Elevating ophthalmic education and practice in India.

The quality, consistency, and sophistication of ophthalmic education in India are clearly heterogeneous. There are a few of the most admired training programs in the world and few at the other end of the spectrum.[1]

Having observed ophthalmic education over the past 60 years,[2] I have lived and watched as ophthalmic education has evolved from primarily a preceptorship experience (“watch me, and do what I do”) to an international “standard” that is a structured, organized experience. Using scientific, educational principles, for example, educational objectives, different methodologies of educational presentations, multiple modalities of evaluation, and the expectation of continuous learning during an individual's practice life, is being implemented globally and India has international leaders in this effort.

This process has not happened overnight and is continuing to be refined and implemented. As yet, it is not uniform. In this issue, an editorial and three important reports document the considerable progress in Indian ophthalmic education.[345] I congratulate the leadership in Indian ophthalmology in structuring the process which is evolving. Clearly, there is work to do to create comparability across educational programs including knowledge, surgical competency, and comprehensive diagnostic skills.[6]

The country where I live has utilized both accreditation and certification to assure a high level of educational programs (accreditation) and a high level of performance in the graduates (certification). A training program is accredited and an individual is certified. This process was a long one, taking decades, dedicated leaders, and a national commitment throughout medicine. This was led by the specialty of ophthalmology,[7] who created the first certifying Board (established 1916). Certifying boards in all specialties evolved over a 40 year period (American Board of Medical Specialties). The accreditation of programs was a similar long development which coalesced in the Accreditation Council Graduate Medical Education in the 1980s.

The International Council of Ophthalmology is undertaking an International program of certification with the pilot project beginning in 2018. Three programs are being voluntarily reviewed for accreditation including one in India. If this pilot program is deemed successful, it will begin to be available worldwide in 2019 and beyond.

A national effort to assure quality education and uniformly well-trained practitioners is long and arduous. While the journey will be difficult, the outcome will be worth it for the profession of ophthalmology and the citizens of India.

About the author

Bruce E. Spivey, MD, MS, MEd trained as an ophthalmologist and medical educator. He has worked extensively to enhance ophthalmic education and eye care nationally and internationally.1

Dr. Spivey was President of the International Council of Ophthalmology (ICO) from 2006 to 2014 and served as ICO Secretary-General from 1994 to 2006. During that time, ICO membership, budget, and educational programs all increased dramatically. Dr. Spivey served as ophthalmology departmental chairman at California Pacific Medical Center (CPMC) in San Francisco for 17 years, and was the Chief Executive of the Medical Center for 16 years. He was the Executive Vice President and founding CEO of the American Academy of Ophthalmology for 17 years, from 1976 to 1992.

Dr. Spivey is the recipient of numerous medals and awards in ophthalmology and medicine including Laureate Award, Highest Honor of the American Academy of Ophthalmology, the Jules Francois Gold Medal of the International Council of Ophthalmology, the Howe Medal, the Highest Award of the American Ophthalmological Society and Bernardo Streiff Gold Medal, the only medal of the Academia Ophthalmologica Internationalis.

His past positions include President of the American Board of Medical Specialties, President of the Council of Medical Specialty Societies, President of the Society of Medical Administrators, President of the American Ophthalmological Society, and President of the American Journal of Ophthalmology. He has given over 40 named lectures and published over 145 refereed publications.

Indian Journal of Ophthalmology is very proud to have Dr. Spivey on its Editorial Board as its Mentor.