Teaching ophthalmology to primary care physicians. The Association of University Professors of Ophthalmology Education Committee.

The evolution of our health care system toward managed care has placed primary care "gatekeeper" physicians in a position where they must examine and treat patients with diseases that are ordinarily treated by medical and surgical subspecialists. Many of these physicians may be poorly prepared to accept this new responsibility. The Association of University Professors of Ophthalmology (AUPO) has published a Policy Statement on Medical Student Education that suggests the minimum level of competence expected of general physicians when dealing with ophthalmologic problems. A recent survey of directors of residency programs in family practice, internal medicine, and pediatrics revealed that the training of primary care physicians (as opposed to academicians or subspecialists) has become a nearly universal programmatic goal. Most program directs believe that less than half of their residents meet the AUPO standard at the completion of medical school, and a significant minority do not meet the AUPO standard at the completion of their residency. An overwhelming majority of program directors believe that additional training in ophthalmology and other subspecialties should be incorporated into the training programs of primary care physicians. Ophthalmologists and other subspecialists should develop programs at the medical student level directed toward the education of primary care physicians, and should participate in the training of primary care physicians, as well as their own subspecialty residents. In the future, the primary care physician must be considered part of the "eye care team." Enhancing the ophthalmologic education of primary care physicians is in the best interest of quality patient care.