Scottish Medical Training

Scotland Deanery North comprises NHS Grampian and NHS Highland, covers 50% of the area of Scotland and serves a population of 900,000. Because of this low population density and varied geography, there is no Ophthalmology training programme like it in the UK. All of the main subspecialties are provided in the two training centres (Aberdeen Royal Infirmary, and Raigmore Hospital, Inverness). We are one of the few regions to have a dedicated physician, (Medical Ophthalmologist) in post, with one Medical Ophthalmology trainee, integrated into the training programme. There are only 9 Ophthalmology trainees for this population, giving extremely favourable surgical opportunities e.g. over 5000 cataract procedures per year are performed in the region. The region has recently acquired an EyeSi simulator, which allows simulated surgical training in cataract surgery, including anterior vitrectomy and vitreoretinal surgery. It is the norm for trainees to finish the training programme with over 1000 cataracts in their logbook.

In both hospitals the on call is banded at 1B (40% supplement), and due to the large rural component and also an advanced community optometry filter, the on call is relatively light yet proportionally high in genuine Ophthalmic emergencies appropriate for high quality training.

The trainees spend 4 or 5 years in Aberdeen and 2 or 3 years in Inverness, which can be split or sequential. Trainee selected components are available in both units, and can be provided in most subspecialties. Both units are committed to training, and mentoring trainees, with a high proportion of trainees choosing to take up consultant posts in the region. ARCP outcomes are mainly outcome 1, with a low rate of non-1 outcomes. There is a good track record for trainees securing subspecialty fellowships wherever they chose, be it Glasgow, Edinburgh, Moorfields or even Australia.

Both Inverness and Aberdeen have airports with regular flights to most major cities in the UK. Reasonably priced nice accommodation to either buy or rent is available near both hospitals, with a short journey time from home to hospital.

Due to the low number of trainees, the GMC survey gives no statistically useful information for either Raigmore or Aberdeen Royal Infirmary. Both units have had recent external Deanery Quality Assessment visits, with extremely positive outcomes reflecting the quality of training in each training centre. It should be noted that the Ophthalmology trainees at Raigmore now do a 1 in 5 on-call (weekends, daytime only) with a 1B banding.

Ophthalmology has now moved towards a competency-based training. The North of Scotland Deanery prides itself in focusing training on an individual basis, covering the core curriculum within the first few years, and listening to its trainees to focus higher specialist training on an individual basis.

Trainees will be exposed to all the sub-specialties including: Anterior Segment and Cornea, Neuro-Ophthalmology, Medical Ophthalmology, Glaucoma, Ocular Motility, Vitreo-Rentinal, Oculoplastics, Paediatric Opthalmology, and Medical Retina. The North is unique in that it also allows trainees to participate in Ophthalmic Ultrasound, Rural Ophthalmology and Ophthalmic Casualty.

The Aberdeen Eye Department is academically active and has close links with the University of Aberdeen, the Institute of Medical Sciences, and The Health Service Research Unit. The Aberdeen University Ophthalmology Dept.(the only University Ophthalmology Professorial Unit in Scotland) is headed by Professor John Forrester, who also runs a weekly teaching clinical ward round which all trainees attend.

Research and audit are encouraged and protected regular weekly sessions are provided for this. Trainees are encouraged to present in regional, national and international meetings, and to publish papers during the course of their training. There is additionally a weekly postgraduate teaching session which is often accompanied by informal discussions and continued professional development. Formal teaching sessions are included, where applicable, as part of training and trainees are also expected to provide teaching to medical students, other trainees, nurses and optometrists. Currently trainees undergo generic 6 month or 1 year blocks in ST1 and 2 to gain relevant "core" ophthalmology competencies, especially early surgical skills, as per the RCOphth curriculum. From ST3 onwards, the programme becomes more modular eg spending 6 month block in glaucoma. Opportunities for those competencies which must be regularly assessed eg laser, lid surgery, are present throughout the 7 year ST programme. Trainees rotate through Raigmore Hospital in Inverness twice during the 7 years - once at basic ST1/2 level, and once again at higher specialist level (between ST3 and ST 7 incl). It is well known that Ophthalmology in the North has seen every trainee obtain the consultant post of their choice in the location of their choice over the past 10 years.

Aberdeen is the only unit in Scotland, and one of only a few in the UK with a University Professor of Ophthalmology: Professor John Forrester. The PMETB Trainee survey 2007-8 rated this North of Scotland Ophthalmology rotation as the best Ophthalmology rotation in the UK in terms of "overall trainee satisfaction" and "trainee workload".The GMC/PMETB trainee survey in 2010 rated North of Scotland Ophthalmology rotation as the best in the UK for "Work Intensity", and scored top in Scotland for educational supervision, induction, and learning opportunities, and came out highly in study leave allowance, handover, working hours compliance and clinical supervision responsibility.

North of Scotland - placements in Aberdeen hospitals and Inverness
Aberdeen Royal Infirmary
Raigmore Hospital Inverness