Dear Editor,
A fortnight of lockdown to curb the COVID-19 pandemic has progressed to multiple curfews nationwide over the past year. This has naturally influenced ophthalmic training.
Clinical and surgical training impact
Doctors have pooled resources to cater to COVID-19 patients, attending to only emergencies and essential services in their specialty. A decline in patient footfall in hospitals[1] and the need to reduce “healthcare worker-patient” interactions have reduced trainees’ contact with patients in their specialty.
Ophthalmic surgeries, mostly non-emergency, being deferred by months have further diminished clinical exposure among residents. The initial 2–3 months of disruption, which was reported to have a negative impact,[2] has now extended, involving more than half the training period of ophthalmology post-graduate degree courses.
Simulation-based training of skills, though useful, cannot substitute patient-care experiences.
Academic impact
Online academic programs have permitted the continuation of classroom learning from experts without travel and stay expenses.[3] However, it is a challenge to identify programs most beneficial to the trainee.[3]
Research impact
This new disease has triggered research;[4] however, dissertation topics are unlikely to be COVID-19-related. Postponement of non-emergency surgeries and reduced health-seeking behavior by patients has resulted in many residents failing to meet their dissertation requirements. Institutes accept adjustments in the sample size. However, publishing these dissertations, a requirement by regulatory authorities, will prove challenging.
Psychosocial impact
Inadequate clinical exposure would prolong the post-residency training period. Worry of financial and personal constraints that this would entail aggravates anxiety caused by the pandemic.[5]
Though the impact of this pandemic on ophthalmic training has been mostly detrimental, there have certainly been some gains. It opens new avenues for research. Online platforms, having overcome limitations of time and location, are important teaching methods. Wet labs and simulations, second fiddle to patient-centric training, have now achieved renewed importance. These modalities that have been adopted as rescue measures are likely to prove a valuable addition to traditional teaching methods in the future.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
- 1.Babu N, Kohli P, Mishra C, Sen S, Arthur D, Chhablani D, et al. To evaluate the effect of COVID-19 pandemic and national lockdown on patient care at a tertiary-care ophthalmology institute. Indian J Ophthalmol. 2020;68:1540–4. doi: 10.4103/ijo.IJO_1673_20. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Nair A, Gandhi R, Natarajan S. Effect of COVID-19 related lockdown on ophthalmic practice and patient care in India:Results of a survey. Indian J Ophthalmol. 2020;68:725–30. doi: 10.4103/ijo.IJO_797_20. [DOI] [PMC free article] [PubMed] [Google Scholar]
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- 5.Khanna R, Honavar S, Metla A, Bhattacharya A, Maulik P. Psychological impact of COVID-19 on ophthalmologists-in-training and practising ophthalmologists in India. Indian J Ophthalmol. 2020;68:994–8. doi: 10.4103/ijo.IJO_1458_20. [DOI] [PMC free article] [PubMed] [Google Scholar]