Ophthalmology Training in England
Ophthalmology in England: how is training geared to supply our future workforce?
Introduction
Training in ophthalmology is currently a 7-year postgraduate run-through programme, where doctors with a full GMC registration are taken through a curriculum to qualify as a consultant ophthalmologist. Understanding their profile, numbers and distribution provides an insight into the state of the ophthalmology workforce at present and into the future.
Patient need and the regional distribution of ophthalmology trainees
Our elderly population carries the greatest burden of eye disease. Public Health England outlined in its 2021 Atlas of variation report [1] that one in three people aged over 84 live with sight impairment, while 79% of those with sight impairment are over 64.
The Office for National Statistics (ONS) [2] projects that, ‘in mid 2018 there were 1.6 million people aged 85 years and over; by mid 2043, this is projected to nearly double to 3.0 million’. They also expect that those aged over 67 will increase by 3.6 million, or 30%, in the period.
The upshot of these trends is borne out in The Royal College of Ophthalmologists’ 2017 The Way Forward report [3]. This projected a 44% rise in glaucoma cases over the next 20 years, a 50% rise in cataract operations and 59% increase in AMD cases.
ONS also produced a regional analysis of the population by age, which reveals that areas in the South West and East of England particularly will see a big increase in the proportion of their populations aged over 65, and their need for eye care services will increase significantly as a result. The geographical distribution of training is thus key.
Almost 1 in 4 ophthalmology trainees in England are London-based (See Table 1). The North West, West Midlands, and Yorkshire and Humber each support between 10–12% of training posts. The remaining 42% of posts are spread across the other 7 regions.