Higher Specialist Training in Medical Ophthalmology
The medical ophthalmology programme is a five year competence-based curriculum consisting of 3 core years followed by 2 years of subspecialty training
The medical ophthalmology curriculum leads to subspecialty expertise in areas such as paediatrics, glaucoma and medical retina. In medical retina, new advances in intraocular injections and laser have revolutionised the treatment of two common sight-threatening conditions, namely age-related macular degeneration and diabetic maculopathy. As these conditions are very responsive to the new therapies, the work is very rewarding. Over the next 20 years Ireland will see a significant increase in both older patients and diabetics and therefore, the number of medical ophthalmologists required to treat these patients is also expected to increase.
Medical ophthalmologists have varying roles in health care in Ireland. Once the programme is successfully completed, specialists work in the community, the hospital or private practice.
Those who wish to enter Higher Specialist Training in medical ophthalmology may do so following the completion of Basic Training in ophthalmology once they have met the following qualifying criteria. Entry to the programme is by competitive interview held centrally at the Irish College of Ophthalmologists.
Selection Criteria for entry into Higher Specialist Training in Medical Ophthalmology
- Successful completion of Core Training in Ophthalmology Y1-3
- Satisfactory CAPA appraisals for each 6 months of the first 3 core years.
- Satisfactory achievement of all summative WBAs at each competency point.
- Successful completion of the MRCSI Examination
- Successful completion of the Human Factors (HF) Examination.
- Documented attendance at obligatory ICO courses.
- A validated logbook to include:
- 150 intravitreal injections
- 20 panretinal lasers and 5 macular lasers
- 10 YAG capsulotomy lasers
- 5 YAG laser PIs
- 20 minor procedures (S+P, I+C, lesion excision and biopsy etc)
- 5 ectropion
- Clinical cases logbook for entry into year 4 to include:
- 1 managed case of glaucoma: POAG, NTG or OHT
- 1 managed case of uveitis: Anterior or posterior
- 1 managed case of ARMD : Wet or dry ARMD
- 1 managed cases of CRVO: Ischaemic or non- ischaemic
- 1 managed cases of childhood strabismus: Esotropia or exotropia
- 3 managed cases of acquired strabismus: IV x 1, VI x 1, III CR N palsy x 1
- 2 managed cases of neuro-ophthalmology: CSF/GCA/ Horners
- 2 managed cases of anterior segment: Herpetic and microbial keratitis
The purpose of the Higher Specialist Training in Medical Ophthalmology programme is to provide in-depth training so as to equip doctors with skills so that they can independently practice as ophthalmologists. As such, the programme has a modular approach and is framed around the three subspecialties located at the core of future independent practice - medical retina, glaucoma and paediatric ophthalmology. Trainees, irrespective of preference and future career choice, need to complete all three modules to successfully complete their training. To reflect the diversity of the future career path of an ophthalmic specialist, training is located both within hospital-based training units as well as in community clinics.
All trainees must keep a record of their surgical and clinical procedures. eLogbook is an online system which facilitates doctors to keep a complete record of procedures performed.
Trainees are assessed using different assessment tools during each rotation. These assessment tools include CBD, mini-CEX and DOPs. At the end of each sub specialty module in Specialty Training in Medical Ophthalmology, there will be also an assessment in a Viva Voce format by a panel of assessors.: This must be passed to progress through the programme.
CAPA Appraisals take place every six months. Trainees must submit two weeks in advance of their assessment the following documentation:
- Capa Form A timetable & procedures - Specialist training in Medical Ophthalmology
- Trainers Report Form (specific to each module of Medical Retina, Glaucoma and Paediatrics. Available on the SCHOOLS for Surgeons website)
- Completed Workplace Based Assessment Forms (see SCHOOL for Surgeons website for relevant forms)
- Summary of logbook, including courses, examination completed, meetings & lectures attended, presentations & publications
The ICO will consider applications for out of programme experience (OPE). The application for OPE must be made to the Dean of Post Graduate Education. Applications for OPE must be made 6 months in advance of the expected start date. OPE activities which further your training programme must be approved by the Dean. Advice can be sought from research supervisors, educational supervisors or the Training Director as necessary. You must complete all documentation recording out of programme progress in the grade to ensure that the Dean is aware of your location and intentions when you are undertaking research or other recognised activities outside the Irish hospital service, taking leave of absence or gaining experience abroad.
If you are employed outside the Irish hospital service and you cease to pursue, for any reason, the research or other activity which has been agreed, you must inform the Dean promptly. It will then be decided, in consultation with the ICO Training Committee, whether it is appropriate for you to remain within the programme. If you are employed outside the Irish hospital service and wish to begin or return to the Training Programme, you must accept a reasonable offer of a suitable placement. Offers of placements will, as far as possible, take into account your training need.
The European Board of Ophthalmology Diploma is the exit appraisal for the Higher Specialty Training in Ophthalmology programme. The EBOD exam is a test of excellence in ophthalmology. It is designed to assess the knowledge and clinical skills requisite to the delivery of a high standard of ophthalmic care.
The examination takes place each year in Paris during the month of May. Further information on the EBOD is available on their website.
For further information on the funding available from the HSE Medical Education & Training Unit for exam fees please review this document
It is essential that trainees achieve both the common and specialty-specific competences defined in the curriculum to be eligible to exit the program. The European Board of Ophthalmology Diploma or EBOD is the formal exit requirement for the Certificate of Completion of Higher Specialist Training. With the Award of the CCST doctors are eligible to be registered on the specialist registrar of the Medical Council in the Division of Ophthalmology.
Medical Ophthalmologist's practice in the community, hospital or in private practice.
The medical workforce is changing and, over recent years, numerous reports have pointed to the importance of providing flexible working arrangements for doctors. The HSE National Flexible Training Scheme for Specialist Trainees is a national scheme managed and funded by NDTP for supernumerary posts. The scheme facilitates doctors to continue their training in a flexible manner for a set period of time. The HSE National Flexible Training Scheme Guide sets out details of the National Flexible Training Scheme and provides information for trainees, training bodies and employers about the programme.
If you wish to apply to the HSE National Flexible Training Scheme please complete and submit the application form.