Training in ophthalmology in the UK has changed since August 2007 into a continuous 7 year programme known as 'Ophthalmic Specialist Training' (OST) and follows 2 years of Foundation training after qualification. Basic Specialist Traing (BST) occurs in years 1 & 2 and Higher Specialist Training (HST) occurs during years 3 to 7. The Certificate of Completion of Training (CCT) is awarded at the end of year 7 to those trainees who have passed Part II FRCOphth.
During the later years of the OST programme, additonal training in subspecialties is encouraged by the College. Subspecialty training outwith the College scheme is also available.
Advaned Sub-Specialty Training Opportunities ('Trainee Selected Components' from August 2007 - see below)
ASTOs (now also called 'Trainee Selected Components') in ophthalmology aim to provide sub-specialty training for UK trainees who have entered Higher Specialist Training in ophthalmology. They are usually 6 or 12 months in duration and they are normally taken during Year 4 or 5 of the HST Programme (years 6 or 7 of the OST programme).
ASTOs are primarily available only to trainees in HST posts in the UK, in contrast to 'Fellowships' (see below) which are available to any suitably qualified ophthalmologist from any country. Some sub-specialty training posts previously designated 'Fellowships' have converted to ASTOs. If an ASTO cannot be filled by a UK trainee it may become available as a standard Fellowship open to any applicant.
ASTOs may be taken in Oculoplastic and Adnexal Surgery (including lacrimal); Cornea and External Diseases; Cataract and Refractive Surgery; Glaucoma; Retina, Vitreous and Uvea (including intraocular tumour); Neuro-ophthalmology (including eye movement disorders); Paediatric Ophthalmology and Strabismus.
All Regional Training Programmes should provide ASTOs to cater for their own trainees but few Regions have a full quota of ASTOs in place. Trainees may apply to train in an ASTO elsewhere, including overseas (usually a 'Fellowship', but recognised as an ASTO), although at present most ASTOs/Fellowships abroad are not yet recognised by the Training Committee of the Royal College of Ophthalmologists for training and therefore cannot count towards the Certificate of Completion of Training (CCT).
ASTOs in the UK must be funded through the Medical and Dental Educational Levy (MADEL) in order to be recognised by the Royal College of Ophthalmologists. This requirement of EEC law does not apply to ASTOs outside the EEC so some unfunded overseas ASTOs/Fellowships will be recognised by the College and count towards the CCT.
Fellowships
Fellowships in the UK are sub-specialty training opportunities that are no longer under the jurisdiction of the Royal College of Ophthalmologists or any other College. They are open to any suitably qualified ophthalmologist from any country. Appointment is usually by application and interview in competition with other applicants.
Fellowships offer extra training outwith the HST training programmes that lead to the CCT. Prior to the introduction of ASTOs the College kept a National Register of Fellowships; this is now obsolete but many of the recognised fellowships previously listed in the Register have continued to offer the same sub-specialty training posts rather than convert to ASTOs.
Many fellowships are fully funded but some are unfunded or only partially funded.
Fellowships, like ASTOs, may be taken in Oculoplastic and Adnexal Surgery (including lacrimal); Cornea and External Diseases; Cataract and Refractive Surgery; Glaucoma; Retina, Vitreous and Uvea (including intraocular tumour); Neuro-ophthalmology (including eye movement disorders); Paediatric Ophthalmology and Strabismus.
(http://www.rcophth.ac.uk)Royal College of Ophthalmologists