Turn the clock back to 1997 and employers were warning of a serious shortage in optometric manpower and pushing for radical changes to the structure of the profession to avert the crisis it faced.
Yet just two years later there were calls for controls on student intake and warnings of an imminent oversupply of optometrists following steep rises in the numbers of students entering the universities and the creation of new courses at Ulster and Anglia.
At that time, Optician hosted an open meeting to examine manpower and recruitment and invited the profession to take part. Among employers, there were those who argued market forces should decide the quantity and quality of recruits to the profession. It was shortage, not oversupply, of optometrists that reduced quality and drove up salaries, they said.
Last week, the consequences of recruitment strategies of the mid-1990s (when combined with social and economic trends) became clearer, as the universities convened a meeting of employers and other stakeholders to examine what went wrong (News, 16.04.10). The discussion also highlighted the wider problem of the profession's public profile, or lack of it.
Professor David Thomson set the scene with data from the universities showing a doubling of the number of university places since the mid-90s while the number of applicants had halved. Although there were some good students, universities were having to accept weaker applicants, he said. A-level entry grades were still high, in some cases AAA, but 'grade inflation' made these misleading and there was little correlation between A-level and degree results.
Gathering views on current intake from the various departments revealed other concerns about quality. Students tended to be focused on their goal, often financial, to the exclusion of all else. They expected to be 'spoon-fed' and some showed poor numeracy and literacy skills. There was a lack of engagement in university life since many students now preferred to, or perhaps needed to, live at home.
Not only did the profession need a concerted campaign to promote optometry, and dispensing optics, as a career. It also needed to look again at entry requirements and selection procedures, such as aptitude tests, to raise standards, said Professor Thomson.
But universities had mixed opinions on the value of interviewing applicants. Some departments, such as Bradford, already interviewed, as happened in medicine and dentistry, but others said there was little correlation between interview performance and ability to interact with patients and staff.
Keiran Loft, studying at Cardiff University, agreed that A levels were not a good benchmark and observed that undertaking work experience before applying played a big part in whether students were right for the profession.
For the Association of Optometrists, education adviser Karen Sparrow said optometry was often a 'default' choice and that school leavers were unaware of the diversity of career opportunities open to them in optometry. 'Many are going into the profession with no real idea what it can do for them and how they can use their skills. They haven't really thought about what the job entails and they're bored when they come out,' she said.
The professional bodies' joint education committee would soon publish a new careers ladder that outlined all the entry points into optics, from courses for technicians and optical assistants to higher degrees. The goal was to make the profession a positive choice, and create a motivated and enthusiastic workforce.
Ian Humphreys described methods the College of Optometrists identified to raise awareness of optometry as a desirable career choice. One option was an online resource for children, teachers and the profession, along with a greater presence on careers sites. Other activities could involve local and national engagement with schools and careers organisations.
But indications are that the profession faces a difficult task. Pete Dobson of London's City & Islington College spent two years visiting schools in south London to promote optics as a career and found little or no interest. He also observed that the best DO students were those who had already had Saturday or Sunday jobs in optical practice.
Optometrists in the audience were involved in local schools and careers events but some found that optometry was not perceived as a healthcare profession and people were unaware of the complexities of its work. 'They see 'Should have gone to Specsavers' and equate that with Poundstretchers,' said Professor Roger Anderson of the University of Ulster.
For employers, the principal concern was the geographical spread of those entering the profession but there was general agreement that the primary goal had to be to increase the pool of applicants. 'We're perilously close to parity in numbers of applicants and numbers of places,' said Chris Howarth of Specsavers. 'If there are 500 applications for 500 places there's only one outcome,' he said.
Professor Thomson summed up the situation saying that how students were selected was becoming a non-issue because there was no pool to select from. 'The first step must be to expand the pool,' he said.
It fell to student Keiran Loft to ask whether the current annual intake, at 630, was sustainable and whether there should be a freeze or decrease in recruitment.
Not surprisingly, there was little support from employers. The numbers were sustainable if you spread them out over the UK, said Richard Edwards of Boots Opticians, who dismissed comments that driving down salaries had deterred applicants. Optometrists could register aged 22 and earn £32k in many areas, and £50k or more in Cornwall, he said, adding: 'Which bit of that is poorly paid?'
It was this comment that aptly recalled arguments a decade or more ago, to 'Let market forces decide on quality'. It seems they have done just that. ?