Medical Students’ Competency in Diabetic Retinopathy Assessment: A UK-Wide Study Identifying Critical Gaps in Undergraduate and Graduate Entry Ophthalmology Education

Abstract

This UK-wide cross-sectional study evaluates 132 medical students’ diagnostic accuracy in diabetic retinopathy (DR) classification across 30 fundoscopic images, revealing systemic deficiencies in ophthalmology education. Participants from 15 UK medical schools (including undergraduate and graduate entry programs) achieved a mean score of 10.9/30 (36.3%), with 88.3% reporting low confidence in their abilities. Severe DR (DR3) recognition was strongest (81.9% accuracy for key images), while healthy retinas and mild DR (DR1) identification fell below 15%. Despite 47.9% having recent clinical exposure, performance remained poor, underscoring urgent needs for curriculum reform. The study highlights disparities between the growing diabetic retinopathy prevalence and inadequate preparedness among future clinicians, with implications for NHS diabetic eye screening programs.