Digital Training Hubs

Sandwich fellowship program combines a series of training modalities to overcome the common barriers ophthalmologists working in LMICs face in accessing medical education, including costs, lack of infrastructure and supportive mentoring. This model also addresses barriers faced by the health system by minimizing the amount of time spent away from a fellow’s home institution and family to no more than a few months at a time. Leveraging telementorship and Cybersight, Orbis’s tele-education platform, a sandwich fellowship includes innovative training techniques such as distance learning, remote surgical mentorship, wet lab mentorship, and hands on surgical skills development. The following sandwich fellowship programs have been commenced as part of the project:

• One year Sandwich Fellowship on Glaucoma: Candidates are undergoing the fellowship at both, SCEH and HVDEH.
• Six months Sandwich Fellowship on Glaucoma: One candidate each at SCEH and HVDEH has completed the fellowship while some are undergoing the fellowship.

In undergraduate and ophthalmology residency programs, due to the wide variety of subjects to be covered, extensive training in diagnosis and therapy of glaucoma has not been possible. Hence Observerships of various durations: one week, one month or three months, based on the training need of the trainee are being imparted to diagnose and treat glaucoma before loss of productive and useful visual function. A total of 14 doctors have completed the various observerships as follows:

• One-week observership on Glaucoma: 7 trainees
• One-month observership on Glaucoma: 4 trainees
• Three months observership on Glaucoma: 3 trainees

Two Hospital Based Trainings (HBTs) on Glaucoma have been conducted. HBT for six participants from HVDEH (two hands-on surgeons and four observer surgeons) was conducted from 28^th Aug to 2^nd Sep 2021, with Dr. Suneeta Dubey, Medical Superintendent & Head of Glaucoma services, SCEH as the resource person. HBT conducted on Glaucoma for six participants from SCEH (two hands-on surgeons and four observer surgeons) from 23^rd to 27^th Sep 2021, engaged Dr. S.S. Pandav, Head, Advanced Eye Center, PGIMER, Chandigarh as the key resource person.

To enroll in Sandwich Fellowship/ Oberservership offered by Dr. Shroff’s Charity Eye Hospital/ HV Desai Eye Hospital, please contact:

Dr. Aditi Gupta, Officer-Medical Education & Training, Dr. Shroff’s Charity Eye Hospital at [email protected] / [email protected]

OR

Bharti Janyani, Manager Projects and Operations, PBMA's H. V. Desai Eye Hospital at [email protected]

“Glaucoma is highly under-diagnosed disease. Most of the comprehensive ophthalmologists are not able to diagnose Glaucoma properly which I was also facing in few cases.”, told Dr. Mazhar Naseem during our interaction with him at Dr. Shroff’s Charity Eye Hospital (SCEH), Delhi. Dr. Mazhar completed the Orbis supported the months Glaucoma observership at Dr. Shroff’s Charity Eye Hospital in May 2022 and is currently working as a Consultant at one of the secondary centers of Dr. Shroff’s Charity Eye Hospital.

33 years old, Mazhar belongs to remote rural village of Basti, near Lucknow in Uttar Pradesh, where there is a dearth of trained ophthalmologists and eye care professionals, leading to poor eye care services. “I have seen many patients suffer, and many would go visually impaired due to lack of timely intervention. I chose ophthalmology to help some of these patients. Subsequently, while I was practicing my comprehensive ophthalmology, I realized the need to enhance my clinical skills, particularly for certain eye conditions like Glaucoma. It is highly under-diagnosed, especially in the population which I cater to in Uttar Pradesh.” Dr. Mazhar chose to take up Glaucoma as his sub-speciality and fill in the wide service gap.

He came to know about the observership program at SCEH through his seniors in medical college back home. As part of the observership, Dr. Mazhar was involved in observing numerous Glaucoma surgeries, seeking mentorship from Consultant at the OPDs, observing and treating patients, and practicing trabeculectomy surgery in the Orbis supported Digital Training Hub (DTH). Powered by state of art wet lab facilities, the digital training hub offers high quality simulation and distance education training. The DTHs are providing enhanced ophthalmic education to ophthalmologists, ophthalmologists-in-training, ophthalmic nurses and anesthesiologists in the eye department at SCEH.

Every participant who joins the observership/ fellowship, supported by Orbis are mentored by Glaucoma specialists at SCEH, who closely monitor the progress and learnings of each participant. Sharing his experience and learnings, Dr. Mazhar says, “The trainers here are very dedicated and focused. If you are lacking in some area, they will try to help you acquire that skill, even if it is one of the basic concepts. Thanks to them, I have improved my gonioscopy and plan of management in various types of secondary Glaucoma. I have seen many new techniques adopted by various consultants.” Working at the secondary center has also helped him in gaining more insights on how to manage Glaucoma. “It is a great observership, a progressive program which can drive career growth opportunity for residents/ ophthalmologists. I will definitely recommend it to my colleagues and juniors.”

Dr. Mazhar is eager to leverage his expertise in near future. Sharing about his future plans, he said, “I will continue working as a consultant for few more years, but eventually I will go back to my native place and serve the community. In my place, we don’t even have a cataract surgeon, and most ophthalmologists are not trained to undertake a phaco surgery. I want to go back and train others, perform surgeries and help Glaucoma patients.”

Dr. Shweta Shinde, Age 28 years completed the three months Observership in Glaucoma at PBMA’s H.V. Desai Eye Hospital (HVDEH) with support from Orbis and Santen Pharmaceutical Co. Ltd.

She completed her MBBS from Vikhe Patil College, Ahmednagar, Maharashtra and then pursued DOMS from MGM, Navi Mumbai. She has been very passionate about working in ophthalmology and always wanted to be part of HVDEH. After her wedding, her in-laws also supported her dream of undertaking trainings and learning more about Glaucoma. Her wish came true when HVDEH announced the ‘Three-month Observership’ in Glaucoma under Orbis - Santen initiative.

Currently, she is examining 50-60 patients per day in the OPD, and undertaking wet-lab sessions and OT observations, to understand details of medical and laser treatment options in Glaucoma. She is much more confident now and independently handles Glaucoma patients under guidance of Dr. Vidya Chelerkar, Head of Glaucoma Department, HVDEH and Dr. Kalyani VKS, Senior Glaucoma Consultant, HVDEH. Going forward, she wants to learn more on prognosis, perimetry and Laser PI.

Dr. Shweta is committed to becoming a skilled medical practitioner and encouraging other women as well.