Ophthalmology training is becoming increasingly competitive every year and is one of the most competitive specialty training programmes in the UK, boasting a competition ratio of 9.91 applications per post in 2023.1 Therefore, getting a training post can seem like a daunting task, particularly given the demands of the portfolio and MSRA, and even more so if you have decided to apply to Ophthalmology towards the end of medical school or during Foundation Training. So, from a current applicant, here is what I have found doing an FY3 year so far and what options you have available if you are contemplating an FY3 and/or a career in Ophthalmology:
Contents
General Advice From Personal Experience
- Try to get in touch with your hospital’s Ophthalmology department to get access to Ophthalmology-related projects and training opportunities. Your hospital department will also be able to support you with clinic/theatre attendance and signpost you to different conferences or training events.
- In addition to this, you can offer to help with different projects going on in your department, or design your own QI project during your FY1 or FY2 jobs; you can then find conferences or journals where you might be able to submit your work. Also, try to present or publish as much work that you’ve been involved with as possible – many conferences are very keen to have participants and you never know where your work might be featured.
- Just because your portfolio may not have been especially Ophthalmology-geared at the start, don’t panic! In the publications, presentations and QIP sections of the portfolio, your projects don’t need to have been in Ophthalmology to count, hence any project that can yield results would be helpful. A lot of the ‘Commitment to Ophthalmology’2 points as well can be achieved quickly with organised effort, e.g. by going to clinics/theatres, organising a taster week in the Ophthalmology department, or attending courses and conferences.
- Similarly, make sure you read the fine print of the portfolio (which changes every year, but there tend to be certain standard elements you can expect). Ensure that the evidence you are planning to add to your portfolio is as accurate to the instructions as possible, as they can be very nitpicky! Oh, and very importantly, as soon as the application window opens, make sure you read the up to date Evidence Folder for the Ophthalmology application!2
- Reach out to current trainees or other FY doctors interested in Ophthalmology, as this will help you collaborate with others, be able to get advice on aspects of the application process, and practise for the interview process together. I have been able to do so in the past year and it has been an invaluable source of support!
So What Jobs Can I do For My F3 Year?
This largely depends on what you want to achieve from your FY3 year. Ophthalmology does not have as many options dedicated to FY3 doctors given the greater degree of supervision required, but there are still ways to get more experience and build your portfolio in the specialty. A short overview of the different types of jobs available is written below – for more information, this exceptional guide from EyeNews provides more information together with advantages and disadvantages of every role.3
- Clinical Teaching Fellowships are increasingly popular options for doctors looking to improve on their portfolios and gain teaching experience, as well as clinical experience if the post allows for it. Such positions may also be Ophthalmology-specific, and they often come with funding for a PgCert in Medical Education (which you can complete part-time simultaneously with the fellowship).
- Research fellowships are also another option for doctors keen on improving their research skills, and provide access to a wide range of different Ophthalmology projects. These are often arranged by teaching hospitals or university departments, and do not have any clinical commitments attached to them, while the involvement in different projects may help applicants boost their portfolio.
- Although these are few and far between, there are some FY3 Junior Clinical Fellow posts in Ophthalmology, either as a stand-alone post or as a Locum Appointment in Training (LAT) post. These posts are often more focused on service provision, but there is the possibility to build skills during that year that you can use in Ophthalmology training, and on occasion may be able to reduce the time required to complete the Ophthalmology training programme.
- A much more common job opportunity across the country includes having a trust-grade position in another specialty or locuming (either through a hospital bank, which is what I opted for, or an agency). These posts may offer some transferable skills, though for an Ophthalmology application the main benefits are the stability offered by a trust grade post or the innate flexibility of locum work, which can allow you to develop other aspects of the portfolio to strengthen your application.
- Lastly, there is also the option of going abroad for a year; it will be very difficult to get paid Ophthalmology work anywhere, if this was something you were specifically hoping to achieve, but you may be able to do voluntary work, or work in a different specialty/environment for some time and enjoy a different country and culture!
Additional Degrees
Master’s degrees are now becoming an increasingly popular option for doctors in training, but may also serve as a good way to both take a year out of clinical medicine and boost your research portfolio. Most Master’s degrees also offer significant exposure to the clinical environment of Ophthalmology, from which you can branch out to finding out more about the specialty and gaining helpful clinical experience. For the ophthalmology application specifically, this might be a bit more of a difficult option as the degree itself won’t count for points (as it needs to be completed by the time the portfolio is submitted in February). Another important consideration is cost, as if you do not qualify for home fees or cannot obtain a postgraduate loan this might be an unnecessary strain on your finances.
Two indicative examples of suitable Master’s degrees can be seen below:
- MSc in Ophthalmology, University College London (consists of a mixture of taught and research components)4
- MPhil in Medical Science (Surgery), University of Cambridge (mostly research-oriented Master’s degree programme)5
A different possibility is a Postgraduate Certificate in Medical Education, which is also a very popular option and is usually an additional opportunity offered to teaching fellows. Most teaching fellowships offer some option to do a PgCert part-time and some funding towards this, although it is possible to self-fund one (again, be mindful of costs as most PgCert programmes cost around £3000-4000). Once again, the degree must be completed by February to count towards the application, therefore aim to do your PgCert in FY2 or try to find a programme that runs for under a year. Also very importantly, your PgCert will be complemented by your own teaching experience, therefore you can use the educational principles you learn in your degree to design and run your own teaching course, which will be further points for your portfolio!
Examples of PgCert degrees in Medical Education can be seen below:
- Medical Education PgCert, Queen Mary University of London (traditional PgCert done through distance learning, runs for 9-12 months)6
- iheed/University of Warwick PgCert in Medical Education for Healthcare Professionals (6-monthly programme running 3 times a year)7
As the ‘Commitment to Specialty’ section offers up to 2 discretionary points, you can also cover those with university courses – the London School of Hygiene and Tropical Medicine offers multiple courses on subjects such as Ophthalmic Epidemiology and Eye Public Health, which can be taken free of charge through their Open Study programme. 8
Any Other Advice for F3 in General
Although it seems like the entire specialty application process is becoming more and more difficult, it is important to remember that an FY3 is also an opportunity for you to have a more tailor-made schedule, both professionally and personally. Make sure you choose something that you will enjoy for your year out of training and do what feels right to you, be that more time to build your portfolio and do things you enjoy, experience a different country or enjoy a year fully immersed in Ophthalmology. The choice is yours and hopefully this guide will help you make decisions about your FY3 and, in the end, achieve your end goal of a training post!
References
- 2023 Competition ratios | Health Education England [Internet]. Health Education England | Medical Hub. Available from: https://medical.hee.nhs.uk/medical-training-recruitment/medical-specialty-training/competition-ratios/2023-competition-ratios
- Evidence Folder – Severn PGME [Internet]. www.severndeanery.nhs.uk. [cited 2023 Dec 22]. Available from: https://www.severndeanery.nhs.uk/recruitment/vacancies/show/oph-st1-24/evidence-folder-lib
- My Top Five: Foundation year 3 jobs for prospective ophthalmology candidates [Internet]. Eye News. [cited 2023 Dec 22]. Available from: https://www.eyenews.uk.com/features/ophthalmology/post/my-top-five-foundation-year-3-jobs-for-prospective-ophthalmology-candidates
- Ophthalmology MSc [Internet]. Prospective Students Graduate. 2023 [cited 2023 Dec 22]. Available from: https://www.ucl.ac.uk/prospective-students/graduate/taught-degrees/ophthalmology-msc
- ‌MPhil in Medical Science (Surgery) | Postgraduate Study [Internet]. www.postgraduate.study.cam.ac.uk. [cited 2023 Dec 22]. Available from: https://www.postgraduate.study.cam.ac.uk/courses/directory/cvsgmpmsc
- ‌Medical Education PGCert – Queen Mary University of London [Internet]. www.qmul.ac.uk. [cited 2023 Dec 22]. Available from: https://www.qmul.ac.uk/postgraduate/taught/coursefinder/courses/medical-education-pgcert/
- Postgraduate Certificate (PG Cert ) in Medical Education Course [Internet]. iheed Health Training Limited. [cited 2023 Dec 22]. Available from: https://www.iheed.org/find-your-programme/uow-postgraduate-certificate-in-medical-education-for-healthcare-professionals
- ‌Free online courses | Short courses | LSHTM [Internet]. www.lshtm.ac.uk. [cited 2023 Dec 22]. Available from: https://www.lshtm.ac.uk/study/courses/short-courses/free-online-courses
Written by Dr Emmanuel Tasos (FY3)
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