British academic ophthalmology in crisis

Abstract

Where from and where to? In December 2004 the headcount for consultant ophthalmologists was 809 (2.6%) of 31 672 NHS consultants.1 Ophthalmologists provide around 10% of all NHS hospital outpatient department appointments2 and similarly perform around 7% of all NHS surgical procedures.3 In a patient care context ophthalmology is unquestionably an important service area. A survey of medical academic staffing levels undertaken by the council of the heads of the UK medical schools in 2004 identified 1146 full time equivalent (FTE) professors,4 4.2% of the 27 640 FTE NHS consultant workforce at that time.1 The survey identified just 15.6 FTE clinical professors in ophthalmology or 2.1% of consultant ophthalmologists (calculated by adjusting the consultant “head count” down by 10% to approximate FTE). Since 2000 medical student numbers have risen by 40% in Britain and four new medical schools have opened.4 Despite this expansion medical academic numbers (all grades) have declined over these 4 years from 3549 FTE to 3113 FTE, a 12% overall drop, with ophthalmology dropping by 17% from 40 FTE to 33 FTE. Of particular concern has been the dramatic 40% fall in the number of clinical lecturers, both overall and in ophthalmology.4 Since the recommendations made in the council of heads’ earlier report,5 a partial recovery in some subject areas has occurred, with worsening in others.4 General medicine and public health medicine, for instance, have made significant recent gains (23% and 30% respectively) across the 2003–4 period, but of …