Training of residents and fellows in retinopathy of prematurity around the world: An international web-based survey

Purpose: To characterize retinopathy of prematurity (ROP) training practices in international residency and fellowship programs. Methods: A publicly available online-based platform (http://www.SurveyMonkey.com) was used to develop a 28-question multiple-choice survey that targeted ROP screening and treatment methods. The authors solicited training programs in the Philippines, Thailand, and Taiwan. Results: Programs from three countries participated in the survey, and a total of 95 responses collected from residents, fellows, and attending ophthalmologists were analyzed. A descriptive analysis demonstrated that 45 participants (47%) reported 1% to 33% of ROP screenings were performed under direct supervision of attending ophthalmologists, and 35 (37%) reported the use of formal assessments. The majority of participants (Country A: 87%, Country B: 71%, and Country C: 75%) estimated 1% to 33% of their practice was spent screening for ROP. Notably, 44 participants (46%) reported performing zero laser photocoagulation treatments for ROP during training (Country A: 65%, Country B: 38%, and Country C: 38%). Conclusions: International ophthalmology trainees perform a limited number of ROP examinations and laser interventions. ROP screenings are often unsupervised and lead to no formal evaluation by an attending ophthalmologist. Limited ROP training among ophthalmologists may lead to misdiagnosis and ultimately mismanagement of a patient. Loss of vision and exposure to unwarranted treatments are among the implications of such errors. The findings highlight the need to improve ROP training in international ophthalmology residency and fellowship programs.