EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/422211
51 EW FEATURE are always harder for trainees to get experience in. Patients aren't looking for a bargain—they're look- ing for the best outcomes possible and often don't think the resident can provide that," Dr. Garg said. "Having residents perform cash procedures is unusual. Even LASIK is usually heavily discounted." Dr. Yeu thinks refractive lens exchange (RLE) will "become more commonly taught as our refractive lens options become better and better," and expects to see both U.S. and international programs expand offerings. Still, "RLE is something that's outside of insurance, and in an academic setting, it's a harder sell," On the other hand, Dr. Yeu is "thrilled" that more residency programs "have excimer refractive surgery training being covered. It was as low as 30% even just a few years ago." Because phakic IOLs are "much more popular outside the U.S., probably because they have several different models available," Dr. Garg is not surprised nearly twice as many non-U.S. residency programs offer access to phakic IOL training. Dr. Yeu also thinks that the lower number of U.S. residency programs that offer phakic IOL training is directly correlated to the procedure's popularity. Because most refractive proce- dures are elective, "cash procedures U.S. Non-U.S. Overall Surface ablation procedures (PRK, LASEK, Epi-LASIK) 76.3% 63.3% 70.0% LASIK 81.4% 66.7% 74.2% Phakic IOL 20.3% 40.0% 30.0% Refractive lens exchange 11.9% 36.7% 24.2% Femtosecond lasers 25.4% 28.3% 26.7% Figure 3: What kind of refractive surgery training is covered in your curriculum? Source (all): 2014 ASCRS Clinical Survey Global Trends in Ophthalmology ™ Copyright © 2014 Global Trends in Ophthalmology and the American Society of Cataract & Refractive Surgery. All rights reserved. Dr. Garg said, so some curriculums simply do not offer it. Both surgeons agreed that mastering the "extras" should take a back seat to the basics. "If surgeons don't understand the basics, it is highly unlikely that they're going to delve into taking care of patients needing advanced corneal and lens-based refractive techniques and be comfortable with those procedures," Dr. Yeu said. EW Editors' note: Drs. Garg and Yeu have no financial interests related to their comments. Contact information Garg: gargs@uci.edu Yeu: eyeulin@gmail.com December 2014 The changing face of medical education "Cash procedures are always harder for trainees to get experience in. Patients aren't looking for a bargain—they're looking for the best outcomes possible and often don't think the resident can provide that." –Sumit (Sam) Garg, MD