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Learning curves in ophthalmology: impact on the clinic

Session Details

Session Title: Ocular pathologies and training and innovation

Session Date/Time: Monday 07/10/2013 | 08:00-10:00

Paper Time: 08:12

Venue: Emerald (First Floor)

First Author: : J.Myerscough UK

Co Author(s): :    S. Muhidin   J. Patel           

Abstract Details


To establish how often ophthalmologists at different stages of training (i)ask for advice during clinic, (ii)request senior review, and (iii)average follow-up time.


New ophthalmologists face a steep learning curve as they embark on a career in the specialty. Confidence in correct recognition of clinical signs takes time to develop and senior colleagues are often asked for advice or to review patients. Time pressures in busy ophthalmology clinics pose two problems. Firstly, the trainee; in feeling under pressure not to interrupt their seniors for advice because either they are hesitant to be perceived as incompetent or because they can see how busy their colleagues may be. Secondly a senior doctor with juniors in clinic may spend as much time reviewing juniors" patients as their own, having impact on their own clinic. Clinic pressure is furthered through hesitance to ask for advice by arranging shorter follow-up intervals than perhaps required.


This prospective observational study compared 100 patient-outcomes seen by ST1 and ST2 ophthalmologists. Primary outcomes were proportion of patients discussed with or reviewed by colleagues and follow-up interval.


Senior advice was sought in 16% of patients by the ST2 compared with 73% by the ST1. 4% of patients seen by the ST2 were reviewed compared to 69% by the ST1. Average ST1 follow-up was shorter.


This study highlights the impact of the steep learning curve in ophthalmology. Consideration should be made when planning clinic numbers, not just for trainees but for their seniors, for whom having a trainee significantly impacts on their own clinic.

Financial Interest:


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