Division of Ophthalmology

Education

Undergraduate training 

Undergraduate training consists of academic lectures on general ophthalmology in the third year of the MBChB program with subsequent assessment by written examination. During their student internship in their final years of the MBChB program students rotate in the division for 3 weeks. During this clinical rotation they are expected, with the guidance of part-time consultants and the registrars, to master an array of clinical skills in ophthalmology. They are continuously assessed by the consultants and registrars and must successfully complete a final clinical slide test and written exam.

Specialist training 

OVERVIEW

Candidates wishing to enter the registrar training program at Tygerberg Academic Hospital and the University of Stellenbosch are encouraged to successfully complete a recognized post-graduate Diploma in Ophthalmology, the Part 1 examination of the College of Ophthalmologists of the Colleges of Medicine of South Africa and to gain general medical and surgical ophthalmology experience by working as a medical officer in ophthalmology before applying for a registrar position.

We currently have 10 registrar positions, 7 of which are fully funded by the Western Cape Provincial department of Health.

There are 4 full time consultants, 3 part time clinical consultants and several part-time consultant lecturers.  Each full-time consultant heads a firm comprising at least 1 senior and 1 junior registrar.

During their 4 years at Tygerberg registrars rotate six monthly through all of the specialist fields and work under close supervision and in close collaboration with a sub-specialist consultant.​

1. Medical and Surgical Retina, Uveitis - Prof Linda Visser and Dr Linett Du Toit
   
2. Anterior segment, glaucoma and cornea - Dr Derrick Smit
3. Paediatric ophthalmology and Strabismus - Dr Helga Abrahamse-Pillay
4. Orbit, Oculoplastic and Lacrimal Surgery, Oncology, Neuro-ophthalmology - Prof David  Meyer​
   

During all rotations registrars are exposed to the full range of ophthalmic practice, including Cataract & Refractive, Glaucoma and a great deal of Ocular Trauma. Specialist clinics are attended every week.

On-call duty

Each firm is allocated a constant week-day call. A one in four weekend call rotation is followed, with calls commencing on Fridays.  A junior registrar is always teamed up with a senior registrar and consultant when on call. A 24-hour service is thus provided throughout the year.

Surgery
Because of the uniqueness of the South African experience, ophthalmologists have always been expected to render a comprehensive 1st world ophthalmic service and it is for this reason that registrars are exposed and encouraged to perform a wide variety of ophthalmic surgical procedures.

Ophthalmic surgery training starts on day 1 of registrarship. Most registrars would have had adequate ophthalmic surgery experience prior to starting specialisation. Registrars are expected to keep a Portfolio of training which includes a log book of procedures performed. A year-round cataract project and our inordinate trauma load greatly enhance surgery opportunities

Research
Continuing a strong tradition of active research in the department, each registrar is expected to contribute to the body of knowledge by completing a research project during his/her 4 year training period. Completion of such a project is a prerequisite for obtaining the Masters of Medicine in Ophthalmology degree [MMed (Ophth)] from the University of Stellenbosch.

Teaching Opportunities
Our registrars have the benefit of training under consultants who, despite excelling in their chosen subspecialties, remain proficient generalists. This provides balanced teaching opportunities regardless of which rotation the registrar finds him-/herself on. Continual on-site consultant cover is available during the day in theatre and at all intake and follow-up out-patient clinics. After hours consultant cover is provided by the ophthalmologist on call.

General meetings, short courses, simposia and congresses

Academic programme 

1. Grand Rounds take place each Monday and Thursday. We are fortunate to be exposed to a wide variety of pathology in our unit with its high patient turn-over. Ophthalmologists in private practice who join our ward rounds provide unique insights from their perspective.
2. Early morning meetings: Research, computer and presentation skills are developed through our twice-weekly pre-ward round registrar presentations. At these sessions registrars present clinical as well as basic sciences topics to the other members of the department.
3. Friday afternoon academic meetings consist of:
   Registrar presentations, videos on interesting topics and general discussion of difficult/interesting clinical cases. Opportunity exists for examination of cases prior to the meeting by all clinicians. This is followed by a journal club session.

Joint meetings
Inter-disciplinary meetings are regularly held with other departments at Tygerberg Hospital, including Neuro-pathology, ENT and Rheumatology. Frequent joint meetings with the Department of Ophthalmology of the University of Cape Town and ophthalmologists in private practice are held at the Cape Eye Hospital (Northern Ophthalmic Group of the OSSA WCape branch) and Christiaan Barnard Memorial Hospital (OSSA Western Cape meetings). 

Academic Partnership with Cape Eye Hospital
The Cape Eye Hospital has been accredited by the University of Stellenbosch as part of our teaching platform. Our division regularly take part in their strong academic programme. Registrars are allowed to observe/assist with surgery by the ophthalmologists in private practice, in order to get exposure to some surgical procedures not available at our hospital. An open invitation has been extended by the Cape Eye Hospital to senior registrars to be taught LASIK surgery; suitable candidates for surgery are recruited from the Tygerberg patient profile.

Prerequisites for completion of the Ophthalmology Specialist Training Programme

• Part I of the MMed (Ophth) (US) or Part I of the FC Ophth (SA) from the College of Ophthalmologists of South Africa.
• MMed (Ophth) Intermediate - clinical and theoretical examination in Optics (including Orthoptics) and refraction.
• Part II of the MMed (Ophth) (US) or Part II of the FC Ophth (SA) from the College of Ophthalmologists of South Africa.
• Research driven thesis towards a Master's Degree in Ophthalmology.
• Satisfactory Clinical Portfolio and Surgical Logbook. 

During the 4 year training period registrars- surgical proficiency, clinical insight and management strategies and academic progress are continuously assessed.   A weekly MCQ test on a given topic is written by everyone. After the successful completion of the 4 year program the candidate is awarded the Master of Medicine degree in Ophthalmology from the University of Stellenbosch - MMed (Ophth) (US).  The vast majority of candidates also obtain the Fellowship of the College of Ophthalmologists of South Africa - FC Ophth (SA).

• 2009 Regulations for the College of Ophthalmologists of the CMSA