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What do I need to achieve during my OST4 year?


During stage 4 of OST you will consolidate all that you learned in previous stages and acquire more skills and knowledge. By the end of OST4 you will be able to assess patients with more complex problems by taking a clinical history and examination (CA). You will be able to arrange and interpret ophthalmic investigations (PI). You will have experience of working in sub-specialty clinics and have identified a possible area of sub-specialisation for yourself (PM). You will be able to perform a large number of practical procedures (PS). You will have acquired a high level of microsurgical skill and be able to perform more complex cataract surgery. You will have performed around 150 cataract operations in total. You will have broadened your surgical and laser skills in at least one sub-specialty area (SS). You will be able to engage in most health promotion and disease prevention strategies (HPDP). You will have good communication skills with patients, their carers and colleagues (C). You will be maintaining a training portfolio and be able to use IT effectively (IH). You will be preparing for the Part 2 FRCOphth examination (PI and BCS). You will have adopted appropriate professional attitudes to patients and colleagues and sought feedback on your performance. You will be practising according to the GMC’s Duties of a Doctor (AER) and Good Medical Practice guidance. You will have begun to develop your role as a doctor in the NHS through involvement in clinical research, audit, teaching and management (HS). You will be aware of your limits as an ophthalmologist and always seek help where necessary. You will reflect on your clinical work and be actively involved in your own learning by keeping a reflective CPD diary (CPD).

Your portfolio must contain the following documents:

General information

  • Form R (personal details, training number)
  • Up to date CV

Good Clinical Care/Relationships with patients/Working with colleagues

  • Verified copies of your work based assessment forms (CRS, DOPS, OSATS, MSF, CbD) – signed forms or e-verification via e-portfolio.
  • Copies of any complaints/letters of thanks
  • Any other written feedback on your performance, personal audit data
  • Logbook of experience

Maintaining Good Medical Practice

  • Appraisal documents and personal development plans
  • CPD/reflective learning diary/details of study leave
  • Any Trust certificates (e.g. CPR, BLS etc)
  • Signed copies of foundation training certificates

Teaching, training, appraising and assessing

  • Details of involvement in teaching with feedback

Health and Probity

  • A statement regarding personal health and probity

Research and audit

  • Details of audit project
  • Details of research

In addition

You may have achieved some of the curriculum learning outcomes that have a target year of achievement later than stage 4. Include evidence of achievement of these learning outcomes in a separate section in your portfolio relating to the appropriate stage of training.

OST4 checklist:

Document (Learning Outcome) Number of copies* Date obtained Included in portfolio? Y/N Comment
CRS1 (CA1) Consultation 2
CbD (Multiple learning outcomes) 10
DOPS (PS3) Drugs 2
DOPS (PS6) Diathermy 2
DOPS (PS9) AC paracentesis 2
DOPS (PS12) Punctual Occlusion 2
DOPS (PS15) Botox 2
DOPS (PS16) Corneal Glue 2
DOPS (PS17) Ocular Ultrasound 2
DOPS (PS19) AC+ Vitreous Sampling 2
DOPS (PS24) Forced Duction 2
OSATS1 (SS1) Surgical Skills 2
OSATS1 (SS7) Lid Surgery 6 (by the end of OST7)
OSATS1 (SS4) Cataract 2
OSATS1 (SS11) Temporal Artery Biopsy 2
OSATS1 (SS5) Surgery Raised IOP 2
OSATS1 (SS6) Repair Trauma 2
OSATS1 (SS8) Surgery for Surface Protection 2
OSATS1 (SS9) Lateral Canthotomy/Cantholysis 2
OSATS1 (SS10) Biopsy 2
OSATS1 (SS12) Muscle Surgery 2
OSATS1 (SS13) Removal of Eye 2
DOPS (SS15) Laser IOP 6 (by the end of OST7)
DOPS (SS16) Laser Retina 6 (by the end of OST7)
MSF report (Multiple learning outcomes) 1
Cataract audit data (see DMCRJ3)
Appraisal record
Educational Supervisor Report(s)
Clinical Supervisor Report(s)
Details of leave taken
CPD diary
Any other evidence of performance

* You are expected to have more than one assessment for each of these work based assessments. If you have been unable to obtain 2 assessments you must explain the reason for this to your educational supervisor

# a proportionate number of these LO should be achieved by end of stage 4 if possible. They all must be achieved before the end of stage 7.