FAQs

All resident doctors are expected to audit their surgical results, especially with reference to cataract surgery and any other Level 4 surgical SIA. A continuous cataract complications audit will be mandatory for every ARCP. The 50 consecutive cataract audit will need to be done within 3 calendar years of being awarded Cataract Surgery Level 4.

All resident doctors are expected to continue maintaining their surgical logbook using the Eye Logbook. The only difference is that there are no mandatory requirements for surgical procedures in Curriculum 2024.

Most resident doctors will achieve descriptors and, in some cases, entire Learning Outcomes in Level 1, ahead of the indicative time. Some training units may choose to use the first Learning Outcomes of Level 1 Patient Management to assess whether residents are ready to be first on-call early in their training.

However, it may take a little longer to be signed off as competent at all of the Learning Outcomes necessary to manage a low complexity ophthalmology patient, including demonstrating underlying knowledge of basic and clinical science (evidenced by the FRCOphth Part 1 examination) and initiating management plan. The end of ST2 is simply the latest point at which entrustment in all of the Level 1 Learning Outcomes must be demonstrated to allow continuation on the training pathway. Where any capability is demonstrated earlier, residents should start working towards achieving entrustment at the Learning Outcomes in the next level.

No, surgical training will continue to be delivered from ST1 onwards, augmented with training in simulated environments.

The curriculum defines the level of training by which the ophthalmologist must be able to perform the described Learning Outcome independently. Therefore, while it is true the Level 3 Learning Outcomes (including surgical capabilities) do not need to be evidenced as competent at an ‘independent’ level until the end of Level 3 (maximum time allowed is 5 ½ years of full-time equivalent training), the EPA summative assessment tools will ensure that surgical capability is being assessed throughout. They will assess the level of entrustment as ‘observing’, ‘under direct supervision’ or ‘indirect supervision’ at the earlier stages of training, and this will be reviewed in the Educational Supervisor Report (ESR) and by the ARCP panel.

When residents are working in a SIA and have achieved the Level 3 surgical capabilities, training can immediately proceed to develop the skill for the Level 4 capabilities, which will initially be at the ‘direct supervision’ level.

The Level 1 and Level 2 capabilities are achievable in a general ophthalmology environment: general clinics, urgent eye care and on-call ophthalmology will all be excellent environments to achieve these. TPDs need to ensure that posts can deliver the curriculum, and this is likely to need a change in programme organisation.

Competence in Level 3 capabilities will require exposure to SIA clinics and theatre lists. There is some overlap between the syllabi in some of the SIAs. Again, TPDs need to review their programmes to ensure the curriculum is delivered. For example, two SIAs may be covered in the same 6-month post.

The EPA is the responsibility of a single Named Clinical Supervisor (NCS). However, there may be other consultants, clinical staff or other health professionals (e.g. orthoptist) who also supervise a resident or witness competencies during a rotation. The MAR is meant for them to be able to give feedback to the NCS to help in completing the EPA.

Please remember that simulation training can be high-fidelity or low-fidelity, each providing differing validity.  Simulation training does not necessarily need to be on an EyeSi and could also include suture boards, plastic eyes or even practice at home with grapes / tomatoes and a pair of rhexis forceps.  As emphasis increases on this valuable learning tool, it will be necessary for departments to invest in simulation materials.

Bookable simulation resources are available at the College. The document Simulation in the Curriculum gives advice and resources to aid development of simulation.

You may be required to use these skills when a specialist oculoplastic surgeon is not available. This may be required as an emergency in a trauma case where you are the on call surgeon and have to proceed yourself.

Whilst record numbers are required in the logbook, they should not be used in the portfolio.

It is important that you understand the technical procedure to obtain biometry measurements as this aids with interpreting the results, and can be essential when nurses are unable to perform biometry for any number of reasons.  We suggest that, where doctors are not routinely involved in biometry, this could be a practical session at a regional Postgraduate Teaching session at which all resident doctors would be able to complete this outcome.  This outcome can be assessed by a technician or nurse who regularly performs biometry as long as they are trained in assessments

The College defines the curriculum requirements to obtain a CCT.  How the curriculum is delivered is largely determined by the NHSE local office/Deanery leads. If a Deanery requires, for example,  EyeSi training or evidence of leadership, as long as it is made clear that this a requirement for ARCP, and the resources are made available to residents to allow completion, residents are expected to meet those requirements.

It is increasingly common to be asked about refractive surgery by patients, and it is therefore important to have a basic understanding of the techniques, risk and benefits. Additionally, patients who have had refractive surgery in the private sector may present to the NHS with complications and require urgent or long term management.

A CbD does not require any supervision of the consultation by the assessor, and can be done retrospectively from the medical notes.  This particularly facilitates cases seen on-call being discussed and assessed.