Neuro-ophthalmology fellowship training programs will be able to apply for admission to a subspecialty-wide compliance program starting in July 2006. The program is designed to provide educational standards, protection of the public, trainees, training institutions, accountability, and enforcement. The evolution of this program is complicated. At the beginning of the 21st century, national leaders in ophthalmology expressed a concern for greater accountability of subspecialty-trained ophthalmologists. This concern led to a recommendation that ophthalmology subspecialty fellowships have American College of Graduate Medical Education (ACGME) accreditation. But that approach would have entailed a heavy bureaucratic effort, enormous cost, and loss of the ability to appoint fellows as junior faculty members. Based on these issues, a counterproposal came from a special task force of the American University Professors of Ophthalmology (AUPO) chaired by Stuart L. Fine, MD (Philadelphia, PA) that recommended voluntary guidelines for compliance with standards developed by subspecialty societies. The guidelines were based on a successful program of fellowship educational requirements conducted by the American Association for Pediatric Ophthalmology & Strabismus (AAPO&S) for the last nine years. In early 2002, AUPO formed a Fellowship Compliance Committee (AUPO FCC) made up of two voting representatives from each ophthalmic subspecialty society (except for The American Society of Ophthalmic Plastic and Reconstructive Surgery) with the charge that each society develop guidelines to assure adequate training. John L. Keltner, MD (Sacramento, CA) was appointed as the chair of the AUPO FCC. The two representatives appointed from the North American Neuro-Ophthalmology Society (NANOS) were Steven E. Feldon, MD (Rochester, NY) and John L. Keltner, MD (Sacramento, CA). The AUPO and the ophthalmic subspecialty societies, with the exception of oculoplastics and orbital surgery, have underwritten the compliance program with financial support. Participation is to be voluntary, but it is expected that some subspecialties may withhold society membership from graduates of non-participating or non-compliant programs. The general guidelines include standards for applicants, institutional facilities, fellowship directors, and faculty. For each subspecialty, there is to be an acceptable clinical experience defined by special guidelines. Pediatric ophthalmology was grandfathered in because of its previous nine-year compliance process. Cornea/external disease/refractive surgery had its guidelines approved and fellowship programs began applying in July 2005. Neuro-ophthalmology and glaucoma fellowship programs become eligible in July 2006. The subspecialties of pathology, retina, and uveitis are expected to join the AUPO FCC compliance process in July 2007. Neuro-ophthalmology fellowship programs that wish to participate must apply to the AUPO FCC at www.aupofcc.org. The applications are available on the web. The cost is $250 for programs training two fellows or less and $50 for each additional fellow beyond two. Programs will be evaluated every three years by a web-based triennial review process and by annual web-based fellow exit surveys. Monitoring will be based on a review of submitted information supplied by the fellowship program director and by review of a confidential questionnaire completed by each graduate of a participating program. The AUPO FCC will base its assessment of compliance on minimal acceptable standards of patient visits, faculty supervision, formal teaching, and compliance with federal guidelines for being on-call as well as surgical and other appropriate logs of clinical activity. Programs in AUPO FCC compliance will be listed on the AUPO FCC Web site (www.aupofcc.org) and the AUPO SF Match Web site (www.sfmatch.org). Steven E. Feldon, MD Rochester, New York John L. Keltner, MD Sacramento, California
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Sep 11, 2006
Beau B Bruce 
Open Access
