AT A GLANCE

  • As it did with all other aspects of society, the COVID-19 pandemic upended the process of ophthalmic education in 2020.
  • Clinic visits and surgeries were canceled, but learning has still taken place through remote and virtual means.
  • Some of the changes instituted due to the crisis this year show promise to be carried forward for future trainees.

For many, 2020 is a year with special meanings. It marks the beginning of a new decade, a time for new beginnings, exciting resolutions, and big dreams. For many doctors in training, 2020 will mark the year of their graduation from medical school, residency, or fellowship. This is the culmination of many years of hard work and studying on their way to becoming an intern, a resident, a fellow, and ultimately to starting a new life as a practicing physician and surgeon.

Many also looked forward to 2020 as the year of ophthalmologists, as 20/20 VA is the hallmark of good vision. However, as we all know by now, it has been a year full of challenges. As the new decade started unfolding, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its associated disease, COVID-19, were reported in Wuhan, China, leading to a rapid epidemic outbreak. On March 11, the World Health Organization declared COVID-19 a pandemic,1 with sustained risk of further global spread.

In the following months, COVID-19 spread worldwide to 188 countries, with more than 25 million cases confirmed and 280,000 deaths as of early September.2 From an isolated outbreak to a pandemic labeled the worst public health crisis since the 1918 flu pandemic in a matter of months.

Soon after its auspicious beginning, 2020 became the year of pandemic with all dreams and resolutions put on hold. Many countries ordered lockdowns to avoid rapid transmission of the virus. Social distancing measures were implemented worldwide, and everyone was encouraged to wear a mask when in public. Health care systems across the world experienced unprecedented burdens, and all specialties of medicine have been profoundly affected. All individuals have been involved in the fight against this disease.

Ophthalmologists soon learned that the use of personal protective equipment (PPE) was necessary to limit the transmission of the virus. Given the requirement in our specialty to be physically close to the patients’ eyes during routine eye exams, use of PPE was key to allowing us to safely perform ophthalmologic examinations.

In a recent report, ophthalmologists were noted to be one of the medical specialties most profoundly affected by COVID-19.3 During this exceptionally challenging time, we were called upon to make difficult decisions for which we did not receive any formal training. Ultimately, we faced the challenge of optimizing our clinical practice to try to balance the benefit of treating patients to prevent vision loss against the maintenance of a safe clinical environment for all.4 We also experienced a notable reduction in clinic volume as routine visits and elective surgeries were canceled or postponed in order to protect asymptomatic patients and providers.5

TRAINING AFFECTED

The outbreak inevitably affected all ophthalmologists-in-training and our educational experiences. To the challenges of the training itself we had to add the challenges of being in training during this global health crisis: the uncertainty of the future, the fear of not being able to learn everything, the need to rapidly acquire new learning methodologies, the stress of transitioning from in-person visits to virtual interviews for future positions, the challenges of conducting research projects remotely and with reduced clinical volume.

Conferences and in-person meetings were canceled with the introduction of physical distancing norms, reducing networking and collaborative opportunities for trainees. On the other hand, the great progress in communications technologies during recent decades gave us the possibility to connect to our mentors using virtual platforms.

In order to provide high standards in ophthalmic research while ensuring safety during the pandemic, our research institution transferred our activity remotely and planned weekly virtual meetings to connect us to our mentors to present ongoing research and to discuss future proposals. Grand rounds, seminars, and conferences were also transferred online. The growth of webinars, podcasts, and online teaching tools allowed us to exchange ideas, interact with our colleagues, network, present challenging cases, and build a new model for acquiring medical education remotely.

Furthermore, the use of social media to communicate scientific information, educate patients, and build new professional connections increased exponentially.6 These virtual opportunities compensated for the lack of in-person meeting and learning due to the pandemic.

NEW FRONTIERS

The events of 2020 have introduced a series of changes in the mentoring of future ophthalmic professionals. These changes have pushed us to discover new frontiers in ophthalmic education. Even though they were forced on us by a crisis, some of these changes appear to hold promise to positively impact the training of future young ophthalmologists. Perhaps they will be adopted as part of the academic education model of the future.

1. World Health Organization. Coronavirus Disease 2019 (COVID-19) Situation Report - 51. March 11, 2019. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200311-sitrep-51-covid-19.pdf?sfvrsn=1ba62e57_10. Accessed September 2, 2020.

2. COVID-19 Dashboard. Johns Hopkins University. https://www.arcgis.com/apps/opsdashboard/index.html?et_rid=1745628662&s_campaign=fastforward:newsletter#/bda7594740fd40299423467b48e9ecf6. Accessed August 5, 2020.

3. Ing EB, Xu QA, Salimi A, Torun N. Physician deaths from corona virus (COVID-19) disease. Occup Med (Lond). 2020;70(5):370-374.

4. Corradetti G, Corvi F, Nguyen TV, Sadda SR. Management of neovascular age-related macular degeneration during the COVID-19 pandemic. Ophthalmol Retina. 2020;4(8):757-759.

5. Olivia Li JP, Shantha J, Wong TY, et al. Preparedness among ophthalmologists: during and beyond the COVID-19 pandemic [published correction appears in Ophthalmology. 2020;127(8):1131]. Ophthalmology. 2020;127(5):569-572.

6. Tsui E, Rao RC, Carey AR, Feng MT, Provencher LM. Using Social Media to Disseminate Ophthalmic Information during the #COVID19 Pandemic [published online ahead of print June 2, 2020]. Ophthalmology.