Late Realisation, Strong Application: Your Ophthalmology Guide
Introduction
Ophthalmology is a highly competitive speciality in the UK, with many applicants preparing their portfolio from early in medical school. But, what if you only discover your passion for ophthalmology in your later years? Say, late in 4th year after your first placement in ophthalmology?
This was the position I found myself in, when after spending 4 days in ophthalmology I was immediately drawn to the specialty.
The good news is it is absolutely still possible to create a strong application. While it may be difficult to build a perfect portfolio, with strategic planning and focused effort, you can still be a serious contender.
1. Accept where you are – then act fast
Firstly, try not to spend time deliberating on the past and why you did not discover this passion earlier. Multiple successful applicants discovered their interest later on. The key and most important thing to focus on is what you can control now – your time, clinical exposure and targeted achievements. Make sure to look up the ophthalmology portfolio requirements via the Severn deanery website and know this inside out.
2. Secure clinical exposure
The best ways to do this are via taster weeks and shadowing. A taster week gets you 1 point on your portfolio, and ‘Attending ophthalmology clinics and theatre sessions outside of a formal taster week and spaced out over more than 3 months (minimum 10 sessions)’ will get you 1 point.
Action points:
Contact your medical school’s placement coordinator or ophthalmology consultant directly – if working, you can ask your educational or clinical supervisor if they have any contacts or any ophthalmology colleagues they can put you in touch with
Express interest in shadowing and willingness to be flexible
Document all clinical exposure clearly in reflective log and this needs to be signed at the end of the shadowing period by the supervising consultant
Aim to get simulation training (at least 4 hours) e.g. on the EyeSi machines as this also will get you 1 point for each experience, up to a maximum of 2 points (‘Evidence of ophthalmology simulation training (including EyeSi experience’)
3. Find research or audit opportunities
You may not have time for a full research paper, but even small-scale audits, case reports or poster presentations can earn portfolio points and highlight your interest in the speciality.
Action points:
Ask ophthalmology trainees if you can assist with existing audits/QI projects or even ideas to initiate your own – this is particularly if you have an ophthalmology job as a foundation trainee
Check your university’s undergraduate research office or speak to teaching staff in ophthalmology
Consider writing a case report from any eye-related patient encounter
4. Start or join a teaching initiative
The teaching section on the ophthalmology portfolio is worth a maximum of 5 points so it is worth trying to get points here, as this can be done at any time.
Action points:
Create a revision series on eye presentations/emergencies for medical students and deliver it regularly over a period of 4 months – particularly useful if you are a working in ophthalmology and every week there is a new cohort of medical students
Run an OSCE-style teaching session with simulated fundoscopy or red eye cases (or both?)
Join your medical school’s ophthalmology society as a committee member or speaker if already graduated
5. Connect with mentors
One of the most helpful and powerful accelerators to achieving anything in life is having mentoring.
Action points:
Reach out to:
Ophthalmology registrars and trainees recently accepted into training, they will have just been on the path you are going on and can give frank and fresh advice
Fellow resident doctors who have recently applied and ask what their experience has been like – what would they have done differently?
Your university’s ophthalmology society or RCOphth student reps
Online resources (such as Eye Academy) and YouTube videos from content creators who talk about their tips and tricks when making an application
Final Thoughts
The most important point to take away from this article is: it is never too late to pursue ophthalmology. What matters is how intentional and strategic you are with the time you have. Focus on what can be done, and not what should have been done. Reflect on why you are taking on this long and effortful journey and remind yourself why you want to dedicate yourself to this career – it will fuel your motivation further.
And, if you are not accepted into training straight after FY2, that’s okay, you now have more time to continue building you portfolio – a clinical or teaching fellow job in F3 will be very useful here.
Plenty of successful applicants decided ‘late’ – why don’t you be one of them?