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Medical ophthalmology

This page provides useful information on the nature of the work, the common procedures/interventions, sub-specialties and other roles that may interest you.

Nature of the work

Medical ophthalmologists are doctors trained in both general (internal) medicine and ophthalmology. They manage medical eye disorders, many of which are related to systemic (ie whole-body) disease such as diabetes, hypertension, atherosclerosis, inflammation, infection and malignancy. Ocular inflammatory disorders may be the first manifestation of systemic disease and it is important that the whole patient is investigated and treated, not just the presenting organ. Their role is different from ophthalmic surgeons who are specialists in the surgical and medical treatment of diseases and injuries in and around the eye.

Medical ophthalmologists treat conditions such as:

• inflammatory/infectious disorders affecting vision, eg uveitis, scleritis, corneal graft rejection, systemic vasculitis, thyroid eye disease
• neurological disorders affecting vision, eg multiple sclerosis, brain tumour, stroke, pituitary disorders, thyroid eye disease,
• raised eye pressure, eg glaucoma
• retina specific disorders affecting vision, eg age-related macular degeneration
• vascular disorders affecting vision, eg diabetes, diabetic retinopathy,
• genetic disorders affecting vision, eg retinitis pigmentosa

“Ophthalmology is a fascinating area and although it is a niche specialty” Dr Richard Gale is a consultant in medical ophthalmology, working at York Teaching Hospital NHS Foundation Trust

Read Richard'’s story

Common procedures/interventions

These include:

• clinical examinations
• prescription of drug treatments, including immunosuppressive therapies
• laser therapy
• intra-ocular injections for the treatment of uveitis (inflammation of the middle layer of the eye) and retinal disorders
• diagnostics taps
• botulinum injections for facial dystonias (involuntary muscle contractions)

Good stereoscopic binocular corrected visual acuity is required for a career in medical ophthalmology.

Sub-specialties

There are no CCT sub-specialties or associated sub-specialties for medical ophthalmology, but medical ophthalmologists usually focus on one or more of the following areas; adult uveitis, paediatric uveitis, orbital inflammation, neuro-ophthalmolology, medical retina, diabetes retinal screening. UKNOSIG is a special interest group for those interested in neuro-ophthalmology.

Want to learn more?

Find out more about:

• the working life of someone in medical ophthalmology
• the entry requirements and training and development
• the specialty through the interview with Dr Richard Gale, a consultant in medical ophthalmology

• Pay and conditions

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  This section provides useful information about the pay for junior doctors (doctors in training), specialty doctors, consultants and general practitioners.

  Find out more about the current pay scales for doctors, and there's more information on the BMA website.

  NHS Employers provides useful advice and guidance on all NHS pay, contracts terms and conditions.

  Medical staff working in private sector hospitals, the armed services or abroad will be paid on different scales.

• Where the role can lead

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  Read about consultant and non-consultant roles in medical ophthalmology, flexible working and about wider opportunities.

  Consultant roles

  You can apply for consultant roles six months prior to achieving your Certificate of Completion of Training (CCT). You will receive your CCT at the end of medical ophthalmology.

  Managerial opportunities for consultants include:

  • clinical lead - lead NHS consultant for the team
  • clinical director - lead NHS consultant for the department
  • medical director - lead NHS consultant for the trust

  Most NHS consultants will be involved with clinical and educational supervision of junior doctors.

  Here are some examples of education and training opportunities:

  • director of medical education - the NHS consultant appointed to the hospital board who is responsible for the postgraduate medical training in a hospital. They work with the postgraduate dean to make sure training meets GMC standards.
  • training programme director - the NHS consultant overseeing the education of the local cohort of trainee doctors eg foundation training programme director. This role will be working within the HEE local office/deanery
  • associate dean - the NHS consultant responsible for management of the entirety of a training programme. This role will be also be working within the HEE local office/deanery

  SAS doctor roles

  There are also opportunities to work at non-consultant level, for example as a SAS (Specialist and Associate Specialist) doctor. SAS doctors are non-training roles where the doctor has at least four years of postgraduate training, two of those being in a relevant specialty. Find out more about SAS doctor roles.

  Other non-training grade roles

  These roles include:

  • trust grade
  • clinical fellows

  Academic pathways

  If you have trained on an academic medical ophthalmology pathway or are interested in research there are opportunities in academic medicine.

  For those with a particular interest in research, you may wish to consider an academic career in medical ophthalmology. Whilst not essential, some doctors start their career with an Academic Foundation post. This enables them to develop skills in research and teaching alongside the basic competences in the foundation curriculum.

  Entry into an academic career would usually start with an Academic Clinical Fellowship (ACF) and may progress to a Clinical Lectureship (CL). Alternatively some trainees that begin with an ACF post then continue as an ST trainee on the clinical programme post-ST4.

  Applications for entry into Academic Clinical Fellow posts are coordinated by the National Institute for Health Research Trainees Coordinating Centre (NIHRTCC).

  There are also numerous opportunities for trainees to undertake research outside of the ACF/CL route, as part of planned time out of their training programme. Find out more about academic medicine.

  The Clinical Research Network (CRN) actively encourages all doctors to take part in clinical research.

  Other opportunities

  There are many opportunities for research and teaching. Most medical ophthalmologists consider teaching medical students, trainee specialists and other professionals such as orthoptists and nurses as an integral and enjoyable part of their job. There are research opportunities both laboratory-based and clinical, in many places with exciting advances for example treatment of autoimmune disease, genetic therapies and artificial vision.

• Job market and vacancies

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  This section provides useful information about the availability of jobs, finding vacancies and where to find out more.

  Job market information

  Medical ophthalmology is a small, but growing medical specialty.

  Medical ophthalmology has around 14 consultants and 10 specialty registrars in the UK. Women make up 29% of the consultant workforce in the UK Less than whole-time working is possible in this specialty.

  In 2016, the competition ratio for CT1 Core Medical Training was 1.53 and for ST3 Medical Ophthalmology it was 9.0 (NHS specialty training, 2016).

  The age profile of the specialty is skewed with nearly half the workforce in their 60s and close to retirement. The Centre for Workforce Intelligence has recommended staged increases in the medical ophthalmology workforce (Securing the future workforce supply Medical ophthalmology stocktake, February 2014) to overcome this problem and to improve the national distribution of medical ophthalmologists as half the regions of the UK do not have access to a dedicated consultant. Eye health services are becoming more and more important as the UK population ages.

  Outside the NHS in private practice, there are opportunities especially in the areas of macular degeneration and diabetes, and to a lesser extent in managing inflammatory eye disease.

  On this section we have information for England only. For information regarding Scotland, Wales and Northern Ireland please click on the links below.

  NHS Scotland medical and dental workforce data

  NHS Wales medical and dental workforce data

  Department of Health, Social Services and Public Safety workforce information for Northern Ireland

  Where to look for vacancies

  All trainees apply through the online application system Oriel. You will be able to register for training, view all vacancies, apply, book interviews and assessment centres, and manage offers made to you.

  All jobs will be advertised on the NHS Jobs website.

  The BMJ Careers website also advertises vacancies.

• Further information

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  Organisations

  Royal College of Physicians

  Royal College of Physicians of Edinburgh

  Royal College of Physicians and Surgeons of Glasgow

  Medical Ophthalmological Society

  The Royal College of Ophthalmologists