Undergraduate Ophthalmology Education in Ireland: A Comparison with International Guidelines and Evaluation of Doctor Confidence in the Management of Ophthalmic Conditions in the General Medical Setting

Background Ophthalmology teaching may form an ever-shrinking component of the undergraduate medical curriculum. This may impact on the ability of medical schools to produce doctors with sufficient knowledge and skills to deal with basic ophthalmic conditions. AIMS AND OBJECTIVES The aim of this project is to survey whether the ophthalmic curricula delivered in Irish medical schools are in accordance with the standards set out by the International Council of Ophthalmology (ICO) guidelines, and how this may impact on the confidence of non-consultant hospital doctors (NCHDs) in managing ophthalmic problems. METHODS In a cross sectional educational study, questionnaires were sent to the six medical schools in Ireland to determine the structure of their respective ophthalmic curricula, while a separate questionnaire was distributed to (NCHDs) working in hospitals in Cork to determine their confidence in assessing and managing ophthalmic conditions. RESULTS All six medical schools in Ireland returned completed questionnaires (100% response rate). The mean (standard deviation) number of teaching hours in ophthalmology was 53.3 hours (26.2). There was a wide variation in clinical attachment hours among the schools. Only two schools taught all the recommended topics and clinical skills from the International Council of Ophthalmology curriculum guidelines. Eighty NCHDs (93%) who returned appropriately completed questionnaires were graduates from Irish medical schools. Their median confidence levels in addressing ophthalmic pathology was “not confident at all”. They were most confident in dealing with neuroophthalmology related cases and performing a physical examination of the eye. They were least confident in managing paediatric ophthalmic cases and performing minor ophthalmic procedures. There was no correlation (p=0.100) between clinical-based ophthalmology teaching hours received and confidence in ophthalmic assessment amongst University College Cork (UCC) medical graduates. CONCLUSION The ophthalmic curriculum in some Irish medical schools may not meet the standards set by the International Council of Ophthalmology guidelines. There is also a wide variation in ophthalmology education across the schools. A majority of Irish medical school graduates are not confident in dealing with ophthalmic cases in general.