Paediatric ophthalmology

What is it in children?

Paediatric ophthalmologists manage the whole range of eye disease in children, with extra depth in children's eye conditions and squint (strabismus) ^[1].

Ophthalmology isn't one of the surgical specialties overseen by the surgical Royal Colleges ^[2]. Its training is set by the Royal College of Ophthalmologists ^[3].

Typical conditions and operations

• Squint surgery for horizontal and vertical strabismus ^[4].
• Retinopathy of prematurity, diagnosed and treated according to its stage ^[4].
• Congenital cataract, operated on early, preferably before three months of age ^[5].
• Retinoblastoma and other tumours ^[4].
• Childhood glaucoma, co-managed with other specialists ^[4].

How to get there

Ophthalmic specialist training (OST) is run-through, and entry is only at OST1. National recruitment is coordinated by NHS England South West for the College, with posts across all four UK nations ^[6].

1. 5 to 6 yearsMedical school

   A medical degree. To apply for the Foundation Programme you need to be eligible for provisional registration with the GMC ^[7].

2. 2 yearsFoundation Programme

   The two-year UK Foundation Programme ^[7].

3. Apply to OST1

   For 2027 entry, the MSRA exam is compulsory, and the first round of shortlisting ranks you on your MSRA score alone, though you also need a self-assessment score of at least 20 to progress ^[8]. For 2026 you needed 30 months or less of ophthalmology experience ^[9].

4. OST1 to OST7Ophthalmic specialist training

   The OST curriculum 2024 is built around levels of competence. Indicative length is five and a half to seven years ^{[10, 3]}.

5. Exams along the way

   Part 1 FRCOphth and the Refraction Certificate, in either order, then Part 2 FRCOphth written and oral ^[11].

6. Last 18 monthsSpecial interests

   You reach the highest level in at least two special interest areas. Paediatric ophthalmology takes 12 to 18 months ^[10].

7. CCT, then a fellowship if you want one

   BIPOSA lists UK paediatric ophthalmology fellowships for doctors after CCT or at the highest training level ^[12].

Good to know

• With Foundation, that's about seven and a half to nine years after medical school ^[10].
• Before the 2024 curriculum, more than 80% of doctors who finished training went on to do more training after CCT. The new top level of training is meant to reduce that ^[10].
• In the 2027 round, the MSRA is used for shortlisting but doesn't count towards your final score ^[8].

Getting involved as a student

• RCOphth associate membership for medical students costs £27 ^{[13, 14]}.
• The Duke Elder Undergraduate Prize Exam is open to medical students worldwide. In 2026 it was online, with 90 multiple-choice questions, a £65 fee, and applications through your medical school. The 2027 dates aren't published yet ^{[15, 11]}.