How to Maximise Your Portfolio
The key is to start early and tailor your portfolio to Ophthalmology! Unlike other portfolios, where you can apply generic teaching, research and projects to different speciality applications, the Ophthalmology portfolio is unique! The Severn deanery website highlights everything that will gain you points, and therefore, I recommend you use this as your Bible.
The portfolio is worth 50% of your marks for applications, and I spent 5 years leading up to the applications, purely focusing on Ophthalmology projects and showing commitment to the speciality. I realised early on in medical school that I wanted to pursue the speciality, and for anyone thinking the same, I would make sure that you have had some experience.
I became President of the Ophthalmology Society at university, attended many ophthalmology clinics and theatres and spent time using the Eyesi simulator. A lot of this was done during my own time due to the limited exposure through medical school and the foundation programme. It is therefore important to be proactive and attend conferences, taster days, do research or even seek out a foundation job to experience the speciality for yourself.
Making the Most of Your Day Job
While Ophthalmology is a speciality focused on the eyes, it is important to remember that many systemic conditions affect the eye, and therefore it is important to be a good doctor first! For example, patients with diabetes can develop severe eye complications without appropriate screening and control of their blood sugar, and it is important to treat conditions holistically and coordinate with other professionals. Learning how to take a good history, working up differentials, and executing management plans are all essential skills which can be applied to ophthalmology.
I would also advise going to the theatre when you can and getting stuck in. Learning theatre etiquette, how to scrub up, and even getting actively involved in cases is all really useful experience. You can record your time and clinics and theatres, and this can get you additional points. Even if you don't have an ophthalmology placement, taking some of your free time to visit the clinics and theatres and asking to watch is something that I did and would recommend. Not only does this show enthusiasm, but it will form connections with people in the speciality and allow you to develop relationships which may lead to projects and other opportunities.
Making the Most of Ophthalmology Placements
Be enthusiastic, get thoroughly stuck in and learn as much as you can. Ophthalmology is difficult to come by, so if it's really a speciality that you want to do, you must maximise this time as much as you can. Ask about audits, ask about research, ask to scrub in. Show that you are hard-working and want to be there, and people will be very receptive to that and get you involved.
When I was on my Ophthalmology rotation, I informed my supervisor of my desire to pursue the speciality, and she helped me to find projects that would enhance my portfolio. One project included an e-learning teaching course to enhance screeners' knowledge of diabetes and allow staff to engage more actively with their patients. The 4-month rotations were very fruitful, and not only did I do audits and research, but I was also allowed to scrub in for every case and learnt how to drape the patient, all really useful now I have started training.
What About Non-Ophthalmology ST1 Placements?
Transitioning from being a good doctor to being a good ophthalmologist requires a specialised focus on eye health and vision care, but the principles of being a good doctor still apply! Empathy, compassion and communication remain essential, as patients often experience anxiety and fear related to eye problems. Communication is therefore a large part of the interview, and ensuring that you build up this skill as well as teamwork and clinical judgement are all important within Ophthalmology. Remember that admission teams are not looking for ready-to-go ophthalmologists! They are looking for someone with a good work ethic, a good attitude and someone who listens to their patients. In essence, being a good doctor lays the foundation for being a good ophthalmologist, so do not underestimate the personal and professional development that can be achieved by experiencing other specialities. For example, on my trauma and orthopaedic rotation, I learnt to do plaster casts, knee aspirations and steroid injections. I developed my manual dexterity and was surprised by how much I really enjoyed it. Even if it's not a speciality of your choice, there is always something that can be learnt.
In addition, even if you have no exposure to ophthalmology in your day-to-day clinical job, there is always something you can do in your own time. For example, the Duke Elder is an exam worth sitting in medical school if you are interested in the speciality. I scored in the top 10% which not only enhanced my knowledge of ophthalmic conditions but also confirmed my interest in the speciality and gained additional points in my portfolio.
