Global Eye Health & Clinical Fellowship Programme

The Challenge

In recent years there has been increasing emphasis in some regions on developing more advanced skills in ophthalmology – sub-specialty training and more defined comprehensive ophthalmology. For example, this is reflected in initiatives led by the West African College of Surgeons (ophthalmology division) and the College of Ophthalmology of Eastern, Central and Southern Africa to build up regional sub-specialty capacity – with curriculum development and the review and approval of several centres. This has been supported by the expansion in the number of ophthalmologists who have received sub-specialty training from these regions, through schemes such as the Commonwealth Eye Health Consortium.

Alongside this there is also increasing emphasis being placed in training programmes on the development of an understanding of the public health aspects of eye care, to enable clinicians to begin to develop an understanding of the key issues and approaches to addressing these.

Programme Aims

To respond to these needs the International Centre for Eye Health (ICEH), the LV Prasad Eye Institute (LVPEI) and the Fred Hollows Foundation have developed an 18-month fellowship training programme that will strengthen individual capacity in public health and clinical skills. The overall aim of the fellowship is to equip ophthalmologists with the knowledge and skills to improve the eye health of populations they serve. It is also aiming to support the development of future leaders in eye health, with particular encouragement for female candidates.

The Programme

Part A – Public health training: e-portfolio in Global Ophthalmology. It will be a fellowship requirement that the e-portfolio is completed prior to the commencement of the comprehensive clinical training phase. It will combine a range of self -directed learning and interactive online sessions with subject experts along with completion of compulsory activities.

Online Compulsory courses as self-directed learning:

1	Ophthalmic Epidemiology 1. Basic Principles	3 weeks
2	Ophthalmic Epidemiology 2. Application to Eye Disease	4 weeks
3	Global Blindness: Planning and Managing Eye Care Services	6 weeks

Optional online Modules (minimum of 1 course required from list below) as self-directed learning:

1	Eliminating Trachoma	5 weeks
2	Diabetic Eye Disease: Building Capacity to Prevent Blindness	4 weeks
3	Retinopathy of Prematurity: Practical Approaches to Prevent Blindness	4 weeks
4	Glaucoma: A Public Health Approach to Preventing Blindness	4 weeks

Extended interaction – compulsory:

1	Facilitated sessions with subject experts on key topics (timetabled)
2	Completion of key formative assignments (timetabled)

These initial approximate six months would be done while based in the fellow’s home institution. An agreement would need to be reached, before starting the fellowship, with the home institution to release the candidate one day per week to work on the diverse elements of the e-portfolio and participate in the interactions with ICEH faculty.

Part B – Clinical Training in comprehensive ophthalmology, for one year with four core modules:

1	Introductory Module	2 months	comprehensive ophthalmic evaluation and diagnosis and management of ocular emergencies
2	Cataract Module	4 months	cataract surgery – small incision and phacoemulsification with IOL
3	Glaucoma management	3 months	medical and surgical management of various types of glaucoma
4	Medical Retina	3 months	management of diabetic retinopathy, retinal vein occlusion, choroidal neovascular membranes and endophthalmitis

The clinical training will be focused to ensure that any clinical practice can be supported by the existing capacity and health system structure in the unit to which fellows will be returning to work. In the initial two years of the programme the plan is for the three candidates to be based at LVPEI in India in the same location together for mutual support and additional public health training/mentorship opportunities. LVPEI, in this initial phase, will concentrate on specific elements of ‘comprehensive ophthalmology’ to meet the needs of each candidate. For example, core training that is needed by recently qualified ophthalmologists working in relatively isolated clinical situations such as an eye unit in a district hospital. In short better trained ‘fit-for-purpose’ general ophthalmologists.

During Part B, the fellowship programme will build on the public health online training in Part A by providing opportunities to learn from programmes in and around the training centre they are based in. They will receive mentorship from a globally recognised expert in ophthalmic public health. They will undertake a structured programme one day a week. They will have an opportunity to develop draft plans for eye care strengthening within their context and specialty area. These plans can then be implemented on their return to their respective countries.

Training Curriculum

Each training institution will have their own formal written training agreement with the fellows, these typically include the core elements that would be covered and the anticipated surgical opportunities, expectations and exit competencies (we do not propose to outline these in this document as they will be different for each candidate).

Priority Countries

Eritrea
Ethiopia
Kenya
Tanzania
Uganda
Rwanda
Burundi
Afghanistan
Palestine

Objectives

Develop an understanding of the role of public health for eye care in strengthening health systems in their country and catchment areas.
Equip fellows to use a structured approach to applying public health principles in developing clinical services at a population and facility level.
Build core research skills for evidence-based eye health – both understanding and developing research.
Acquire additional practical clinical skills to enable individuals to deliver more effective comprehensive clinical ophthalmology services.
Facilitate personal development and career progression through self-reflection and critical appraisal.

Who should apply – eligibility

The opportunities will be targeted at ophthalmologists who have relatively recently completed their residency training in the list of countries above where FHF is particularly invested. The long-term plan is for clinical fellowships (both sub-specialty and comprehensive ophthalmology) to be based within the individual’s region where training placements make this possible. Initially, training will take place in one of the LVPEI campuses. A core programme focus will be to promote gender equity in the training of future ophthalmic leaders.

How to apply

Download application form here – Due Monday 3 July 2023 @ 12:00pm (BST)

Please complete the fellowship application form clearly. All information relevant to your application must be included on this form.

Additional documents to be included in your application:

Your CV.
Primary medical qualification certificate.
MMed / Residency completion certificate.
Letter from you, the candidate, providing a clear written commitment to returning to their home institution at the end of the fellowship period and continuing to work there for a minimum of two years.
Letter of support from the head of your department.
Letter of support from the head of your institution.

The letters from your head of department and your head of institution will need to state:

strong support for the candidate receiving this training.
how this combined public health and clinical training fellowship is relevant and desirable for their context.
that they will release the fellow from clinical duties for a minimum of 1 day per week during the first six months, in order study for the post-graduate e-portfolio in public health for eye care.
what the institution will commit to ensure that the fellow will be properly resourced (with a position, facilities and equipment) to develop ophthalmology their services on completion of the fellowship.
Confirm that there are no “safeguarding” concerns in relation to the candidate.