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Ophthalmology is a popular and competitive speciality, and there has been increasing concern regarding the balance of specialists completing training and the number of vacancies for their employment.1 The Royal Colleges have suggested trainees develop their skills during training to improve employment in the evolving NHS. This is the first study to evaluate the popularity and competitiveness of ophthalmology subspecialities, and identified an imbalance between the skills acquired during specialist registrar training and those in demand in the workforce. Trainees are able to identify their preferred subspeciality interest at an early stage; this information may be used by both trainees and trainers to develop a coherent strategy for workforce planning in both the NHS and academia.
We evaluated skills acquired in training by surveying the career intentions and subspecialty interests of current ophthalmology specialist registrars (SpRs) in North Thames (London Deanery). An electronic questionnaire was emailed to all 60 ophthalmology SpRs in the North Thames Region during 2005, via the Royal College of Ophthalmologists' Ophthalmic Trainees Group. The demand of skills in the workforce was evaluated by assessing the advertised posts for consultant ophthalmologists in the UK in 2005.
Thirty four questionnaires were returned, representing 56.7% of SpRs in the North Thames Region. Twenty three (68%) were male and 11 (32%) were female, with a mean age of 35 (range 30–47) and stage year 3 of SpR training. Preferred subspecialty interests stated by respondents and subspecialty requirements of advertised consultant ophthalmologist posts for 2005 are shown in table 11 and figure 11.
The most popular subspecialty interests among SpRs were Vitreoretinal surgery (23.2%), Oculoplastics (22.0%) and Anterior Segment (15.9%). The least popular common subspeciality was Paediatrics and Strabismus (9.8%). Of the 62 consultant posts advertised in 2005, the subspecialist interests specified were: Glaucoma (21.0%), Medical Retina (21.0%), Paediatrics and Strabismus (19.4%), Adnexal (16.1%), Anterior Segment (6.5%) and Vitreoretinal (6.5%). This information shows a mismatch between the subspecialty interests, especially for Vitreoretinal surgery and Anterior Segment. Our findings suggest that a majority of trainees surveyed still intend to pursue these careers despite the uncertainty of securing a consultant post. Conversely, Paediatrics and Strabismus was third most common consultant post advertised (19.4%), but less popular among trainees, with only 9.8% stating an interest in this subspecialty.
A large proportion of SpRs had completed (25%) or were currently undertaking a higher degree (23%). This may reflect the high level of competition for ophthalmology training positions,2 however there was a substantial interest in academic ophthalmology among those surveyed, with 26% stating an intention to pursue a career in academia.3 The impact of shrinking education budgets is likely to impact the availability of such posts, however the introduction of defined training programmes in academic medicine4,5 may enable this potential to be tapped.
This is the first study to evaluate the popularity and competitiveness of ophthalmology subspecialities, and has identified an imbalance between the skills acquired during training and those in demand. This study indicates that SpRs are able to state their preferred subspeciality interest at an early stage; this information may be used by both trainees and trainers to develop a coherent strategy for workforce planning in both the NHS and academia.
Competing interests: None.
This paper was presented at the Oxford Congress, UK, July 2006