Ophthalmology residency training program - Is it time to amend the traditional training program?

Residency training is contemplated as the foundation for all postgraduate medical training. This necessitates building efficiency to diagnose, treat, and manage the diseases medically and surgically encountered in clinical practice.[12] The most ideal approach to pass on the careful aptitudes from a professional specialist to a resident is the Ace apprentice strategy.[3]

The residency training curriculum should be programmed in such a manner that no resident exits with any skill deficit. In the current strategy, many residents are discontented due to a limited number of clinical cases.[4] The COVID-19 pandemic has further convoluted the residency training program, the number of patients in the outpatient department has drastically decreased, and the number of surgeries has gone down radically. This situation has given rise to a paradigm shift to the training of resident doctors away from the actual patients. We can say this was an eye-opener for our current curriculum of resident training programs and enabled us to make a new strategy for our budding ophthalmic residents. This underlined the importance of Tele education or e-learning, Mannequin, Simulation, and Wet Lab as the training tools.[56] We need to include newer techniques and teaching methods for the training of residents. So, in this letter, we try to inform how to improvise the current training program for ophthalmology residents.

Utilization of social media platform – All institute should develop its official website and upload various case presentations by residents as well as by teachers. Picture gallery of their rare, own patients will be incredibly pedagogic for residents as the visual impression is superior to theoretical reading. Standard operating protocols for various ophthalmic procedures and surgeries will be a path enlightener and should be uploaded in website. So, from the beginning, all residents will be aware of procedures and protocols.

Didactic lectures, case-based e-learning modules, and active e-learning through live webinars – This can be a good substitute for physical classes to establish good clinical rationale. Small library in the department will facilitate residents to clear their doubts in the department itself.

Dry laboratory – This includes the Mannequin and Simulators.

The Mannequin is a beneficial device for demonstrating and practicing various ophthalmological procedures like multiple modes of ophthalmic anesthesia. There are models available where the pupil has been designed to dilate with mydriatic drops and enable residents to carry out fundus examination.[7] Familiarity in approach by Mannequin helps the residents deal before the time they deal with actual patients.

Simulators can be used for direct and indirect ophthalmoscopic examination, cataract, and vitreoretinal surgery training. The EYE Exam Simulator (Kyoto Kagaku Co. Ltd., Kyoto, Japan) and Eyes Direct and indirect Ophthalmoscope Simulator (VR magic, GmbH, Mannheim, Germany) are the novel mannequins for retina evaluation. It produces a true and accurate 3D simulation of eye anatomy.[1]

Wet laboratory – After development of hand eye co-ordination on simulation, residents can practice surgical steps on goat’s eye in Wet Lab. It would be helpful for residents to learn different surgical steps in a stress-free environment so as to improve the surgical outcome. Ramani et al. have concluded that wet laboratory training helped in decreasing complication in surgeries done by residents.[8]

Ophthalmology training institutes can upgrade and include these technologies into their armamentarium of teaching for uninterrupted residency training.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.