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Yang X, Zheng D, Wan P, Luo X, Zhang M, Zhang L, Zhang S, Huang J, Zhuo Y. Standard ophthalmology residency training in China: an evaluation of resident satisfaction on training program in Guangdong Province. BMC MEDICAL EDUCATION 2023; 23:550. [PMID: 37537562 PMCID: PMC10401789 DOI: 10.1186/s12909-023-04527-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 07/21/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND National standardized training for resident doctors (STRD) in mainland China has been formally established since 2014 as a kind of postgraduate education. The purpose of this survey was to assess the satisfaction of the training residents in Guangdong Province on the ophthalmology STRD program after a duration of 5 years. METHOD A 48-item survey was sent to all postgraduate ophthalmology residents from bases in Guangdong Province to inquire about their attitude towards the program. The survey contained questions about demographic and work-related information, job satisfaction, psychological resilience, and job performance. All responses were verified, and invalid questionnaires were excluded. Statistical analyses were performed using SPSS software version 22.0 (SPSS, Inc., Chicago, IL). Multiple logistic regression analysis was used to evaluate the factors (demographic information, working environment, clinical exposure, supervision and hands-on training opportunities, and involvement in academic activities) impacting the overall satisfaction. P < 0.05 was considered statistically significant. RESULTS A total of 471/635 (74.17%) valid questionnaires were returned from all the STRD bases of Guangdong Province, which included 38 hospitals. 60.3% of the respondents reported overall satisfaction with their training. The satisfaction with operative teaching (60.7%) was slightly lower than the other settings of teaching experience (above 65%). Meanwhile, the satisfaction on different secessions of operative experience was all below 70%, of which in the areas of cornea and orbit were 55.42% and 57.53%, respectively. Some potential factors were found to affect general satisfaction, including the training grade, marriage, working time, income level, the doctor-patient relationship, family members working as doctors, the time proportion spent on writing medical documents during clinical work, and the frequency of attending academic meetings. Improvement was observed in both performing and reporting clinical examinations in the last year of training in comparison to the first year. Finally, 82.8% of the residents acknowledged this training was helpful for future clinical work. The first five career preferences for residents were cataract (67.1%), refractive surgery (42.3%), vitreo-retina (36.5%), optometry (28.7%), and oculoplastic (27.2%). CONCLUSION Ophthalmology residents in Guangdong Province expressed comparable satisfaction with the STRD program. To further improve satisfaction, factors such as resident subsidy, harmonious marriage, the patient-doctor relationship, and chances of attending academic conferences should be emphasized.
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Affiliation(s)
- Xiaonan Yang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, No.7, Jinsui Road, Guangzhou, China
- Department of Ophthalmology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, Guangdong Province, China
| | - Danying Zheng
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, No.7, Jinsui Road, Guangzhou, China
| | - Pengxia Wan
- Department of Ophthalmology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, Guangdong Province, China
| | - Xiaoling Luo
- Department of Ophthalmology, Shenzhen People's Hospital Second Clinical Medical College of Jinan University, Shenzhen, China
| | - Mingzhi Zhang
- Joint Shantou International Eye Center, Shantou University & the Chinese University of Hong Kong, Shantou, 515041, China
| | - Liang Zhang
- Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106, Zhongshan Er Road, Yuexiu District, Guangzhou, Guangdong, China
| | - Shaochong Zhang
- Shenzhen Eye Hospital affiliated to Jinan University, Shenzhen, China
| | - Jingjing Huang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, No.7, Jinsui Road, Guangzhou, China.
| | - Yehong Zhuo
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, No.7, Jinsui Road, Guangzhou, China.
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Tsai ASH, Yeo BSY, Anaya Alaminos R, Wong CW, Tham CC, Fang SK, Lam DSC, González-Andrades M, Ang M. Survey of Ophthalmology Training Experiences Among Young Ophthalmologists in the Asia-Pacific. Asia Pac J Ophthalmol (Phila) 2022; 11:434-440. [PMID: 36102646 DOI: 10.1097/apo.0000000000000556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 07/06/2022] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To describe ophthalmology training experiences across the Asia-Pacific (APAC). DESIGN Survey study. METHODS We utilized an anonymous online survey, which was previously validated and conducted in Europe, through Young Ophthalmologist leaders from the national member societies of the Asia-Pacific Academy of Ophthalmology (APAO) from September 2019 to July 2021. Responses were based on a 5-point Likert scale (where applicable) and data were analyzed using Microsoft Excel. Our main outcome measures were differences between regions, that is, Southeast Asia (SEA) and Western Pacific (WP); and seniority, that is, trainees/junior ophthalmologists and senior ophthalmologists. RESULTS We collated 130 responses representing 20 regions in the APAC region. The year of completion of ophthalmic training ranged from 1999 to 2024. The mean duration of training was 3.7±1.0 years. Most (98/130, 75%) indicated an interest for a common training standard across the APAC. Comparing SEA and WP trainees, both regions had similar working environments, but those in SEA reported significantly lower remuneration than their counterparts in WP ($600 vs $3000, P <0.05). WP trainees performed more phacoemulsification surgeries (76 WP vs 19 SEA), while SEA trainees conducted more manual small incision cataract surgeries (157 WP vs 1.5 SEA per duration of training). Senior ophthalmologists performed more cataract surgeries (210.9 senior ophthalmologists vs 40.1 junior ophthalmologists). Trainees had less confidence in medical competency areas such as interpreting an electroretinogram/visual evoked potential/electrooculogram (SEA=1.8, WP=2.1) and conducting an angiography (SEA=2.8, WP=3.4). CONCLUSIONS Our study highlighted heterogeneity among ophthalmology training experiences in the APAC region, with the majority indicating an interest in a common training standard.
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Affiliation(s)
- Andrew S H Tsai
- Singapore National Eye Centre, Singapore, Singapore
- DUKE NUS Medical School, Singapore, Singapore
| | - Brian S Y Yeo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Roberto Anaya Alaminos
- Department of Ophthalmology, Hospital Universitario San Cecilio, VISIÓON Ophthalmic Clinic, Granada, Spain
| | - Chee Wai Wong
- Singapore National Eye Centre, Singapore, Singapore
- DUKE NUS Medical School, Singapore, Singapore
| | - Clement C Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Dennis S C Lam
- C-MER International Eye Research Center of The Chinese University of Hong Kong (Shenzhen), Shenzhen, China
- C-MER Dennis Lam & Partners Eye Center, C-MER International Eye Care Group, Hong Kong, China
| | - Miguel González-Andrades
- Department of Ophthalmology, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital and University of Cordoba, Cordoba, Spain
| | - Marcus Ang
- Singapore National Eye Centre, Singapore, Singapore
- DUKE NUS Medical School, Singapore, Singapore
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Solyman O, Abu Serhan H, Kamel HF, Eldib A, Abo Obaia AS, Aref A, Sayed-Ahmed IO, Khashaba M, Khodeiry MM, Abushanab MM. A Novel Cost-Effective Simulation Model for Continuous Curvilinear Capsulorhexis. Clin Ophthalmol 2022; 16:2759-2764. [PMID: 36046573 PMCID: PMC9420924 DOI: 10.2147/opth.s378298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/09/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction We describe and validate a low-cost simulation model for practicing anterior lens capsule continuous curvilinear capsulorhexis (CCC). Methods A simulation model for CCC was developed from widely available low-cost materials. Ophthalmologists attending the annual scientific meeting of the Research Institute of Ophthalmology, Giza, Egypt, were asked to perform a five CCC model task and then anonymously answer a questionnaire that assessed the realism and training utility of the model using a five-point Likert scale (1 = unacceptable, 2 = poor, 3 = acceptable, 4 = favorable and 5 = excellent). Results Twenty-seven ophthalmologists completed the task and the anonymous questionnaire. Overall, participants felt that the model simulated CCC step in cataract surgery well (mean: 3.5) and was comparable to other kinds of CCC simulation models (mean: 3.3). The model scored highly for its overall educational value (mean: 4.00) and for enlarging a small CCC (mean:3.7), while the feasibility of this model in practicing the management of a runaway leading edge of CCC scored 2.9. Conclusion This model may provide an alternative method for training for CCC and other anterior lens capsule-related maneuvers. This option may be particularly helpful for residency training programs with limited access to virtual reality simulators or commercially available synthetic eye models.
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Affiliation(s)
- Omar Solyman
- Department of Ophthalmology, Research Institute of Ophthalmology, Giza, Egypt
- Department of ophthalmology, Qassim University Medical City, Al-Qassim, Saudi Arabia
- Correspondence: Omar Solyman, Department of Ophthalmology, Research Institute of Ophthalmology, Giza, Egypt, Email
| | | | - Hesham F Kamel
- Department of Ophthalmology, Research Institute of Ophthalmology, Giza, Egypt
| | - Amgad Eldib
- Department of Ophthalmology, Research Institute of Ophthalmology, Giza, Egypt
- Division of Paediatric Ophthalmology, Strabismus, and Adult Motility, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA
- UPMC Eye Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Ahmed S Abo Obaia
- Department of Ophthalmology, Research Institute of Ophthalmology, Giza, Egypt
| | - Amr Aref
- Department of Ophthalmology, Research Institute of Ophthalmology, Giza, Egypt
| | - Ibrahim Osama Sayed-Ahmed
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, 77030, USA
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| | - Mohamed Khashaba
- Department of Anesthesiology, Research Institute of Ophthalmology, Giza, Egypt
| | - Mohamed M Khodeiry
- Department of Ophthalmology, Research Institute of Ophthalmology, Giza, Egypt
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| | - Mokhtar M Abushanab
- Department of Ophthalmology, Research Institute of Ophthalmology, Giza, Egypt
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Tsou BC, Vongsachang H, Purt B, Srikumaran D, Justin GA, Woreta FA. Cataract Surgery Numbers in U.S. Ophthalmology Residency Programs: An ACGME Case Log Analysis. Ophthalmic Epidemiol 2021; 29:688-695. [PMID: 34913813 DOI: 10.1080/09286586.2021.2015395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To describe and assess the cataract experience of ophthalmology residents throughout the United States (U.S.). METHODS Cataract procedures logged by graduating ophthalmology residents nationwide and published by the Accreditation Council for Graduate Medical Education (ACGME) from 2009 to 2020 were analyzed using linear regression on log-transformed response variables with robust variance. RESULTS As primary surgeon, average numbers logged for phacoemulsification increased yearly by an average of 4.1% prior to 2019 and then decreased by 22.1% in 2019 for an overall average yearly increase of 2.9% (95% CI: 0.5, 5.4%, p = .03), non-phacoemulsification extracapsular extraction decreased yearly by an average of 4.6% (95% CI: -7.7, -1.5%, p = .01), other cataract/intraocular lens surgeries decreased yearly by an average of 8.4% (95% CI: -10.1, -6.6%, p < .001), anterior vitrectomies decreased yearly by an average of 12.5% (95% CI: -14.9, -10.1%, p < .001), and laser capsulotomies increased yearly by an average of 6.0% prior to 2019 and then decreased by 3.0% for an overall average yearly increase of 5.3% (95% CI: 4.5, 6.2%, p < .001). As assistant, average numbers logged in all ACGME minimum categories showed decreasing trends. CONCLUSIONS Over the last decade, the average numbers of phacoemulsification and laser capsulotomies logged by residents as primary surgeon increased while other ACGME cataract minimum procedures decreased. Surgical volume in 2019-20 was lower due to the coronavirus disease-19 pandemic but higher than from 2009 to 2013.
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Affiliation(s)
- Brittany C Tsou
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Hursuong Vongsachang
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Boonkit Purt
- Department of Ophthalmology, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.,Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Divya Srikumaran
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Grant A Justin
- Department of Ophthalmology, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.,Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Fasika A Woreta
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Geary A, Wen Q, Adrianzén R, Congdon N, Janani R, Haddad D, Timbo CS, Khalifa YM. The impact of distance cataract surgical wet laboratory training on cataract surgical competency of ophthalmology residents. BMC MEDICAL EDUCATION 2021; 21:219. [PMID: 33874941 PMCID: PMC8054504 DOI: 10.1186/s12909-021-02659-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 04/05/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND This study assessed the impact of distance cataract surgical wet laboratory training on surgical competency of ophthalmology residents at a tertiary-level ophthalmic training center in Trujillo, Peru. METHODS Three five-week distance wet lab courses were administered through Cybersight, Orbis International's telemedicine platform. Weekly lectures and demonstrations addressed specific steps in phacoemulsification surgery. Each lecture had two accompanying wet lab assignments, which residents completed and recorded in their institution's wet lab and uploaded to Cybersight for grading. Competency was assessed through anonymous grading of pre- and post-training surgical simulation videos, masked as to which occurred before and after training, using a standardized competency rubric adapted from the Ophthalmology Surgical Competency Assessment Rubric (OSCAR, scale of 0-32). Day one best-corrected post-operative visual acuity (BVCA) was assessed in the operative eye on the initial consecutive 4-6 surgeries conducted by the residents as per the norms of their residency training. An anonymous post-training satisfaction survey was administered to trainees'. RESULTS In total, 21 ophthalmic residents participated in the courses, submitting a total of 210 surgical videos. Trainees' average competency score increased 6.95 points (95%CI [4.28, 9.62], SD = 5.01, p < 0.0001, two sample t-test) from 19.3 (95%CI [17.2, 21.5], SD = 4.04) to 26.3 (95%CI [24.2, 28.3], SD = 3.93). Visual acuity for 92% of post-training resident surgeries (n = 100) was ≥20/60, meeting the World Health Organization's criterion for good quality. CONCLUSIONS Structured distance wet lab courses in phacoemulsification resulted in significantly improved cataract surgical skills. This model could be applicable to locations where there are obstacles to traditional in-person training, such as the current COVID-19 pandemic.
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Affiliation(s)
- Amelia Geary
- Orbis International, 520 8th Avenue, Floor 12, New York, NY, 10018, USA.
| | - Qing Wen
- Centre for Public Health, Queen's University Belfast, Belfast, BT12 6BJ, Northern Ireland
| | - Rosa Adrianzén
- Instituto Regional de Oftalmología Javier Servat Univazo, Trujillo, La Libertad, Peru
- Universidad Nacional de Trujillo, Trujillo, La Libertad, Peru
| | - Nathan Congdon
- Orbis International, 520 8th Avenue, Floor 12, New York, NY, 10018, USA
| | - R Janani
- Aravind eye hospital, Madurai, Tamil Nadu, 625020, India
| | - Danny Haddad
- Orbis International, 520 8th Avenue, Floor 12, New York, NY, 10018, USA
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Affiliation(s)
- Manavi D Sindal
- Vitreo-Retina Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry, India
| | - Kanika Chhabra
- Vitreo-Retina Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry, India
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