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Project trains Chinese physicians to meet need for cataract surgery
A group of faculty and residents from Dean McGee Eye Institute is helping speed the process of training Chinese ophthalmologists.
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An outreach project designed to more quickly train Chinese medical residents in the country’s largest province could help meet an increasing need for cataract surgeons there.
 John A. Hovanesian |
Bradley K. Farris, MD, spearheads an exchange program of faculty and residents from the Dean McGee Eye Institute in Oklahoma to the Sichuan Provincial Hospital in Sichuan province’s capital city, Chengdu, through the nonprofit group Heart-to-Heart International to deliver services. In the past 5 years, he and colleagues have been demonstrating to Chinese faculty how residency training can be administered quickly and effectively.
“It’s a cultural exchange with the net effect of helping the Chinese get their treatable blindness problem addressed,” Dr. Farris said. “It’s been wonderfully advantageous for both.”
This year, the Sichuan Provincial Hospital opened a new eye training residency center based on the project, he said. This fall, the Eye Doctor Training Center will begin training the first three residents in a 3-year program.
“It turns out to be a wonderful learning experience for both the Chinese and American teams, and the result is that treatable blindness is slowly being addressed in rural China in a way that’s most efficient. The Chinese can take great pride because they’re the ones doing the work, not us,” Dr. Farris said. “We come home with a great sense of satisfaction, knowing that we’ve helped their education system, and we’ve learned much from them. They’ve taught us so much on how to work with what you have in an efficient manner.”
How it began
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Preventable blindness from mature cataracts poses considerable problems in rural China, according to Dr. Farris. Those who are blinded by mature cataracts often cannot work and have problems with everyday tasks. Sichuan province alone has more than 500,000 residents who are blind from mature cataracts, Chinese officials have said. Although Chinese medical training can meet the need for safe, effective cataract surgery, the number of ophthalmologists in practice cannot, Dr. Farris said. The residency program there currently spans up to 15 years, compared with the typical 3-year American program.
“The problem was that treatable blindness was increasing, and they had a small amount of experienced cataract surgeons available,” he said. “We could see right away that they were not training their eye surgeons at a sufficient rate to meet the needs of the community.”
Dr. Farris said a more traditional approach of ophthalmic outreach, such as taking a mobile U.S. or international unit of ophthalmologists to the province for a short time, would be superficial at best. A more permanent solution was required.
That solution came in the form of the Chinese-based education training project. In 2002, Dr. Farris was first approached by officials from Heart-to-Heart International, a Kansas-based humanitarian organization. Officials requested his assistance and a partnership with the Dean McGee Eye Institute in organizing an ophthalmic project in Sichuan province. The organization had been working with the Sichuan province health bureau and the Sichuan Provincial Hospital. Officials there were looking for a way to address preventable blindness, Dr. Farris said, and were willing to explore different approaches.
At first, Dr. Farris said he did not think he could juggle the project with his work as professor at the University of Oklahoma School of Medicine. However, after repeated requests from Heart-to-Heart International, as well as encouragement from Dr. David Parke, chairman and CEO of Dean McGee Eye Institute, Dr. Farris agreed to assist. He and officials from Dean McGee Eye Institute went to Sichuan and began working with faculty there to develop a core curriculum residency program.
“We have introduced basic core curriculum that would be typical for an American ophthalmology residency. We have shared with them the various subspecialties of ophthalmology that they can teach, and we’ve tried to introduce more efficient surgical training, so that we can help get their residents up to speed and get them sent out quickly,” he said.
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Images: Farris BK |
How it works
The program will add three Chinese residents to a fast-track education residency at Sichuan Provincial Hospital each year. Residents will be trained by Chinese faculty in small-incision extracapsular cataract extraction and phacoemulsification, completing their training in 3 years.
“The impact to this area of the world will be gradually felt in increasing numbers over years,” Dr. Farris said. “What a team of three American surgeons could only do in 2 weeks, three additional Chinese surgeons will be doing every day, throughout the year, at the same skill level as the three American surgeons would only do in several weeks [when visiting]. Multiply that years upon years, with an additional three surgeons a year being sent out. I couldn’t even begin to estimate the number or the impact on the community, but the concept, clearly, makes a lot of sense.”
Heart-to-Heart International has assisted by coordinating interpreters to assist with the Mandarin-English language barrier, planning and staffing a mobile eye unit to treat patients in rural China.
“Heart-to-Heart International takes care of everything,” Dr. Farris said. “The red carpet is rolled out. It’s invaluable.”
An exchange program has also been going on between Dean McGee Eye Institute and the Sichuan Provincial Hospital, with Chinese residents and faculty visiting the United States to see first-hand the residency program at Dean McGee Eye Institute, Dr. Farris said.
Every May since 2002, Dr. Farris has taken a team of three American ophthalmology senior residents and four to seven American faculty members to Sichuan Provincial Hospital. The American faculty and residents spend several weeks lecturing Chinese residents about Western medical technologies and demonstrating cataract, strabismus, glaucoma and other subspecialty surgeries and medicine. They also provide an overview on the American education system and residency program.
In return, the Chinese residents and faculty demonstrate surgical techniques and skills, Dr. Farris said. The exchange of ideas has been excellent, with both sides benefiting from the interaction, he said.
“It is great to give our American residents an opportunity to see how you can give back from what you’ve been taught,” Dr. Farris said. “They’re excited about going to China and participating in lectures and demonstration surgery with the Chinese ophthalmology residents. It is more important for the Chinese residents and faculty to see what we can do at Dean McGee in 3 years with a resident, showing them that an American resident can be trained in 3 years to go out into the community and do excellent cataract surgery.”
For more information:
- Bradley K. Farris, MD, a professor of ophthalmology and adjunct professor at the University of Oklahoma School of Medicine, Dean McGee Eye Institute, can be reached at the Center for Healthy Living Office, Neuro-Ophthalmology, Suite 390, 1000 N. Lincoln Blvd., Oklahoma City, OK 73104; 405-271-1091; fax: 405-271-1226; e-mail: bradley-farris@dmei.org.
- Heart-to-Heart International can be reached at 401 S. Clairborne, Suite 302, Olathe, KS 66062; 913-764-5200; fax: 913-764-0809; Web site: www.hearttoheart.org.
- Erin L. Boyle is an OSN Staff Writer who covers all aspects of ophthalmology.