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International Council of Ophthalmology Foundation


Programs: Ophthalmic Education and Training


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Ophthalmic Education and Training

ICO programs of ophthalmic education and training advanced in 2009 through the broad initiative of “Refocusing Ophthalmic Education” and enhancement of specific education and training programs. 

“Refocusing Ophthalmic Education”—initiated by Dr. Bruce Spivey (United States), ICO President, and Dr. Mark Tso (United States and China), ICO Education Committee Chair—encompasses (1) change from measurement by duration of training to measurement by assessment of competence in medical knowledge, surgical skills and other components, (2) the principles of adult learning and (3) the vast amount of medical-related information on the Internet for both learning and guidance at the time and place of contact with patients. The concepts of refocused education apply to:

Ophthalmology Curricula

Addressing the question of “What to teach?”, the ICO Education Committee and specific task forces have developed curricula for Ophthalmology Medical Student Education, Ophthalmology Resident-Specialist Education, Ophthalmology Continuing Education, and Para-Ophthalmic Vision Specialist Education.

Klinische Monatsblätter für Augenheilkunde, November 2006,on the Internet at: www.icoph.org/pdf/icocurricmed.pdf.

Ophthalmology Medical Student Education 

Cataract, glaucoma, age-related macular degeneration and diabetic retinopathy are increasingly prevalent and of growing importance in world health care. Consequently, the ICO and the ICOFoundation are committed to ophthalmology education for medical students through a universally applicable curriculum. With revisions by the ICO Medical Student Education Committee led by Dr. Susan Lightman (United Kingdom), this curriculum presents a core of essential knowledge, content appropriate for specific geographic regions, and measures for objective assessment of the student’s knowledge and skill (www.icoph.org/pdf/icocurricmed.pdf).

This medical student curriculum is augmented by the ICO handbook for medical students, illustrated lectures and teaching images that are a valuable resource for teaching medical students.

Ophthalmology Resident-Specialist Education

The ICO multinational committee led Dr. Andrew Lee (United States) works to determine the “need to know” for ophthalmologists throughout the world and directs the multilevel “Principles and Guidelines of a Curriculum for Education of the Ophthalmic Specialist” that is presented on the Internet (www.icoph.org/pdf/icocurricres.pdf).

As a part of regular curriculum review, an additional module on Teaching Community Eye Health emphasizes the importance of providing eye care for all members of the community.

In 2009, the European Board of Ophthalmology, led by President Marko Hawlina (Slovenia), accepted the ICO Resident-Specialist Curriculum as the scaffold for training of the ophthalmic specialist. Importantly, in accordance with the principles of “Refocusing Ophthalmic Education”, this action by the European Board of Ophthalmology directs attention to the knowledge, skills and additional competencies to be mastered during ophthalmology resident-specialist education.

Ophthalmology Continuing Education

A multinational committee led by Dr. Juan Verdaguer (Chile) coordinates curriculum activity and program action concerning ophthalmology continuing education. This program recognizes the need for continuing enhancement of knowledge, professional skills and training for utilization of advanced technology throughout a professional career. In basic form, the continuing education curriculum is posted on the Internet (www.icoph.org/pdf/icocurriccme.pdf).

In 2009, the ICO Continuing Education Committee initiated a Visiting Professor Program that provides for highly qualified ophthalmology specialists to devote periods of one week or more to ophthalmology training centers in developing countries with emphasis on didactic training and skill enhancement.

Para-Ophthalmic Vision Specialist Education

Addressing para-ophthalmic vision specialist education, Dr. William E. Astle (Canada) leads a multinational ICO committee committed to the education of community-based para-ophthalmic personnel; hospital based para-ophthalmic personnel, orthoptists and ophthalmic technicians. This program, developed by this team of educators, is presented at www.icoph.org/pdf/icocurricpara.pdf.

Ophthalmology Resident Program Directors Courses

The ICO Task Force on Coordination and Education of Program Directors of Ophthalmology Residencies led by Dr. Karl Golnik (United States) stimulated distribution of resident-specialist educational materials on the Internet (www.icoph.org and www.icoword.org) and concentrated on Ophthalmology Resident Program Directors Courses. These courses focus on methods of instruction, assessment of resident skills, changing resident behavior and measuring competence. Presented by the ICO and ICOFoundation, Program Directors Courses during 2009 were conducted in China, Colombia and Indonesia.

China
At Beijing, China, on May 10–12, 2009, the Program Directors Course was led by Dr. Li Xiaoxin (China), Chair, and Dr. Karl Golnik (United States), Co-Chair. The program was co-sponsored by the Chinese Ophthalmological Society and the ICOFoundation through an unrestricted grant from Allergan, Inc. Faculty members also included Dr. Eduardo Mayorga (Argentina), Dr. Gabriela Palis (Argentina), Dr. Peter Quiros (United States) and Dr. Bruce Spivey (United States). The agenda was determined in part by a needs assessment completed by the hosts. Participation by more than 50 educators was enthusiastic and a frequent question was “When will the next ICO China Program Directors Meeting take place?”

Colombia
At Bogotá, Colombia, the Program Directors Course on February 9–10, 2009, was chaired by Dr. Fernando Gomez (Colombia) and co-chaired by Dr. Peter Quiros (United States). ICO faculty participants were Dr. Enrique Graue-Wiechers (Mexico), Dr. Eduardo Mayorga (Argentina), Dr. Gabriela Palis (Argentina) and Dr. Peter Quiros. The course was attended by more than 40 program directors from Colombia, Bolivia, Costa Rica, Ecuador, El Salvador, Guatemala, Honduras, Nicaragua, Panamá and Venezuela. At the conclusion of the meeting, Colombia educators formed a Task Force to adapt a written standardized curriculum for ophthalmology resident training in Colombia.

Indonesia
At Bali, Indonesia, on May 14–15, 2009, the Ophthalmology Program Directors Meeting was hosted by Dr. Tjahjono Gondhowiardjo (Indonesia), Chair, and the Indonesian Ophthalmologic Society. Faculty included the Co-Chair, Dr. Karl Golnik (United States), Dr. Anthony Arnold (United States), Dr. Eduardo Mayorga (Argentina), Dr. Gabriela Palis (Argentina) and Dr. Bruce Spivey (United States). Response was enthusiastic from the 33 representatives of ophthalmology training programs in Indonesia, Laos, Maylasia, Nepal, Philippines, Thailand and Vietnam. Evaluations by these participants emphasized the stimulus to ophthalmic education and appreciation for sponsorship by the ICO and ICOFoundation through an educational grant from Allergan, Inc.

Turkey and China in 2010
Continuing the educational programs for Ophthalmology Resident Program Directors in 2010, courses are planned to take place in Ankara, Turkey and Beijing, China. In 2009, the Task Force on Coordination and Education of Program Directors of Ophthalmology Residencies worked to achieve continued improvement of the ICO Program Directors Courses, devise methods to measure success of the Program Directors Meetings, sustain interaction among program directors following a regional meeting and continually explore innovative approaches to global ophthalmology program director education.

World Ophthalmology Residency Development (WORD) Forum

In 2009, the ICO Task Force on Emerging Technologies for Teaching and Learning chaired by Dr. Eduardo Mayorga (Argentina), markedly enhanced Internet options appropriate to global education. The World Ophthalmology Residency Development (WORD) Forum, initiated by Dr. Eduardo Mayorga and Dr. Gabriela Palis (Argentina), continued to function prior to and following the Program Directors Courses and also presents monthly Newsletters in English and Spanish. Newsletters contain blogs, for example, on adult learning and use of technology in teaching, as well as lectures and videos contributed by program directors for use by other program directors throughout the world. The collection of teaching materials for use in medical student and resident-specialist education is the section entitled, “What to Teach With: ICOpedia Video and Lecture Center.” All material can be accessed online at www.icoword.org.

Ophthalmology Training and Eye Care Centers

The ICO and ICOFoundation are working with philanthropic donors, foundations, public service organizations, corporations and government representatives to build ophthalmology training and eye care centers in Nigeria, China, Slovenia and Cameroon.

Nigeria

With a population of 146 million, Nigeria is Africa’s most populous nation. Nigeria also has one of the highest prevalence rates of blindness in the world, an estimated 2 million blind and 5 million with disease related visual impairment or uncorrected refractive error. (Ref. 9. Ajayi BGK. Primary Eye Care in Western Nigeria. In Primary Health Care in Western Nigeria 1977–2007. Awojobi OA Editor, 2007, 119–121).

Broadband Internet Education
Following a 2006 survey of training and eye care in Nigeria by ICO leaders, the ICO and ICOFoundation funded equipment for broadband Internet access at six regional Resident-Specialist Training Centers in Nigeria; one center in each of Nigeria’s six administrative zones.

University College Hospital, Ibadan
Since 2006, University College Hospital, Ibadan, has undergone progressive development as a regional center for training of ophthalmologists and for population-based eye care. With support from Vision 2020, the Carl Zeiss Project, the Alcon Foundation, ICOFoundation and other sources, ophthalmologists have received specialized training in corneal-anterior segment disease, cataract surgery and retinal surgery.

Network of Catholic Eye Hospitals, Ibadan District
In 2008, Dr. B.G.K. Ajayi (Nigeria), Medical Director of Catholic Eye Hospitals, organized a Network of Catholic Eye Hospitals and Clinics in the Ibadan District to provide sustainable population-based eye care to nearly 4 million people in the suburbs and rural areas adjacent to Ibadan, regardless of ability to pay. Supported by the Catholic Church, a three year grant from the Lavelle Foundation for the Blind to the ICOFoundation, and donations from international and Nigerian sources, the Network is aided by consultants from Lions Aravind Institute of Community Ophthalmology (LAICO), India.

Documented in the LAICO 2009 Report, the four eye hospitals and clinics in the Network provide an increasing volume of primary and secondary eye care as well as community outreach. Through Agreement with University College Hospital, Ibadan, patients requiring specialized eye care are referred to subspecialists at University College Hospital and receive eye care regardless of the patient’s ability to pay.

China

Eli Lilly & Company to establish the Peking University Eli Lilly Diabetic Eye Disease Center. With formal approval by Peking University, direction by Dr. Zhi- Zhong Ma (China), Executive Vice President of Peking University Eye Center, leadership by Dr. Mark Tso (United States and China), Honorary Director of Peking University Eye Center, and ongoing consultation by Lions Aravind Institute of Community Ophthalmology (LAICO), India, the Diabetic Eye Disease Center is implementing a strategic plan that encompasses:

  • Distribution of diabetes and eye health educational materials
  • Creating awareness of the diabetic eye disease program
  • Community eye care outreach in urban and rural areas
  • Tertiary eye care services at Peking University Eye Center
  • Academic training programs for doctors and health care workers

Peking University Eye Center and Network of Eye Hospitals
Implementing the strategic plan, Peking University Eye Center conducted urban outreach and rural outreach through a broad network of health care systems and eye hospitals in the provinces of Gansu, Henan, Jilin, Shandong, Yunnan and Inner Mongolia. In 2007–2009 assessment, LAICO Consultants reported distribution of more than 100,000 educational pamphlets, screening of over 32,000 people in 200 rural screening camps, screening of more than 21,000 urban diabetics and performing over 3,000 laser procedures for diabetic retinopathy. This urban and rural program is designed to provide sustainable and population-based eye care

Slovenia

Ophthalmologists fully trained in subspecialties such as glaucoma, retinal disease and pediatric ophthalmology are needed in developing countries. Full qualifications in these and other ophthalmic subspecialties require fellowship training of one year or longer duration in a carefully structured program at an advanced ophthalmology center.

Recognizing the need for subspecialty training in upwardly mobile developing nations, the Alcon Foundation awarded a grant to the ICOFoundation for an initial ICO/Alcon Ophthalmology Training Center.

University Eye Hospital, Ljubljana, Slovenia
Following a competitive review of applications by an international committee, the ICO/Alcon Ophthalmology Training Center was established under leadership of Dr. Marko Hawlina and Dr. Brigita Drnovšek-Olup at University Eye Hospital in Ljubljana. Dr. Hawlina, elected President of the European Board of Ophthalmology, stated that “we would like to host young specialists from teaching hospitals in Eastern Europe who plan to practice in a public teaching hospital.” In 2010, the first two Subspecialty Fellows are scheduled to commence training.

Cameroon

Within this large region, Central Africa represents an area in particular need of eye care services. Cameroon, at the heart of Central Africa, is a Central African nation with a maritime border on the Atlantic Ocean, a population of nearly 20,000,000 and an elected democratic government. With French and English as official languages, the country is primarily French-speaking and at the core of Francophone Africa. The United Nations Human Development Index, which ranks nations by combining life expectancy, educational attainment and income, places Cameroon 153 among 182 nations worldwide (Ref 10 http://hdr.undplorg/en/statistics)

To evaluate the opportunity for developing an advanced ophthalmology subspecialty training and eye care center in Cameroon, Dr. Bruce Spivey (United States), ICO President; Dr. Akef El-Maghraby (Egypt), ICO Vice President; Dr. Jean-Jacques De Laey (Belgium), ICO Secretary-General; Dr. Soliman Aref (Egypt), Al Noor-Magrabi Foundation Executive Director; Dr. Daniel Etya’ale (Cameroon and Switzerland), ICO Trustee; and Dr. Bradley Straatsma (United States), ICOFoundation President Emeritus, traveled to Yaoundé, Cameroon (the nation’s capital) in December 2009. In a succession of meetings, Cameroon’s Prime Minister and government officials expressed full support for an international initiative to build an advanced ophthalmology center—the first in the country—at Yaoundé.

The Yaoundé University Rector, Medical School Dean and ophthalmology staff confirmed enthusiastic endorsement of an advanced ophthalmology training and eye care center.

After assessing the great need and the opportunity to improve eye care throughout Central Africa, the ICO representatives were unanimous in support of an advanced ophthalmology subspecialty training and patient care center at Yaoundé, Cameroon.

Correction of Refractive Error

The Durban Declaration, which followed the first Congress on Uncorrected Refractive Error in March 2007, recognized that 153 million people worldwide have severe visual impairment, not including presbyopia, due to uncorrected refractive error. Recognized by the World Health Association and endorsed by the ICO, this Declaration emphasized the need to prioritize countries in greatest need and especially school children.

School Eye Health Programme
The ICO Task Force on Uncorrected Refractive Error led by Dr. Muhammad Babar Qureshi (Pakistan) developed the School Eye Health Programme (SEHP) to meet the eye health and refractive needs of school age children (age 5-15 years) in regions of Pakistan and Nigeria. The SEHP is designed to carry out school screening for children, teachers and the siblings of children with significant refractive error. Children with refractive error will receive spectacles dispensed at the location of screening, treatment for minor eye disease on site and referral for major eye disease to the nearest District/State eye unit. Additional SEHP components are eye health and general health education, research to assess the program’s benefits and advocacy to encourage long-term sustainability by schools and governments.

In 2010, 2011 and 2012, the SEHP plans activities in specific regions of Pakistan and Nigeria with ambitious targets of eye health screening and refractive service for 1,000,000 school children, 10,000 teachers and 10,000 siblings in addition to dispensing of 100,000 spectacles. In a formative stage at this time, ability of the SHEP to achieve objectives depends on support by Light For The World (Austria), CBM, the ICOFoundation and other philanthropic and public service entities.

ICOFoundation Support for Ophthalmic Education and Training 

In 2009, the ICOFoundation provided support funds for the:

  • Ophthalmology Medical Student Curriculum
  • Ophthalmology Resident-Specialist Curriculum
  • Ophthalmology Continuing Education Curriculum
  • Para-ophthalmic Vision Specialist Curriculum
  • Ophthalmology Program Directors Courses
  • World Ophthalmology Residency Development (WORD) Forum
  • Resident-Specialist Education and Eye Care Centers

More on programs supported by the ICOFoundation:


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