Presentation by Brad H. Feldman, MD at the 2016 Association of University Professors of Ophthalmology annual meeting in Fort Lauderdale, Florida.

1. U.S. Residencies Promoting
International Training
Brad H. Feldman, Wills Eye Hospital
January 28, 2016

2. U.S. Residencies Promoting
International Training
• Resident interest as the driving force
• What’s being offered?
• Is residency the right time for this?
• The Wills Eye Int’l Residency Experience

3. References:
Surveys from 2005, 2011, 2012, 2014
1. Gattey DM, Lauer AK. International Ophthalmology in
Training Programs. Ophthalmology. 2006; 113(12): 2379-2380.
2. Tibbetts MD, Feldman BH. Wills Eye International Elective
Survey. July 2011.
3. Coombs PG et al. Global Health Training in Ophthalmology
Training Programs. J Surg Educ. 2015 July-Aug; 72(4): e52 –
e59.
4. Welling J et al. Global Ophthalmology Training
Opportunities in US Residency Programs: A Survey of Program
Directors. 2015. Submitted for Publication.

4. Resident Interest as the Driving Force
Nearly all residents are interested these
electives
From Wills Eye survey2:
24/24 interested, even if no credit awarded
21/24 would prioritize over another elective
18/24 felt offering an int’l program makes the
residency more desirable

5. Resident Interest as the Driving Force
• 63% of PDs believe int’l electives
influence medical students’ match
choices3
• Multiple residents tell me that our int’l
offerings played an outsized role in their
match list decision-making

6. What’s Being Offered? 3
2005
(out of 43)
2012
6
9
34
5
,1

7. What’s Being Offered? 3,4
 PGY-3 or PGY-4 in good standing 4
 2 weeks long (range 7 – 35 days)4
 Financial support given 3
 Academic time allotted 4
 Surgical & clinical experience 4

8.  Barriers cited by PDs 3
:
 Financial
 Coverage/time
 Lack/hassle of ACGME credit
 Difficulty arranging experience
 Safety & liability
Is Residency The “Right Time”
For This?

9.  This should be a positively disruptive experience
for our residents
 Significantly alter the path they choose and
how they practice
 Create awareness & perspective
 Ignite a passion for global health
 Establish a new network for continued global
pursuits
Is Residency The “Right Time”
For This?

10.  This should not be a negatively disruptive
experience for the visited communities
 Drain on local resources or eye care network
 Creation of dependency on charity
 Surgical complications and subsequent
mistrust
 Real or perceived exploitation
Is Residency The “Right Time”
For This?

11. Is Residency The “Right Time”
For This?
 If in residency, allows for proper instruction on:
 Effects of foreign intervention on community
 Ethical issues while working abroad
 Critical safety, legal & logistical
considerations
 Enables graduates to more effectively
participate in global ophthalmology

12.  2012 launch
 Demonstrated demand -> Faculty buy-in
 Created MoUs with 2 int’l partnering sites
 2013 funded by alumni society
 Enthusiasm & knowledge of returning
residents convinced society leaders of value
Wills Eye International
Residency Experience

13.  Structure:
 1-2 weeks (vacation matched by academic)
 PGY-4 must apply for the privilege
 2K reimbursed (above that resident pays)
 Travel to pre-approved partnering sites
 Pre-travel orientation, didactics, health
exams, licensing/documentation review
Wills Eye International
Residency Experience

14.  20 resident participants
 Kenya, Peru, Haiti, Rwanda, Dominican Republic,
Swaziland, Japan
 All complete extensive post-experience
evaluation & present to faculty during special VP
 End of year review of residents by partnering
sites
 Annual assessment of partnerships
Wills Eye International
Residency Experience

15. Wills Eye International
Residency Experience
• All 6 AGME core competencies consistently met
• Residents’ point to these 1-2 weeks as the best of their PG
training and say it reminds them why they wanted to be
docs:
This experience galvanized my desire to serve others who are in
great need.
I saw new pathology I had only read about. This experience
expanded my horizons.
This kind of experience highlights what really matters in
medicine.
Ehrlich JR, Hannush SB, Feldman BH. Opportunity for surgical education and fulfillment of ACGME core
competencies: Wills International Residency Experience. Poster presentation. ASCRS 2015. San Diego.

17. Thank you
www.aupo.org