González-Andrades Miguel, Fung Simon S M, Potic Jelena, Chidambaram Jaya D, Karimi Ayesha, Quigley Clare, Pontoppidan-Toms Radka, Scott Andrew, Rasmussen Marie Louise R
Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Department of Ophthalmology, Reina Sofia University Hospital and University of Cordoba, Cordoba, Spain.
Department of Ophthalmology, University of California Los Angeles, Los Angeles, USA.
Eye (Lond). 2023 Oct;37(15):3256-3262. doi: 10.1038/s41433-023-02502-2. Epub 2023 Mar 17.
One of the core aims of the European Union of Medical Specialists is to harmonize training across Europe by creating European Training Requirements for all medical specialties including Ophthalmology. The theoretical part is already defined by the EBO, however as ophthalmology also includes surgical skills, we herein propose a surgical minimum curriculum for ophthalmology residents in Europe.
National and international ophthalmic training curricula which are publicly available in English were reviewed and compared. The final proposal was created from 5 criteria: 1. Disease prevalence; 2. Patient safety; 3. Case-trainee ratio; 4. Skill transfer; and 5. Technical difficulty.
In total 7 different training curricula from across the world were compared. Among the surgical procedures, cataract surgery has the highest median number of procedures required to be completed during residency: 86 procedures (50-350). Followed by oculoplastics: 28 procedures (10-40) and panretinal photocoagulation: 27.5 procedures (10-49) Full procedural competence is proposed in 9 surgical skills, including YAG laser posterior capsulotomy, retinal argon laser, intravitreal injection, corneal foreign body removal, removal of corneal sutures, facial and periocular laceration repair, eyelid laceration repair, minor eyelid procedures, and punctal occlusion. These procedures are deemed essential and feasible for all ophthalmology residents in Europe to perform independently upon completion of their training.
This proposal should be regarded as a recommendation based on comparable surgical curricula in use worldwide to establish standards across European countries and may serve as valuable insight to those responsible for compiling ETRs for ophthalmology, or their national curriculums.
欧洲医学专家联盟的核心目标之一是通过为包括眼科在内的所有医学专业制定欧洲培训要求，实现全欧洲培训的协调统一。理论部分已由欧洲眼科委员会（EBO）界定，然而由于眼科还包括手术技能，我们在此提出欧洲眼科住院医师手术最低课程。
对以英文公开提供的国内和国际眼科培训课程进行了审查和比较。最终提案基于5项标准制定：1. 疾病患病率；2. 患者安全；3. 病例与受训人员比例；4. 技能转移；5. 技术难度。
总共比较了来自世界各地的7种不同培训课程。在外科手术中，白内障手术在住院期间需要完成的手术中位数最高：86例（50 - 350例）。其次是眼整形手术：28例（10 - 40例）和全视网膜光凝：27.5例（10 - 49例）。提议9种手术技能具备完全操作能力，包括YAG激光后囊切开术、视网膜氩激光、玻璃体内注射、角膜异物取出、角膜缝线拆除、面部和眼周裂伤修复、眼睑裂伤修复、小型眼睑手术和泪点封闭。这些手术被认为对欧洲所有眼科住院医师在完成培训后独立进行操作至关重要且可行。
本提案应被视为基于全球使用的可比手术课程提出的建议，以在欧洲各国建立标准，并可能为负责编写眼科欧洲培训要求（ETR）或其本国课程的人员提供有价值的见解。
