The ophthalmic physician: an indulgence or a necessity?

Abstract

Recognition of the need for medical ophthalmologists has resulted in the Royal College of Ophthalmologists and Royal College of Physicians jointly establishing a professional training programme leading to accreditation and registration on the specialist register in the new subspecialty of medical ophthalmology-that is, a training for the ophthalmic physician. Currently, entry to the new training programme may be gained from a background in general medicine or general ophthalmology and the training programme appropriately tailored in line with a general template which ensures full exposure to the various aspects of medical ophthalmology. This training programme is in its infancy, but it is already clear that the route of entry to a medical ophthalmic training programme is less important than how we are going to provide training. Relevant postgraduate general medical training at some'stage, however, appears appropriate. When medical ophthalmology as a specialty has become sufficiently well established in the number of trained specialists, it will be in a better posi-782 on 11 April 2019 by guest. Protected by copyright.

Untitled

“…A recent commentary in the BJO 1 highlighted the widening dichotomy between the ophthalmic surgeon and the ophthalmic physician, in part spearheaded by the new subspecialty of medical ophthalmology. Developments like these are fashioned by changes in practice and indeed the ever increasing subspecialisation in ophthalmology has necessitated the emergence of fully trained ophthalmic physicians who are expert in diagnosis and management of many difficult medical ophthalmic conditions, properly out of the purview of the superspecialist surgeon.…”

The relative contribution of medical and surgical referrals to the workload in general ophthalmic practice

“…This is the argument for a new kind of ophthalmologist who is skilled in ophthalmic medical diagnosis, who can relate systemic medical disease to ophthalmological conditions, who can assess the general medical status of patients who have a primary ophthalmological disease, and who can prescribe and monitor the most appropriate drugs for treatment of medical sight threatening disease. 4 It is on this basis that a limited training programme for consultant specialist medical ophthalmologists is already in place in the United Kingdom. However, recruitment in this programme has been slow, the result in part of the limited number of consultant positions currently funded.…”

FasL antibodies may compromise ocular immunity rather than cause eye disease

“…This is the argument for a new kind of ophthalmologist who is skilled in ophthalmic medical diagnosis, who can relate systemic medical disease to ophthalmological conditions, who can assess the general medical status of patients who have a primary ophthalmological disease, and who can prescribe and monitor the most appropriate drugs for treatment of medical sight threatening disease. 4 It is on this basis that a limited training programme for consultant specialist medical ophthalmologists is already in place in the United Kingdom. However, recruitment in this programme has been slow, the result in part of the limited number of consultant positions currently funded.…”