Cataract surgical training among residents in India: Results from a survey

Abstract

Purpose: To assess the quantum of cataract surgical training opportunities for trainees enrolled in ophthalmology residency programs in India.

Methods: An anonymous online survey was sent across to resident ophthalmologists across India through various social media platforms. The results were tabulated and analyzed.

Results: A total of 740 resident ophthalmologists participated in the survey. In all, 40.1% (297/740) were independently performing cataract surgeries. Of those who were not performing independent cataract surgeries, 62.5% (277/443) were in the third year of residency. A significantly higher proportion of trainees who were not operating independent cataract surgeries were enrolled in MD/MS programs as compared with DNB courses (65.6% vs. 43.7%; P < 0.0001). Of those who were operating independent cases; 97.1% had exposure to manual small incision cataract surgery (MSICS), whereas only 14.1% performed phacoemulsification. It was noted that 31.3% of residents reported that on an average a trainee in their training program performed less than 100 independent cataract surgeries throughout the residency. Apart from cataract surgery, the most performed surgeries by residents were pterygium excision (85.3%), followed by enucleation/evisceration (68.1%). When it came to training aids, 47.2% (349/740) of the respondents reported no access to wet lab, animal/cadaver eyes, or surgical simulators for training.

Conclusion: The amount of surgical exposure in terms of cataract surgery across residency programs in India is low with most of the ophthalmology residents who participated in this survey not operating cataracts independently; even in their final year of residency. Exposure to phacoemulsification in residency programs is very limited across the country. Although some programs do provide well-rounded surgical exposure to trainees, such centers are scarce; the stark variations in infrastructure, training opportunities, and surgical numbers warrant an overhaul in the structure and curriculum of residency programs in India.

Keywords: HelpMeSee; MSICS; residency; simulation; wetlab.

Figure 1

Graphical representation of trainees based on the residency course enrolled

Figure 2

Split-up of trainees based on the type of parent institute of the trainees

Figure 3

Figure depicting the year of training of the respondents at the time of responding to the survey

Figure 4

Responses of the trainees when asked if they were currently performing independent cataract surgery

Figure 5

Year of training when trainees operated independently

Figure 6

The type of surgery that the trainees were exposed to during residency

Figure 7

Graphical representation of the number of independent cataract surgeries that the responding trainees had performed at the time of taking the survey

Figure 8

Responses of the trainees when asked if they were allowed to handle surgical complications during residency

Figure 9

Graphical representation of the noncataract surgeries performed by residents during their training period

Figure 10

The facilities and infrastructure that respondents have access to help them develop surgical skills