Cataract surgical training in Europe: European Board of Ophthalmology survey

Abstract

Purpose: To survey recently graduated European ophthalmologists concerning CS training opportunities. Setting: Countries affiliated to the European Board of Ophthalmology (EBO). Design: Cross-sectional study of anonymous survey results. Methods: A 23-question online survey was emailed to candidates who sat the EBO Diploma examination as residents between 2018 and 2022. Results: Eight hundred twenty-one ophthalmologists from 30 countries completed the survey. The mean residency duration was 4.73 (SD 0.9) years. The mean reported number of entire CS procedures performed was 80.7 (SD 100.6) at the end of residency, but more than 25% of respondents (n=210) had received no live CS training during their residency. The self-confidence (scale, 1-10) to perform a simple case or challenging case, manage posterior capsular rupture, and realize a corneal stitch were rated 4.1, 3.2, 4.2, 2.4, respectively. We observed extensive variation in clinical exposure to CS and self-reported confidence to perform CS between European trainees. Females reported a mean of 18% fewer entire procedures than their male colleagues and were also less confident in their surgical skills (p<0.05). Trainees in residency programs longer than 5 years performed fewer procedures and were less confident than trainees in residences of shorter duration (p<0.001). The importance of fellowships to complete surgical education was rated 7.7 out of 10. Conclusions: CS training across European countries lacks harmony. Female ophthalmology trainees continue, as in other specialties, to experience apparent gender bias. European level recommendations seem necessary to raise and harmonize competency-based CS training programs and promote post-residency fellowship training programs.