FAQ

• What conditions can be managed and what drugs can be prescribed?
• What training is required to become a specialist in ocular therapeutics?
• Who is the programme for?
• How long will it take to complete?
• Is prior experience required?
• Will prior learning and experience be accredited?
• Do I have to take exams?
• How much does it cost?
• What do I have to do to stay on the Therapeutic Register once I have qualified?
• Does attending the course count towards CET?
• When does the next course start?
• How can I find out more?
• How can I apply?

What conditions can be managed and what drugs can be prescribed?

Optometrists on the Additional Supply (AS) register can supply and administer additional POM medicines (over and above those available at entry-level). This allows the practitioner to manage a number of common non-sight threatening disorders. The drugs that can be used by AS optometrists are linked to an approved formulary and include some topical antibiotics, lubricants, mast-cell stabilisers, anti-histamines, one non-steroidal anti- inflammatory as well as miotics and mydriatics (see http://www.mhra.gov.uk).

Optometrists on the Supplementary Prescribing (SP) register work in partnership with an independent prescriber (IP), such as a GP, an ophthalmologist or appropriately qualified optometrist, and can use any medicine to treat an eye condition diagnosed by the IP, as long as it is included in the Patient Management Plan and agreed with the IP and the patient. As such, there are no legal restrictions for drugs which may be used by SP optometrists.

Optometrists on the Independent Prescribing register also have no limitations as to the drugs they can prescribe. In contrast to SP, IP optometrists can diagnose and treat independent of a medical practitioner. The restriction to the range of medicines that can be used and conditions that can be treated for IP optometrists is by reference to their competence:

‘Optometrist independent prescribers should be able to prescribe any licensed medicine for ocular conditions, affecting the eye and adnexa, within the recognised area of expertise and competence of the optometrist.’

The likely areas, in which optometrists are expected to work as Independent Prescribers, are Primary Eye Care and / or Glaucoma.

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What training is required to become a specialist in ocular therapeutics?

Additional training consists of taught theory modules and a period of clinical placement under the supervision of a designated ophthalmologist. The taught course has to encompass all aspects of the GOC’s therapeutic prescribing curriculum and the competency framework for prescribing optometrists that has been published by the National Prescribing Centre in conjunction with the GOC.

The aim of the course is to provide optometrists with a broad education in prescribing practice that will equip them with the necessary knowledge and skills to enhance their career and contribute effectively to extended professional roles. Throughout the training practitioners will develop their clinical skills in the management of common ophthalmic conditions. The overall structure of Glasgow Caledonian’s course, including both theoretical and practical components, is outlined in the flowchart (LINK). A modular structure has been developed to allow maximum flexibility to enter at the appropriate level and develop clinical knowledge and skills within their own time-scale and at their own pace. The course is divided into three theoretical modules and a ‘learning in practice’ clinical placement.

Theoretical training

Each module consists of lectures, practical workshops and distance learning. Two days of lectures and workshops take place at Glasgow Caledonian University. This is followed by part-time, guided distance learning with set tasks and regular self-assessment opportunities. Those involved in course delivery come from a variety of different disciplines including Optometry, Ophthalmology, Pharmacology, Microbiology, Biochemistry, General Medical Practice and Nursing.

The first module (Ocular Therapeutics) covers basic aspects of ocular therapeutics, including the pharmacology and use of ocular therapeutic drugs, clinical features and management options for anterior eye disease, and the potential impact of medications on the eye and vision. The weekend lectures cover topics such as the assessment and management of keratitis, blepharitis and scleritis, assessment and management of dry eye as well as practical workshops on e.g. gonioscopy. Distance learning is facilitated by provision of several specially written articles, tailored to match the needs of therapeutic-prescribing optometrists and written by experts in the field of therapeutic management of ocular disease. Topics include basic principles of therapeutics, anti-infective drugs for ophthalmic use, anti-inflammatory drugs, diagnosis and management of infectious keratitis, management of allergic eye disease etc. Continuous self-assessment of students’ understanding of the distance learning components is available via Internet-based multiple-choice questions.

The syllabus for the second module (Practical Prescribing) broadly encompasses four areas: the use of medications in the management of selected ocular conditions (with a special emphasis on Glaucoma), the development of a clinical management/treatment plan, drug legislation and strategies of care that meet the specific needs of patients presenting with selected eye diseases. Upon successful completion of the second module’s exam, optometrist will have two options. If they wish to train for AS or SP, they can start the practice-based learning (see below) at this point.

For those who wish to train for Independent Prescribing, a third theoretical module is designed to specifically encompass more general and systemic aspects of prescribing. The main aspects of the third module (Independent prescribing) are the pharmacokinetics & pharmacodynamics of systemically administered medicines, the legal and ethical aspects of the professional autonomy of an independent prescriber, the understanding of the public health issues related to medicines use and the ability to work within clinical governance frameworks that include audit of prescribing practice and personal development.

Practice-based training/ Clinical placement

Following completion of the theoretical modules, trainees embark on a period of practice-based training. The primary purpose of this component of the training programme is to develop competency in the practice of prescribing and to facilitate the integration of prescribing theory and practice with the conditions that he or she will manage therapeutically. This training will typically take place in the Hospital Eye Service under the supervision of a designated ophthalmologist. It is the responsibility of the trainee to arrange the clinical practice placement.

For IP and SP, the Clinical Placement comprises a minimum of 12 days (24 sessions of not less than 3 hours); for AS the minimum requirement is 5 days. Optometrists already registered as AS or SP and wishing to upgrade to IP will require a minimum of 7 or 3 days respectively. 

Who is the programme for?

The aim of the course is to train optometrists to diagnose and manage certain eye-conditions, either in partnership with an Independent Prescriber (SP) or independently (IP). It is intended for those optometrists, who will have the opportunity to work as AS/SP/IP following successful completion.

Optometrists with relatively limited prior therapeutic experience can use the programme to gain theoretical and practical knowledge in order for them to work therapeutically in practice and ultimately to become Supplementary or Independent Prescribers. In addition, the course allows those optometrists, who are already engaged in therapeutic practice, to extend their role by becoming Supplementary or Independent Prescribers. 

How long will it take to complete?

Each of the three theoretical modules entails 200 hours of notional effort, each worth 20 postgraduate credits, which can be used for further studies towards qualifications such as an MSc degree. An MSc programme is currently being developed at GCU.

It is recognised that optometrists will possess varying base-line experience, which will affect the absolute amount of learning and training required to meet the stated learning outcomes.

The modular format with a strong emphasis on distance e-learning makes the duration and the timing of the course flexible, in order to meet individual needs. Participants can enrol at any time and upon registration will receive the distance learning material. To complete each module, optometrists are required to attend the 2-day workshops and to complete the exam. Past experience has shown that a period of 3-4 months per module allows sufficient time to study on a part-time basis. Hence, for an optometrist training to become an IP without any prior therapeutic qualifications, three periods of about 3-4 months (i.e. 1 year) is the shortest time needed to complete the taught course, although practitioners can choose to complete the course at a slower pace.

Following the completion of the three theoretical modules, practitioners are required to undertake a clinical placement, typically in the Hospital Eye Service under the supervision of a designated ophthalmologist (see above). The minimum requirement for IP is 12 days (24 half-day sessions). These sessions have to be scheduled to suit both the training optometrist and the supervision ophthalmologist and the time taken to complete this clinical placement varies from case to case.

Based on previous experience with optometrists studying on a part-time basis, it is anticipated that the typical time to complete the three theoretical modules and the hospital placement (i.e. the entire programme leading to IP) will be 2 years, although it is possible to do it in just over 1 year.

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Is prior experience required?

The general aspects of the course (modules 1 and 2) are open to all UK registered optometrists with the additional requirement that practitioners must have worked for a minimum of two years in practice before they can start the clinical placement. However, given the clinical expertise required of an IP, practitioners must supply evidence that they have up-to-date knowledge in the diagnosis and management of the eye conditions for which they train to prescribe before commencing with the third module (Independent Prescribing). At this stage, optometrists should define their intended area of practice, which is likely to be Primary Eye Care and / or Glaucoma.

The course structure allows both optometrists with and without prior therapeutic experience to enter. Those with limited prior therapeutic experience can complete the first two modules, giving them the necessary theoretical background to subsequently gain practical therapeutic experience before commencing with module 3. Alternatively, less experienced optometrists might wish to complete the programme to the level of AS (which includes clinical placement and Common Final Assessment) and return for Independent Prescribing after gaining practical experience with therapeutic management.

Evidence of prior practical experience in the diagnosis and management of eye conditions will be based on records on documents of achievement, e.g. attended courses, qualifications gained and clinical experience in the form of portfolios of clinical case records. Examples of optometrists, who might typically be expected to meet these criteria, include those with experience in Hospital Eye Services, Specialist General Practice, Grampian Eye Health Care, Glasgow Integrated Eyecare Services (GIES), Welsh Eye Care Initiative (WECI) and Patient Group Directives. 

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Will prior learning and experience be accredited?

Prior and experiential learning will be credited to reflect the wide range of experience that individual optometrists may have gained in the ocular therapeutics field during their career. Decisions regarding prior experience will be made on an individual basis and be based on documents of achievement, portfolios, and clinical records.

Where applicants can provide satisfactory evidence of prior learning, they may be exempt from the distant learning part of module 1, module 2 or both and the exemption might include assessments. There are no exemptions for any part of module 3 (Independent Prescribing).

Exemption might be given to individuals who have completed and passed a certified ocular therapeutics course (e.g. College of Optometrists qualifications or as part of an MSc from the University of Bradford or City University) or to optometrists with extensive experience in Hospital Eye Services or Specialist General Practice, although the extent of the exemption will have to be decided on an individual basis. Exemption from parts of the theoretical components will also be considered in cases where sufficient prior learning can be evidenced, as would be the case for recent graduates (from 2008 onwards) from Glasgow Caledonian University, given the strong emphasis on therapeutics in its undergraduate Optometry program.

Optometrists who are already registered as AS or SP will typically be exempt from modules 1 and 2 (including exams) and allowed to enter module 3 directly. Similarly, optometrists who have successfully completed a training program for AS/SP but have not yet sat the Common Final Assessment exam will also typically be exempt from modules 1 and 2 (including exams). 

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Do I have to take exams?

Optometrists are required to pass a theoretical exam at the end of each module to demonstrate that they have acquired the necessary understanding of the learning outcomes. They are further required to pass a practical exam to demonstrate that they have the necessary clinical skills before commencing the clinical placement. The exams use a variety of methods including multiple-choice questions, short answer questions, essay questions, visual identification and management of ophthalmic conditions and, for the practical exam, objective structured clinical examination.

At the conclusion of the clinical placement, trainees sit a Common Final Assessment (CFA) run by the College of Optometrists. The CFA involves the candidate submitting a portfolio of practice evidence, which provides details of the patients seen during their clinical placement. The submitted portfolio will be reviewed by two examiners (typically one ophthalmologist and one suitably qualified optometrist). The candidate will then sit a viva-type examination with the two examiners; the length of the examination varies depending upon which qualification is sought.

Following completion of the CFA the successful candidate will be awarded AS, SP or IP status and be allowed to register on the specialist GOC list. Full details of the CFA can be downloaded from the College of Optometrists website (www.college-optometrists.org).

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How much does it cost?

Each of the three theoretical modules cost £630. The costs for the clinical placement, which is to be arranged by each trainee, can vary, depending on the fees, if any, imposed by the respective HES. The examination fee for the Common Final Assessment, charged by the college of optometrists, is currently £566 for AS or SP and £395 for IP.

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What do I have to do to stay on the Therapeutic Register once I have qualified?

Once registered on the GOC Therapeutic Register, optometrists have to keep their skills up-to-date in order to comply with the additional CET requirement for specialists in ocular therapeutics (similar to the contact lens requirements for dispensing opticians). Various CET providers are tailoring events to offer specialist therapeutic points. Current changes to the CET requirement for optometrists with therapeutics specialties specify that 18 therapeutics-specific points are needed over a three-year cycle independent on the number of additional qualifications (i.e. 18 points for AS only, for AS+SP or IP).

To reflect the importance of on-going exposure to prescribing activities, continuing registration on the GOC Therapeutics Register for IP will be subject to an annual renewal process when registrants are required to demonstrate activities in relation to prescribing. Details of this have still to be verified.

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Does attending the course count towards CET?

The two-day workshops for each module are registered for CET points and typically provide 10-12 points each. The modules also provide academic credits that can be accrued towards a diploma or Masters degree in Clinical Optometry.

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When does the next course start?

The course runs once per year with the first module normally taking place in March of every calendar year. Applications for the next available course are being accepted from UK-based and international practitioners throughout the year. Upon commencement of the next available course, students will receive the distance-learning material for this module.

A top-up course (Module 3 - Independent Prescribing) for optometrists who are already on the AS/SP register, who have completed training for AS/SP or those who are otherwise sufficiently qualified in the field of ocular therapeutics, starts in October of each year with the exam following in January of the following year.

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How can I find out more?

For more information or for an application form, please contact:

Programme Administrator

Department of Vision Sciences

Glasgow Caledonian University

Cowcaddens Road

Glasgow G4 0BA

Phone: 0141 331 3379 Option 4

Email: PrescribingOptom@gcal.ac.uk

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How can I apply?

To apply, please complete an application form (LINK) and return electronically (PrescribingOptom@gcal.ac.uk) of via regular mail:

Programme Administrator
Department of Vision Sciences
Glasgow Caledonian University
Cowcaddens Road
Glasgow G4 0BA

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