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. 2017 Oct 6;7(10):e018526.
doi: 10.1136/bmjopen-2017-018526.

Changes in UK ophthalmology surgical training: analysis of cumulative surgical experience 2009-2015

Jeremy Hoffman  1   2 , Fiona Spencer  3   4 , Daniel Ezra  1   2 , Alexander C Day  1   2
Affiliations

Changes in UK ophthalmology surgical training: analysis of cumulative surgical experience 2009-2015

Jeremy Hoffman et al. BMJ Open. .

Abstract

Objective: To investigate changes in the patterns of cumulative surgical experience for ophthalmologists in the UK following the introduction of a new national training scheme.

Design: Retrospective review of all surgical training records submitted to the UK Royal College of Ophthalmologists by trainees for the award of Certificate of Completion of Training (CCT) for the period 2009-2015.

Setting: Secondary level care, UK.

Participants: 539 trainees achieving CCT over the 7-year study period.

Interventions: Higher specialist training or ophthalmology specialist training.

Outcome measures: Number of CCT awards by years and procedures performed for cataract surgery, strabismus, corneal grafts, vitreoretinal (VR) procedures, oculoplastics and glaucoma.

Results: Cataract surgical experience showed little change with median number performed/performed supervised (P/PS) 592, IQR: 472-738; mean: 631. Similarly, the median number of strabismus (P/PS 34), corneal grafts (assisted, 9) and VR procedures (assisted, 34) appeared constant. There was a trend towards increasing surgical numbers for oculoplastics (median 116) and glaucoma (57). Overall case numbers for ophthalmic specialist training (OST) trainees (7-year training programme) were higher than higher surgical training (HST) trainees (4.5-year programme) with the exception of squint (P/PS), corneal grafts (P/PS) and VR cases (P/PS).

Conclusions: Overall case numbers reported at time of CCT application appear stable or with a marginal trend towards increasing case numbers. HST (4.5-year programme) case numbers do not include those performed before entry to HST, and although case numbers tended to be higher for OST trainees (7-year programme) compared with HST trainees, they were not proportionately so.

Keywords: cataract and refractive surgery; medical education; ophthalmology; resident; surgery; training.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
(A) Frequency histogram of the number of trainees achieving accreditation, Certificate of Completion of Surgical Training (CCST) or Certificate of Completion of Training (CCT). Data from 1993 to 2008 from Ezra et al. Note missing data between 2002 and 2004; (B) Frequency histogram of the number of trainees achieving accreditation during our 7-year study period, CCST or CCT.
Figure 2
Figure 2
(A) Frequency histogram showing total number of cataract surgeries performed by trainees at the time of accreditation (Certificate of Completion of Surgical Training or Certificate of Completion of Training (CCT)) during our 7-year study period (2009–2015); (B) Cumulative cataract surgery experience for 2009–2015. P, performed; PS, performed supervised.
Figure 3
Figure 3
(A) Cumulative vitreoretinal (VR) surgery experience (‘performed/performed supervised’ (P/PS)) for 2009–2015; (B) cumulative corneal graft surgery experience (P/PS) for 2009–2015. Note the outliers have been omitted to allow for scaling.
Figure 4
Figure 4
(A) Cumulative squint surgery experience (‘performed/performed supervised’ (P/PS)) for 2009–2015; (B) cumulative oculoplastic surgery experience (P/PS) for 2009–2015.
Figure 5
Figure 5
Cumulative glaucoma surgical experience (‘performed/performed supervised’) for 2009–2015.
See this image and copyright information in PMC

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References

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MeSH terms

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INTERN 3
Note 2
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