Ophthalomology?!-Who needs to learn that?

March 15, 2005

In the first issue of Ophthalmology Times after assuming the mantle of chief medical editor, I wrote a piece praising this publication as an effective instrument for providing important, clinically relevant information in ophthalmology. I wish the same could be said for America's medical schools.

In the first issue of Ophthalmology Times after assuming the mantle of chief medical editor, I wrote a piece praising this publication as an effective instrument for providing important, clinically relevant information in ophthalmology. I wish the same could be said for America's medical schools.

Let me explain. Each year, the Association of University Professors of Ophthalmology ( http://www.aupo.org/) convenes in some lovely setting. The attendees are largely department chairpersons and residency program directors from about 125 departments across the United States. The idea is to have a forum where academic leaders can learn from each other about how best to teach their residents and fellows, survive the changes in the healthcare system, strengthen their research programs, etc. For a new chairperson, it represents an opportunity to seek out advice from the most successful chairpersons and to learn some of the things about the position that were taught in medical school.

At this most recent meeting, I learned there is something else they don't teach you in medical school, and it's called ophthalmology. A speaker at the podium asked for a show of hands of those departments where the medical curriculum had a required rotation in ophthalmology. About one-fifth of the hands went up, including my own. No required rotation in ophthalmology and about 80% went up.

But why should a dean worry about strengthening a department that does not even have a serious place at the table when it comes to educating his/her medical students? For all I know, perhaps at some schools the ophthalmology faculty are relieved that they do not have to teach every student some of the basics about eye diseases and clinical care in our field. By extension, why should a brilliant medical student consider a career in our field if he or she has no exposure to it, and observes that house officers on the medical and surgical wards are getting by just fine without doing basic examination of the eye, including direct ophthalmoscopy, on every patient?

As an academic ophthalmologist, this trend disturbs me greatly, and I hope we can do something about it. I would like the AUPO and perhaps the American Academy of Ophthalmology to help educate all medical school deans about this issue. Perhaps those of you with influence in your local medical school can also help its leaders to realize what a minority of deans-including mine at Johns Hopkins University School of Medicine-understand, namely that educating our future physicians about the eye is important, and that a medical school that aspires to be great should have a department of ophthalmology that is excellent.

And I would like to offer a medical school dean who doesn't think it is important to educate U.S. medical students about the eye the chance to tell us why in some future issue of Ophthalmology Times.

Peter J. McDonnell, MD is director of The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, and chief medical editor of Ophthalmology Times. He can be reached at 727 Maumenee Building, 600 North Wolfe St., Baltimore, MD 21287-9278. Phone: 443/287-1511Fax: 443/287-1514 E-mail: pmcdonn1@jhmi.edu