Academic quality of incoming ophthalmology residents in India: Concerns for the future.

Dear Editor:

We note with concern, for ophthalmology, the results of round-1 seat allotment for National Eligibility-cum-Entrance Test—Post-Graduation (NEET-PG) 2020, declared in April 2020.[1] Except for a few institutions, all-India ranks (AIRs) on the NEET-PG perform as the sole admission criterion to the majority of residency positions in India, and thereby to a career as specialist. Top rankers here represent the finest candidates offered by our medical education system. Currently, India has 1616 MD/MS, 103 Diploma, and 292 DNB (post-MBBS) positions for ophthalmology training.[2]

Unfortunately, top AIRs have continued to ignore ophthalmology, as per last available data since NEET-PG 2017, when the exam began. In 2020, not a single examinee under-100 AIR chose ophthalmology, while seven of top-10 AIRs picked general medicine.[1] Similarly, no more than 2 in top-500 AIR and 10 in top-1000 AIR in each year have chosen ophthalmology. This year also saw the least number of candidates in both top-2500 and top-5000 AIRs choosing ophthalmology [Fig. 1].

Figure 1

The graphs provide data of the number of candidates preferring ophthalmology residency via the NEET-PG, from its introduction as NEET-PG 2017, till the year 2020, amongst (a) the top-500 all-India ranks (AIRs); (b) the top-1000 AIRs; (c) the top-2500 AIRS; and (d) the top-5000 AIRs

Regarding the academic quality of incoming ophthalmology residents in India, these observations are perturbing, considering the speciality's extremely competitive nature in developed nations. In the USA, where US Medical Licensing Examination Step-1 scores serve as a critical surrogate of competitiveness, average score for applicants accepted to ophthalmology usually hovers amongst the highest of all specialities.[34] Similarly, in the UK, as per “competition ratios”, i.e., number of applicants per training position, ophthalmology is highly preferred as a speciality.[5]

Urgent action on multiple fronts, led by All India Ophthalmological Society, is warranted to encourage the best candidates to choose ophthalmology. While we have been addressing ways to improve our residency and fellowship programmes, time and again, this important aspect has been largely ignored.[67] These unfortunate findings and ignorance of non-preference for speciality training have been true for otorhinolaryngology (ENT) as well, a field that is taught to MBBS students in the same year as ophthalmology.[8] Good quality seeds grow into the greatest trees; and the time has come to actively work towards acquiring them. Highlighting the obvious advantages of our field to the undergraduates, encouraging greater participation in clinical work, and having online career counselling prior to NEET-PG seat selection are some of the suggestions. We also need to widely promote the virtues of our profession through greater engagement on social media. By viewing third-year students as future trainees and treating them so, we shall go a long way.

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