Medical ophthalmology is an holistic specialty which provides specific expertise in the diagnosis and medical treatment of people with disorders of vision.

More than 50% of new ophthalmic referrals present with a medical rather than surgical problem; hence medicine comprises a large proportion of the workload of any eye department.


Medical ophthalmology - trainee characteristics

Trainee physicians with the below skills will be suited to a training programme in medical ophthalmology:

  • good team-player skills, including skills in clinical leadership and change-management

  • flexibility, attention-to-detail and lateral thinking

  • excellent communication skills - both spoken and written

  • the ability to work (and enjoy working) under pressure.


Working in medical ophthalmology

The specialty

Medical ophthalmology is an emerging medical specialty in the United Kingdom. In the future it is expected there will be one ophthalmic physician (medical ophthalmologist) per population of 263,000.

The primary purpose of the specialty is the medical assessment, investigation, diagnosis and management of disorders affecting vision, particularly:

  • inflammatory disorders affecting vision (eg uveitis, scleritis, corneal graft rejection, systemic vasculitis

  • vascular disorders affecting vision (eg diabetes, arteriosclerosis, hypertension, stroke)

  • neurological disorders affecting vision (eg multiple sclerosis, stroke, pituitary disorders, thyroid eye disease)

  • public visual health (eg diabetic retinopathy screening).

Other important aspects include:

  • genetic disorders affecting vision (eg retinitis pigmentosa)

  • retina-specific disorders affecting vision (eg age-related macular degeneration)

  • visual rehabilitation (eg age-related macular degeneration)

  • ophthalmic procedures, particularly laser therapy for diabetic retinopathy, and local injection therapy for age-related macular degeneration.

Application of medicine in ophthalmology

Of the new referrals to ophthalmology that require intervention or specialist follow-up, 50% are medical in nature and benefit from the expertise of a clinician with expertise in internal medicine.

The 2000 Royal College of Ophthalmologists Survey of Demand for Medical Ophthalmology in the United Kingdom found that many units wished to have an ophthalmic physician to enable them to deliver effective care. Inflammatory eye disease is a particular issue.

A 2005 survey, conducted by ophthalmologists with an interest in uveitis in Scotland, revealed a marked variation in the delivery of immunosuppression for sight-threatening uveitis, the commonest cause of treatable blindness in young adults.

Application of ophthalmology in medical specialties

Expertise in ophthalmic medicine is also appropriate for diabetes where the prevalence is expected to rise by 60% in the next decade as a consequence of the ageing population and the epidemic of obesity.

As the eye is a direct extension of the brain, then expertise in neurology is beneficial as many patients with visual disorders have conditions affecting the brain and its pathways rather than the eye itself.

The ophthalmic physician requires to have varied clinical skills beyond expertise in the assessment and diagnosis of visual symptoms and signs. He or she must have expertise in immunosuppression, neurology and cardiology.

In addition, many ophthalmic physicians will be involved in managing large diabetic retinopathy screening programmes, which require organisational and public health skills. Some will be required to manage retina-specific disorders requiring practical skills such as laser therapy and intra-ocular injections.

Benefits and workload

Ophthalmic medicine is a fascinating and rewarding specialty. It is predominantly out-patient based.

The workload of an ophthalmic physician is varied ranging from the personal delivery of care such as laser therapy for diabetic retinopathy through to the intellectual challenge of neuro-ophthalmic disorders. It is also very rewarding with the majority of conditions responsive to therapy.


Further information

Queries regarding the progress of a submitted application should be directed to the lead recruiter for this specialty:

London and South East (LaSE) Recruitment
ST3/general queries General enquiries - http://applicantenquiries.londondeanery.ac.uk 
Disability/GIS queries - confidential confidentialenquiries@southlondon.hee.nhs.uk
Fitness to practise queries - confidential fitnesstopractice@southlondon.hee.nhs.uk
website http://www.lpmde.ac.uk/laserecruitment/

General / application queries

For general queries relating to areas such as eligibility criteria, making an application or the Oriel system, please contact the Specialty Recruitment Office via email at st3recruitment@rcplondon.ac.uk.

Eligibility for medical ophthalmology

Please be aware that the specialty also accepts applicants from ophthalmology training routes.

Non-physician applicants must have obtained the basic specialty professional examination (FRCOphth Part 1) in addition to specific clinical experience and competences to be eligible. Therefore applicants seeking a position in medical ophthalmology must have one of the following:

  • Physician training (eg CMT) - MRCP(UK) Part 1 at time of application; full MRCP(UK) by required deadline

  • Opthalmology training - FRCOphth Part 1 by required deadline

Please view the medical ophthalmology person specification for information about the examinations, experience and competency required for applying to the specialty from a non-physicianly training background and the deadlines for when this must be achieved..

Medical trainees please view the standard eligibility criteria as detailed in the am I eligible? section.

National single centre model

This specialty uses the single centre recruitment model.

You will not be required to give any preferences of particular regions when completing your application; you are applying purely for the specialty at that stage.

Later on, you will be required to give preferences of the available posts – at that point, you can opt to be considered for as many (or as few) post vacancies available nationally as you wish.

Lead region and single centre interviews

The specialty will nominate a particular region to act as lead for the round; this region is shown under the 'Who do I contact?' tab above. This lead region will review all applications, liaise with all candidates, host interviews, verify assessments, and make offers on behalf of all regions nationally.

Your application will be handled solely by the lead region throughout the entire round, up to the point where you receive and accept an offer; after which it will be transferred to the region where the post is based for pre-employment checks.

All interviews will be held at this lead region although the clinicians making up the interview panel will be drawn from a national background – ie not just from the host region.

It is possible that there could be changes between now and the interview period. Please bear this in mind when reviewing the information below, although in most cases it is not expected this will change, or any changes will be minimal.  You are advised to check back in closer to the time of interview. The date at the foot of this page shows when the page was last updated.

Interview content

You will spend approximately 10 minutes at each of the three interview stations, with three-to-five minutes' transfer time between each. Thus the overall time for the interview will be approximately 40-45 minutes.

Click on the relevant stations below for more information on the content of the interview.

Please note that this is subject to change, and will be confirmed by the date of interview.


Interview scoring

Appointable - automatic

If you are awarded a score of  at least 3 / 5, for all marks  given to you at your interview, then you will automatically be classed as appointable .

Not appointable - automatic

If  any of the 12 scores awarded to you at interview are 1 / 5 , this will reflect poor performance and an area of major concern.

If  four or more of your 12 interview scores are of 2 / 5 , this will reflect several areas of concern across your whole interview.

Should your interview assessment falls under either category above, the level of concern over your potential progression to ST3 will see your application classed  automatically  as  not appointable  .

Appointability subject to panel decision

In the event that your 12 interview scores contain  one, two or three marks of 2/5  (and the rest 3/5 or above), your appointability status will be subject to discussion in the post-interview 'wash-up' meeting.

The clinicians who have interviewed you will discuss your general performance during the interview and any concerns or otherwise they have about your application as a whole.

Should they deem it appropriate, your application will be classed as appointable, and you can then be considered for post offers; whereas if they feel their concerns are too substantial for this outcome, they must class your application as not appointable, and it will progress no further in the current recruitment round.

Review vs automatic status

Please note there is no distinction made between candidates judged as appointable automatically, and those classed as appointable on review. Once deemed appointable it is only your overall score which will be used to determine ranking.


Establishing appointability

Appointable - automatic

If you are awarded a score of  at least 3/5, for all marks  given to you at your interview, then you will  automatically  be classed as  appointable .

Not appointable - automatic

If  any  o f the 12 scores awarded to you at interview are  1/5 , this will reflect poor performance and an area of major concern.

If  three or more  of your 12 interview scores are of  2/5 , this will reflect several areas of concern across your whole interview.

Should your interview assessment falls under either category above, the level of concern over your potential progression to ST3 will see your application classed  automatically  as  not appointable .

Appointability subject to panel decision

In the event that your 12 interview scores contain  one or two marks of 2/5  (and the rest 3/5 or above), your appointability status will be subject to discussion in the post-interview 'wash-up' meeting.

The clinicians who have interviewed you will discuss your general performance during the interview and any concerns or otherwise they have about your application as a whole.

Should they deem it appropriate, your application will be classed as appointable, and you can then be considered for post offers; whereas if they feel their concerns are too substantial for this outcome, they must class your application as not appointable, and it will progress no further in the current recruitment round.

Review vs automatic status

Please note there is no distinction made between candidates judged as appointable automatically, and those classed as appointable on review. Once deemed appointable it is only your overall score which will be used to determine ranking.

Total score weighting

After interview, a weighting is applied to the scores in each area, as well as the 'shortlist' score awarded to your application form.

These scores are then combined to give your total score which is determing your ranking which will in turn be used to inform how offers are made. The weighting of different sections, as well as the method by which your total score is established, can be seen by clicking on 'Total score calculation' below.

Please note that this is subject to change, and will be confirmed by the date of interview.

page updated 28 July 2017

As part of the process of applying to ST3, you may wish to gain an idea of how recruitment progressed in previous years for the various specialties participating in JRCPTB-coordinated recruitment.

To this end, we have published data dating back to 2013 (where this is available), based around four main areas:

  • Competition ratios - application numbers submitted to each specialty, along with the number of NTN and LAT posts available in each. It is worth noting that posts are subject to change throughout the round (increasing on average between 20-40%), and post numbers for this data are taken at the end of the round.

  • Shortlist scores - the scores awarded to all submitted applications, including average scores and distribution nationally.

  • Total scores - the total score awarded to all candidates who completed the full recruitment process for a specialty (application and interview), including some analysis of scores.

  • Post fill rates - the number of posts filled by region. 

We have published information for all specialties participating in our process that year; consequently not all specialties will have data in all cases.

Provisional post numbers

Specialty vacancy numbers are available in the table below, broken down by region and divided between substantive national training number (NTN) and locum appointment for training (LAT) posts.

It is the intention that initial post numbers for all regions will be published prior to the application opening date, although this cannot be guaranteed.  Numbers will be updated as and when notifications are received from each region and will be checked later in the round when programme preferences are open for selection.

Numbers subject to change

Please be aware that it is not uncommon for vacancy numbers to change throughout the round.

More commonly, post vacancy numbers can increase as the round goes on (and confirmation of posts becomes available); but it is also possible that numbers can reduce as well. On average post numbers rise between 20-40% from the start to the finish of the round but this can vary greatly for individual specialty/region combinations.

It is possible that regions which do not have a post at the start of the round may declare one after applications have closed. Whilst we try and minimise instances of this, it is not always possible to predict vacancies so even if there appears not to be a vacancy in your preferred specialty/region combination, you may wish to consider applying in case one becomes available during the round; you can check with the region concerned if you wish to check on the likelihood of a post arising.

Generally, once a region enter a post into a round they would always have at least one post available and would only withdraw it in exceptional circumstances.

Round 2 Interview dates & post numbers

Region NTN posts LAT posts* Interview date(s)
HE East Midlands 0 n/a

London

Wednesday 30 August

HE East of England 0 n/a

London and South East

0

 n/a
 n/a
HE North East 0 n/a
HE North West

Mersey

1

n/a

North Western

0

n/a
HE South West

Peninsula

0

n/a

Severn

0

n/a
HE Thames Valley 0 n/a
HE Wessex 0 n/a
HE West Midlands 0 n/a
HE Yorkshire & Humber 0 n/a
Scotland** 0 tbc
Wales 0 tbc

Round 1 Interview dates & post numbers

 

Region NTN posts LAT posts* Interview date(s)
HE East Midlands 0 n/a

London
Tuesday 11 April

HE East of England 0 n/a

London and South East

(lead)

Kent, Surrey & Sussex

 n/a

 London
0

 n/a
HE North East 0 n/a
HE North West

Mersey
2

n/a

North Western
0

n/a
HE South West

Peninsula
0

n/a

Severn
0

n/a
HE Thames Valley 0 n/a
HE Wessex 0 n/a
HE West Midlands 1 n/a
HE Yorkshire & Humber 0 n/a
Scotland** 1 0
Wales 0 0

*English LATs

Please note, English regions do not recruit to LAT posts.

**Scotland post numbers

If you are interested in working in Scotland, a breakdown of post numbers by the four Scottish deaneries is available on the Scottish Medical Training website. This has details of all specialty training post numbers in Scotland, including specialties which are not part of the JRCPTB-coordinated process.

Please note that whilst we endeavour to keep the ST3 recruitment website up to date, the SMT website will always be the more accurate one where they differ.