The impact of the bottleneck to entry into ophthalmology specialty training

Abstract

Seventy-nine per cent of those living with visual impairment are over 60 and increased longevity will increase the prevalence of eye diseases by more than 50%. To meet the escalating demand for eye care, more ophthalmologists must be trained. Changes to the application in 2024 have been aimed at facilitating this. Aim: To evaluate the opinions of aspiring and current ophthalmology trainees regarding the recent changes. A survey-based questionnaire of 11 questions was developed and distributed amongst medical students and junior doctors. We received responses from 17 medical students (17.6%), foundation doctors (5.9%), junior doctors out of training (17.6%), and ophthalmology trainees (58.9%), with 76.5% trained in the UK. Demographically, 41.2% were Black, 11.8% White, 29.4% Asian, and 5.9% Arab. Among current trainees, 60% had been unsuccessful in their first application, and an additional 10% on their second attempt. Despite 88.2% being aware of the competition, all found securing a training post challenging. Over half disagreed with the sufficiency of ST1 positions, and none supported the elimination of the ST3 application route. Applicants are applying multiple times, each with progressively more competitive portfolios and higher entry exam scores. For this reason, the recruitment process may be missing out on good ophthalmologists who did not have the necessary privileges to excel relatively early on in their professional careers. Such candidates may have fared better as ST3 candidates. To service the widening and complex demographic of patients, changes may need to be made to meet the demand with a diverse workforce.