Many opportunities are open for doctors specialising in ophthalmology to be at the cutting edge of research

EVERY little move is magnified between three to 10 times under the microscope as the eye surgeon skillfully manoeuvres the instrument into the eye.

The incision she makes is so tiny that no suture is required when the operation is done and the patient can see clearly again.

Ophthalmology is a highly competitive specialty that sees dozens of fresh graduate doctors competing for the few places available each year at the Singapore National Eye Centre (SNEC).

Those who are accepted go through three years of basic training and three years of advanced training before they are certified as an eye specialist, or ophthalmologist.

It is a long and challenging process that involves diagnosis of eye diseases and mastering at least 10 different surgical and laser techniques.

This means observing senior doctors performing surgeries, practising on 10 to 20 pig’s eyes in the wet lab before actually beginning supervised training on real patients.

“A young specialist would have had done 100 supervised operations before being given one simple cataract operation to handle on his own,” says Dr Daniel Su, a consultant in the glaucoma service and member of the training and education department at SNEC.

Every single surgical procedure is video-recorded through the operating microscope for a collective
review session.

There is also an annual audit of all the surgeries performed to ensure that complication rates remain low
and success rates stay ahead of world averages.

“The review sessions are not about fault-finding — they are collective sharing sessions to help everyone
learn how to improve his or her surgical technique and note the mistakes to avoid,” says Dr Su.

“Even qualified specialists like myself continue to attend the trainees’ teaching sessions because we
find them useful.”

A spirit of camaraderie permeates the trainee’s surgical and research mentorship in SNEC.

“Every surgery or research requires a team effort,” says Dr Su. “Trainee specialists are roped in to assist
in complex surgery as well as research projects.”

The Clinician Investigator Award encourages young specialists to set their sights on research by providing
funding for equipment and manpower support.

The senior doctors and trainee specialists look forward to the biannual Asia-ARVO meeting, which
is hosted by SNEC every four years.

Co-hosted by Association for Research in Vision and Ophthalmology (ARVO) in the United States, doctors and scientists from around the globe share their findings in cutting edge ophthalmic and vision research.

“It’s really important that we are challenged to rethink old ways of patient care and constantly seek to improve our skills in our endeavour to improve treatment outcomes for our patients,” says Dr Su.

The Asia-ARVO meeting is also an opportunity for young trainees to seek out learning opportunities at eye institutes in countries such as the US, Canada, UK, Australia and Japan.

In 2007, Dr Su earned a prestigious fellowship after an introduction to the chairman of the Duke Eye Centre in the US.

Doctors nearing the end of their advanced training are guided in their decision to undergo further specialised training in ophthalmology. They are encouraged to venture overseas for fellowship training in leading eye centres around the world.

The SNEC also welcomes eye specialists from other countries to train under the tutelage of its senior doctors through a fellowship programme for foreign doctors.

Says Dr Su: “Having an all-rounded education is not just about learning to take a good medical history, clinical examination techniques, diagnosis of disease and performing surgery.

“We teach our doctors to be responsible stewards of resources and advocates for the patient. A doctor’s word can greatly influence a patient’s decision to go ahead with a surgery or not.

“The risk-benefit analysis of a surgery should be about making a real difference in improving the patient’s quality of life.”