On the Ground, From Home

Historically, global ophthalmology education relied heavily on in-person volunteerism, primarily with a focus on cataract surgery. However, recent developments in technology combined with the COVID-19 pandemic have brought forth novel solutions to address public health disparities in eye care. These solutions extend beyond cataract treatment to encompass a broader range of curable causes of blindness. Central to this paradigm shift is the emphasis on sustainability and skills transfer.

This article explores various avenues for making a significant impact on global ophthalmology education from one’s home country. Entry points exist for physicians at all different stages of their careers, from medical students to seasoned attendings, and they include local global health courses, collaborative programs, remote teaching, virtual internships, and online lectures and podcasts. By embracing these innovative approaches, individuals can actively contribute to global ophthalmology education from anywhere and help to effect positive change.

CONSIDER FEEDBACK FROM THOSE ON THE GROUND

To gain a comprehensive understanding of global ophthalmology education, it is crucial to consider the feedback and insights from those who have engaged in these initiatives. Multiple factors play a role in their success, including ethical and economic implications and sustainability. By analyzing the experiences and perspectives of those involved, we can shape the future of global ophthalmology education and ensure its continued growth and effectiveness.

EXAMPLES AND CASE STUDIES

The following examples illustrate the impact and effectiveness of global ophthalmology education initiatives. These real-life experiences highlight the power of education to promote positive change and improve eye care outcomes worldwide.

Local Global Health Courses

Local undergraduate and medical programs play a crucial role in global health education. These institutions offer courses that focus on economic and social barriers to health care, cultural considerations, and ethical issues related to short-term international medical services. Students in these courses can engage in community-based projects, clinic observations, and workshops to deepen their understanding and foster a sense of purpose in their future careers.

I have served as a course leader for the University of Dayton’s Perspectives in Global Poverty and Health in Oaxaca, Mexico. This semester-long course consisted of weekly lectures and group projects, culminating in 9 days on site in Oaxaca. While there, students participated in service-learning projects that included daily engagement with a community after-school program, visited the homes of students, rotated in clinics, worked with a traditional healer, studied traditional medicinal plants in a botany center, and participated in community mapping on nutrition and obesity.

As the physician lead, I did not provide direct clinical supervision, but rather, I was there to compare and contrast health care systems and discuss the ethical considerations related to providing short-term international medical services. Facilitating small-group evening reflections helps students to connect academic study with practical experience working in a different community abroad.

Collaborative Programs and Skills Transfer

Collaborative programs such as the Surgical Eye Expeditions, Indian Muslim Relief & Charities, Syrian American Medical Society, and Islamic Medical Association of North America exemplify long-term commitment to sustainable eye care. These programs have partnerships with local nongovernmental organizations and facilitate comprehensive health initiatives that prioritize preventive care, referrals for procedures to local doctors, and technical training for local health care professionals. Such programs ensure knowledge and skills transfer, empowering local communities to address eye care needs effectively.

Many of these outreach programs (traditionally referred to as mission trips) require extensive needs assessments, prescreening, advertising of the mission beforehand, and collaboration with host institutions to provide hospital and clinic space. Much of this leg work requires continuous communication with the host country, much of which is done from one’s home country. The best programs provide local communities with in-depth sustainability and follow-up for patients until the next mission begins.

Remote Medical Education

In countries with a shortage of educators, innovative initiatives like the University of Global Health Equity in rural Rwanda are making a significant impact. This program, in collaboration with institutions like the California University of Science and Medicine, focuses on building medical educator capacity through faculty development programs. In countries with a shortage of attendings, physicians can pair with local medical schools and teach on virtual platforms. These initiatives involve remote teaching, curriculum development, and clerkship collaborations, enriching the learning experience for medical students.

Virtual Internships

Virtual internships provide opportunities for students based in one country to collaborate with researchers and ophthalmologists in other countries. Through these initiatives, students can be actively involved in research and gain skills to publish and present their work. This requires a dedicated physician at the site who can mentor and lead research questions with periodic check-ins and assessments of key research initiatives.

Host Programs

Many academic centers host mini fellowships that allow physicians from low-resource countries to visit and learn specific skills to take back to their home countries. One example is Global Eye SITE, an innovative specialized training program at Bascom Palmer Eye Institute in Miami that hosts skilled surgeons from areas of need for 3 months. During this time, the surgeons receive training in the treatment and management of pediatric glaucoma, with a curriculum that covers the workup and management of childhood glaucoma, ocular syndromes, and ocular genetics. Participants are given the opportunity to work with leading specialists in pediatric glaucoma, pediatric ophthalmology, and genetics. Global Eye SITE Scholars are supported with travel expenses and accommodations in Miami and are provided the instruments required to put their newfound surgical skills to use when they return to their home country.

Podcasts and Online Resources

In addition to the numerous courses on Cybersight, Orbis International’s online training platform, which is geared toward practicing ophthalmologists, educational resources also exist for aspiring ophthalmologists in their undergraduate and medical school years. Student-led initiatives such as Honestly Bilal and Open Globe Talk are great examples of podcasts that can serve as incredible resources for medical students and residents looking to learn about ophthalmologists working in the global ophthalmology space.

CONCLUSION

With advances in technology and a focus on skills transfer and long-term solutions, there are more opportunities than ever to participate in global outreach without leaving one’s home country. Global ophthalmology begins at home, with educating oneself about the logistics and ethics of outreach initiatives. Self-learning and pairing with mentors who are aligned with one’s values are key to making a sustainable impact.