Zuhaib Ehsan

Introduction

Ophthalmology can feel completely new when you first encounter it at medical school. Compared with many other specialties, undergraduate exposure to ophthalmology can be relatively limited and varies considerably between medical schools (1,2). As a result, students may arrive on their first placement with little experience of ophthalmic examination or the equipment used in the specialty.

The slit lamp and ophthalmoscope may be unfamiliar, while the examination techniques themselves can take time to become comfortable with. This can make the first few days of a placement feel overwhelming, particularly when you are also being introduced to unfamiliar terminology and a number of different subspecialties.

The good news is that you are not expected to know everything on your first placement. Your placement is an opportunity to explore the specialty, gain confidence with basic examination skills and discover which areas of ophthalmology interest you. Clinical exposure can also play an important role in developing students’ understanding of the specialty and may influence their interest in ophthalmology as a future career (3).

Make the Most of the Specialty

One of the best things about an ophthalmology placement is the opportunity to see how varied the specialty actually is. Try not to spend your entire placement in one clinic or focusing on one area. If possible, experience different parts of ophthalmology. Attend medical ophthalmology clinics, surgical clinics and theatre sessions. Undergraduate ophthalmology teaching can involve exposure to patients across different clinical environments, including outpatient clinics and surgical theatres (4). Seeing both the medical and surgical sides of the specialty can give you a much better understanding of what ophthalmology involves as a career.

Get Hands-On with the Equipment

The equipment used in ophthalmology can be intimidating at first. The slit lamp and ophthalmoscope may look complicated, particularly if you have never used them before.

Whenever appropriate, ask clinicians whether you can have a go. You may not be able to use the equipment confidently straight away, and that is completely normal. The purpose of your placement is to gain experience, not to become an expert after a few sessions. Interactive teaching and clinical exposure can help students become more familiar with ophthalmic equipment, terminology and examination skills (5).

It can also be helpful to ask the clinician what they are specifically looking for when examining the patient, rather than simply asking what the diagnosis is. This encourages you to think like a clinician and helps you understand how examination findings lead to a diagnosis.

Use Your Placement as OSCE Preparation

Your ophthalmology placement can also be an excellent opportunity to prepare for your OSCEs. When you see a clinician performing an examination, pay attention to the sequence they use. Look at how they introduce themselves, explain the examination, position the patient and use the equipment. Then, when appropriate, have a go yourself.

You can also use clinics to practise your communication skills. Watch how clinicians explain diagnoses, discuss investigations and reassure patients. These are all skills that can be transferred directly into your OSCEs.

Making the Most of Theatre

Ophthalmology theatre can be particularly interesting, especially if you have never seen eye surgery before. However, walking into theatre without any preparation can also leave you feeling completely lost. One simple tip is to watch a few videos before attending theatre. Even a basic understanding of the procedure you are going to see can make a huge difference. You do not need to understand every surgical step; the aim is simply to have some context for what you are watching. Once you are in theatre, don’t be afraid to ask questions. Surgeons and theatre staff are often happy to explain what they are doing, particularly when they know you are a medical student who is interested in learning. Depending on the procedure and the circumstances, you may also be given opportunities to get involved in practical aspects of the experience.

Most importantly, don’t worry about not knowing everything. Your first experience in ophthalmology theatre is about exposure and learning. You are there to gain an understanding of the specialty and see procedures that you may not have encountered elsewhere in medical school.

Making the Most of Clinics

A lot of medical students are not particularly enthusiastic about clinics. They can sometimes feel repetitive, and it can be tempting to think that you would learn more by spending your time elsewhere. However, ophthalmology clinics can actually be one of the best places to learn.

Think of a clinic as an opportunity to go deep into a particular area of ophthalmology. You may see multiple patients with the same condition but at different stages of their disease. This can help you understand how conditions present, how they are investigated and how they are managed over time.

Clinics are also an excellent opportunity to observe patient–doctor interactions. Pay attention to how clinicians explain complicated conditions in simple language, how they discuss treatment options and how they respond to patients’ concerns. These communication skills are highly transferable and can provide useful ideas for your own OSCEs. If appropriate, you can also ask patients questions yourself under the supervision of the clinical team. This can be a great way to practise taking a focused ophthalmic history.

Finally, keep an eye out for interesting cases. If you come across an unusual or particularly interesting presentation, make a note of it and look into it afterwards. Depending on your medical school and the circumstances, an interesting case may even provide an opportunity to become involved in a case report.

My Top Tips

Explore the different subspecialties

Don’t assume that you know what ophthalmology is like after attending one clinic. Try to experience as many different areas as possible. Cornea, retina, glaucoma, oculoplastics, paediatrics and neuro-ophthalmology can all feel very different. The breadth of ophthalmology teaching can vary between medical schools, so taking advantage of opportunities to experience different areas can help you develop a broader understanding of the specialty (2,4).

Find what interests you

Your placement is an opportunity to discover what you enjoy. Pay attention to the clinics and procedures that you find yourself wanting to learn more about. You don’t need to decide whether you want to pursue ophthalmology immediately but finding an area that interests you can make the rest of your placement much more enjoyable. Early clinical exposure has been suggested as one way of maintaining and developing interest in ophthalmology as a career (3).

Experience both the medical and surgical sides

Ophthalmology brings together both medical and surgical aspects of patient care. Try to experience both sides of the specialty before forming an opinion about it. You may discover that you love the diagnostic and medical aspects, or you may find that you are more interested in the practical and surgical side.

Speak to doctors at different stages of training

If you have the opportunity, speak to doctors at different stages of their careers. A resident doctor who is relatively new to ophthalmology may have a very different perspective from a senior ophthalmologist who has spent many years in the specialty. Ask them what they enjoy, what they find challenging and what they wish they had known when they were medical students. Comparing these different perspectives can give you a much more realistic idea of what a career in ophthalmology might look like.

Final Thoughts

Your first ophthalmology placement can feel intimidating simply because the specialty is unfamiliar. You may not recognise the equipment, understand the terminology or know what you are supposed to be looking for. Use the placement to explore the specialty, get comfortable with the equipment, observe experienced clinicians and ask as many questions as you can. You may discover that ophthalmology is far more interesting and varied than you initially expected.

References

1. Baylis O, Murray PI, Dayan M. Undergraduate ophthalmology education: a survey of UK medical schools. Med Teach. 2011;33(6):468-471. doi:10.3109/0142159X.2010.540594.
2. Hill S, Dennick R, Amoaku W. Present and future of the undergraduate ophthalmology curriculum: a survey of UK medical schools. Int J Med Educ. 2017;8:389-395. doi:10.5116/ijme.59ac.f69b.
3. Lambert TW, Barat A, Goldacre MJ. Junior doctors’ aspirations for careers in ophthalmology: 40 years of surveys of UK medical graduates. JRSM Open. 2020;11(5):2054270419892155. doi:10.1177/2054270419892155.
4. Krungkraipetch L, Krungkraipetch N, Savatsomboon G. Undergraduate ophthalmology education according to International Council of Ophthalmology guidelines: a systematic review. GMS J Med Educ. 2025;42(2):Doc29. doi:10.3205/zma001753.
5. Chadha N, Gooding H. Twelve tips for teaching ophthalmology in the undergraduate curriculum. Med Teach. 2021;43(1):80-85. doi:10.1080/0142159X.2020.1758649.