Residency Training - UK vs. US

[MPS]

I don't know whether any of you have heard about the changes afoot in post-medical degree training in the UK. Up until now, the minimum length of training in ophthalmology has been:

1 year in general medicine or surgery as a "house officer"
3 years in ophthalmology as a "senior house officer"
4.5 years in ophthalmology as a "specialist registrar"

I should point out that there are almost twice as many senior house officer posts than specialist registrar posts, and this means that there is a bottle-neck in training. Many people take time out to do a research degree (either PhD or MD) to improve their CVs before applying for a specialist registrar post. Half never finish training and leave for general practice.

For those graduating this summer, the structure has changed, such that there will be a single run-through grade in ophthalmology plus a year's extra experience in general medicine/surgery:

1 year in general medicine or surgery as a "house officer"
1 year in general medicine or surgery as a "senior house officer"
6 years in ophthalmology as a "registrar"

Many people have argued that the reduced amount of training, combined with reduced working times (that have taken effect as part of the European working time directive) will produce inexperienced consultants (= "attendings" in US). The training programs in the US are significantly shorter, but possibly more focussed - are those who finish a US residency considered fully capable of practicing and operating independently?

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[Andrew_Doan]

are those who finish a US residency considered fully capable of practicing and operating independently?

Yes we are.

 

[MPS]

Andrew,

Thanks for the info. There has been talk in the UK of creating "junior" consultants who will still require the supervision of "senior" consultants - I'm not certain whether this has been proposed for ophthalmology. I don't necessarily think that reducing training time will be a bad thing, as the training at the moment is a little too unfocussed. Certainly the US system shows that you can produce a competent ophthalmologist in a much shorter time than 8.5 years post-graduation.

 

[Andrew_Doan]

Is there a research requirement or block during your training? Our research time is basically done on our free time.

 

[MPS]

Andrew,

There is no formal requirement for research and no research block. However, it's impossible to progress without publications and without having conducted some form of audit. Many people do MDs or PhDs to be competitive for specialist registrar posts.

 

[Redhawk]

Andrew,

There is no formal requirement for research and no research block. However, it's impossible to progress without publications and without having conducted some form of audit. Many people do MDs or PhDs to be competitive for specialist registrar posts.

"Many people do MDs or PhDs..." So not all UK ophthalmologists are MDs? Interesting. It appears that you do an intern year ("house officer") then 3 years of ophthalmology ("senior house officer") as in the US. Does "specialist registrar" equate to subspecialty fellowship training available in the US or is it a combination of general and subspecialty training? I'm curious as to how such subspecialty training would occur with the new structure you described. Would it be incorporated into the 6 years of ophthalmology?

 

[MPS]

Redhawk,

All UK ophthalmologists are medically qualified if that's what you're asking. There is no US equivalent of the UK MD degree: it is a 2 year higher research degree. The UK equivalent of the US MD is the MB BS/MB BCh/MB ChB/MB BChir, depending on which University grants the award (in any case it stands for "bachelor of medicine bachelor of surgery"). At the moment (and in the future) the specialist registrar grade includes a year of sub-specialty training.