Challenges of practising ophthalmology in the West Indies

ABSTRACT

With increasing globalisation and better communications the world has shrunk to the point where information of any kind is easily acceptable but not necessarily understandable by the masses. Practising ophthalmology in the West Indies, we are not immune to the effects of this phenomenon. The expectation is that we should be producing a level of care that is at least equivalent to what obtains in the developed world. We are even expected to exist at the cutting edge of medicine. The level of ophthalmology that is offered in the West Indies bears testimony to the hard work, intelligence and sacrifice that is invested in the profession. Training for ophthalmologists from the West Indies is not widely available locally. When it is sought, it is done at considerable financial and social cost. Because we must access training in foreign lands we must be satisfied with less than the best. The best is reserved for the local doctors and it is very difficult for us to ascend the ladder of training to the point of good exposure. Therefore, although our doctors may be brilliant, they are usually deficient in surgical skills and have to come home to home their skills under the guidance of seniors who themselves would have gone through the same routine. What is the answer? Training of ophthalmologists in the West Indies is the obvious way to go. This, however, needs money, and determination by the authorities in the University of the West Indies to offer a wider syllabus. Unfortunately, we ophthalmologists are partly to blame since we have not until recently given ophthalmology the attention that it deserves as a speciality. We have to influence the other branches of the profession to accept ophthalmology as an important speciality. When the speciality gets the respect that it deserves and attains the status that ranks it with the other major specialities then we can push for increasing attention to academia. Ophthalmology in the West Indies suffers from a lack of money. On the one hand, there is inadequate funding by the various governments and, on the other hand, inability of patients to compensate doctors adequately for services rendered. In the former, it leads to chaos in the hospitals and loss of initiative in the public health workers. In the latter, it leads to inadequate funding for investment in private practice (AU)