Training of Residents and Fellows in Retinopathy of Prematurity (ROP) Around the World: an International Web-based Survey
Tala Al-Khaled, BA; Mikel Mikhail, MD; Karyn E. Jonas, RN; Wei-Chi Wu, MD, PhD; Rachelle Anzures, MD; Atchara Amphonphruet, MD; Peter Campbell, MD; RV Paul Chan, MD, FACS
Illinois Eye and Ear Infirmary
University of Illinois at Chicago
Introduction: As the rate of neonatal survival continues to rise in lower and middle-income countries, the number of newborns who are susceptible to developing retinopathy of prematurity (ROP) will increase. Therefore, there will be a greater need for ophthalmologists skilled in ROP diagnosis and management. The purpose of this study is to characterize ROP training practices in international residency and fellowship programs.
Methods: The study was granted an exemption by the Institutional Review Board. A publicly available online-based platform (http://www.SurveyMonkey.com) was used to develop a 28 question, multiple-choice survey that targeted ROP screening and treatment methods. We solicited training programs in the Philippines, Thailand, Mongolia, Costa Rica, and Taiwan.
Results: A total of 101 responses collected from residents, fellows, and attending ophthalmologists from three countries were analyzed. Responses from three countries had adequate participation to be included in the analysis, and results from two countries were excluded due to either no response or incomplete responses. Descriptive analysis demonstrated that 46 of 96 participants (48%) reported 1-33% of screenings were performed under direct attending supervision, and 35 of 95 participants (37%) reported the use of formal assessments. The majority of respondents (Country A, 88%; Country B, 72%; Country C, 75%) estimated 1-33% of their practice was spent screening for ROP. Notably, 44 of 96 participants (46%) reported performing zero laser photocoagulation treatments during training (Country A, 63%; Country B, 38%, Country C, 32%).
Discussion: International ophthalmology trainees perform a limited number of ROP examinations and laser interventions. ROP examinations by trainees are often unsupervised and lead to no formal evaluation by an attending ophthalmologist. Limited ROP training among ophthalmologists may lead to misdiagnosis and ultimately mismanagement of a patient. Loss of vision and exposure to unwarranted treatments are among the implications of such errors.
Conclusion: Our findings may serve as a foundation to improve ROP curriculum and highlight the need to improve ROP training in international ophthalmology residency and fellowship programs.
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Myung JS, Chan RVP, Espiritu MJ, et al. Accuracy of retinopathy of prematurity image-based diagnosis by pediatric ophthalmology fellows: Implications for training. Journal of AAPOS?: the official publication of the American Association for Pediatric Ophthalmology and Strabismus / American Association for Pediatric Ophthalmology and Strabismus. 2011;15(6):573-578. doi:10.1016/j.jaapos.2011.06.011.