Medical Student Education in Ophthalmology: Crisis and Opportunity

Abstract

The number of medical schools requiring a formal ophthalmology rotation has declined significantly during the first years of the 21st century—down from 68% in 2000 to 30% in 2004 (Association of University Professors in Ophthalmology 2004 Survey on Medical Student Teaching). At first glance, this seems shocking. How can it be that the specialty we love so much receives so little attention in the overall scheme of medical education? But the explanations are numerous. The explosive growth of scientific information dictates that more time be devoted to the core areas of medical education. Because the Liaison Committee on Medical Education does not specifically require ophthalmology training in medical school, ophthalmology rotations are vulnerable. And frankly, many academic departments of ophthalmology have disengaged from the medical student education process for a variety of reasons, including limited financial support for medical student teaching and inability— or unwillingness—to devote sufficient resources to the task. As a result of limited ophthalmology education in medical schools and primary care residency programs, medical students and primary care physicians are inadequately trained to deal with the initial management or appropriate referral of even the most basic ophthalmic problems. 1,2 They have an insufficient understanding of ocular anatomy, fundamental eye examination skills, common causes of vision loss, and the relationship between the eye and systemic disease. An equally disturbing possibility is that the best students may not consider a career in ophthalmology because of their limited exposure to the field in the formative years of medical school. There is a clear need to improve ophthalmology educa