Ophthalmology resident assessment in India: Are we on the right track?

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Dear Editor, The period of residency molds one’s future and is a critical part of training. An undergraduate who graduates from a medical college becomes a full-fledged practicing ophthalmologist with a large number of societal expectations after this period. But are the ways used to assess the training of these residents sufficient enough to allow the young surgeons to operate on and treat the eyes of millions of people who need their services?[1] When one graduates from medical school, usually there is very limited knowledge about ophthalmology. At the entrance level itself, most of the institutes examine the visual acuity and color vision of the candidates applying for admission in a particular stream. However, that is not sufficient for ophthalmology as surgeries require good stereopsis too (more than 120 arc seconds),[2] which must be examined using the standard tests. During residency, apart from the theoretical and practical assessments of the residents conducted from time to time, proper psychological assessment of the resident is also an important aspect that is missed. Intraocular surgeries do have a learning curve that cannot be neglected. Knowing theory and translating it into surgical skills does require patience, learning and correct teaching. An inadvertent feeling of guilt seeping into young, sensitive minds can affect their psychological status leading to anxiety, depression and loss of self confidence. In a study conducted by Tran et al.,[3] 68.4% of their respondents reported issues such as depression, suicide, or burn-out being present amongst residents at their workplace. Moreover, only 26.7% of them reported the presence of a formal resident wellness program. In the challenging times of COVID-19 with an uncertainty of the future, depression was found to be present in 32.6% of the trainee ophthalmologists.[4] Hence, before entering the formative assessment, it is essential to assess the psychological status of the residents. Prophylactically scheduled psychological counseling by the mentors should be done for all the residents. There is still a lack of uniformity in the training and assessment done across various medical colleges in the country, which should be addressed. For surgical assessment, each surgery performed by the residents should be recorded progressively, and the practical assessment should be taken as an average of their performance in all the surgeries. Similarly, at the end of a fellowship in a particular sub-specialty, a fellowship exit evaluation should be done, which is lacking. Assessment should also be done on the scientific knowledge and innovative mindset of the resident—a factor that is given the least importance in our country. In conclusion, resident assessment needs to be amended in several ways to give our nation a well-trained ophthalmologist with good knowledge and correct decision-making. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

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