Higher surgical training in ophthalmology: trends in cumulative surgical experience 1993-2008

Abstract

Introduction: Recent years have seen significant changes in the provision surgical training for ophthalmology. The aim of this study is to establish the patterns in long-term trends of cumulative surgical experience of ophthalmology trainees in the United Kingdom.

Materials and methods: Data were obtained from the department of training and education at the Royal College of Ophthalmologists (RCOphth). The cumulative surgical experience of all ophthalmology higher surgical trainees attaining accreditation, CCST, or CCT between 1993-2001 and 2005-2008 was included for descriptive analysis.

Results: Cumulative cataract surgical experience per trainee has been relatively stable at levels between 500 and 600 for most years. The cumulative experience vitreoretinal and corneal graft surgery have historically been low with a large outlier effect, although trends demonstrate a decrease in the median numbers of procedures. Squint surgery has seen a downward trend with a decrease in the median numbers from 121 in 1993 to 43 in 2008. Oculoplastics procedures demonstrate a decrease in overall numbers from 46 in 1993 to 15 in 2001. A jump from 2005 coincides with changes in the definition of what is counted as an oculoplastics procedure. The role of the RCOphth in legislating minimum levels of experience has had an impact on the data distribution manifest by the truncation of the inferior quartile of many of the dataspreads.

Discussion: These data demonstrate that although the cumulative experience of cataract surgery for trainees has remained stable, there has been a reduction in the median numbers of subspecialty procedures performed over the past 15 years.