Higher Specialist Training in Surgical Ophthalmology


The surgical ophthalmology programme is a seven-year competence-based curriculum consisting of 3 core years followed by 4 years of subspecialty training. With the Award of the Certificate of Completion of Specialist Training (CCST) doctors are eligible to be registered on the specialist registrar of the Medical Council in the Division of Ophthalmic Surgery.

Surgical ophthalmologists perform microsurgical intraocular operations such as cataract extraction surgery or retinal detachment repair surgery. Most surgical ophthalmologists perform cataract surgery as well as sub specialising in another area. Although the eye is a very small organ there are a numerous subspecialties in ophthalmology.

The purpose of the Higher Specialist Training Programme in Surgical Ophthalmology is to provide in-depth surgical training so as to equip doctors with skills both in cataract surgery as well as in the subspecialties of anterior segment (corneal transplant), glaucoma (trabeculectomy), strabismus (squint surgery), orbit (enucleations), vitreo-retinal (retinal detachment repair), nasolacrimal and oculoplastic surgery.  Specialist trainees, irrespective of preference and future career choice, must undertake training in all subspecialties to successfully complete their training.

Following completion of Higher Specialist Surgical Training and with the award of CCST,   most trainees go on to complete a Fellowship in the subspecialty of their choice.

Download ICO HST Trainee Guide 2019


After successful completion of the 3 core years of Basic Training in Surgical Ophthalmology, trainees can compete to enter the Higher Specialist Training program provided they meet the selection criteria. Progression is based on performance in core training and by competitive interview held centrally in conjunction with the RCSI. Further information on the application process is available on the RCSI website.

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


There are 10 sub-specialties in ophthalmic surgery and the training programme covers all 10.

  1. Cataract and Refractive Surgery
  2. Paediatric Ophthalmology
  3. Corneal and External Diseases
  4. Glaucoma
  5. Vitreoretinal surgery
  6. Neuro-ophthalmology
  7. Oculoplastics
  8. Orbital/lacrimal disorders
  9. Strabismus
  10. Ocular Oncology

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. 

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


Trainees are assessed via Competence and Assessment of Performance Appraisal (CAPA).  Trainees are required to submit assessment documentation for the first six-months rotation in December and the second six-months rotation in May.  Trainees are required to attend the formal CAPA assessment session with the Programme Director in June.

Mandatory Components of HST Assessment:

  1. CAPA Assessment Session
  2. Audit
  3. Peer Reviewed Paper
  4. International Presentation
  5. Clinical Case Based Discussion
  6. Presentation Major Clinical Topic
  7. Teaching Activities
  8. Logbook
  9. Exams: EBOD and FRCSI
  10. Mandatory Courses
  11. Recommended Courses / Meetings
  12. Trainer Report
  13. Core Competencies

HST CAPA Assessment Documentation (every 6 month rotation):

The following documents, which are available on the School for Surgeons (SFS) website should be submitted to the ICO office at the completion of each 6 month rotation for review by the Programme Director.

  1. HST Training Assessment Form (7- one per sub-specialty - listed below):

This form is a record of Trainees’ Timetable, Clinical Skills, Clinical Case Based Discussion, Presentation of Major Clinical Topic, Audit, Peer Reviewed Paper, International Presentation, Teaching Activties/  SFS, Trainer Report.

Core Competency Form(s) (Any 1-7): This is contained within the HST Assessment Form 

Logbook per 6 month rotation: This is contained within the HST Assessment Form

  1. HST Assessment Form for Cataract Surgery and Refractive Surgery
  2. HST Assessment Form 2020 for Cornea & External Disease
  3. HST Assessment Form 202 for Glaucoma
  4. HST Assessment Form 2020 for Medical Retina & Vitreo-Retinal Surgery
  5. HST Assessment Form 2020 for Neuro-ophthalmology Surgery
  6. HST Assessment Form 2020 for Oculoplastics & Lacrimal Orbital
  7. HST Assessment Form 2020 for Paediatrics        

2. HST Summary Logbook 

HST Summary Logbook 2020

Training Performance Management

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 Fellowship of the Royal College of Surgeons in Ireland (FRCSI) is the exit appraisal for the Higher Specialist Training in Surgical Ophthalmology (STSO) programme.

The FRCSI examination is a test of competence to practice as an independent specialist (consultant) in ophthalmic surgery and is aimed at trainees who are coming to the end of their Higher Specialist Training in Ophthalmology. The MRCSI is an entry requirement for the FRCSI and candidates for the FRCSI must be in their final year of Higher Specialist Training in Surgical Ophthalmology in Ireland. 

Trainees must also have the European Board of Ophthalmology Diploma (EBOD).  The examinations takes place each year in Paris during the month of May.  Further information on the EBOD is available on their website here 

Download EBO Application 2019

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 surgical and clinical, personal and professional competences defined in the surgical curriculum to be eligible to exit the program. The exit exam is the FRCSI (Ophth) and is taken in the final years of training, usually in year 7. The award of the CCST requires both success in the FRCSI examination and the documented and satisfactory completion of specialist training.  

With the Award of CCST doctors are eligible to be registered on the specialist registrar of the Medical Council in the Division of Ophthalmic Surgery.

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.

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 .