The ST1 ophthalmology portfolio has strict criteria and a stringent mark scheme. The requirements are updated annually on the Severn Deanery website, four months in advance of the interview: http://www.severndeanery.nhs.uk/recruitment/vacancies/show/ophth2018/portfolio-review-lib
Your portfolio is marked during the interview day in a separate room to you, so you do not get any opportunity to sell yourself or to explain the contents. This also accounts for 50 out of 150 points of your total score, so it is worth spending time preparing it. To help you do well in the rest of the interview we’ve prepared our Ophthalmology ST1 Interview Question Bank
When organising your portfolio layout, structure it according to the guidelines published on the Severn website. Remember, interviewers will be going through hundreds of anonymous portfolios on the interview day, so it is vital your folder is well organised. Marks are also allocated for overall presentation and organisation.
Here are some tips on the various portfolio sections:
It is important to be strategic when opting for particular degrees or postgraduate exams. Having a BSc or MSc gets you a point each at interview, but they also give you opportunities to gain points elsewhere as the work you do during them generates presentations, publications, prizes and bursaries. Additionally, for postgraduate exams, there are some potentially easier points to be gained than others. For example, in 2017, passing FRCOpth Part 1 scored three points; whereas passing the full MRCP scored only two points. With this in mind, it is a better use of your time to do FRCOpth part 1 in your Foundation Year 2 than inefficiently spending time on passing all parts of the MRCP exam.
As an undergraduate, ranking within the top 60% of the Duke Elder exam will give you 1 point; coming top 10% will give you 2 points. Bear in mind, obtaining an Honours Medical degree or 1st in your undergraduate degree counts as an award. Foundation schools offer awards to Foundation doctors for ‘teaching’ or ‘best audit of the year’ and these are just as valuable as prizes at international meetings or conferences. Other examples of merit can include bursaries or funding for research, grants or electives.
Commitment to specialty
Try to organise an ophthalmology medical elective, which can either be a clinical placement, a research elective or a mixture of both. The key to getting the most out of your elective is to plan early. Renowned eye units such as Moorfields Eye Hospital in London or Wills Eye Hospital in Philadelphia have established visiting schemes open for applications every quarter of the year. Many research institutions such as Harvard University and UCL Institute of Ophthalmology offer small projects for visiting students, but they require at least 6 months to 1 year of preparation in advance. Once you have your elective arranged, try applying for an elective bursary award e.g. Patrick Trevor-Roper Travel Award by RCOphth, Student Elective Award by RCPSG etc.
Apply to undertake a taster week at your local ophthalmology department during your foundation years. This also lets you experience what ophthalmologist do and what training is like. Make sure you get a letter from a consultant as evidence of your taster week.
The EyeSi Surgical Simulator by VR Magic is a virtual reality simulator for intraocular surgical training available at most ophthalmology units throughout the United Kingdom. Any ophthalmology trainee should be able to point you in the right direction to access this.
Ophthalmology related courses and workshops are easy ways of building your portfolio. Some useful ones are:
- Microsurgical skills course, Royal College of Ophthalmologists
- FOCUS (Foundation Course in Ophthalmology), Edinburgh
- Ophthalmology Summer School, UCL Institute of Ophthalmology
- Tropical Ophthalmology, London School of Hygiene and Tropical Medicine
Audit, Research and Training
In medical school, be as involved as possible in your local university / hospital’s Ophthalmology department. Get to know the research clinicians in your unit as early as you can, as research and presentations can sometimes take years to complete and for a manuscript to be accepted. Bear in mind that a quality project can potentially get you a prize, presentation and a publication.
Points are awarded for publications in any speciality and do not have to be Ophthalmology-specific. According to the most recent portfolio guidance, marks for publications are awarded based on your authorship status and the impact factor of your PubMed citable publication.
The formula used for allocation of marks for publications is as follows:
Author’s score multiple by Journal Impact Factor:
- 4 points – 1st author
- 3 points – 2nd author
- 2 points – 3rd author
- 1 point – 4th or later author
|Name of Journal||Impact Factor||Score for authorship||Impact Factor x Score|
|Example – European Journal of Ophthalmology||2.81||2||5.6|
|Example – UK Journal of Orthopaedics||0.62||4||2.5|
Table 3: Example of score allocations for publications in OST application (taken from Severn Deanery website)
Based on this, it will be useful to be first author in a high profile journal, but it is equally useful and perhaps more time efficient to have a few more papers with your name as second author and lower.
Note that journals in other specialties, such as general surgery and general medicine, have much higher impact factors than ophthalmology journals, as there is a broader readership. Choose your mentors wisely and it is advisable to start off by getting involved with clinicians or academics that have a good publishing profile in any specialty.
Audit and Quality Improvement Projects
You are asked to only include your best audit/QIP project in your portfolio, therefore there is no gain in spending time and effort doing extra audits / QIPs which you may not need. “Best” usually implies having to close the loop of an audit cycle (re-auditing the clinical practice after implementation of change) and effecting a significant improvement in clinical practice. Thus, it is wise to focus on simple audits and QIPs where data can be easily collected and analysed.
Try to submit your work to international conferences as these score more points than local conferences. These do not have to be Ophthalmology specific. Do apply for bursaries to fund your conference attendance as these do count as “Prizes” in your portfolio. Start early at medical school if you can, as universities are generally much more generous with funding and bursaries than the local hospital or Health Education England.
Remember to keep a copy of the programme booklet with your work highlighted, as this can be used as evidence in your portfolio.
There are points for writing a chapter in a textbook, designing an educational course or e-learning tool, completing a teaching the teacher’s (TTT) course, formal role in examining undergraduates and higher teaching qualification such as a Diploma, Certificate or Masters in medical education.
On top of ad-hoc bedside teaching and occasional small group teaching in the NHS setting, try and organise your own regional teaching course on any subject. You would need participants from more than one University / Hospital to qualify your teaching course as regional. For any form of teaching, do get feedback forms from the attendees. It is best to summarise all the feedback gathered and present this neatly in your portfolio. You could write short reflective pieces on your teaching to demonstrate your professional development.
To be formally involved with examining undergraduates, most universities welcome junior doctors to assist in examining undergraduate OCSE examinations. If you know of academics or clinicians in who are in touch with publishers, always ask if you could contribute a chapter for a textbook or course book.
Preparing a good quality portfolio will be useful in any specialty you apply for. The best tip is to get started early, and get organising early (months in advance!) as filing and gathering evidence will always take longer than you think!
Try our other articles on the Ophthalmology ST1 Interview.