Since the last national ophthalmology trainee survey was conducted in 2014, the UK government introduced a new junior doctor contract (JDC) whilst demand for ophthalmology services has risen to unprecedented levels. To assess the impact of these and other factors on Ophthalmic Specialist Training (OST), a follow-up 25-question online survey was conducted.
Despite a high overall satisfaction in the OST, several factors have led to an erosion of training opportunities. The survey highlights targets for improving OST, particularly with regard to rota design, flexible working arrangements and educational support. The previous national survey of OST trainees concluded that further research is necessary to determine how the recently imposed JDC affects training. In response, our 2019 survey confirms that a combination of the new JDC, increasing service demand and lack of capacity are contributing to an erosion of training opportunities. There remains a strength of feeling among trainees that adequate generalist and special interest training can be achieved within the existing seven-year programme.
Despite laudable initiatives within the new curriculum to make OST more focused and provide more flexibility for trainees, it is clear that much more effort will be required to balance the frequent conflicts between service demands and training opportunities.
The development of a new training curriculum by The Royal College of Ophthalmologists provides an opportunity to address some of the issues highlighted in this survey. Given recent data on the impact of simulation training on cataract surgery complication rates in junior trainees, improving local access to simulation resources must also remain a priority for trainers.
Whilst the majority of ophthalmology trainees intend on pursuing a surgical career pathway, it is of interest that a small minority would consider taking up a consultant post as a non-operating ophthalmologist. This, along with the ability to work flexibly, should be considered by employers and reflected in consultant job plans that are adapted to the changing needs of the workforce. It remains to be seen how recent contract updates to the JDC, the departure of the UK from the EU and the proposed new curriculum will impact ophthalmology training in the UK.
View the full survey document here.