Ophthalmology has become a very popular speciality, generating a vast interest amongst medical students with competition for training posts increasing yearly. Yet it is often difficult to get adequate exposure to the speciality prior to applications, with very limited time offered by medical schools to have dedicated placements in ophthalmology with some offering only days or a week placement. It is therefore very important to optimise the exposure gained during this pivotal time. This article highlights eight key recommendations that have allowed me to create an enjoyable and constructive placement.
1. Find a supervisor and set aims / objectives for the placement
Often in medical school you are rotating placements and hospitals over a space of months and it is difficult to become familiar with your environment and colleagues in a short period of time. Therefore, finding a consultant supervisor in your local ophthalmology department is a great way to gain insight and support during your time on the placement. Having initial thoughts of objectives to discuss with your supervisor would definitively help. My recommendation would be to look through the ST1 ophthalmology evidence folder to identify which points can be achieved during your time on placement. For example, attending 10 clinic / theatre sessions, doing a ‘QI / audit’ or using the ‘EyeSi Simulator’ [1]. These are achievable in the time period you spend in the department, and it sets the agenda with your supervisor and ensures you have goals to aim for.
2. Pre-read before attending
Having an insight into the conditions and skills you expect to see allows you to be more involved and understand case discussions during clinic and theatres. For example, if attending a retinal clinic, an appreciation of equipment like slit-lamps and the different investigations like optical coherence tomography (OCTs) allow you to have more in-depth discussion with the ophthalmologists and allows you to be involved in using the equipment to identify the eye pathologies.
3. Expose yourself to different subspecialties and combination of clinic / theatre / eye casualty
Ophthalmology has a vast number of subspecialties including cornea, cataract, vitreoretinal surgery, oculoplastic, neuro-ophthalmology and glaucoma to name a few [2]. As mentioned before, time is very limited during these rotations. At the start of the rotation, designing a timetable with your supervising consultant is a great idea to ensure adequate exposure to the different subspecialties within ophthalmology both in outpatient clinics and theatre. Having exposure to these areas allows you to appreciate the diverse nature of ophthalmology including the medical and surgical practices, and the interaction with other speciality departments including rheumatologists, dermatologists and endocrinologists where systemic diseases present with ocular manifestations [3]. In addition, gain exposure to patients of all ages, from paediatric, adults, and elderly population.
4. Network and find out more about the speciality
Whether you attend a tertiary ophthalmology centre like Moorfields Eye Hospital or a local district general ophthalmology centre, there are great opportunities to network with clinicians across the speciality including consultants, registrars, optometrists, orthoptists, and specialist nurses [4]. One of the best ways of better understanding a speciality is to speak to the people who are in it. And using this opportunity of being on placement in ophthalmology is a great way to ask senior colleagues about their own motivations and interests that made them choose the speciality. This allows you to appreciate the day-to-day benefits and challenges ophthalmologists face and allows you to make an informed decisions about career options.
5. Stay connected with department (e.g. research)
After a long and enjoyable placement in ophthalmology, it is important that you maintain the relationships you have built and continue developing the competences and goals you achieved during your time within a department. Try and stay in contact with your supervisor, seeking opportunities for further involvement. This can be done by carrying out research and continuing projects / audits / case reports after you complete the placement. Bear in mind, there are significant ophthalmology speciality training (OST) portfolio points for research, publications and audits which can often take months if not years to complete [1].
6. Organise an elective in ophthalmology
A productive and insightful ophthalmology placement in medical school can go a long way in supporting your journey to becoming an ophthalmologist. Often, one rotation is not enough, therefore continuing to get more exposure for example doing an elective in ophthalmology can further help develop contacts at your department or branching out to further departments elsewhere in the country or abroad. It allows you to have dedicated time over a longer period (four–six weeks) which allows you to really embed yourself in the department and feel more part of the team. Organising an ophthalmology elective can be challenging but can be achieved through early planning and using resources effectively, including contacting potential departments, supervisors and applying for grants – see the Eye News article on ‘How to get the most out of your ophthalmology elective’ for further information [5].
7. Complete the Duke-Elder examination
Doing the Duke-Elder examination prior to attending the placement is not mandatory, but the literature you will encounter will enhance your experience of the clinical presentation you witness on placement, and further add to your discussions with the ophthalmologists in clinic. The exam also helps gain points for ST1 ophthalmology applications with two points for ranking top 10%, one point for top 20% and 0.5 for top 60% [1] (see Eye News articles on Duke-Elder for further information [6–9]).
8. Attend conferences / meetings and courses
In addition to completing an ophthalmology placement, attendance to conferences and meetings is a fantastic opportunity to network with other ophthalmologists in the profession. It allows you to see the latest advances in the field and allows you to be involved by presenting audits / posters which can be completed during your placement. There is a plethora of regional and national conferences in the UK which provide sessions to support medical students, such as RCOphth Annual Congress, Oxford Congress, North of England Ophthalmological Society (NEOS) and the South-Western Ophthalmological Society (SWOS) [10–12]. Speak to ophthalmologists currently in training and ask about meetings they would recommend attending.
Attending courses allied to the speciality can be a great way to gain a better understanding and build some basic clinical skills, e.g. Introduction to Ophthalmic Surgery by RCOphth.
Finally, don’t forget there is a lot you can do in medical school itself – join your ophthalmology society and consider completing selected study modules in ophthalmology as part of your medical school curriculum [13].
Medical school is a great opportunity to maximise your exposure to any speciality. Within ophthalmology, there are many opportunities available and it is down to you to make the most of it, because before you know it you will be on the other side!
References
1. Ophthalmology Evidence Folder. NHS England.
https://www.severndeanery.nhs.uk/
recruitment/vacancies/show/oph
-st1-24/evidence-folder-lib
2. The complete guide to becoming an ophthalmology doctor. BMJ.
https://www.bmj.com/careers/article/
the-complete-guide-to-becoming
-an-ophthalmology-doctor
3. Gudu T, Jadon DR. Multidisciplinary working in the management of axial and peripheral spondyloarthritis. Ther Adv Musculoskelet Dis 2020;12:1759720X20975888.
4. Eye Care Professionals in ophthalmic practice. Royal College of Ophthalmologists.
https://www.rcophth.ac.uk/our-work/ophthalmology
-careers/eye-care-professionals
5. Leung HSK, Wong HM, Ameen S. How to get the most out of your ophthalmology elective. Eye News 2022;(29)3:26-8.
6. Chow BJ, Raharja A. Getting the Duke Elder examination right: reflections and tips from a medical student (2023). Eye News.
https://www.eyenews.uk.com/features/
ophthalmology/post/getting-the-duke-elder
-examination-right-reflections-and
-tips-from-a-medical-student
7. Chen Y. The Duke Elder Exam of Ophthalmology: A Comprehensive Guide for Success (2021). Eye News.
https://www.eyenews.uk.com/reviews/
book-reviews/post/the-duke-elder-exam-of-ophthalmology
-a-comprehensive-guide-for-success
8. Agarwal P, Vonica O, Ali Z. My Top Five: Duke Elder Undergraduate Ophthalmology Prize Exam Tips. Eye News 2023;(29)4:61.
9. Vyas N. The Duke-Elder exam: A medical student’s head start into ophthalmology (2021). Eye News.
https://www.eyenews.uk.com/education/
trainees/post/the-duke-elder-exam-a-medical
-student-s-head-start-into-ophthalmology
10. Annual Congress. Royal College of Ophthalmologists.
https://www.rcophth.ac.uk/events-courses/
annual-congress/
11. OOC. https://www.ooc.uk.com
12. NEOS. https://neos.org.uk
13. Skills Courses. Royal College of Ophthalmologists.
https://www.rcophth.ac.uk/training/
simulation/skills-courses/
[All links last accessed May 2024]
Declaration of competing interests: None declared.
