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.

Entry to medical ophthalmology training is from either internal medicine/ core medical training or ophthalmology specialty training.


Medical ophthalmology - trainee characteristics

Trainee physicians with the skills detailed below 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.

New medical treatments for eye disease, including the use of biological agents for inflammatory eye disease, have increased the demand for medical specialists in ophthalmology.

The Centre for Workforce Intelligence issued a report in 2014 recommending a staged increase in medical ophthalmology training posts to meet the growing requirement for medical care in ophthalmology.

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. There are opportunities to specialize within medical ophthalmology and to combine clinical care with research or educational roles.


Medical Care

Find out more about medical ophthalmology and the services delivered by the specialty on Medical Care – the RCP’s online guide to service design.


Further information

General / application queries

For general queries relating to areas such as eligibility criteria, making an application or the Oriel system, please contact the Physician Specialty Recruitment Office.

Queries regarding the progress of a submitted application should be directed to the lead recruiter for this specialty. The lead recruiter for medical ophthalmology in 2021 is London and KSS (LaKSS) Recruitment:

London and KSS (LaKSS) Recruitment
ST3/general queries General enquiries - Enquiry Form 
Fitness to practise/Disability/GIS queries - confidential https://lasepgmdesupport.hee.nhs.uk/support/home
Website http://www.lpmde.ac.uk/laserecruitment/

 

Eligibility for medical ophthalmology

Please be aware that, in addition to physician training, the specialty also accepts applicants from ophthalmology training routes.

Paediatric applicants must have obtained the basic specialty professional examination in addition to specific clinical experience and competences to be eligible. 

Please view the specialty's  person specification  for information about the requirements for applying from a non-physician background and the deadlines for when this must be achieved.

Physician trainees can view the standard eligibility criteria as detailed in the  am I eligible?  section.

Please note that due to the ongoing COVID-19 situation, certain recruitment processes have been affected for round 2 ST3 PSRO-coordinated specialties. As a result, the below information on this page is not applicable for this round only and should not be used where the process has changed. Please refer to the applicant guide for the latest information about how round 2 will operate.

Further guidance about the scoring format of interviews will be published to each specialty page and we hope to have this updated by application closing date. Please visit the specialty pages closer to the time for updated information.

 

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 fall 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.

Total score calculation

After interview, a weighting is applied to the scores in each area, as well as the application form score, to give a 'total score'. This score determines your ranking which is 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.

date of last review: 6 December 2019

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 the nationally-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 1 interview dates & posts

Region NTN posts LAT posts* Evidence upload date(s)Interview date(s)
East Midlands 0 N/A

20 January 2021

22 March 2021

East of England 1 N/A

London and KSS

Kent, Surrey & Sussex
N/A

 N/A

 London
0

 N/A
North East 0 N/A
North West

Mersey
TBC

N/A

North Western
0

N/A
South West

Peninsula
0

N/A

Severn
0-1

N/A
Thames Valley 0 N/A
Wessex 0 N/A
West Midlands 0-1 N/A
Yorkshire & Humber 0-1 N/A
Scotland** 0-1 TBC
Wales 0 TBC

*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 nationally-coordinated process.

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

Interview content

The format for interviews in 2021 is being confirmed and will published here as soon as it is available.

Scoring Framework

The score of 1-5 an interviewer will award you for each assessment area is judged in relation to how well you perform against an expected level. Below is the framework used to award scores at interview, as well as interpretation of what these scores represent:

  

  

  

Mark

  

  

  
  

  

  

 Rating

  

  

  
  

  

  

Assessment

  

  

  

1

poor

not considered appointable

2

area for concern

performed below the level expected; possibly unappointable, subject to discussion and performance in other areas

3

satisfactory

performed at the level expected during CT2; the candidate is suitable for an ST3 / LAT post

4

good

above average ability; the candidate is suitable for an ST3 / LAT post

5

excellent

highly performing trainee; the candidate is suitable for an ST3 / LAT post

As shown in the table, for each of the question areas at interview, 3/5 is considered a satisfactory score; and reflects the level of performance that would be expected of a trainee ready to progress to a specialty training programme.

Should your performance go above and beyond this expected level, interviewers can award marks of 4/5 or 5/5 as appropriate.

Conversely, should your interview performance not reach the expected level, then interviewers can award marks of 1/5 or 2/5, as reflects their level of concern over your performance.


Appointability

From the eight scores awarded during your interview, an 'appointability' status will be calculated to determine whether you can be considered for an offer.

The intention is to ensure successful candidates can display competence consistently across all areas of assessment covered at interview, rather than allowing outstanding achievement in one or more areas to make up for sub-par performance elsewhere.

Appointability is awarded automatically and is based on two factors: individual interview scores and the 'raw interview score'.

Appointability criteria

To be classed as 'appointable', you must meet three criteria below:

  • none of your 8 interview scores can be 1/5
  • no more than two of your 8 interview scores can be 2/5
  • your RIS must be 24 or above.

If you meet all three requirements, your application will be assessed as appointable, and can progress to be considered for post offers.

However, if you fail to meet any of these requirements, your application must then be assessed as not appointable, and it will progress no further in that round.


Total Score

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

These scores are then combined to give your total score which determines 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, is detailed in the table accessible through the link below:

    
 
  
    
 Interviewer 1
  
    
 Interviewer 2
  
    
Weighting
  
    
Max score
  
Question 1
TBC
/ 5
/ 5
TBC
      TBC
TBC
/ 5
/ 5
TBC
TBC
Question 2
TBC
/ 5
/ 5
TBC
TBC
Question 3
 
 
 
TBC
/ 5
/ 5
TBC
TBC
Raw interview score
/ 40
Interview score (w weighting)
/ 80
 Application score
/ 56
0.36
/ 20.16
 Total score
/ 100.16