Current Status of Ophthalmology Residency Training in China: The Experience From Well-Structured Centers Around the Country

Abstract

Chinese ophthalmology residency training is continuously evolving with an emphasis on standardization. In this article, we assess the current status of ophthalmology residency training in China compared with that in the United States through analysis of literature review and onsite data collection. We comprehensively review various aspects of the residency training structure in China, including accreditation, resident selection, clinical and surgical curricula, research requirements, and evaluation. Our report demonstrates significant regional differences among training programs due to the lack of a national standard, resulting in varying competencies of graduating Chinese ophthalmology residents. The Chinese ophthalmology community is determined to improve the standardization process and quality of training for their ophthalmologists, an important goal that will facilitate international fellowship studies, exchange scholars, and research collaboration.

Shortening Training Duration to Address the Insufficiency of Ophthalmologists: A Deeper Look at the China Experience

“…11 Monitoring standards for medical education are also not centralized and not strict, unlike in the UK, where its Academy of Medical Royal Colleges monitors medical schools' compliance and gives sanctions when needed. 6,12 The same concerns were shared in the ophthalmology residency training (and other residency training programs). Chinese ophthalmology residency training programs employed different tracks despite the introduction of a 5-year standardized residency training program in Ophthalmology in 2013 to improve residents' competency and for them to be at par with international standards.…”

“…5 China's system was to meet the high demand for ophthalmologists as a result of China's fast-growing population by shortening the number of years of training even before the UN resolution. 6 In China, one can be an ophthalmologist after around 7-10 years from high school graduation: 3-5 years MBBS plus 3-5 years of ophthalmology training and a year for National Medical Licensing Examination (NMLE). The non-requirement of a prior college degree, like in the Philippines, significantly cuts 4 years from medical education.…”

“…The medical curriculum and admission requirements were deemed insufficient to train "leading" or world-renowned physicians. 6 The multi-tiered medical curriculum produced a heterogenous group of physicians, which created inequity in patients' access to "good" or competent physicians since those with higher education often get hired in urban areas. 8 It is also unclear if all MBBS students get necessary supervised hands-on clinical exposure similar to their counterparts in the UK since standardization is difficult to implement.…”

“…Chinese ophthalmology residency training programs employed different tracks despite the introduction of a 5-year standardized residency training program in Ophthalmology in 2013 to improve residents' competency and for them to be at par with international standards. 6,7,9 For those pursuing an additional graduate degree during residency training, the residency component must be no less than 33 months. 9 Although five years are allotted for the standardized residency training program, there appears to be insufficient time appropriated for clinical and surgical training in the setting of increasing pressure to publish.…”

“…9 Although five years are allotted for the standardized residency training program, there appears to be insufficient time appropriated for clinical and surgical training in the setting of increasing pressure to publish. 6,13 Ophthalmology is primarily a surgical specialty, and the number of supervised surgeries performed matters to a surgeon's surgical competency. 14 To do essential surgeries such as cataract extraction and enucleation only in the last year of training can negatively affect the development of a resident's surgical skill.…”