Posters

20 years of ophthalmic surgical training opportunities in an Irish teaching hospital: 1995 to 2015, what has changed?

Poster Details

First Author: N. Collins IRELAND

Co Author(s):    T. Murphy   M. Hickey-Dwyer                 

Abstract Details

Purpose:

The past 20 years have seen vast changes in ophthalmic surgical training in Ireland and internationally. Evolving service demands, such as the burden of intravitreal (IVT) injection treatments, has lead to concern among national ophthalmology training bodies, regarding provision of adequate surgical training opportunities for trainees. This study examines the changing nature of surgical opportunities for trainees across a 20-year period from 1995 to 2015 in University Hospital Limerick, Ireland (UHL).

Setting:

University Hospital Limerick, Ireland, a tertiary referral ophthalmology teaching hospital.

Methods:

Cross-sectional comparative retrospective study: Surgical records of ophthalmic theatres in UHL from 1995 and 2015 were examined. Numbers and types of cases performed, and the training level of the operating surgeon were extracted from these records for a four-month sample period (August to November) in 1995 and in 2015.

Results:

Differences in surgical opportunities between 4-month periods in 1995 and 2015: Trainees performed 402 of 754 (53%) IVT injections in 2015 (no injections in 1995). Trainees performed 1 of 211 (0.5%) cataract surgeries in 1995, vs. 87 of 354 (24.6%) in 2015. More surgeries were performed in 1995 vs. 2015 for strabismus (30 vs. 19), glaucoma (24 vs. 2 trabeculectomies) and cornea (3 vs. 0 grafts). In 1995 trainees performed none of these; in 2015, trainees performed 6 of 19 (32%) strabismus surgeries. Vitreoretinal opportunities increased from 0 of 7 cases performed by trainees in 1995, to 8 of 18 (44%) in 2015.

Conclusions:

The surgical opportunities for trainees in ophthalmic surgery have changed dramatically in the past 20 years at UHL. The exposure to subspecialty cases is more limited now compared to 20 years ago. Much of trainees’ dedicated surgical time is now taken up by IVT injections. However, excluding IVT injections, trainees also now perform a greater proportion of surgeries than in 1995. These results have implications for ophthalmic surgical training, and requirements for subspecialty surgical experience.

Financial Disclosure:

NONE