Higher Specialist Training in Medical Ophthalmology


The National Training Programme in Medical Ophthalmology is the route to qualification and career as a Consultant Medical Ophthalmologist in Ireland.

The medical ophthalmology programme is a five year competence-based curriculum consisting of three basic years (BMT 1-3) followed by 2 years (HMT 4-5) of subspecialty training.

In the last decade ophthalmology has seen a vast expansion in medical treatments that has driven ophthalmology practice to become more medically based, allowing us to address the areas of greatest patient demand particularly in the specialties of medical retina, glaucoma and paediatric ophthalmology.

Advances in the specialty have afforded the ICO the opportunity to strategically plan to deliver the best eye care for our population in the 21st century coupling our ageing demographics and chronic eye diseases with preventable treatments, timely therapeutics and avoidable blindness.

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.  The majority of cases of blindness are reversible and treatable through early diagnosis and intervention, including those medical in nature.

Over the next 20 years Ireland will see a significant increase in both older patients and those with diabetes and therefore, the number of medical ophthalmologists required to treat these patients is also increasing

There has been significant investment in the specialty in recent years due to demand for specialists in this area.  This will continue with the roll out of the Integrated Eye Care Team and appointment of new Consultant Medical Ophthalmologist posts nationally.

Medical Ophthalmology is predominately an out-patient based specialty with a varied work-load including laser sessions, minor-op sessions, and injection sessions while incorporating new technological and ophthalmic advances, including the development of Integrated Eye Care Teams.

The programme of specialist training in ophthalmology is designed to equip doctors to work in the hospital, community, both or in the independent sector. The developments in the training programme are a response to the changing needs of the population which have evolved in the last 10 years and the programme is focused on meeting those needs.

With respect to the new Consultant Medical Ophthalmologist posts, this role is designed to deliver specialist care in both the traditional acute setting and the developing non-acute setting. The design of the new appointments is deliberately co-located. The incumbents work in both settings, to ensure access to acute inpatient services if required, sub specialty resources for more complex cases, cross specialty multidisciplinary care and participation in the delivery of on-call services.

Patients will be provided with specialist care irrespective of whether it is delivered within the traditional acute hospital building or in newly developed and equipped specialist community eye clinics.

After successful completion of the 3 years Basic Specialist Training in Medical Ophthalmology*, trainees can compete to enter the Higher Specialist Training programme provided they meet the selection criteria. Progression is based on performance in core training and by competitive interview.

Minor adjustments (5-7% of total score) may be made to the scorecard as required during each selection process.

*The HMT selection process for 2021 will be the final opportunity for applications from trainees who completed the basic specialty training programme (i.e. prior to the reconfiguration of basic training into separate medical and surgical pathways). From 2022 onwards trainees must have completed basic medical training in ophthalmology to be eligible to apply for HMT.


The purpose of the Higher Specialist Training in Medical Ophthalmology programme is to provide in-depth training to equip doctors with skills and expertise they require to independently practice as ophthalmologists. The programme has a modular approach and is framed around the three subspecialties located at the core of current and future patient demand  - 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 a Consultant Medical Ophthalmologist, training is located  in hospital-based training units and will also take place in community clinics as the new Consultant Medical Ophthalmologists take up their posts and non-acute facilities are developed. 

The European Board of Ophthalmology Diploma (EBOD) Exam and Higher Medical Training Modular sub-specialty Structured Oral Examination (SOEs) are the formal exit appraisals for the HMT in Ophthalmology programme and for doctors to be eligible for the Specialist Registrar of the Medical Council in the Division of Ophthalmology.

Download the ICO Specialist Training in Medical Ophthalmology curriculum (PDF Document)

Medical ophthalmologists have varying roles in health care in Ireland. Consultant Medical Ophthalmologists work in the acute and/or non-acute setting and lead the Integrated Eye Care Team.

Graduates of the programme are trained to deliver general ophthalmology care with subspecialty expertise in glaucoma, paediatric ophthalmology and medical retina. Graduates may opt to continue with further subspecialty Fellowship training and practice in either the public or the private sector. Many ophthalmologists combine private practice with their HSE role.

Given the frequency of ocular involvement in many systemic diseases, ophthalmologists often work in close collaboration with other specialists including diabetologists, rheumatologists, neurologists, ENT and maxillo-facial surgeons as well as paediatricians and geneticists. 

There has been significant investment in the specialty in recent years due to demand for specialists in this area.  This will continue with the roll out of the Integrated Eye Care Team and appointment of new Consultant Medical Ophthalmologist posts nationally.

Thinking of a Career in Ophthalmology - a short guide from the Irish College of Ophthalmologists 

The medical workforce is changing and, over recent years, numerous reports have pointed to the importance of providing flexible working arrangements for doctors.

The ICO understand the importance of work-life balance. We support flexible timetables and advocate for your continued health and wellbeing throughout your career in medicine.

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.

Financial Supports

There are currently three schemes in operation which provide financial supports to NCHD's and Consultants, funded by the NDTP.

Details of the schemes can be found on the HSE website .