Ophthalmology Training Pathway
How to become an ophthalmologist in Australia — the RANZCO Vocational Training Program, how national selection works, the exams, and why ophthalmology is the highest-earning specialty by ATO data.
Ophthalmology is one of the hardest specialties to enter. Selection is national and very competitive — RANZCO publishes the numbers, and they show only around one in four applicants is selected. Most successful applicants spend several pre-vocational and unaccredited years building a CV first.
Why ophthalmology
You diagnose and manage eye disease across medicine and microsurgery — cataract and refractive surgery, retinal disease and injections, glaucoma, cornea, oculoplastics and paediatric eyes — mixing high-volume day-surgery lists with clinic-based medical and laser procedures. Hours are largely sociable with comparatively light on-call. It suits people who want fine microsurgery and procedural work with mostly office-hours lifestyle, are comfortable with a long and very competitive entry, and like a field that blends medicine, surgery and technology.
- Draws: Microsurgical and procedural work with high day-surgery volume, Largely sociable hours and light on-call for a surgical field, The highest-earning specialty by average ATO taxable income, Strong, growing demand from an ageing population.
- Trade-offs: One of the most competitive specialties to enter (~1 in 4 selected), Years of pre-vocational/unaccredited CV-building before selection, A demanding exam load across four assessments and a research requirement, Heavily private — building a practice takes time and capital.
- Subspecialties: Cataract & anterior segment, Vitreoretinal (surgical retina), Medical retina, Glaucoma, Cornea & external eye / refractive, Oculoplastics, lacrimal & orbit, Paediatric ophthalmology & strabismus, Neuro-ophthalmology, Uveitis / ocular inflammation.
The training pathway
The same fellowship, two very different timelines. The fast route assumes everything goes right; most people land on the realistic one.
How competitive is it?
Ophthalmology is consistently among the hardest specialties to enter, and unusually for Australian training RANZCO publishes the numbers. Across recent intakes there have been roughly 150–160 applicants a year for about 30–42 training places — for example 158 applicants and 39 selected for 2024, and 151 applicants and 36 selected for 2025 — so only around one in four applicants is selected (a ratio of roughly three to four and a half applicants per place, derived from RANZCO's two published figures). These counts are bi-national (Australia and New Zealand combined), with New Zealand taking about seven to ten places a year. RANZCO's published statistics also show successful applicants average around five years since graduating, reflecting the pre-vocational and unaccredited "service-registrar" years most spend building a CV before selection — and ophthalmology experience is explicitly rewarded in the scoring. For workforce scale, the AIHW recorded about 1,004 ophthalmologists working in Australia in 2023.
Unaccredited time: In practice, usually — there's no formal requirement, but most successful applicants spend pre-vocational and unaccredited ophthalmology years (service-registrar time is heavily rewarded in scoring) building a CV before selection.
Sources: RANZCO — Vocational Training Program selection, RANZCO — selection statistics 2017–2025 (applicants & intake), RANZCO — selection FAQs, AIHW — eye health measures 2024 (ophthalmologist workforce).
Selection criteria & how to apply
Selection is national and two-step. RANZCO runs a centralised selection — CV, referee reports, a multiple mini-interview (MMI) and a situational judgement test (SJT) — that produces a national pool; regional training networks then run their own assessment and make employment offers, with a matching program allocating places. RANZCO publishes that the score is out of 100 points, with 65 fixed centrally and 35 controlled by the network, and publishes some component maxima — but not a complete percentage rubric (the MMI and SJT maxima aren't published), so the steps below are shown qualitatively rather than as a points bar. The assessed steps:
Key documents: RANZCO — VTP Selection & Appointment Policy (2023), RANZCO — selection scoring criteria.
How it works, network by network
NSW
Who runs selection: Two networks — the Sydney Eye Hospital (SEH) Network (Sydney plus regional NSW, and host to ACT, NT and Tasmanian posts) and the Prince of Wales Hospital (PoWH) Network. Selection is national; the network is where you're employed and rotate.
Where to apply: RANZCO national selection + network matching (NOMP) — application portal.
Worth knowing: NSW has the largest training footprint, anchored by Sydney Eye Hospital. Smaller jurisdictions' posts (ACT, NT, parts of TAS) sit within the SEH network rather than standalone networks.
Links: RANZCO — training networks, RANZCO — accredited training positions.
VIC
Who runs selection: The Victorian Network, anchored by the Royal Victorian Eye and Ear Hospital, spanning metropolitan and regional Victoria and hosting some Tasmanian and ACT posts. National selection applies.
Where to apply: RANZCO national selection + network matching (NOMP) — application portal.
Worth knowing: The Royal Victorian Eye and Ear Hospital is one of the country's two largest standalone eye hospitals and a major subspecialty-fellowship centre.
Links: RANZCO — training networks.
QLD
Who runs selection: The Queensland Network, rotating across the Royal Brisbane & Women's, Princess Alexandra, Mater, Queensland Children's, Gold Coast and Sunshine Coast hospitals. National selection applies.
Where to apply: RANZCO national selection + network matching (NOMP) — application portal.
Worth knowing: Queensland Health careers material describes the usual build-up through ophthalmology RMO and service-registrar roles before national selection.
Links: RANZCO — training networks, Queensland Health — ophthalmology.
SA
Who runs selection: The South Australian Network, rotating the Royal Adelaide, Flinders, The Queen Elizabeth, Modbury and Women's & Children's hospitals, and hosting the Alice Springs (NT) post. National selection applies.
Where to apply: RANZCO national selection + network matching (NOMP) — application portal.
Worth knowing: A cohesive statewide network; the NT's Alice Springs training sits within it.
Links: RANZCO — training networks.
WA
Who runs selection: The Western Australian Network across Royal Perth, Sir Charles Gairdner, Fremantle and Perth Children's hospitals, with regional sites. National selection applies.
Where to apply: RANZCO national selection + network matching (NOMP) — application portal.
Worth knowing: WA careers guidance is explicit that you usually work as an unaccredited service registrar before getting onto the program.
TAS
Who runs selection: Tasmania has no standalone network — accredited posts sit within the Sydney Eye Hospital, Victorian and Western Australian networks. Selection is national.
Where to apply: RANZCO national selection + network matching (NOMP) — application portal.
Worth knowing: Training is delivered through host networks rather than a Tasmanian network, so rotations include interstate time.
Links: RANZCO — training networks.
ACT
Who runs selection: The ACT has no standalone network — Canberra Hospital posts sit within the Sydney Eye Hospital and Victorian networks. Selection is national.
Where to apply: RANZCO national selection + network matching (NOMP) — application portal.
Worth knowing: Canberra training is embedded in the larger east-coast networks rather than run as its own.
Links: RANZCO — training networks.
NT
Who runs selection: The NT has no standalone network — Darwin posts sit within the Sydney Eye Hospital network and Alice Springs within the South Australian network. The Regionally Enhanced Training Network also covers northern Australia. Selection is national.
Where to apply: RANZCO national selection + network matching (NOMP) — application portal.
Worth knowing: Distinctive remote and Aboriginal eye-health exposure, delivered through host networks and the Regionally Enhanced Training Network.
Links: RANZCO — training networks.
How to optimise your application
- Build ophthalmology experience (tied to CV / experience score, start PGY1–3) — Ophthalmology RMO and unaccredited service-registrar terms are heavily rewarded in scoring; continuous recent eye-unit time counts most.
- Publish and present (tied to Scholar points (max 8), start early) — A first-author publication and conference presentations both score and help meet the later research requirement.
- Prepare hard for the MMI (tied to Interview, start pre-application) — RANZCO's published averages show interview performance dominates the points separating selected candidates — practise MMI and SJT scenarios.
- Use regional exposure (tied to Regional points (max 7), start PGY1–3) — Eligible regional experience scores directly and the Regionally Enhanced Training Network offers additional pathways.
Key documents & official links
- RANZCO — Vocational Training Program
- RANZCO — selection & scoring criteria
- RANZCO — examinations
- RANZCO — Specialist International Medical Graduates
FAQ
Is ophthalmology hard to get into?
How long does training take?
Is selection national or state-based?
What are the exams?
Do ophthalmologists really earn the most?
Trained overseas? (IMG pathway)
How overseas-trained ophthalmology doctors get recognised
Overseas-trained ophthalmologists are assessed by RANZCO as a Specialist International Medical Graduate (SIMG) for comparability to an Australian-trained ophthalmologist, after AMC primary-source verification of qualifications. Substantially comparable applicants complete a period of oversight of up to 12 months (minimum 3); partially comparable applicants do up to 24 months FTE of supervised practice in an Australian public hospital, reviewed every three months, and may be required to sit the RACE clinical exam.
See the RANZCO — Specialist International Medical Graduates and our IMG internship guide.
Related specialties
Last reviewed 2026-06-01.