YO Training October 2021

Yishay Weill, MD

– Residency at Shaare Zedek Medical Center, Jerusalem Israel.– Currently a Clinical Fellow in Cornea, External Ocular Diseases and Refractive Surgery at the Toronto Western Hospital, Toronto, Canada.

Israeli med-school is usually a 6–7-year journey. Upon graduating there is one year of internship before one can start residency. Ophthalmology residency in Israel lasts five years and it is one of the most sought-after residency programs in the country. Unlike the matching system which is customary in certain countries, the process of admission and acceptance into a residency program in Israel is less structured. It involves review of the candidate’s grades assessment of the candidate’s clinical evaluations during medical school, several weeks of observership in the department and interviews by the department’s staff. 

Prior to commencing the residency, a personal schedule is outlined for each resident and each resident is coupled with a senior mentor. Residents alternate between all the different sub-specialty clinics, with each round ranging from 3-6 months. All Ophthalmology residency programs in Israel are conducted according to a single national curriculum, which is updated every few years by a dedicated committee of the Israeli Ophthalmologists Association. A resident is obligated to follow this curriculum and to perform and observe a certain number of procedures (YAG-laser, intravitreal injections etc.) and surgeries (retina, glaucoma, cornea, oculoplastic and of course cataract). An average resident will perform between 150-200 cataract surgeries, and in some centers, residents have access to a surgical simulator. 

In terms of workload, the residency is extremely intensive. A resident will work more than 200 hours a month in the hospital, including four monthly on-calls shifts (which are 26 straight hours on premises). There is also a great emphasis on research during the residency. Almost every day there is an academic meeting (lectures/journal club) with the residents. Each resident also has a built-in six-month period dedicated for basic-science research (that is expected to be published), and there are several research/PhD tracks for those who are interested. For a resident to become “board-certified”, she/he needs to complete the curriculum and pass two board examinations- one in writing, after about three years of residency, and one orally in the final year of the residency. After residency, some decide to practice in private clinics, and those seeking staff position in a university hospital are expected to complete a fellowship (abroad) to apply for such position. Since Israel has a high rate of ophthalmologists per population (http://www.icoph.org/ophthalmologists-worldwide.html), these positions are highly competitive. 

Overall, I believe that the Israeli ophthalmology residency program is well structured, it combines extensive clinical and research activities, and although it is very demanding, it prepares the residents for independent work at the end of the residency period.