Ophthalmology residents (or registrars) in training from around the world always wonder if they are doing enough surgical volume during their training. The ophthalmology training can be very long in some places (such as 7 years in the UK!) compared to 4 years in the USA. The typical USA pathway is for an 18 year old to finish high school then do 4 years at a university to earn a bachelor’s degree. Then some do an option additional degree or a gap year to strengthen their resume. Then medical school is 4 years to earn the MD (or DO) degree. Then ophthalmology residency is 4 years and of these years the first year is often 9 months of general medicine internship and then 3 months of ophthalmology. So in total the ophthalmology residency training program in the USA is 3 years + 3 months = 39 months.
The ACGME (American College of Graduate Medical Education) has determined that a resident needs to perform 86 cataracts during residency as a primary surgeon. The other common surgical procedures are listed in this chart with S indicating surgeon and A meaning Assistant. This seems low but remember that the purpose of residency is to teach you the basics building blocks of ophthalmic surgery and then for you to continue with lifelong learning. I learned so much on my own because they did not exist when I was a resident 25 years ago: OCT, Anti-VEGF, tomography, femtosecond lasers, trifocal IOLs, EDOF IOLs, lamellar corneal transplantation like DMEK, all of MIGS, and so much more. You will continue to learn every day (by watching CataractCoach videos!) and you will keep advancing your skills and knowledge base. In the USA the average residency program gives about 150 to 200 cataracts to each resident. And busy programs may push that number to 300 or more. But even if you just do the 86 required cases, do not fear — you can still become a good surgeon with continued learning. And remember that 500 cataract cases is only half-way up the learning curve (at best!) — how many cataract surgeries did you perform in residency and was it enough?
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