Abstract
BackgroundTo study the differences in ophthalmology resident training between China and the Hong Kong Special Administrative Region (HKSAR).MethodsTraining programs were selected from among the largest and best-known teaching hospitals. Ophthalmology residents were sent an anonymous 48-item questionnaire by mail. Work satisfaction, time allocation between training activities and volume of surgery performed were determined.Results50/75 residents (66.7 %) from China and 20/26 (76.9 %) from HKSAR completed the survey. Age (28.9 ± 2.5 vs. 30.2 ± 2.9 years, p = 0.15) and number of years in training (3.4 ± 1.6 vs. 2.8 ± 1.5, p = 0.19) were comparable between groups. The number of cataract procedures performed by HKSAR trainees (extra-capsular, median 80.0, quartile range: 30.0, 100.0; phacoemulsification, median: 20.0, quartile range: 0.0, 100.0) exceeded that for Chinese residents (extra-capsular: median = 0, p < 0.0001; phacoemulsification: median = 0, p < 0.0001). Chinese trainees spent more time completing medical charts (>50 % of time on charts: 62.5 % versus 5.3 %, p < 0.0001) and received less supervision (≥90 % of training supervised: 4.4 % versus 65 %, p < 0.0001). Chinese residents were more likely to feel underpaid (96.0 % vs. 31.6 %, p < 0.0001) and hoped their children would not practice medicine (69.4 % vs. 5.0 %, p = 0.0001) compared HKSAR residents.ConclusionsIn this study, ophthalmology residents in China report strikingly less surgical experience and supervision, and lower satisfaction than HKSAR residents. The HKSAR model of hands-on resident training might be useful in improving the low cataract surgical rate in China.
Highlights
To study the differences in ophthalmology resident training between China and the Hong Kong Special Administrative Region (HKSAR)
Our results indicate that ophthalmology residents perform significantly less surgery during training in China than in the HKSAR
This appears to reflect in part different training standards between the two regions: the current minimum standard for cataract surgery is 100 cases by the completion of residency training in the HKSAR [19] while the Chinese Ophthalmological Society has proposed a target of 15 cases [20], our data suggest that residents may be falling far short of this figure
Summary
To study the differences in ophthalmology resident training between China and the Hong Kong Special Administrative Region (HKSAR). China accounts for 18 % of the world’s blind, with an estimated 5 million people who have lost the ability to self-care, half of them due to un-operated cataract [3, 4]. The Chinese Ministry of Health has made it a priority to tackle preventable blindness nationally, but the estimated number of cataract operations performed annually (360,000) falls short of the number becoming blind each year from cataract (400,000) [3]. The cataract surgical rate (CSR) is the number of cataract operations per million population per year. China’s cataract surgical rate of 900 is far lower than that of neighboring India (5600) [5] and Vietnam (1900) [6], both of whom have lower per capita incomes [7]
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