The impact of surgical training on the practice of recently graduated ophthalmologists at Riyadh's ophthalmology residency program.

Purpose: To evaluate how well the training residency program prepared recent graduates to practice comprehensive ophthalmology with special focus on surgical competency.

Methods: This is a cross-sectional study that included Ophthalmologists who graduated from Riyadh ophthalmology residency program between the years 2002-2012. A total of 126 graduates were invited through e-mails and electronic social media platforms to anonymously complete an electronic survey. The survey included questions that aim to assess the surgical competency of graduated ophthalmologists in doing various surgical procedures that were among the requirements of residency training.

Results: Ninety participants in the mean age of 38.7 years completed the survey. The majority of respondents (93%) joined fellowship programs and around half of them sub-specialized in anterior segment. More than half (55.6%) of the respondents reported that the acquired surgical skills during residency training were adequate. By the end of the residency period, the respondents' competency in doing extra capsular cataract extraction was better than phacoemulsification while 52% of them reported incompetence in both glaucoma and strabismus surgeries whereas the majority were incompetent in oculoplastics' procedures (e.g. entropion repair). However, the majority felt competent in doing primary repair, minor and laser procedures. Lack of exposure was the major cause of such incompetency.

Conclusion: This self-reported survey showed that the lack of adequate surgical exposure during residency training was the main reason of incompetency. This resulted in reduction of ophthalmologists' future practice of surgical procedures outside the scope of their sub-specialty. This emphasizes that physicians mainly practice what they surgically acquire during their fellowship training.