The How To Guide for Curriculum 2024

The application is submitted to the GMC, which will require the application to ensure that the new curriculum is evidenced. There is specific information on the RCOphth website. All candidates are encouraged to register their intention to apply with the RCOphth Portfolio Pathway team ([email protected]).

Candidates wishing to apply to the new curriculum will be able to download Word versions of the new curriculum forms from the curriculum microsite

You should go to the OST Curriculum 2024 microsite  which is a complete repository of all learning outcomes and assessments. It also contains core documentation such as the Curriculum Handbook and Matrix of Progression.

The RCOphth has developed the Matrix of Progression which describes the key progression requirements for each year of training, taking into account the requirements for advancement between levels. The Matrix has been disseminated to all deaneries as essential guidance for ARCP panels. The ARCP process itself is exactly the same as before.

The Curriculum Sub-Committtee produced this Simple Guide to the Curriculum. It is designed to help both resident doctors and their educational and named clinical supervisors navigate the curriculum documentation.

You will find all the information you need in the Curriculum Handbook, particularly in the Level Guides and Section 7 ARCP.

Yes. The Transition Progression Requirements explains how Outcome 1 and completion of Curriculum Transition Checklists were used to guide transition to Curriculum 2024. This is because you did not repeat the competencies in the current curriculum, and so you could see as soon as you transfer to the new curriculum where any ‘training gaps’ exist, allowing you to plan your continuing training. You will not be required to repeat things that have already been assessed as competent.

This was a one-off exercise and is left here for reference.  Only specific documents needed to be uploaded after the transfer in August 2024 (requirements were determined by the curriculum you follow).  It was not necessary to upload more evidence for competencies already signed off in the old portfolio system.

You can change the ‘tagging to’ order and switch between Level 1 & 2 and level 3 & 4 domain/ learning outcome coverage.

If you experience technical difficulties, please contact the FourteenFish Helpdesk.

The Community Ophthalmology Level 3 SIA sign off requirement for transfer was the transition checklist that lists all learning outcomes and descriptors. The lists of evidence on that document as well as the guide to Community Ophthalmology on Inspire are not prescribed pieces of evidence or modules that need to be completed – they are simply examples of evidence that can be used to demonstrate that a learning outcome has been met.

It is important to remember that this is not a tick box exercise – the quality of evidence against every learning outcome should be assessed to determine if it demonstrates that the outcome has been achieved. Some of these pieces of evidence will be modules; others will include passing of exams, CbDs and time spent in a community optometrist practice or in a triage service, communication with community optometry, attendance at primary care provider meetings, etc. Sometimes one piece of evidence of good quality may suffice for more than one learning outcome.

No, that is all you need to do.

No examination result will show in the ePortfolio until early 2026, at the earliest, due to further technical glitches encountered by FourteenFish when transferring the data.

You should retain all correspondence from the Examinations team and, in the interim, upload result emails to the Curriculum Catch-up tab in your Learning Logs.

The answer is that if CCT is due to be awarded after August 2026, then you have to transfer to the new curriculum, regardless of whether you are LTFT, OOP or academic.

If the CCT was due to be awarded in or before August 2025, then you have to stay on the old curriculum.

If the CCT was due to be awarded after August 2025 and in/or before August 2026, you will have a choice but, in most circumstances, it may be in your benefit to transfer to the new curriculum. Residents will be encouraged to transfer, and indeed, this will be in their best interests as it will mean that advanced training in the new curriculum will be funded, as opposed to fellowships, which are not.

The answer is that if CCT is due to be awarded after August 2026, then you have to transfer to the new curriculum, regardless of whether you are LTFT, OOP or academic.

If the CCT was due to be awarded in or before August 2025, then you have to stay on the old curriculum.

If the CCT was due to be awarded after August 2025 and in/or before August 2026, you will have a choice but, in most circumstances, it may be in your benefit to transfer to the new curriculum. Residents will be encouraged to transfer, and indeed, this will be in their best interests as it will mean that advanced training in the new curriculum will be funded, as opposed to fellowships, which are not.

You should use the Helpdesk button to raise a ticket and include a full description of the problem, with screenshots if possible, so that the support agents can address queries more quickly.

FourteenFish aim to respond within 5 working days and a unique ticket reference number is generated. You should escalate to [email protected] if the response is inconclusive or unclear (including the reference number in your correspondence).

Click the green Portfolio button at the top of the screen to access the Portfolio Overview page, from which you can:

• find the Learning Logs to upload other evidence (audits, certificates, etc.)
• start assessment forms (Educational Assessments)
• check progress (Portfolio Summary and Training Map)
• locate/download historical data from the old system, if applicable (Educator Notes)

Please contact [email protected] if your CCT date is wrong or missing.

Any leave, including sick leave, that is recorded in the TOOT section will deduct from the WTE total days in training.

Please consult the Help Centre for more details.

A one-off Educator Notes entry was created by FourteenFish as a way to give access to historical data (ARCPs, assessments and other documents). This is not their main function and, in this instance, was for the purpose of migration. Please disregard any MACOSX folders.

See also ‘How to find your historical portfolio data’ further above.

Other Educator Notes may be added by your ES, TPD and Deanery administrators.

ESs and NCSs alike must be invited by you to create their own account, which will give them access to evidence you have linked to EPAs and GSATs.

Other assessors do not need an account to sign forms off. Assessment requests to complete WpBAs are sent directly by you, and emails will contain links to forms.

In some specific local circumstances, the NCS and ES can be the same person.

Please follow the link for more details about the different roles.

If you have a number of supervisors listed, this is because you have selected them yourself. You should only have an ES and NCS for each Review Period. You should try to remove the other names and raise a ticket if you need help.

This is for Form R which applies to England, Wales and Northern Ireland. The SOAR form applies to Scotland only. They are equivalent.

You will find full details of all the assesments and their requirements in the Assessment section of the Curriculum Handbook. The Assessment Blueprint and Matrix of Progression summarise the assessments required for each level and year of training.

Your supervisors and assessors should receive emails from the system when you send them assessment forms to complete.  Please remember that:

• you must invite your ES and NCS to view your portfolio, and they have to create an account before they can access your evidence.
• GSATs and EPAs need to have items linked to them for the ES and NCS to review – you will not be able to get these assessments signed off without providing the required evidence. Any learning outcome can be tagged to any entry or assessment for the relevant level. However, no item should be linked/tagged more than three times.

The Curriculum Handbook outlines who signs which assessments:

• You should send EPAs to NCSs.  The NCS should normally only sign off an EPA in their own SIA. However, local solutions might be necessary in some specific areas.
• You should send GSATs to your ES. If the GSAT is signed by an NCS in error, you should contact the Helpdesk. It is likely that you will need to repeat the entire process with the correct supervisor.
• You have to do one GSAT, one EPA and one ESR every six months.
• The term “formative tool” used in the EPA is used for occasions when you might wish to demonstrate progress but are not yet ready to have that competence fully assessed. DOPS or OSATS can be used as formative rather than summative assessments. These can be tagged/linked in exactly the same way as other items.

Please use the Make a copy button to create a new version of the previous EPA or GSAT for a new Review Period.

The Chair of the Curriculum Sub-Committee has developed a handy checklist for resident doctors, NCSs and ESs as to the forms that need to be completed at the end of each rotation.

The Curriculum Handbook contains full details of who completed what forms and when.

Please note that the ePortfolio refers to “survey” rather than “MSF”. You should follow this guidance for completing your MSF and also consult the Help Centre articles for more details.

• Once past the self-assessment questionnaire, please add the appropriate mix of colleagues.
• The list of assessors must be discussed and agreed with the ES prior to starting the process. Failure to do so is a probity issue.
• Only professional hospital/Trust email addresses must be used. Personal addresses are not allowed.
• The system will automatically send reminders to any non-responders 10 days after their initial invites are sent out. Should you need any further reminders sent out, please contact the Helpdesk.
• You can add assessors to the MSF at any time. Once you have received 11 responses, the option to Close Survey will become visible in the Progress box.
• The ‘Collect patient feedback’ and peer benchmarking data (percentages) should be disregarded as not applicable to Ophthalmology.
• The comparator data in the Summary Report should also be disregarded – it a feature of the system that cannot be changed.

The process of updating Training Maps to show the next ST stage and Level is manual and will be completed by College staff as soon as possible. In the meantime, you should:

• Ensure the Review Period ending 05/08/2025 is linked to the pre-ARCP Level, if you have one in your Training Map
• Add a new Review Period (August 2025 – February 2026) and mark it as current
• Invite your new ES/NCS to gain access to your portfolio

You should be able to add new evidence and tag items to the higher Level / learning outcomes whilst waiting for your Training Map to be updated.

The ePortfolio is not replacing the existing surgical logbook. You should use the same ESR button (Output Data) to generate your PDF report and then upload it to the Logbook tab in your Learning Logs.

The role of the College is to define the curriculum requirements only, and it is for the deaneries to manage Level 4 timetables. While all deaneries are supposed to offer Level 4 posts, they do not have to guarantee a resident’s preferred choice.

Professional bodies (e.g. BEAVRS, BIPOSA, etc.) were consulted about the amount of time likely to be required for trainees to be entrusted to undertake independently the activities described in the Level 4 Learning Outcomes. Those that are more surgically based, and/or where experience of the specialist surgery is likely to have been limited before entering Level 4 training, are longer. These are only indicative times as Curriculum 2024 is competency-based rather than time-based.

All trainees are required to complete at least two Level 4 SIAs.  It is expected that most trainees will achieve or be close to achieving Level 4 in Cataract Surgery by the mid-point of ST6, as well as achieve Level 3 in all other SIAs. They may then proceed to complete their Level 4 Cataract Surgery (if not already done) and take on another Level 4 in the remaining training time. However, equally, they could choose to complete two further Level 4s in the remaining time. For example, trainees who have completed Level 4 Cataract Surgery and all Level 3 in other SIAs by mid-ST6 could use their final 18 months of allowed training to complete Level 4 training in both Urgent Eye Care and Community Ophthalmology. However, training cannot be extended beyond the 7-year training envelope to undertake additional, longer SIAs. Educational Supervisors and TPDs will advise about individual selections.

The professional bodies have advised us that the curriculum content stated for Level 4 is deliverable within the indicative times given. This will ensure that trainees can perform the core special interest procedures independently in the Level 4 areas they have selected.

To note that in some of the SIAs, eg Vitreoretinal Surgery and Cornea and Ocular Surface Disease, the Level 4 curriculum does not cover the full complexity of surgical procedures performed by specialist consultants. In some cases, trainees will still choose to proceed to a post-CCT fellowship in these SIAs to gain these additional skills.

However, it is anticipated that, in many of the SIAs, ophthalmologists with a CCT will be equipped to move straight into a consultant post.

Completion of Level 4 training in all of the generic domains and at least two of the Patient Management domains is a requirement for CCT.  If you had only completed one Level 4 Patient Management domain by the end of the 7 years of training, you would be awarded an Outcome 3 (‘inadequate progress’) to extend your training time to allow you to complete your second SIA.  In reality, this situation would have been picked up by you, your trainers and your TPD before you reached the end of ST7. If you are unable to achieve the necessary competence in at least two Level 4 Patient Management domains, you would not be awarded a CCT.

Having successfully completed the training programme, you will hold a CCT that allows you to apply for consultant posts. Your consultant employer will include in their selection procedure a person specification for the post. The RCOphth will advise that Level 4 competence in Cataract Surgery is the minimum standard for a consultant practicing in this area.

Most ophthalmic academic trainees will transition from Level 3 to 4 during their post-doctoral periods e.g. as NIHR (National Institute of Health and Care) Clinical Lecturers (CLs) or during their personal post-doctoral training fellowships. Completion of training is competence (not time) based, so having time protected for academic training (e.g. 50% clinical:50% research) should not affect the CCT date, provided the required clinical competencies are met.

However, ophthalmology is a craft specialty, with trainees required to undertake certain procedures on a number of occasions to become competent to perform the procedure independently, and clinical training may take longer, for example if the recommended minimum two operating lists per week for academic trainees is not provided.

NIHR CL posts are for a maximum of four years or until CCT is reached. The GMC has agreed with NIHR that ‘setting a target CCT date is best determined flexibly, and tailored to the needs of the individual trainee.’  The target date for CCT for NIHR CLs should be determined at the first annual ARCP following the award of a CL and following assessment of the initial progress in post.  The same process would be appropriate for those on personal post-doctoral fellowships.

Once this has been set, the CCT date can be extended further through the use of an ARCP Outcome 3. This may prove particularly important once trainees progress to Level 4, if it becomes apparent that competencies may not be met on a timetable of 50% clinical work. The RCOphth endorses the NIHR’s view that ‘if there is a need to extend clinical training this should not be regarded as a failure’, but rather necessary to achieve the outcome of simultaneously completing specialist clinical training and academic training.

Usually, yes. We have undertaken various mapping exercises with TPDs to ascertain that all Deaneries will be able to offer Level 4 training in virtually all SIAs. We intend that this should be achievable as Out of Programme Training (OOPT), rather than an Inter-Deanery Transfer (IDT).

We expect that most trainees will want to stay in the Deanery in which they have been based for the preceding six years. However, if Level 4 training in their chosen SIA is not available in their own Deanery, they may choose to look elsewhere.

This is unlikely to be a frequent event. The median number of trainees in a Deanery is about 35, which means that approx. 5 trainees/yr will be entering Level 4 training, with 11 different SIAs to choose from. Our priority is to maintain the quality of training, which means there has to be a limit on the number of Level 4 posts in each SIA in the Deanery, or the experience is diluted. If the trainee is unable to get a Level 4 post in their chosen SIA in their Deanery, they may have to complete Level 4 in a different SIA and then choose to apply for a post-CCT Fellowship in their chosen SIA.

Some will be converted to Level 4 training posts. Others will become Level 1-3 posts.  Those remaining on the old curriculum will continue doing TSCs even after August 2024, but these are different from Level 4 posts, even though timetables will have similarities. TSC posts cannot be referred to as Level 4 posts after August 2024.

As these are funded by local Trusts / Health boards, they will not be affected by changes to the curriculum. If a unit is able to provide both Level 4 and a post-CCT Fellowship in a particular SIA, the post-CCT fellowship will continue in their current form.

At Level 4 training, two SIAs may be done simultaneously or sequentially. This will very much depend on the logistics of the timetable that can be created for that post. Similarly, any restrictions to the combinations will be guided by the indicative time required and the ability of the unit/region to provide the required timetable for training (for example, it may be extremely difficult to do Level 4 in Oculoplastics and Paediatric Ophthalmology as the indicative time is up to 18 months and 12 months respectively).

Only two Level 4 SIAs are required for CCT. In practice, it would be difficult to fit three SIAs into 7 years of training though, in theory, it may be possible in rare circumstances. However, it is to be remembered that, if a trainee wants to pursue a third SIA, this could also be done as a post-CCT fellowship.

No, numbers are much less important in Curriculum 2024. The emphasis is on competence. Some trainees will be excellent independent cataract surgeons after 250 phacos. Others may need to do over 400 under supervision before they are fully competent cataract surgeons. However, the majority of trainees will be competent after completing 350 phacos, and this may be used as an indicative number for Level 4 Cataract Surgery (similar to the current curriculum CCT requirement) by some Deaneries. However, the syllabus does not require any minimum numbers of any surgical procedure.

Generally, they would get an Outcome 3 at their ARCP, and would be given additional time to achieve the required competencies.

No, Level 4 training is part of run-through specialty training. However, we expect that there will be less demand for post-CCT fellowships from UK trainees, as they will be able to obtain their SIA experience prior to CCT. This means that there will be greater opportunities for non-UK trainees to obtain post-CCT fellowships.

No. Once a trainee has been signed off at Level 4 for Cataract Surgery, there will be no requirement to demonstrate ongoing competence while doing a different SIA at that Level. This is similar to some post-CCT fellowships, which concentrate solely on one SIA with no exposure to cataract surgery.

Deaneries will use the following ranges when planning their Level 4 SIA programmes:

• Up to 18 months – Oculoplastics, Cornea and Ocular Surface, Glaucoma, Vitreoretinal Surgery
• 12-18 months – Ocular Motility, Uveitis, Paediatric Ophthalmology, Medical Retina, Neuro-ophthalmology
• 6-12 months – Urgent Eye Care, Community Ophthalmology
• 6-12 months – Cataract Surgery (to be integrated longitudinally)

There must be no discrimination against LTFT resident doctors in the selection process. The same transparent selection method – including an application form and scoring system – must be used for all applicants.

Where an LTFT resident doctor is selected for a Level 4 SIA, their timetable or hospital placements may differ from full-time equivalents. Ad hoc timetable arrangements should be discussed with the Postgraduate Dean. TPDs should ask resident doctors to declare their preferred working percentage as early as possible. OOPT is not an appropriate mechanism for expanding Level 4 opportunities for LTFT resident doctors.