My clinical elective was spent at the Royal Victorian Eye and Ear Hospital (RVEEH) in Melbourne. As Australia’s only specialist tertiary hospital dedicated entirely to eye disease, RVEEH gave me significant exposure to, and enhanced my clinical understanding of, ophthalmology.
Throughout my four-week placement, I rotated through multiple ophthalmology subspecialty clinics, including retina, glaucoma, cornea and neuro-ophthalmology. This allowed me to see a wide spectrum of conditions, from common presentations such as diabetic retinopathy and age-related macular degeneration to more complex neuro-ophthalmic and corneal disease. Observing and interpreting slit-lamp examinations, fundoscopy, OCT imaging and visual field testing on a daily basis, rapidly improved my confidence with ophthalmic assessment.
Although the elective was largely observational, I consistently felt involved in both clinics and theatres. The advantages of observational learning are well-reported, such as allowing students to translate theoretical knowledge into practical competence by watching clinical encounters [1]. Clinicians were keen to include medical students, often talking through cases and encouraging questions. I was given opportunities to practise using the slit lamp under supervision, which was invaluable in developing a practical understanding of anterior segment examination. In the emergency department, I was also able to take my own focused ophthalmic histories, helping consolidate my approach to acute eye presentations and apply theoretical knowledge in a clinical setting.
The timing of the elective was especially beneficial for my Duke Elder examination shortly afterwards. The Duke Elder exam is a highly competitive, UK-national ophthalmology exam for medical students, run annually by the Royal College of Ophthalmologists. It consists of a two hour, 90 question single best answer paper that covers the full breadth of eye disease, anatomy, physiology and optics, often going beyond the standard undergraduate curriculum. During my elective, concepts such as visual field defects, optic nerve pathology and retinal disease became much easier to understand as I encountered them repeatedly in clinical practice, making revision more intuitive and significantly boosting my confidence going into the examination!
One particularly memorable aspect of my elective was the opportunity to act as a mock patient for a postgraduate ophthalmology examination. As part of this, my eye was dilated for the first time which was an interesting and mildly disorientating experience but offered valuable insight into a typical patient’s experience. Observing candidates perform structured ophthalmic assessments under exam conditions and listening to examiner feedback was highly educational. Importantly, it also gave me insight into the ophthalmology postgraduate specialty training programme in Australia.
Beyond the hospital, Melbourne was an ideal location to spend my vacation despite me visiting in its Winter season! It had a vibrant culture, excellent food and coffee scene, reliable public transport and proximity to beaches and green spaces. I recommend visiting St Kilda’s beach for some penguin spotting or going for a jog around Albert Park. If you have time, Sydney is only an hour away by plane and makes for an excellent weekend excursion.
Overall, my elective at the RVEEH was an outstanding experience. It gave me a significant exposure to ophthalmology that I had not yet experienced in medical school and solidified my desire to pursue the specialty. I’m grateful for the welcoming and supportive culture within the hospital, including the doctors, nurses and allied health staff who were consistently approachable. I would highly recommend this elective to anyone seeking a focused clinical experience in a world-class specialist centre.
References
1. Sajjad M, Mahboob U. Improving workplace-based learning for undergraduate medical students. Pak J Med Sci 2015;31(5):1272–4.
Declaration of competing interests: None declared.
