SOE platform for YOs provides a useful tool for looking at fellowship offers in Europe

The database of current positions is a first step toward expanding fellowship opportunities and offers a paradigm shift in education.

Issue: August 2016

A platform for young ophthalmologists seeking fellowship opportunities across Europe is now available on the European Society of Ophthalmology website. The platform was set up by a subgroup of the Young Ophthalmologists committee and provides for the first time a complete picture of what is offered with the relevant information on where and how to apply.

Marko Hawlina, MD, PhD, chair of the SOE Education Committee, said that this database, located at http://soevision.org/fellowship-platform/, is part of a larger project aimed at fostering implementation of fellowship positions across Europe.

“Continental Europe does not have a formal fellowship system. Usually university hospitals offer postgraduate training that is in-house training for the best or most favorable young ophthalmologists after completing their residency program. Other young ophthalmologists do a fellowship in the U.K. (which may become by far more difficult after Brexit) or the U.S. and then return to their home countries. Many pay to be trained in intraocular surgery in India, where surgical training courses have become a huge business,” he said.

“This reflects the inadequacy of our system, something we need to address,” Hawlina said, echoing comments made by Peter Ringens, MD, PhD, FEBO, president of the European Board of Ophthalmology.

The database

Some years ago, a questionnaire was sent by the SOE to university centers across Europe. Most of the centers responded that they would be happy to have fellows but are unable to establish fellowships due to lack of a system that would provide an option to finance fellowships, such as what is in place in the U.K. or U.S.

“Probably times are ready for a change that is strongly advocated by the young generation of eye doctors. There are many challenges along the way, but we are determined to move with them and for them in this direction,” Hawlina said.

The SOE Fellowship Platform is a first step. Fellowship offers are classified as one of three types. First is post-specialist fellowships offered by hospitals. Most of them are in the U.K., but a few are in Switzerland, Finland, Italy, Germany and the Netherlands. The second type is post-specialist fellowships offered by professional societies, such as the European Society of Cataract and Refractive Surgeons, European Glaucoma Society, European School for Advanced Studies in Ophthalmology and European Association for Vision and Eye Research. The third is observerships and short fellowships for both residents and young specialists, offered by the European Board of Ophthalmology, International Council of Ophthalmology, SOE or ESCRS.

“We believe that this platform will encourage more centers to set up fellowships because they will gain visibility and at the same time the opportunity to have more applicants and select the best candidates. There are a lot of bright YOs who can potentially apply but up to now did not have the information,” Hawlina said.

Fostering implementation of fellowships

In a broader perspective, the project aims at developing strategies for expanding fellowship opportunities in Europe.

“Current appointments in continental Europe are usually meant for local young specialists who are offered a permanent contract. It is not customary to employ someone for 1 year or 2 and then see if he or she is a good candidate to remain, or to employ someone who comes from a different country for 1 year or 2, as the system of funding does not provide for that,” Hawlina said.

This is only partly due to the language, which remains a barrier particularly for small countries.

“Foreign students may know English, German, French or Spanish well, but it is more unlikely that they are prepared to learn Czech or Lithuanian. In our profession, being fluent in the language is very important for dealing with patients,” Hawlina said.

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A letter has been sent to all the institutions that are on the list of SOE training centers. They have been asked to state whether or not they want fellows, whether or not they would be able to pay them, and whether or not they would require the local language. A good number responded positively, and interestingly, initial knowledge of local language was not reported as mandatory in most centers that responded. If they have something to offer in terms of fellowship opportunities, they can now contact the society and advertise on the website. Some have already replied, Hawlina said.

“What we want eventually is a paradigm change,” he said. “We want to see most European teaching hospitals open the doors to bright people from abroad who can stay there for a short period or, why not, for a long time. We also want to see them evolve toward an entirely new concept of training. People who go there for just a few years are in the best age to produce something. There is a lot they can offer to the department if they are involved in research, in training younger residents, in writing papers and learning surgery. Shifting the paradigm means seeing them as a resource and not a burden.” – by Michela Cimberle

For more information:
Marko Hawlina, MD, PhD, can be reached at Eye Hospital, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; email: marko.hawlina@gmail.com.

Disclosure: Hawlina reports no relevant financial disclosures.

Rotterdam, where fellowships exist

At the Rotterdam Eye Hospital, we have several fellowship programs in place for retina, glaucoma and cornea as well as pediatric ophthalmology and strabismus. The first three have a duration of one semester to 1 year, may or may not be funded depending on several factors, and are aimed at providing specialized surgical training to national or EU candidates. The pediatric ophthalmology and strabismus fellowships are open also to non-EU candidates, have a duration of 3 months and focus on diagnosis, surgical indications and surgical techniques. They are paid by a child eye care foundation. Besides fellowships, there are observerships lasting 1 month, sponsored by the SOE. These are mainly attended by young ophthalmologists from Eastern Europe who come to the West to “sniff in a different kitchen.” I tell my fellows how important it is to do so and that they should look around, take the good parts of what they see and eventually make their own recipe. I also ask them to write in their final report what they think is positive in our settings and what they would do differently. This helps us improve and increasingly meet the needs of our fellows. Everywhere in Europe, YOs are screaming for more surgical training. In the Netherlands, like in the U.K., we have a good system of task delegation to optometrists, which allows us to gain a lot of time for surgery and specialized training and to implement fellowships programs in our institutions.

Jan Tjeerd de Faber, MD
OSN Europe Edition Board Member
The Rotterdam Eye Hospital, the Netherlands

Disclosure: de Faber reports no relevant financial disclosures.