Training Days

The 2013 ESCRS Congress in Amsterdam saw a great deal of activity organised by the Young Ophthalmologists’ Committee. While most of the sessions were intended for early-career ophthalmologists as well as trainees, the session entitled, “Taking Training into Your Own Hands” was aimed at those delegates who have not graduated. “On average, residents comprise approximately 10-20 per cent of the total ophthalmologist workforce across Europe, although that depends on the absolute numbers of ophthalmologists in each particular country,” said Thiemo Rudolph MD, FEBO. The percentage is particularly high in the UK and The Netherlands, which have far fewer ophthalmologists per capita than the European mean of approximately 80 per million. More variation is evident in the residents’ duration of training, with countries like Spain and Greece requiring only four years and the UK and Ireland seven years. The latter countries and the Netherlands offer a great deal of surgical training during residency, whereas many European countries do not. For graduates who might be considering working in another country, Dr Rudolph also had encouraging words regarding freedom of movement within the European Union. “The most important thing to remember is that you have the law on your side,” he said.

Nino Hirnschall MD, of Austria, placed the emphasis of his talk on online learning. He provided delegates with an overview of the ophthalmology training resources available online, with their relative strengths, weaknesses and unique characteristics. Dr Hirnschall evaluated 13 different online resources and divided them into three categories based on content, quality and ease of use. “After spending a lot of time looking at these sites, I’d like to share my opinions on these sites, whether ‘Excellent,’ ‘Useful’ or ‘Not Useful’ in my hands,” he said. Evaluated as “Excellent” were the ESCRS iLearn; the Atlas of Ophthalmology; the Atlas of Gonioscopy; Ophthalmology UNIMAS; and the American Academy of Ophthalmology’s (AAO) Resident Hub.

Paul Rosen MD, MBA, of the UK also discussed preparation, but his presentation concerned the development of surgical skills, in which the preoperative planning plays a major role. “Plan every procedure as if it were your first,” suggested Dr Rosen. “It doesn’t matter whether it’s your thousandth case. You have to be prepared for what can go wrong.” This includes review of all patients prior to surgery, to be able to predict possible complications and to plan alternative routes to successfully complete the procedure. “Plan your escape route.” Besides planning, there are many things that can be done to develop surgical skills. “Reading about cataract operations and observing surgery, either live or on video, is very useful for the developing surgeon,” said Dr Rosen, “as are face-to-face discussions with colleagues and postoperative case reviews with your mentors.” Dr Rosen advised the delegates, “Don’t be too ambitious, but definitely push the boundaries while maintaining a perfectionist mindset. Take the opportunity to learn in a protected training environment and don’t be afraid to seek advice.” The question of financial assistance is a frequent concern for residents. “I’ll focus on sources of financial support that are available outside the confines of standard ophthalmology training,” said Oliver Findl MD, MBA, of Austria, and the current chairman of the ESCRS Young Ophthalmologists’ Committee.

Dr Findl discussed three categories of funding: observerships, travel grants for congresses and research grants for scientific work. “Observerships, which are usually for a period of one to four weeks, are offered by the various organisations across Europe, and mostly offer €1000 each to around 50 residents per organisation per year,” he said. Dr Findl also discussed travel grants, which are widely available to help fund travel to a conference in which the applicant will present research. On how to fund research, Dr Findl said, “Generally speaking, there are two types of research grants: Unrestricted grants, which offer less money but in which the data belong to the investigator; and sponsored trials, which are better paid but often less exciting.” Once funding has been obtained, research can commence.

Wim Weber MD, PhD, the European editor of the British Medical Journal, spoke about how to take an idea from conception to publication. “Make sure your research plan matches the question you want answered,” he said. “You cannot use a case report to prove the validity of an intervention. “A great deal of the work involved in research is very lowly, but as soon as you get to the end of the process, you will make many friends who will want to share the glory,” said Dr Weber. “So make sure you agree authorship before starting the study.” He referred delegates to the International Committee of Medical Journal Editors (ICMJE) authorship guidelines.