Did you know that AI tools are revolutionising the diagnosis of diabetic retinopathy, or that ophthalmologists perform over 10 million cataract surgeries annually?
Ophthalmology is a dynamic field that blends medicine, surgery, and innovation, making it a fascinating career choice.
There is a well-recognised deficiency of ophthalmic education in UK medical schools, resulting in a loss of confidence in the diagnosis and management of eye conditions. This has the additional effect of a poor appreciation of the speciality across the board and reduced opportunities for students and foundation doctors withan interest in the speciality.
This article aims to bridge this educational gap by providing practical advice in five areas to help medical students navigate the path to a career in ophthalmology.
For the latest information, scoring information for the ophthalmology ST1 portfolio is detailed on the Severn Deanery website.
Our Opthalmology Series
Tip 1 - Electives and Student-Selected Placements
The diversity of medical and surgical specialties in today’s hospitals makes it impossible to cover each niche in detail. Student-selected placements (SSPs) offer the opportunity to explore a speciality of your interest and are described in GMC’s ‘Tomorrow’s Doctors’ as an essential part of the medical school curriculum.
Further on in medical school, an elective can provide an effective extension of an initial SSP experience by providing the opportunity to learn in a different healthcare setting abroad. While most teaching hospitals offer Ophthalmology electives, tailor-made experiences at large eye hospitals such as Moorfields may provide unique sub-specialist exposure.
Electives abroad can provide a lens on the practice of ophthalmology in other countries - e.g. the considerations in resource-poor environments or advanced eye hospitals such as Wills Eye Hospital in the USA. However, note that these typically require early preparation and even the need to sit exams such as the USMLE. One junior doctor describes his experience of a varied elective in detail in this article and another describes an elective at Harvard.
Takeaway tip: Organise your elective as early as possible to avoid any disappointments.
Tip 2. The Duke Elder Prize Exam
The Duke Elder exam, named after prominent Scottish Ophthalmologist Sir William Steward Duke-Elder, is a two-hour multiple-choice exam run every year by the Royal College of Ophthalmologists. This exam provides you with the opportunity to gain points for the portfolio while learning important concepts in the subject.
Resources such as Prep Duke Elder provide a well-summarised overview of the important areas to study; while textbooks such as ‘Kanski’s Clinical Ophthalmology’ can help those seeking to excel.
Takeaway tip: You can sit the Duke Elder exam multiple times - so aim for the highest score!
Tip 3. Your Local Ophthalmology Department
Most teaching hospitals have an associated ophthalmology department. Attending at least ten clinic and theatre sessions offers further essential portfolio points while providing a varied experience of the different subspecialties within. This can often be easily and readily arranged by contacting local eye departments.
The official wording of this criteria is as follows:
‘Attending ophthalmology clinics and theatre sessions outside of a formal taster week and spaced out over more than 3 months (minimum 10 sessions with dates & supervisor-signed evidence)’
Hence it is essential to ensure the spacing of these sessions to hit the relevant points. One tip is to aim to attend one clinic session per month during your final year of medical school or first foundation year.
Takeaway tip: Start attending clinic and theatre sessions from early on in medical school to gain a broad and deep understanding of ophthalmology.
Tip 4. Research
Research is an ongoing endeavour to help us increase our understanding of the world around us and evidence-based practice makes the most effective practitioners. Involvement in research can take many forms - from lab-based projects investigating cellular systems and pathology to large-scale epidemiological studies considering factors that influence various diseases. The most successful method for this is to reach out directly to scientists carrying out research in areas of your interest. Balancing research alongside other commitments can be time-consuming and hence it is important to triage effectively and avoid committing to too many projects!
Takeaway tip: pick one or two projects and see them through to completion.
Tip 5. Presentations
Presenting your research at national and international meetings offers the opportunity to disseminate the findings to other interested parties. In addition, it can help you develop networks to advance this research.
Student-selected components (SSCs) provide dedicated time to immerse in research and even write systematic reviews with guided support. These can often be presented at national ophthalmology meetings such as the Royal College of Ophthalmology annual congress.
Ophthalmologists, who sometimes see thirty to fifty different patients in one day, often have numerous interesting cases to write about. Using the connections you build through attending clinic and theatre sessions, you can show initiative and reduce a colleague's workload by offering to help write up a case report. Look in particular for rare conditions, unusual presentations, or unexpected complications during your clinical rotations.
Takeaway tip: make your hard work work for you! Submit your work to conferences and share your findings.
Conclusion
Ophthalmology is a highly competitive specialty with a competition ratio of 14.41 in 2024. By exploring ophthalmology early in your medical career, you’ll not only build a competitive application but also discover a speciality that offers the opportunity to profoundly change lives every day.
References
[1]: Tariq, F. et al. (2019) ‘Survey of current undergraduate ophthalmology teaching in the United Kingdom’, 26(3).
[2]: Student Selected Components - a modern curriculum to ... | MedEdPublish (no date). Available at: https://mededpublish.org/articles/5-13
[3]: Broadening horizons in ophthalmology: crafting a varied elective experience (no date) Eye News. Available at: https://www.eyenews.uk.com/education/trainees/post/broadening-horizons-in-ophthalmology-crafting-a-varied-elective-experience
[4]: My ophthalmic elective: Harvard Medical School (no date) Eye News. Available at: https://www.eyenews.uk.com/features/ophthalmology/post/my-ophthalmic-elective-harvard-medical-school
[5]: 2024 Competition ratios | Workforce, training and education | NHS England (no date) NHS England | Workforce, training and education | Medical Hub. Available at: https://medical.hee.nhs.uk/medical-training-recruitment/medical-specialty-training/competition-ratios/2024-competition-ratios
