Manitoba to train more eye specialists

Residency program needed to meet demand for services

From left to right: Dr. Lorne Bellan, Dr. Andre Jastrzebski and Dr. Brian Postl announce new residency program.
From left to right: Dr. Lorne Bellan, Dr. Andre Jastrzebski and Dr. Brian Postl announce new residency program.

Winnipeg Health Region
Published Friday, February 24, 2012

The number of people requiring specialized eye care for conditions such as glaucoma and macular degeneration is expected to rise by as much as 100 per cent over the next 20 years.

As a result, the University of Manitoba is teaming up with the Buhler Eye Centre of Excellence at Misericordia Health Centre and the Winnipeg Health Region to train more eye specialists in Manitoba.

The Ophthalmology Residency Program was unveiled today during a press conference by Dr. Brian Postl, Dean of Medicine, University of Manitoba, and Dr. Lorne Bellan, Head of the Department of Ophthalmology at the U of M and an ophthalmologist at the Buhler Eye Centre of Excellence.

Bellan said the program will help Manitoba keep pace with increased demand for services. "There will be a 100 per cent increase in the prevalence of all eye conditions over the next 15 to 20 years," he said. "Conditions will continue to occur at the same rate, but the population mostly affected - those ages 65 and older - will double," he explained.

Postl said the program will enhance access to care. "It comes as no surprise that as we age, our vision changes and access to eye care becomes an important factor in our quality of life," Postl said. "By training more ophthalmologists in the province, this residency program will also help decrease provincial wait times for specialized eye care."

The first resident under the five-year program, which begins July 1, is Dr. Andre Jastrzebski.  The program will take in one additional resident each year and, in five years, will graduate one ophthalmologist per year. Eventually, it is hoped the program will be expanded to two residents per year.

Conditions treated by ophthalmologists - including cataracts, glaucoma, macular degeneration and diabetic retinopathy - are most prevalent in people 65 and older, although ophthalmologists also treat some children for congenital eye problems within the first eight years of their lives.

"Serious eye conditions are most often seen in the elderly," says Bellan.

Residents will provide support for the Eye Centre of Excellence at the Misericordia Health Centre, one of the two largest eye surgery centres by volume in Canada. The centre runs four to five operating rooms per day and does up to 9,000 cataract surgeries per year. There are 20 ophthalmologists and four retinal surgeons here, to teach residents their new profession.

The residents' teaching clinic, located at Misericordia and funded by the Winnipeg Health Region, will see a small number of select patients. The addition of residents will not immediately alleviate the need for ophthalmologists by taking on an increased volume of patients now, says Bellan. But they will be expected to complete the program and open their own private ophthalmology practises to serve patients in the future.

The Winnipeg program is one of 15 ophthalmology residency programs offered in Canada. Most train two to three residents per year with the exception of Toronto which trains six every year.

An ophthalmology residency program has not been offered in Manitoba since the early 1980s. Since that was discontinued, the province tried funding the training of one resident every two years in Alberta, encouraging them to return to Manitoba to practise once they completed their training. Unfortunately, about half of them remained in Alberta.

"We need to train our own," said Bellan. "We have a better chance with our own program. Experience shows us that there is a higher probability of people staying here if they are trained locally. They establish roots here and feel like staying."

Bellan said the new residency program should help alleviate the demand for services going forward. "The projected ratio of ophthalmologists to population is falling. We worry about how to provide the level of care required."

In 2011, there was one ophthalmologist per 4,378 people over the age of 65 in Canada. By 2021, that ratio is projected to slip to one per 5,707 over the age of 65. By 2030, it is expected to be one to 7,190 over 65.

"Those are big changes," said Bellan. "The number of ophthalmologists is limited by the opportunities for training. Ophthalmology is one of the top three sought-after residency programs. Last year, it had the highest ratio of people applying for the available positions. We have more applicants than the programs can handle."

For example, the new Manitoba program received 68 applications. They interviewed 18 people in order to select the first resident.

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