Surgical competency in residents

To review the literature for recent work that will help educators develop programs to produce residents who are competent cataract surgeons.

Medical educators feel increasing pressure from the Accreditation Council for Graduate Medical Education (ACGME) to emphasize competence in our residency program graduates. Residency program director and resident graduate surveys show problems in our ability to produce cataract surgeons competent in all areas. The resident surgery learning curve increases the risk of complications in early cases. Several recent papers address curriculum development, which may be of interest to cataract teachers and program directors. Assessment of surgical skill continues to be an area of interest and has prompted some interesting work. The use of simulation with wet laboratories and computer devices is of increasing interest in an effort to hasten the learning curve.

An organized surgical curriculum with defined expectations using simulation and assessment tools will help residency programs meet ACGME mandates. A competent resident in cataract surgery will have to develop skills in all of the six ACGME competencies. Several recent articles address these issues.