Variability of ophthalmic training in the world
I had the chance to meet ophthalmology residents from Europe recently, and it’s fascinating to hear about their medical training experiences.
In particular, I learned about ophthalmology training in Portugal. As with most professional training outside of the United States, specialization begins directly after high school. Medical school totals six years of schooling, although they do not have an equivalent to “college” as we do in the U.S. During the last year of medical school, students rotate through certain medical specialties much like we do in our 3rd year of medical school.
During this 6th year, students prepare for a cumulative exam on Harrison’s Principles of Internal Medicine
That’s right. No application essays. No interviews. No traveling. Your career is determined by how well you do on one single exam. Mind you, this isn’t like the SAT’s that Toby-the-school-jock (who happens to have a reasonable grasp on English) can get a 1600 (or 2400 now) without preparation. Any sort of all-inclusive exam on internal medicine borders insanity.
As far as I understand, ophthalmology training in Europe has great variability. What you learn is certainly dependent on which hospital you train at. It seems to me that much of the cerebral knowledge comes from independent learning from textbooks. Surgical training, however, can be impressive. One of the first year residents I spoke with had already performed over thirty pterygia and over ten phacoemulsifications! I would be fortunate to clock even 15 pterygia this year. A vitreoretinal fellow from India had told me he did over 500 phaco’s in addition to hundreds of extracapsular extractions during his residency.
In a way, it is humbling to hear about experiences outside of the U.S. Indeed, we have an overwhelming amount of funding and resources, yet our training isn’t necessarily superior. Where do our investments go? Research labs? Lawyers? Administration and unionized workers? The abyss?