Abstract
Purpose :
To investigate cataract surgery training curricula and timing of resident participation in phacoemulsification cataract surgery (phaco) as primary surgeon.
Methods :
An anonymous survey including multiple choice and Likert-style questions was created on surveymonkey.com. An e-mail with a description of the study and link to the survey was sent to the program director (PD) of each ophthalmology residency training program accredited by the Accreditation Council for Graduate Medical Education (ACGME). Weekly reminders were sent for 2 consecutive weeks.
Results :
Fifty of 116 (43%) PDs completed the survey. Over 2/3 (72%) of PDs indicated their program had a formal cataract surgery training curriculum which most commonly included lectures (88%) and wet lab (91%). Most PDs reported their residents begin learning phaco using clear corneal incision (91%) and divide and conquer (100%). The proportion of PDs who indicated their residents start performing phaco as primary surgeon in the first, second, or third year of residency was 34%, 56%, and 10%, respectively. Only 1 (2%) PD reported a requirement to perform extracapsular cataract extraction (ECCE) before attempting phaco. Inadequate resident knowledge and surgical skill base (58%), anticipation of increased surgical complication rates (38%), and no perceived benefit to resident education (32%) were the most commonly reported barriers for implementation of earlier resident performed phaco. The proportion of PDs who believed that surgical complication rates of resident performed phaco would be higher if residents started performing phaco as primary surgeon in the first or second year instead of the third year of residency was 38% and 8%, respectively.
Conclusions :
Survey results indicate that while most training programs have a formal cataract surgery training curriculum, over 25% of ACGME-accredited programs do not. Residents begin performing phaco as primary surgeon in the first 2 years of residency at the majority of training programs in the United States, and residents are no longer required to complete a certain number of ECCE surgeries before attempting phaco. Program directors perceive inadequate resident knowledge and surgical skill base, as well as anticipation of increased surgical complication rates, as barriers to early resident exposure to phaco as primary surgeon.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.