Back to School

Since it’s that time of year when school kicks back in, I thought I’d school myself on well, schooling. Ophthalmology schooling, that is. And, since M&S will be in Milan for the WCPOS (World Congress of Pediatric Ophthalmology and Strabismus) in a few short weeks, I was curious as to what schooling is required for ophthalmologists in other countries. Here’s what I found…

First, an ophthalmologist is a specialist in medical and surgical eye problems. Since ophthalmologists perform operations on eyes, they are considered to be both surgical and medical specialists.

In the United States, four years of residency training after medical school are required, with the first year being an internship in surgery, internal medicine, pediatrics, or a general transition year. Optional fellowships in advanced topics may be pursued for several years after residency. Most currently practicing ophthalmologists train in medical residency programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) and are board-certified by the American Board of Ophthalmology. United States physicians that train in osteopathic medical schools may hold the Doctor of Osteopathic Medicine degree (DO) degree rather than an MD. The same residency and certification requirements for ophthalmology training must be fulfilled by osteopathic physicians. Completing the requirements of continuing medical education is mandatory for continuing licensure and re-certification.

Ophthalmology includes sub-specialities which deal either with certain diseases or diseases of certain parts of the eye. Some of them are:

• Cataract (not usually considered a subspecialty per se, since most general ophthalmologists perform cataract surgery)
• Cornea, ocular surface, and external disease
• Glaucoma
• Oculoplastics & Orbit surgery
• Pediatric ophthalmology/Strabismus (mis-alignment of the eyes)
• Refractive surgery
• Vitreo-retinal surgery, deals with surgical management of retinal and posterior segment diseases and disorders. Medical retina and vitreo-retinal surgery sometimes together called posterior segment sub-specialization

Education and licensing varies throughout Europe. The minimum and usual length of training for Ophthalmology is four years but, in several countries, this may be longer. Some, such as the Netherlands, often expect a potential trainee to have spent some time in allied work, such as research towards a PhD in basic ophthalmic science, before entering the clinical specialty. Other countries have, in effect, two levels of specialization in ophthalmology; for example, in Germany all trainees complete the initial 4 years in basic training which qualifies the trainee for a state licence with or without an examination. If an individual obtains a faculty position, only then does true surgical training begin. There is no time limit to the training and true independence of practice may only be reached when the individual is given a chair.

The systems range from four years with a moderate amount of surgical experience in Finland to a very protracted period in Denmark, where doctors are limited to working 36 hours a week including periods on call. Often 10 years is needed to obtain sufficient experience, which is very frustrating for junior ophthalmologists. In Italy, there is no fixed number of trainees and experience may be diluted considerably. In France, trainees rotate between different units that may be widely separated. In Austria, subspecialism may
begin at the start of training and it is possible for a trainee to be exposed to one area only—for example, oculoplastic surgery, and yet satisfactorily complete training. The European Board of Ophthalmology (EBO) has tried to rectify these inconsistencies by encouraging trainees to take the Diploma of the European Board of Ophthalmology but, so far, it has not achieved wide popularity mainly because there is no significant perceived advantage in obtaining it.

In the UK, there are three colleges that grant postgraduate degrees in ophthalmology. The Royal College of Ophthalmologists (RCOphth) grants MRCOphth and FRCOphth (postgraduate exams), the Royal College of Edinburgh grants MRCSEd, the Royal College of Glasgow grants FRCS. Postgraduate work as a specialist registrar and one of these degrees is required for specialisation in eye diseases. There are only 2.3 ophthalmologists per 100,000 population in the UK – fewer pro rata than in any other nation in the European
Union.

In Ireland, the Royal College of Surgeons of Ireland grants Membership (MRCSI (Ophth)) and Fellowship (FRCSI (Ophth)) qualifications in conjunction with the Irish College of Ophthalmologists. Total postgraduate training involves an intern year, a minimum of 3 years of Basic Surgical Training and a further 4.5 years of Higher Surgical Training. Clinical training takes place within public, Health Service Executive-funded hospitals in Dublin, Sligo, Limerick, Galway, and Cork. A minimum of 8.5 years of training is required before eligibility to work in consultant posts. Some trainees take extra time to obtain MSc, MD or PhD degrees and to undertake clinical fellowships in the UK, Australia and the United States.

courtesy of Wikipedia and this article

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If you’re heading to Milan for WCPOS or ESCRS, please stop by and see us at Booth W05. We’re offering a very special show discount on our Smart System^® PC-Plus. Safe travels everyone!

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