Ophthalmology Speciality Curriculum Coordinator and Senior Clerkship Ophthalmology Teaching Coordinator:
Dr. Kendrick Co Shih
Clinical Associate Professor of Practice
Clinical Foundation Block and Junior Clerkship Ophthalmology Teaching Coordinator:
Dr. Nicholas Siu-Kay Fung
Clinical Assistant Professor
The main objectives we aim to address in undergraduate ophthalmic training include:
Attain competency in essential ophthalmic skills - especially in the context of a non-ophthalmic physician
Attain action-oriented medical knowledge - to recognise salient symptoms and signs of ophthalmic emergencies for urgent referral and to appreciate common eye conditions.
Appreciate the important public health concern and societal burden of potentially preventable blinding diseases
Appreciate the role of ophthalmologists in the medical community and to upload the highest standard of medical ethics
As medical practitioner, he or she should be able to conduct a basic clinical eye examination and, if necessary, order appropriate investigations and initiate treatment. He or she should be able to communicate the clinical diagnosis and its implications for management with a patient and other health professional.
The medical practitioner should be aware of his or her limitations, in terms of knowledge, experience and skills, and always practises within these limits. He or she should be prepared to refer patients to other practitioners where appropriate, whether for diagnosis, treatment or support. He or she should have an aptitude for and commitment to continuing professional development.
Horizontal and Vertical Integration
The curriculum is integrated horizontally (with other parts of the curriculum being delivered each year) and vertically (from one year to another in a progressive manner).
Year 1 & 2 (System-based Blocks)
In the first two years, ophthalmology is taught along with anatomy and physiology illustrating the clinical relevance and importance of basic science. An introduction to ophthalmic clinical skills, particularly visual acuity and pupil examination, will be conducted during the Endocrine and Reproductive Systems Block (ERS).
Year 4 (Clinical Foundation Block and Junior Clerkship)
The objective of the fourth year is to achieve competencies in ophthalmic clinical examination skills. The teaching is done in the form of skill laboratory during the integrated block. This will ensure that that the students are equipped with the skills and confidence to examine patients when they start their junior clerkship. They will be encouraged to utilise these skills during their junior clerkship. Furthermore, these basic ophthalmic examination skills can enable them to perform a more complete systemic evaluation of patients during their junior clerkship.
Two new whole class sessions (WCS) will be delivered to cover the ophthalmic manifestations of systemic diseases and common eye diseases to provide background information when the students encounter patients later in their clerkship.
An OSCA station dedicated to ophthalmology will take place during the Junior Clerkship Block C End-of-Rotation Examination. This OSCA aims to test the clinical examination skills that were taught during the clinical foundation block and re-enforced during junior clerkship Block C.
Year 5 (Senior Clerkship)
Year 5 will give the students the greatest exposure to ophthalmology. The knowledge and clinical examination skills acquired in Years 1 to 4 provide the necessary background for the students to begin their clinical attachments in Year 5.
At the beginning of their senior clerkship, 6 WCS, in the form of didactic lectures will be introduced. The topics of these lectures are symptom based and enhance clinical application:
Trauma & Ocular emergency
Eye problems in children
Acute visual loss
Gradual visual loss
Furthermore, students will have 6 days of tutorials and clinical attachments. We plan to deliver part of the teaching based on a problem-based format. There are 5 clinical scenarios and the students are given resources to look for the information to answer the questions posed, before group discussions and guided discussions lead by a teacher. The clinical scenarios for the problem-based learning sessions are as follows:
Acute and chronic visual loss
Eye problems in children
Ophthalmic manifestations of systemic disease
Additionally, to better prepare our students for the digital age of telemedicine, we will have an additional tutorial on ‘A systematic approach to fundus photo interpretation’. Using 20 case scenarios, teachers will guide students to identify and report salient physical signs on fundus photos.
The students will be assigned to the ophthalmic clinic service of the Grantham Hospital Lo Fong Shiu Po Eye Centre. During the clinical attachments, students will be exposed to busy clinics, operating theatre and different advanced ophthalmic investigations. There will be structured pathway through the clinics to reinforce skills, with a particular focus on direct ophthalmoscopy. Students are expected to learn alongside a multi-disciplinary team including nurses and optometrists.
We have also introduced a half day attachment to our 6-day clerkship at the HKU-Southern District Eye Screening Program with a focus on common eye diseases in the community. It would allow students to 1) practice direct ophthalmoscopy on subjects who give consent to this and would also allow 2) review of fundus photos with our teaching staff as well as 3) learn to interpret common ophthalmic investigations.
The WCS at the Final Revision block will be conducted in the form of an interactive slide quiz of common eye conditions and ophthalmic manifestations of systemic disease to prepare students for the final summative examination.
Medical Education-related Publications
Ophthalmic clinical skills teaching in the time of COVID‐19: a crisis and opportunity. KC Shih, JCH Chan, JY Chen, JSM Lai
Medical education 54 (7), 663-664
Clinical skills education at the bed‐side, web‐side and lab‐side. ACO Tsang, KC Shih, JY Chen
Medical Education 55 (1), 112-114
Does the COVID-19 Pandemic Spell the End for the Direct Ophthalmoscope? KC Shih, CYC Chau, JCH Chan, JKW Wong, JSM Lai. Ophthalmology and therapy 9 (4), 689-692
Teaching Development Grants
Introduction of Virtual Reality to the Teaching of Direct Ophthalmoscopy for Medical Students at the University of Hong Kong
Principal Investigator: Dr Nicholas Siu Kay Fung, Department of Ophthalmology
Co-investigators: Dr Rachel Cheung, Dr Amiee Pang, Ms Christina Wong, Prof Wai Ching Lam
Developing Telemedicine Consultation Skills for Future Doctors
Principal Investigator: Dr Anderson Chun On Tsang, Department of Surgery
Co-investigators: Dr Gary Kui Kai Lau, Dr Kendrick Co Shih, Professor Kent Man Chu, Dr Raymond King Yin Tsang, Dr Tsui Yee Emily Tse
Introduction of Augmented Reality (AR) Technologies to Educate Medical Students the Visual Symptoms and Progression of Important Vision-threatening Diseases
Principal Investigator: Dr. Yau-Kei Chan, Department of Ophthalmology
Co-investigators: Dr. Kendrick Co Shih, Dr Nicholas Siu Kay Fung, Professor Wai Ching Lam