The Royal Australian and New Zealand
College of Ophthalmologists
A.C.N. 000 644 404
94 – 98 Chalmers Street, Surry Hills, NSW 2010
AUSTRALIA
Telephone: +61 2 9690 1001
Facsimile: +61 2 9690 1321
E-mail: ranzco@ranzco.edu
http://www.ranzco.edu
05/68

13 July 2005

Health Workforce Study
Productivity Commission
P O Box 80
BELCONNEN   ACT  2616

SUB-SPECIALISATION OF THE OPHTHALMOLOGY WORKFORCE

1.	An imbalance of general and sub-specialist ophthalmologists will have workforce implications (geographically and professionally) and the potential for dissatisfaction (failure to meet expectations) of newly graduated ophthalmologists.

2.	The Royal Australian and New Zealand College of Ophthalmologists has a policy of training general ophthalmologists in its vocational training program leading to qualifications to be recognised as a specialist ophthalmologist.  However, there is an apparent reduction in the numbers of newly trained ophthalmologists who wish to practise as generalists.

3.	The reasons for this are varied and may be influenced by factors such as the influence of training within sub-specialty rotations, the expectation of studying overseas in specific sub-specialties, role models by mentors, and a change in recruitment practices for VMOs within the public hospital system.

4.	Until the emergence of the sub-specialist, the eye health needs of the Australian communities were largely served by ophthalmologists who trained and practised as general ophthalmologists and were available to practise in areas outside the densely populated urban regions.  A reduction in generalists will cause a paucity of replacement ophthalmologists for the existing generalist workforce.

5.	Although it is of concern that fewer ophthalmologists will remain generalists and therefore be available for country and smaller urban centres and the suburbs, there has been no attempt to systematically address the issue.

6.	If the general ophthalmologist model is to be maintained there will need to be a philosophical and attitudinal change required within the profession to reinforce the value of general ophthalmology, not merely for advanced training, but also for professional 

work throughout a lifetime.  These changes will need to extend to the public hospital system to ensure that general ophthalmologists are recruited into the highly sub-specialised eye hospitals in Sydney and Melbourne that conduct a large proportion of the training.

7.	The same problem appears to be developing in other specialties including physicians, surgical, and obstetric and gynaecological workforces.

Yours sincerely

DR ALLAN ROSENBERG
President