Master of Medicine in Ophthalmology

This qualification forms part of the credentialing process, for medical practitioners, as specialists in Ophthalmology. The Health Professions Council of South Africa (HPCSA) stipulates training requirements, including a minimum period of experiential learning. It is usual for the examination to be taken and passed prior to the completion of the required period of supervised learning specified by the HPCSA. The aim of this qualification is to meet the needs for formal examination certification, as well as to set standards, nationally, for such a qualification (equivalent qualifications may be offered by the country's 8 medical schools).

Recognition of Prior Learning (RPL)

The institution conducts RPL in terms of the policy and guidelines of the institution to recognise other forms of formal, informal and non-formal learning and experience. In cases where learners do not comply with the formal admission requirements, the institution applies its RPL policy.

Entry Requirement

The minimum requirement for this qualification is

• Bachelor of Medicine and Bachelor of Surgery, Leve 8.

Or

• Equivalent acceptable to the Health Professions Council of South Africa Current registration as a medical practitioner.

1. Be able to diagnose and manage eyelid, lachrymal, orbit and socket disorders to a level that would be expected of a consultant ophthalmologist not specialising in ocular plastics.
2. Be able to understand the causes of cataract, its normal clinical progression, diagnosis, clinical assessment, and management.
3. To have an understanding of the pathogenesis, aetiology, diagnostic criteria and management of corneal and external eye disease.
4. To understand and be able to explain the pathogenesis, aetiology, diagnostic criteria and management of all types of glaucoma.
5. To have an understanding of the pathogenesis, aetiology, diagnostic criteria and management of medical retinal, inflammatory and neoplastic disease.
6. To be able to understand the pathogenesis, aetiology, diagnostic criteria and management of neurological disorders which affect vision.
7. To have an understanding of the pathogenesis, aetiology, diagnostic criteria and management and disorders of ocular motility, strabismus and nystagmus.
8. To have an understanding of the pathogenesis, aetiology, diagnostic criteria and management of surgical vitreoretinal diseases.
9. To be able to assess the eye care needs of the community, including population-based surveys.
10. To have an understanding of the pathogenesis, aetiology, diagnostic criteria and management of eye disorders in children.

1. Ability to identify and solve problems using critical and creative thinking.
2. Ability to use science and technology appropriately.
3. Ability to communicate effectively both verbally and in writing.
4. Ability to work as a team member.
5. Ability to demonstrate empathy and sensitivity to the individual and community, acknowledging cultural and religious differences.
6. Ability to organise and manage one's activities responsibly and effectively.
7. Ability to collect, analyse and critically evaluate information.

b) 1. Be able to clinically assess and interpret changes in the position of the globe, levator function, ocular movements, and lid position as well as eyelid lesions and socket appearance.

• Be able to interpret the results of investigations, especially CT scans, MRI, and dacryo-cystograms as well as orthoptic and visual field assessment and follow-up.
• Be able to perform minor lid procedures such as correction of entropions, ectropions, ptoses, lid retraction, tumour excisions and eyelid reconstructions.

1. Be able to use all the diagnostic equipment required for the assessment of cataract and any other associated ocular disorder, and to assess the influence of cataract upon visual function.

• Be trained in the use of Yag laser equipment of the management of posterior capsular opacities in pseudophakic patients.
• Be trained in the use of biometry equipment for the pre-operative assessment of implant power.
• Be trained in the performance of extra capsular cataract extraction with intraocular lens, small incision cataract surgery with phako-emulsification, and secondary anterior chamber intraocular lens implantation.

1. Be trained in the use of the pachymeter and video kertoscope.

• Be trained in the diagnosis of ocular infections with special reference to obtaining corneal specimens and intraocular biopsies in addition to appropriate preparation of smears for microscopy and inoculation of culture media.
• Be able to excise a pterygium, to perform a conjunctival flap, a corneal graft and an intraocular biopsy and to repair corneal lacerations.
• Be able to insert punctual plugs, perform botulinum toxin injection for ptosis, tarsorraphy, aqueous and vitreous taps, and corneal scrapes and biopsy.

1. Be able to use the slit lamp biomicroscope in association with preset lenses and diagnostic contact lenses to examine the anterior segment, optic disc, and fundus, and to interpret visual fields.

• Be able to perform surgical drainage procedures in combination with antimetabolites, combined cataract and drainage procedures, ciliary's body laser ablation and Yag peripheral iridectomy.

1. Be able to use the indirect ophthalmoscope and slit lamp bio microscope to assess retinal disease.

• Be able to perform and interpret fluorescein angiography's and ultrasound examinations of the orbit.
• Be able to perform laser photocoagulation of the retina, and subtenons, intra-orbital injections and intra-vitreal injections.

1. Be trained in the use of the direct and indirect ophthalmoscope in the assessment of optic nerve disease and retinal vascular disease.

• To interpret disorders of ocular motility, general medical and neurological disorders in relation to eye diseases and fluorescent angiography.

1. Be trained in methods of detection of strabismus, methods of managing strabismus and methods of assessment of ocular motility.

• Be able to interpret written data, such as orthoptic reports, Hess charts and visual fields.
• Be able to post- operatively assess patients undergoing adjustable suture surgery.
• Be able to perform horizontal and vertical rectus muscle recession and resection as well as oblique muscle tenotomy, disinsertion and plication and muscle transposition.

1. Be able to perform botulinum toxin injection for all forms of strabismus.

• Be trained in the use of the indirect ophthalmolmoscope in association with scleral depression to identify retinal breaks and vitreoretinal abnormalities including peripheral retinal degeneration.
• Be able to use the slit lamp bio microscope in association with pre-set lenses and diagnostic contact lenses, to examine the vitreous and retina.
• Be trained in the performance and interpretation of diagnostic ultrasound.
• Be trained to perform scleral buckling with explants, cryopexy, drainage of sub retinal fluid, vitreous biopsy, cataract extraction in vitrectomies eyes and to remove explants.

1. To have a working knowledge of epidemiological and statistics.

• Be able to plan, manage, and evaluate an eye care programme in terms of availability, accessibility, and affordability.
• Be able to design, conduct, and analyse interventional studies.
• Be able to advocate community eye health with politicians, health policy makers, and the medical profession.

1. To be familiar with the detection, investigation and treatment of eye disorders that specifically occur in children.

• To be able to advocate, plan and manage interventions aimed at prevention of childhood blindness.

Integrated Assessment

Assessment to ensure the purpose of the degree is achieved

In order to be accepted for the degree, the candidate has to have passed the Primary Examination of the College of Ophthalmology of the CMSA, or of the ICO. All candidates have that qualification and are credited with part I of the MMED Examination.

Certification, by the head of the candidate's training department that at least three years of learning will have taken place, in an approved training post, prior to the date of the first written examination paper.

Certification by the head of the candidate's training department, that the candidate has satisfied the head of the department as to his/her clinical and surgical skills, prior to the date of the first written examination paper.

To pass the FCO Part II of the CMSA. This consists of two written 3-hour closed book examination papers, potentially covering the entire syllabus, but collectively demonstrating a reasonable balance between different sections. There are also clinical examinations and an oral assessment. Candidates obtaining Part II of the FCO examinations are credited with Part II of the MMED Degree.

Submission of a dissertation (maximum 70 pages) reporting on the results of an analytical quantitative ophthalmologic study carried out and interpreted by the candidate.

An oral examination in two parts of 30 minutes each. In the first part the candidate will be expected to defend the dissertation before a panel of three examiners. In the second part the candidate will be expected to demonstrate oral communication skills by conducting a discourse on any topic relevant to ophthalmology before a panel of the same three examiners. The two parts may be conducted in either order. The overall pass mark is 55%.