PREAMBLE
The prevalence of blindness in Ghana is estimated to be one percent, 80% of which is
preventable or treatable. The national ratio of ophthalmologists to population is
1:500 000. This however varies from region to region and from urban to rural ranging
from 1:150 000 to 1:1 850 000
It is envisaged that minimum ratio of one ophthalmologist to 500 000 population would be
achieved and uniformly distributed throughout the country by the year 2010. This ratio should
continue to improve over the long term so that by the year 2020 quality basic eye care will be
accessible to all people resident in Ghana.
Efforts will be made to address the need of providing basic safe eye care by training a
highly efficient and knowledgeable middle level Membership Ophthalmologists.
1.2 JOB DISCRCIPTION
• Clinical medical, optical and surgical ophthalmic duties. He/she is the intermediate point
of referral for all other eye care workers
• Training eye care workers at levels under him/her
• Administration of eye care programme
• Research
1.3 GOAL
• To produce a specialist with the requisite amount of knowledge, skills and attitudes to be
able to practice independently as a specialist.
• Such a specialist at the end of his training should be capable of critically reviewing new
development and research findings in science and medicine as they apply to
ophthalmology.
• He/she should be able to contribute to his specialty through publications and is also
expected to participate in the training of all other eye care workers at all levels under
him/her.
1.4 CORE COMPETENCIES AND SUB-COMPETENCIES
In addition to the specialized cognitive and technical skills described in this curriculum,
several generic core “competencies” are expected of ophthalmic, as well as other, medical
specialists, See the promulgation by the Accreditation Council for Graduate Medical
Education (ACGME). Their website is www.acgme.org.
These core competencies include the following:
- Patient care
- Medical knowledge
- Practice-based learning and improvement
- Interpersonal and communication skills
- Professionalism, and
- Systems-based practice.
1.5 Patient Care
Trainees (“residents”) must be able to provide patient care that is compassionate,
appropriate, and effective for the treatment of health problems and the promotion
of health. Residents are expected to:
• communicate effectively and demonstrate caring and respectful behaviours when
interacting with patients and their families;
• gather essential and accurate information about their patients;
• make informed decisions about diagnostic and therapeutic interventions,based on patient
information and preferences, up-to-date scientific evidence, and clinical judgment;
• develop and carry out patient management plans;
• counsel and educate patients and their families;
• use information technology to support patient care decisions and patient education;
• perform competently the medical and invasive procedures considered essential for the area
of practice;
• provide health care services aimed at preventing health problems or maintaining health;
• work with health care professionals, including those from other disciplines, to provide
patient-focused care.
1.6 Medical Knowledge
Residents must demonstrate knowledge about established and evolving biomedical,
clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the
application of this knowledge to patient care. Residents are expected to:
• demonstrate an investigatory and analytic thinking approach to clinical situations;
• know and apply the basic and clinically supportive sciences which are appropriate to
ophthalmology.
1.7 Practice-based Learning and Improvement
Residents must be able to investigate and evaluate their patient care practices, appraise and
assimilate scientific evidence, and improve their patient care practices. Residents are expected
to:
• analyze practice experience and perform practice-based improvement activities using a
systematic methodology;
• locate, appraise, and assimilate evidence from scientific studies related to their patients’
health problems;
• obtain and use information about their own population of patients and the larger
population from which their patients are drawn;
• apply knowledge of study designs and statistical methods to the appraisal of clinical
studies and other information on diagnostic and therapeutic effectiveness;
• use information technology to manage information, access on-line medical information;
and support their own education; and
• facilitate the learning of students and other health care professionals.
1.8 Interpersonal and Communication Skills
Residents must be able to demonstrate interpersonal and communication skills that result in
effective information exchange and teaming with patients, patients’ families, and professional
associates. Residents are expected to:
• create and sustain a therapeutic and ethically sound relationship with patients;
• use effective listening skills and elicit and provide information using effective non verbal,
explanatory, questioning, and writing skills; and
• work effectively with others as a member or leader of a health care team or other
professional group.
1.9 Professionalism
Residents must demonstrate a commitment to carrying out professional responsibilities,
adherence to ethical principles, and sensitivity to a diverse patient population. Residents are
expected to:
• demonstrate respect, compassion, and integrity; a responsiveness to the needs of patients
and society that supercedes self-interest; accountability to patients, society, and the
profession; and a commitment to excellence and on-going professional development;
• demonstrate a commitment to ethical principles pertaining to provision or withholding of
clinical care, confidentiality of patient information, informed consent, and business
practices; and
• demonstrate sensitivity and responsiveness to patients’ culture, age, gender, and
disabilities.
1.10 Systems-based Practice
Residents must demonstrate an awareness of and responsiveness to the larger context and
system of health care and the ability to effectively call on system resources to provide care
that is of optimal value. Residents are expected to:
• understand how their patient care and other professional practices affect other health care
professionals, the health care organization and the larger society, and how these elements
of the system affect their own practice;
• know how types of medical practice and delivery systems differ from one another,
including methods of controlling health care costs and allocating resources;
• practice cost-effective health care and resource allocation that do not compromise quality
of care;
• advocate for high quality patient care and assist patients in dealing with system
complexities; and
• know how to partner with health care managers and health care providers to assess,
coordinate, and improve health care and know how these activities can affect system
performance
Professional attitudes and conduct require that trainees must also have developed a style of
care which is:
• humane (reflecting compassion in providing bad news, if necessary; the management of
the visually impaired; and recognition of the impact of visual impairment on the patient
and society);
• reflective (including recognition of the limits of his/her knowledge, skills and
understanding);
• ethical;
• integrative (including involvement in an inter-disciplinary team for the eye care of
children, the handicapped, the systemically ill, and the elderly); and
• scientific (including critical appraisal of the scientific literature, evidence-based practice
and use of information technology and statistics).
1.11 QUALIFICATION FOR ACCEPTANCE TO THE PROGRAMME
A medically qualified candidate who has
• Registered with the Ghana Medical and Dental Council
• Completed one year of non ophthalmic general medical practice preferably in a Regional
or District Hospital.
• An entry exam for selection of candidates may be conducted
• A candidate who has pursued the West African College of Surgeons DO course may
enroll to do the Membership Programme.
1.12 DURATION
The duration of the course shall be 3 years
1.13 ASSESSMENTS
Various Work Based Assessments (WBAs) will be used to assess residents while in
training.
• Competence in patient management and health promotion and disease prevention is
assessed using Case based Discussion (CbD).
• Clinical Rating Scale (CRS) and Objectively Structured Clinical Examination (OSCE)
will be used to assess the resident’s clinical skills.
• Procedural skills will be assessed by Direct Observation of Procedural Skills (DOPS)
• Most of the “Attitudes, Ethics & Responsibilities” and Communication skills will be
assessed using Multiple Source Feedback (MSF) where appropriate persons are
approached to give feedback on the resident’s performance.
• Technical skills will be assessed using Objectively Structured Assessment of Technical
Skills (OSATS)
• Log Books will be kept by each resident and regularly assessed by trainers
1.14 REQUIREMENTS FOR CERTIFICATION
A candidate will be awarded the certificate of Member of the Ghana College of Surgeons,
Faculty of Ophthalmology after passing all prescribed examinations.
These shall be
a. The Part 1 Examination
b. The Part 2 Examination
1.14.1 The Part 1 Examination will be in the Basic sciences
The examination shall consist of a 3 hour MCQ paper.
A candidate must score at least 50% to pass the primary examination.
1.14.2 The Part 2 Examination will be in the principles and practices of optics, refraction, medical
and surgical ophthalmology. The candidate must have passed the Part1 exams and spent
another 2 and half years in clinical Ophthalmology and prescribed rotations in Neurology,
Endocrinology, Haematology, Pathology, ENT, Plastic surgery and Neurosurgery before
being admitted to this examination.
•Written Papers.
– Paper 1
– Paper II
– Paper II
– MCQ – 2 hrs
– Visual Optics and Refraction – 3 hrs
– Medical and Surgical Ophthalmology – 3 hrs
• Clinical/ Practical
– Refraction – Practical and Oral
– Clinical examination – Long and short cases
• Oral – Viva voce
1.14.3 Conditions for pass:
Candidates must pass the Refraction practicals in addition to passing the clinical examinations
and score 50% of the overall marks to pass the Part 2 examination.