Objective:

To critique the reliance on time-based training in ophthalmology and advocate for a competency-based medical education (CBME) approach, emphasizing its implications for patient safety.

Key Findings:

• Competence cannot be assumed based on time spent training; it must be demonstrated.
• Trainees progress at different rates, necessitating individualized training paths to ensure patient safety.
• Objective assessment tools are essential for ensuring trainee competence and protecting patient safety.

Interpretation:

The shift to CBME in ophthalmology training is crucial for enhancing patient safety and ensuring that trainees are adequately prepared before performing surgeries, addressing the limitations of time-based training.

Limitations:

• Implementation of CBME faces institutional resistance and concerns about workload, which can impact patient safety.
• There is skepticism regarding the ability of metrics to fully capture competence, despite evidence supporting their effectiveness.

Conclusion:

Competence in ophthalmology must be measured and demonstrated, moving away from outdated time-based training models to ensure patient safety and effective training.