Specialist Training in Medical Ophthalmology

Overview

The medical ophthalmology curriculum is four and a half-year competence-based curriculum consisting of 3 common core years followed by 1.5 years of subspecialty training

Medical ophthalmology refers to non-surgical general ophthalmology. However, following recent changes to the medical ophthalmology curriculum, the new training pathway allows subspecialty expertise to be developed in certain areas such as paediatrics, glaucoma and medical retina. Especially in the latter area of medical retina, new advances in intraocular injections and laser have revolutionized 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 around the country. Once they have successfully completed the medical ophthalmology curriculum, they can take up a post as a community ophthalmic physician, a hospital based ophthalmic physician or set up private practice as an independent practitioner.

They can also have public health roles such as running a diabetic screening programme and/or extending eye care to the community.

Those who wish to enter specialist training in medical ophthalmology may do so following the completion of core training in ophthalmology once they have met the following qualifying criteria. Applicants are also required to understand and provide evidence for their suitability to become an ophthalmologist at specialist registration level. Entry to the programme is by competitive interview held centrally at the Irish College of Ophthalmologists.

Applications are currently invited for entry onto the Specialty Training in Medical Ophthalmology for July 2016.  For details, please see here 

Selection Criteria for entry into Specialty Training in Medical Ophthalmology

  1. Successful completion of Core Training in Ophthalmology Y1-3
  2. Satisfactory CAPA appraisals for each 6 months of the first 3 core years.
  3. Satisfactory achievement of all summative WBAs at each competency point.
  4. Successful completion of the MRCSI Examination
  5. Successful completion of the Human Factors (HF) Examination.
  6. Documented attendance at obligatory ICO courses.
  7. 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
  8. 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
  9. Audit

 

The purpose of the Medical Ophthalmic Specialist Training programme is to provide in-depth specialist training so as to equip trainees with skills so that they can independently practice as generalists within ophthalmology, deliver an on-call emergency service and also deliver more specialised services to a defined level. 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 (6 months each) 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.

Download the curriculum (PDF Document)

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. 

Ophthamology Trainees use an eLogbook.
Further information and to register for an online account is available at www.elogbook.org

Trainees are assessed every six months in the Irish College of Ophthalmologists.
Trainees must submit two weeks in advance of their assessments the following documentation:

  1. Up to date CV, including contact details
  2. Summary of logbook, including courses, examination completed, meetings & lectures attended, presentations & publications
  3. Current timetable
  4. Trainers Report Form
  5. Capa Form A timetable & procedures - Specialist training in Medical Ophthalmology

 

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 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 ophthalmologic care both in hospitals and in independent clinical practices.

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 Specialist Training. Award of the CCST will allow the Medical Ophthalmic Specialist Trainee to be registered on the specialist registrar of the Medical Council and will indicate that the Ophthalmic Specialist has reached the curricular standards of competence to practice independently as a Medical Ophthalmic Specialist in Ireland.

The Medical Ophthalmic Specialist qualified to specialist registration level may

  1. Work as a Community Ophthalmic Physician.
  2. Apply for a HSE public post as a hospital-based Ophthalmic Physician
  3. Apply for a contract with the HSE to see Medical Card patients.
  4. Apply to the Department of Social Protection for a contract to see PRSI entitled patients.
  5. Work alongside their surgical consultant colleagues in a tertiary referral unit.
  6. Work 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 equivalent to 12 whole WTE fully funded supernumerary posts, i.e. up to 24 participants at any one time.

The scheme facilitates doctors at higher specialist training level to continue their training in a flexible manner for a set period of time.

Trainees must be enrolled in a Specialist Training Programme under the auspices of one of the postgraduate medical training bodies recognised by the Medical Council in Ireland.

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.