving and excellent overview of the specialty)
The Joint Royal College of Physicians Training Board (JRCPTB)