Indian Journal of Ophthalmology

LETTER TO THE EDITOR
Year
: 2020  |  Volume : 68  |  Issue : 10  |  Page : 2319--2320

Senior residency: An opportunity missed?


Rajat M Srivastava, Siddharth Agrawal 
 Department of Ophthalmology, King Georges' Medical University, Lucknow, Uttar Pradesh, India

Correspondence Address:
Dr. Rajat M Srivastava
Department of Ophthalmology, King Georgesf Medical University, Lucknow, Uttar Pradesh
India




How to cite this article:
Srivastava RM, Agrawal S. Senior residency: An opportunity missed?.Indian J Ophthalmol 2020;68:2319-2320


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Srivastava RM, Agrawal S. Senior residency: An opportunity missed?. Indian J Ophthalmol [serial online] 2020 [cited 2020 Dec 3 ];68:2319-2320
Available from: https://www.ijo.in/text.asp?2020/68/10/2319/295671


Full Text



Dear Editor:

We draw attention towards the potential benefits of restructuring the Ophthalmology senior residency in government institutes.

Sub-standard specialty training during Ophthalmology residency is a known concern and the ever-increasing trend of fellowship courses in non-government institutes following post-graduation further raises doubts on its scope in government institutes.[1],[2] Except for a few premier government institutes, most of the sub-specialty training in Ophthalmology is offered by non-government hospitals and institutes.[3] The absence of any 'structured senior residency program' may be attributed to this trend.

It is time for the government institutes to strive for developing sub-specialties including structuring their senior residency program. Presently, the majority of bright students after completion of post-graduation take up fellowships with compromised finances in pursuit of a bright future. This leads to not only loss to the government institutes in terms of capable human resources but also in terms of trained future faculty. Since the current Medical Council of India (MCI) guidelines mandate a minimum duration of senior residency, the probability of trained fellows joining as faculty in government institutes is remote as fellowships are not recognised by MCI. Besides this obvious advantage, sub-specialty-based restructuring of senior residency program can have other potential benefits.

Academic and clinical exposure of postgraduates during residency would improve. These ophthalmologists would be better adept in catering to the needs of the society at large with their knowledge not being limited to 'financially viable' and popular practices of cataract and refractive procedures [4]Infrastructure of departments would get a boost with the development of sub-specialty units. The impact of improved infrastructure in government departments on the underprivileged population can never be overestimatedWith the development of sub-specialties residents no longer will be just 'cataract carpenters'. Equal emphasis on other branches will help in developing a more holistic understanding of Ophthalmology [5]Retention of best brains, good training, development of infrastructure and the large number of patients would be a natural impetus for research and developmentQualified ophthalmologists will not have to work for meagre stipends and occasionally occurring exploitation during fellowships would be done away with. Many private institutes have been known to run fellowships to ensure the availability of inexpensive qualified working hands.

At present, a Senior Residency in a government institute doesn't offer any specialisation and is considered a job. However, it must be emphasised that soft clay of senior residents is the transition between student and consultant and must be optimally baked into a competent ophthalmologist. Often there isn't any structured rotation or training of these residents in sub-specialties. Since the focus of the government has remained on combating cataract-related blindness in our country, the maximum emphasis during post-graduation and senior residency has been on cataract-related training overshadowing other equally important diseases like glaucoma, diabetic retinopathy and cornea-related blindness.[6],[7]

It is time that the government institutes take up the responsibility of standard sub specialty training in Ophthalmology and overcome dependence on non government setups. Formal senior residency in sub-specialties may be an important step in overcoming the existing deficiencies in Ophthalmology training in India.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Grover AK. Postgraduate ophthalmic education in India: Are we on the right track? Indian J Ophthalmol 2008;56:3-4.
2Gupta A. Ophthalmology postgraduate training in India: Stirring up a hornet's nest. Indian J Ophthalmol 2017;65:433-4.
3Aios.org. 2020. All India Ophthalmological Society. [online] Available at: <https://www.aios.org/article-131-fellowship-programmes.php> [Last accessed on 2020 Jun 17].
4Honavar SG. Pediatric ophthalmology, neuro-ophthalmology, uvea, and oculoplasty: Survival is the only option. Indian J Ophthalmol 2017;65:1071-2.
5Gogate PM, Deshpande MD. The crisis in ophthalmology residency training programs. Indian J Ophthalmol 2009;57:74-5.
6Honavar SG. Ophthalmology residency training in India: Quo vadis? Indian J Ophthalmol 2017;65:427-8.
7Biswas P, Gogate PM, Maskati QB, Natarajan S, Verma L, Bansal PK. Residency evaluation and adherence design study III: Ophthalmology residency training in India: Then and now-Improving with time? Indian J Ophthalmol 2018;66:785-92.