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LETTER TO EDITOR
Year : 2016  |  Volume : 4  |  Issue : 1  |  Page : 49-50

Postgraduate training programs in ophthalmology in India: Idealistic versus realistic. Where there is a will, there is a way


1 Department of Ophthalmology, Bharti Vidyapeeth Medical College; Dr. Kulkarni Eye Hospital, Miraj, Sangli; Atharva Netralaya and Research Pvt Ltd, Pune, Maharashtra, India
2 Atharva Netralaya and Research Pvt Ltd; Department of Ophthalmology, Padmashri Dr. D.Y. Patil Medical College, Pimpri; Dr. Gogate's Eye Clinic, Pune, Maharashtra, India

Date of Web Publication19-Jan-2016

Correspondence Address:
Parikshit M Gogate
Gogate's Eye Clinic, Pune, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2320-3897.174427

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How to cite this article:
Kulkarni AN, Gogate PM. Postgraduate training programs in ophthalmology in India: Idealistic versus realistic. Where there is a will, there is a way. J Clin Ophthalmol Res 2016;4:49-50

How to cite this URL:
Kulkarni AN, Gogate PM. Postgraduate training programs in ophthalmology in India: Idealistic versus realistic. Where there is a will, there is a way. J Clin Ophthalmol Res [serial online] 2016 [cited 2022 Jan 26];4:49-50. Available from: https://www.jcor.in/text.asp?2016/4/1/49/174427

Sir,

Dhalival and Ayyala have written on excellent commissioned article. "Postgraduate training programs in ophthalmology in India: Idealistic versus realistic." [1] But there are a few minor errors: The authors stated twice that onchocerciasis has been eliminated from India like trachoma and Vitamin A deficiency. Mercifully onchocerciasis, a bane in West Africa, was never present in India. While cataract is still the major cause of blindness in India as per the rapid assessment of avoidable blindness, [2] there are enough ophthalmologists (20,000+ for certain) to tackle its cataract backlog. What is lacking, is not the number of surgeons, but rather their commitment and quality of cataract surgeries. Even if each ophthalmologist done 3 surgeries per day, around 1000 surgeries per year, the backlog of cataract blindness can be easily eliminated. The UK and USA have excellent residency training programs, but a 7 years course may not be practical for a developing countries like India. But we do have a 2-3 years course followed by 1-2 years of fellowship.

The authors rightly stated that regular and repeated assessment of residents is the sine quo non for an effective residency program. Studies done by us earlier had showed that residents were eager to learn but did not find the system conducive, a perception not shared by their teachers. [3],[4] The Indian system is still a bit like the old Gurukul system, where the pupil would spend a few years with the master to excel in a craft or domain of knowledge. Instead of this apprentice system, we need a regular appraisal system as suggested by the authors.

Teachers training and updating should be an integral part of improving students knowledge and understanding. There is a huge difference in the approach to teach when the teacher herself/himself is confident and willing to share their knowledge. Feedback about teachers and allowing and nudging them to improve will go a long way. A continued evaluation is probably the only way to achieve standardization. The Academic and Research Committee of the All India Ophthalmological Society can take an initiative in organizing online exams for teachers and students and award them appreciation certificates. It should be like International Organization for Standardization or National Accreditation Board for Hospitals where a status is accorded when you achieve it. But the huge gap between online use by the senior teachers and young students also need to be kept in mind. Rotation of residents between institutions could be another option where different specialties are available. A flexibility in schedules but the insistence on certain basic norms is required.

While the Medical Council of India lays several norms for medical education, they are mostly for "hard" systems like infrastructure, human resource, and equipment, but few for "soft" systems like learning outcomes, feedbacks, and skill development. All India Ophthalmological Society could suggest guidelines. The numerous universities (public and private) who have a monopoly over medical postgraduate degrees are perhaps too overburdened to ensure and apply these standards. But regular rotations, feedbacks, periodic assessments, and surgical hands on training could go a long way to make Indian ophthalmology nearer to the developed world. The focus should be on the outcomes (what the resident learns) and not just the output (the amount taught/demonstrated) and the outlay (the money spent). [5] We have the people (trainees and trainers), the resources (equipments and instruments), but we need to muster, as an Indian Journal of Ophthalmology editorial put it, the will, and the desire to improve our system. [6],[7]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Dhalival S, Ayyala RS. Post-graduate training program in ophthalmology in India: Idealstic vs realistic. J Clin Ophthalmol Res 2015;3:36-40.  Back to cited text no. 1
    
2.
Neena J, Rachel J, Praveen V, Murthy GV, Rapid Assessment of Avoidable Blindness India Study Group. Rapid assessment of avoidable blindness in India. PLoS One 2008;3:e2867.  Back to cited text no. 2
    
3.
Gogate P, Deshpande M, Dharmadhikari S. Which is the best method to learn ophthalmology? Resident doctors' perspective of ophthalmology training. Indian J Ophthalmol 2008;56: 409-12.  Back to cited text no. 3
[PUBMED]  Medknow Journal  
4.
Murthy GV, Gupta SK, Bachani D, Sanga L, John N, Tewari HK. Status of speciality training in ophthalmology in India. Indian J Ophthalmol 2005;53:135-42.  Back to cited text no. 4
[PUBMED]  Medknow Journal  
5.
Gogate PM, Deshpande MD. The crisis in ophthalmology residency training programs. Indian J Ophthalmol 2009;57:74-5.  Back to cited text no. 5
[PUBMED]  Medknow Journal  
6.
Thomas R, Dogra M. An evaluation of medical college departments of ophthalmology in India and change following provision of modern instrumentation and training. Indian J Ophthalmol 2008;56:9-16.  Back to cited text no. 6
[PUBMED]  Medknow Journal  
7.
Grover AK. Postgraduate ophthalmic education in India: Are we on the right track? Indian J Ophthalmol 2008;56:3-4.  Back to cited text no. 7
[PUBMED]  Medknow Journal  




 

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