The curriculum consists of seven curriculum Domains. Each domain is subdivided into four levels, which describe the standard ophthalmologists in training need to evidence by defined critical advancement points.
Domains
- Patient Management
- Health Promotion
- Leadership and Team Working
- Patient Safety and Quality Improvement
- Safeguarding and Holistic Patient Care
- Education and Training
- Research and Scholarship
The Patient Management domain is divided into twelve Special Interest Areas (SIAs).
SIAs
- Oculoplastics and Orbit
- Cornea and Ocular Surface Disease
- Cataract Surgery
- Glaucoma
- Uveitis
- Medical Retina
- Vitreoretinal Surgery
- Ocular Motility
- Neuro-ophthalmology
- Paediatric Ophthalmology
- Urgent Eye Care
- Community Ophthalmology
Advancement Points
Level 1
During this stage (usually spanning the OST1-2 years), ophthalmologists in training develop clinical and procedural skills which are essential for both acute care and general ophthalmology. They also develop values and behaviours in all other curriculum domains, including reflective practice and communication, and acquire the basic science knowledge essential for the practice of ophthalmology, which is assessed by the Part 1 FRCOphth examination.
Level 2
The theme of general ophthalmology continues at this stage (usually spanning the OST3 year), with ophthalmologists in training adopting spiral learning and demonstrating increasing independence and efficiency. They continue to use skills of reflection and self-awareness to recognise their own achievements and limitations. They begin supervision of more junior doctors where appropriate.
At the end of this stage the Refraction Certificate examination must have been passed to progress further. This test of knowledge involves an understanding of theoretical principles of optics, refraction and the related clinical skills, essential for higher practice.
Level 3
During this stage (usually spanning the OST3 to mid-way OST6 years), ophthalmologists in training rotate through posts to receive mandatory training in the specific clinical skills related to the twelve SIAs in order to have an understanding of ophthalmology as a whole and prepare to work in specialty-based hospital eye services. Ophthalmologists in training develop transferable surgical skills as they move between these specialty posts and continue to consolidate their cataract surgical skills. Progression in cataract surgery is demonstrated by the completion of more complex procedures, a continuous cataract complications audit and formative assessments. Other surgical and procedural skills are also assessed formatively. Clinical knowledge is assessed by the final Part 2 FRCOphth examination.
Level 4
During the final 18 months of the programme, ophthalmologists in training develop Level 4 skills of at least two areas of special interest within the Patient Management domain.
Level 4 training is designed to be flexible to meet changing service requirements, allowing to maintain the highest level of clinical outcomes as well as supporting the efficiencies gained from delivering special interest area services.
Ophthalmologists in training planning to work in localities where it is necessary to provide a more generalist ophthalmology service could continue to develop their skills in Urgent Eye Care and/or Community Ophthalmology along with their cataract expertise.