Abstract
Purpose :
Cataracts remain the leading cause of blindness and visual impairment in Africa. In sub-Saharan Africa the supply of ophthalmologists able to provide high-quality, low-cost cataract surgery lags behind the need. The primary aim of this study was to survey ophthalmology residents from sub-Saharan countries on the current state of small incision cataract surgery (SICS) training in their programs.
Methods :
Ophthalmology residents in Ghana, Ethiopia, Zambia, and Nigeria were invited to complete an online survey on their SICS training. Information about surgery volume, resources, best practices, and attitudes within residency programs and in medical outreach settings were collected. Wilcoxon signed rank, and descriptive statistics tests were used for statistical analysis.
Results :
A total of 23 residents from programs across the four countries completed the survey. While 74% of participants reported having completed some SICS cases during their residency training, the mean of completed cases was low: approximately 30 cases per resident. Among senior residents the mean cases completed increased to only about 60 cases. Only 32% of residents agreed that their case volume would prepare them to provide high quality visual outcomes. 61% of residents reported participating in cataract surgery outreach, of these most reported operating daily while on outreach while only weekly at their home institution. There was significant differences between rated availability and desired availability of surgical training resources (written material, SICS training videos, SICS question banks, ICO SICS scoring rubrics, and wet lab practice) and post operative feedback at residents training institutions (p <0.001). Only 50% of residents felt that their current SICS training curriculum would prepare them to deliver high quality visual outcomes to patients upon graduation.
Conclusions :
This study highlights the need for increased trainee support in ophthalmology training programs in sub-Saharan Africa. Increased surgical volume, surgical mentoring, and training resources may all play a role in producing confident, competent cataract surgeons who are urgently needed. Cataract outreach opportunities may provide a valuable avenue for trainees to accelerate their learning curve, while also providing quality care for underserved populations. We believe these trainee perspectives provide valuable insight for stakeholders seeking to strengthen residency training in sub-Saharan Africa.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.