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Addressing Surgical Competence in Ophthalmology

In a newly released article in press for Ophthalmology, American Board of Ophthalmology Director Steven J. Gedde, MD, discusses the assessment of surgical competence from the perspective of residency program directors.

To learn more about recent program graduates who reportedly struggled with surgical competence and to evaluate differences that have occurred since a similar survey was last conducted nearly 20 years ago, Dr. Gedde and his team of co-researchers from the Bascom Palmer Eye Institute distributed a survey to accredited ophthalmology training programs in 2019. The survey addressed surgical competence among ophthalmology residents who graduated during the past decade.

Of the 116 program directors who received the survey, 91 (78%) completed a response. Their responses accounted for 3,848 ophthalmology residents who were graduated within a 10-year period, of which 268 (7%) were designated as falling behind in surgical competence. Dr. Gedde’s study found that 84% of those with noted surgical skill development issues were successfully remediated by the programs, leaving programs to advance to the American Board of Ophthalmology’s certification process fewer than 4 residents per year who struggle to demonstrate appropriate surgical skills.

What happens to these individuals once they reach the ABO process is something George B. Bartley, MD, the ABO’s Chief Executive Officer, addresses in an accompanying editorial, also in press. Dr. Bartley explores various methods for addressing surgical competence, such as having certifying boards serve as the “last line of defense” between patients and a physician who lacks sufficient surgical skills or whether an alternative option, such as a non-surgical ophthalmology certificate, could be developed.

Ultimately, Dr. Bartley concludes, ophthalmology is a surgical specialty, and training programs are best equipped to address surgical competence. “Unless and until a superior means of assessment becomes available, the ABO must rely on the attestation of program directors and department chairs, whose faculty are in the best position to fairly determine the surgical skills of their graduating residents,” he writes.


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