Purpose: To survey recently graduated European ophthalmologists concerning cataract surgery (CS) training opportunities. Setting: Countries affiliated to the European Board of Ophthalmology (EBO). Design: Cross-sectional study of anonymous survey results. Methods: A 23-question online survey was emailed to candidates who sat the EBO Diploma Examination as residents between 2018 and 2022. Results: 821 ophthalmologists from 30 countries completed the survey. The mean residency duration was 4.73 (SD 0.9) years. The mean reported number of entire CS procedures performed was 80.7 (SD 100.6) at the end of residency, but more than 25% of respondents (n = 210) had received no live CS training during their residency. The self-confidence (scale, 1 to 10) to perform a simple case or challenging case, manage posterior capsular rupture, and realize a corneal stitch were rated 4.1, 3.2, 4.2, 2.4, respectively. We observed extensive variation in clinical exposure to CS and self-reported confidence to perform CS between European trainees. Females reported a mean of 18% fewer entire procedures than their male colleagues and were also less confident in their surgical skills (P < .05). Trainees in residency programs longer than 5 years performed fewer procedures and were less confident than trainees in residences of shorter duration (P < .001). The importance of fellowships to complete surgical education was rated 7.7 out of 10. Conclusions: CS training across European countries lacks harmony. Female ophthalmology trainees continue, as in other specialties, to experience apparent gender bias. European level recommendations seem necessary to raise and harmonize competency-based CS training programs and promote post-residency fellowship training programs.

The comprehensive European Board of Ophthalmology Diploma (EBOD) examination is one of 38 European medical specialty examinations. This review aims at disclosing the specific procedures and content of the EBOD examination. It is a descriptive study summarizing the present organization of the EBOD examination. It is the 3rd largest European postgraduate medical assessment after anaesthesiology and cardiology. The master language is English for the Part 1 written test (knowledge test with 52 modified type X multiple-choice questions) (in the past the written test was also available in French and German). Ophthalmology training of minimum 4 years in a full or associated European Union of Medical Specialists (UEMS) member state is a prerequisite. Problem-solving skills are tested in the Part 2 oral assessment, which is a viva of 4 subjects conducted in English with support for native language whenever feasible. The comprehensive EBOD examination is one of the leading examinations organized by UEMS European Boards or Specialist Sections from the point of number of examinees, item banking, and item contents.

A survey conducted by the European Board of Ophthalmology (EBO) revealed significant differences in the surgical training of the ophthalmology residents in Europe, including a disparity between the sexes and a variation in the experience on cataract surgery (CC) between them. This study is about the Spanish sub-cohort of the survey, and its objective is to present and analyse the peculiarities of ophthalmology training in Spain within the European context, as well as discussing ways to harmonise and improve that training throughout the EU. We analyse data of the Spanish participants in the EBO exams, defining subgroups by the Autonomous Communities existing in Spain. 93 of 135 requested participants (68.9%) responded. A 60.2% passed the EBO exam between 2021-2022, being mostly women (65.59%) aged 31 years old on average. The 91.4% were right-handed, coming from 13 of the 17 Spanish autonomous communities, although mostly from the Community of Valencia, Madrid and Catalonia. Respectively, 16.1%, 3.2% and 8.7% of the respondents said they have completed 10 or more training sessions on animal eyes, synthetic eyes and through the virtual reality simulator. This training was correlated with greater self-confidence in the management of a posterior capsular tear during surgery (p .025). All respondents manifested to have already performed stages of the CC. The average number of operations reported was 181.6 with regional disparities. A significant difference is observed between the sexes against women (-28.3%, p 0.03). Ophthalmologists in Spain, much more than other European countries, have greater opportunities for surgical training, with surgical procedures during the residency, that nearly triples those made by the others. Spanish women refer, like their European colleagues, to be in disadvantage in learning opportunities about cataract surgery. The Simulation Based Medical Education (SBME) allows to respond to the training deficit and complements the training on the patient. Although we demonstrate a significant correlation between the number of procedures carried out and self-confidence to operate simple cases, the SBME would be a complementary tool in self-confidence in front of a complication like capsular rupture. Spain massively adopts the model named by us "surgery for all", despite the underrepresentation of women in this area, emphasising a need for cultural change that the SBME could facilitate.

Background and Objective: To compare the cost and utility of scleral buckle (SB) and pars plana vitrectomy (PPV) techniques for repairing moderately complex rhegmatogenous retinal detachment (RRD). Patients, Materials, and Methods: A cost-utility analysis was conducted using data from the Primary Retinal Detachment Outcomes Study (PRO) and a study conducted by the author. Total costs, patient utility over a lifetime, and cost per quality-adjusted life year (QALY) were calculated for each surgical procedure. Results: The cost of scleral buckle surgery was € 287.93, with an estimated lifetime QALY of 7.49. Costs per QALY were € 38.44. According to the PRO study and Belin et al, total costs were $5975, with a lifetime QALY of 5.4 and costs per QALY of $1106. The cost of pars plana vitrectomy (PPV) was € 1468.26, with an estimated lifetime QALY of 6.84 and costs per QALY of € 214.65. Based on the PRO study and Belin et al, total costs were $8125, with a lifetime QALY of 4.7 and costs per QALY of $2196. Conclusion: Repairing moderately complex RRD presents a highly cost-effective profile for both SB and PPV techniques, well below recommended QALY thresholds. SB demonstrated a slightly more favorable profile compared to PPV.

The European Board of Ophthalmology (EBO), whose mission is to guarantee high standards of care in ophthalmology, has assessed residency training quality for over 30 years through the EBO Diploma (EBOD) examination, undertaken by residents and certified ophthalmologists from the 27 European Union member states as well as Norway, Switzerland, the United Kingdom, and Türkiye. Preparation for the EBOD is largely self-directed, conducted alongside demanding clinical duties, and relies mainly on asynchronous learning. This study aimed to analyse trends in the use of learning tools among European residents and ophthalmologists preparing for the EBOD and factors associated with their choice of study resources. A 27-item online survey was distributed to past (2016 to 2024) EBOD candidates. Data collected included demographics, study habits, learning resources, meeting attendance, and financial support. Univariable and multivariable logistic regression analyses were performed to analyse associations between use of learning tools and gender, examination year, clinical workload, study time, English proficiency, and country of training. A total of 633 responses (response rate, 10%) from 31 countries were analysed. Book use was high (92%) and stable over time. Respondents who sat the examination before 2020 were more likely to read journal articles (p < 0.0001, OR 2.47, 95%CI 1.56-3.92) and less likely to use social media (p = 0.002, OR 0.58, 95%CI 0.41-0.82), websites (p = 0.018, OR 0.51, 95%CI 0.29-0.88), and smartphone applications (p = 0.019, OR 0.55, 95%CI 0.47-0.94). Candidates reporting fewer than the median of study hours were less likely to read journal articles (p = 0.0002, OR 0.49, 95%CI 0.34-0.72). Candidates receiving financial support attended international meetings more frequently than those without support (p < 0.0001). Differences in digital tool use and funding sources were observed among the five most represented countries (France, Germany, Spain, Switzerland, and Türkiye). EBOD candidates demonstrate increasing engagement with digital learning tools. Associations between learning resource use, examination year, study time, and country of training highlight the need for adaptable educational strategies reflecting evolving technologies and diverse learner profiles.