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Muñoz-Negrete, M.P. Villegas-Pérez" "autores" => array:2 [ 0 => array:4 [ "nombre" => "F.J." "apellidos" => "Muñoz-Negrete" "email" => array:1 [ 0 => "franciscojmunoz@telefonica.net" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "M.P." "apellidos" => "Villegas-Pérez" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, IRYCIS, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Presidente de la Comisión Nacional de la Especialidad de Oftalmología" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Hospital General Universitario Reina Sofía, Universidad de Murcia, Murcia, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Vicepresidente de la Comisión Nacional de la Especialidad de Oftalmología" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Sobre la necesidad de actualización del programa oficial de la especialidad de oftalmología en España" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We found the editorial by González Martin-Moro et al.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> on the need to update the official Ophthalmology Specialty Program (OSP) very interesting. However, at the National Commission of the Specialty (NCS) of Ophthalmology we believe it advisable to clarify some aspects.</p><p id="par0010" class="elsevierStylePara elsevierViewall">As the authors rightly point out, the OSP for our specialty is now 14 years old and during this period Ophthalmology has presented numerous advances that logically are not included. Its modification corresponds to the NCS of Ophthalmology, which has repeatedly submitted this request to the Subdirectorate General for Training and Professional Organization of the Ministry of Health. The response is that, despite being in agreement, the updating of the OSPs of specialties must be carried out progressively and chronologically, so we must wait our turn (there are still OSPs from 1996 that have not yet been updated).</p><p id="par0015" class="elsevierStylePara elsevierViewall">With regard to the time off for on-call duty, we do not believe that this is a reduction in training, because on-call duty is an essential part of training and, taking into account its duration of 24 h, the time off for the following day is amply compensated.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Regarding the suggestion to extend the period of residency, the average duration in the European Union (EU) is 4 years and in the United States and Canada it is 3 years. It is worthy noting that the number of surgeries performed by residents in the EU is lower in countries with longer periods of residency. Thus, in countries with a residency duration of 5 or more years, the average number of complete cataract surgeries performed during the entire training period is 59.6, while in countries with a duration of less than 5 years it is 111.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a> When the OSP can be updated, we will also have to take into consideration the "European Training Requirements" (ETR) that the <span class="elsevierStyleItalic">European Union of Medical Specialists</span> (UEMS) has begun to draw up for Ophthalmology in order to be in line with the rest of the EU countries in terms of duration and content, taking into account our healthcare peculiarities.</p><p id="par0025" class="elsevierStylePara elsevierViewall">With regard to subspecialties, Royal Decree 589/2002, of July 19, 2002, on transversal training in Health Science specialties, regulates the creation of specific training areas, which will be the official name for subspecialties in Spain. We recently published an editorial on this subject.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">In addition, it is suggested that the OSP require that the resident does not start clinical surgery before acquiring skills with simulators. Evidently, these can be of great help to increase patient safety, reduce the learning curve and the suffering of teachers.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,6</span></a> However, surgical simulation has not been included as mandatory in training in any country given its high cost, continuous evolution and difficult access. Its usefulness as a complement in surgical training is undeniable, but it should never be a substitute for surgery in patients.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,6</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The classic form of surgical teaching is still in force and is the only feasible form for most ophthalmological surgeries. In our country and in our specialty, teachers have provided the resident with theoretical training, in experimental operating rooms, with visualization of surgeries and facilitating access to surgery in a progressive and always supervised manner. In this way we have trained thousands of ophthalmologists in the last decades, who have obtained a magnificent surgical preparation which most of the countries of the European Union look up to.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Lastly, the NCS of Ophthalmology considers that the current teaching accreditation criteria are very undemanding and allow the accreditation of centers with questionable capacity for complete training in the specialty. We intend to update them when we are allowed to modify the Ophthalmology OSP.</p><p id="par0045" class="elsevierStylePara elsevierViewall">We would like to end saying that, although we are aware that our OSP is outdated and in need of updating, we are certain that our teachers make a great effort to provide our residents with a magnificent ophthalmologic training, including the recent advances in our specialty, not yet included in the current OSP, which explains the high level of our specialty in Spain.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">None in connection with the present manuscript by all the authors.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reflections on the mandatory and urgent need to update the official formative program of the specialty in ophthalmology" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. 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"fecha" => "2022" "volumen" => "11" "numero" => "6" "paginaInicial" => "1961" "paginaFinal" => "1974" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/36001249" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735794/0000009900000005/v1_202405010625/S2173579424000173/v1_202405010625/en/main.assets" "Apartado" => array:4 [ "identificador" => "5813" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letter to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735794/0000009900000005/v1_202405010625/S2173579424000173/v1_202405010625/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579424000173?idApp=UINPBA00004N" ]
