How effective is undergraduate and postgraduate teaching in ophthalmology?

PURPOSE: To gain an insight into the adequacy of ophthalmic medical education for doctors in the primary care setting.
METHODS: A short forced-choice questionnaire was set to 150 randomly selected primary care practitioners in and around Bristol. Information was collected in relation to undergraduate and postgraduate ophthalmic education, ophthalmic confidence, facilities and understanding.
RESULTS: One hundred and thirty-three primary care doctors replied to the questionnaire of whom 35% were fundholders and 47% in training practices. Only 22% of all respondents felt their undergraduate ophthalmic medical education to be adequate. However, 83% of the 86 primary care doctors who had attended postgraduate update courses in ophthalmology felt these to be adequate. Despite the availability of an ophthalmoscope and distance vision chart, only 56% felt confident with the ophthalmoscope and only 61% reported that their distance chart was set up in accord with manufacturer's instructions. Seventy-one per cent of respondents reported having access to dilating agents but only 61% felt confident using them. Understanding of two key ophthalmic terms was also poor. Despite the general satisfaction, attendance of postgraduate update courses did not appear to alter facilities, confidence or understanding.
CONCLUSIONS: It is apparent that most primary care doctors view their undergraduate ophthalmic medical education as inadequate and this is reflected in their confidence and understanding. Postgraduate courses, although more favourably received, do not appear to after these findings. We strongly suggest, therefore that general ophthalmic education is aimed at teaching examination techniques and ophthalmological principles suitable for primary care practice.