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Viewpoint

Ophthalmic Surgery in Egypt: Partnerships, Innovation, and Healthcare Reform into Action

January 10, 2024

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Dr. Abdelrahman

I am an ophthalmology resident, from Cairo, Egypt, where I serve as the Resident and Associate Society (RAS) liaison for the Egypt Chapter of the ACS. I also was recently appointed to the position of RAS liaison to the ACS Advisory Council for Ophthalmic Surgery.

As part of my liaison tenure, I’d like to share my unique experiences as a trainee in Egypt and discuss how partnering with the ACS has encouraged growth in the field of ophthalmology, fostered international collaboration, and promoted excellence in patient care.

Very much a modern medical system, ophthalmologic surgery in Egypt looks remarkably similar to how it is practiced in the US. With public, private, and military hospital systems within the country, trainees have the opportunity to experience a broad diversity of work settings to foster clinical and academic growth. Since I spent my early junior career in a military hospital, I experienced the best of three worlds.

To become a physician in Egypt, students enter medical school right after high school graduation. After completing my International General Certificate of Secondary Education (IGCSE–British high school diploma), I achieved a high score that secured me a place at Benha University–Faculty of Medicine. This placement required long travel every day for 2 months, passing by many rural areas on the way.

Having had this exposure and spending time at a noncentral governorate where people are not as privileged as those coming from and residing in Cairo and Giza definitely shaped my social responsibility early. It amazed me how professors at Benha University tirelessly cared for their patients, and despite many obstacles, they were able to provide the best care.

They also were very sincere academically with us as their students. I was able to transfer to Cairo University–Kasr Al Ainy School of Medicine 2 months later. Studying in Cairo, I met patients coming from rural and noncentral governorates seeking medical help that was not available for them at home.

Medical training in Egypt used to include 7 years of academic time with a 1-year internship, but recent governmental reforms have been instituted to include more clinical experience for students. Medical school now requires 5 years of training with 2-year clinical internships. Medical schools in the country also have expanded, ballooning from just under 20 schools in 2008 to more than 45 schools as of 2023.

Unlike the US where graduation from medical school is followed by residency placement through a national matching system, Egyptian physicians, especially those interested in ophthalmology, have several available routes for specialization. An Egyptian ophthalmology fellowship, obtaining a master’s degree, or acquiring an equivalent international qualification are all acceptable routes of specialization, although recent changes from the Egyptian Ministry of Health and Population are impacting these options by validating a single route of specialization—the Egyptian Board—similar to the American Board of Ophthalmology.

I specialized in ophthalmology by enrolling in an accredited master of science (MSc) degree program at Helwan University. It was my first mentor, Professor Fawzi El Shahed, supervisor of postgraduate studies, who inspired me to become clinically competent and eagerly seek continuing medical education (CME). Studying ophthalmic modules, paramedical modules, research, and medical statistics modules at Helwan University pushed me further to also pursue my MSc in Global Health at The University of Manchester in the UK. Studying vulnerability, ethical considerations, and global medical issues was a life changer for me.

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A phacoemulsification wet lab was available for attendees of the Egyptian Society of Ocular Implants and Refractive Surgery meeting, including Dr. Passant Abdelrahman, in May 2023.

Once in training, Egyptian residents have access to most of the state-of-the-art resources familiar to US providers. I am currently a physician in training at Watany Eye Hospitals (WEH) and the Memorial Institute for Ophthalmic Research (MIOR). My ophthalmic training has included various subspecialty clinical rotations: comprehensive ophthalmology, ophthalmic investigations, pediatric ophthalmology and strabismology, surgical hands-on, and more.

Working at WEH–Thawra Branch, a private hospital on the outskirts of Cairo, I am fortunate to have available 10 operation theaters, femtosecond laser machines in two refractive suites, and 16 fully equipped clinics that have provided me with robust technical and clinical experiences.

Home to the Association for Research in Vision and Ophthalmology, Egypt Chapter, WEH also offers trainees opportunities to continue extensive research on how the eye functions. These experiences all occur in the context of a commitment to high-quality healthcare standards. Like every other ophthalmic institute, WEH follows the General Authority for Healthcare Accreditation and Regulation standards with a focus on quality standards, CME, and paramedical fields.

MIOR is a public institute established by Sir Arthur Ferguson MacCallan, CBE, MD, FRCS—an ophthalmic surgeon who pioneered the first classification system for trachoma, which is still in use today. An English surgeon, Dr. MacCallan took his pioneering work to Egypt where his profound contributions to the country and the field of ophthalmic surgery would result in the erection of a statue of honor at MIOR.

MIOR offers clinical examinations, surgical healthcare services, visiting residency programs and fellowships to enhance knowledge exchange, and has the Memorial Institute Kids Eye Center, a specialized hospital offering a full range of pediatric ophthalmic care.

Committed to the advancement of not just ophthalmology, but medicine as a whole, much of the innovation and growth in Egypt’s medical sector has come through international partnerships with other surgical organizations such as the ACS, the Royal College of Physicians and Surgeons of Glasgow, and The Royal College of Ophthalmologists (RCO).

In April 2022, through collaboration with the RCO, the first Refraction Certificate examination in Egypt was held at the Kobri Al-Kobba Medical Complex. The addition of this certificate allowed for all four parts of the prestigious Fellowship of the RCO (FRCOphth) qualification exam to be held within Egypt.

Later that year, in November 2022, the RCO’s first hybrid exam, including eye simulators and human retinoscopy, was introduced worldwide and held in Cairo. I was one of the first 11 candidates to pass this examination format.

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Dr. Passant Abdelrahman speaks at the 2023 Watany Ophthalmology Summit about the ACS and RAS.

These additions allow Egyptian providers to participate in international standardized assessment and be held to similar quality standards without the undue burden and cost of international travel to achieve these certifications.

In addition to high-quality training and international collaboration, ophthalmic surgery in Egypt also is supported by society and institute meetings where scientific talks are held, dry and wet labs are provided, and instructive courses are made available for residents. These are amazing educational opportunities to meet with colleagues and enjoy time at different cities in Egypt.

As a member of the ACS and RAS, representing my local chapter and the ACS Advisory Council for Ophthalmic Surgery, I have gained skills and knowledge by attending webinars, making many friends and networking with junior and senior surgeons from different parts of the world. I attended the first Africa Health ExCon in 2022, the largest medical meeting in Africa to date, representing RAS and discussing medical issues, surgical techniques, research, healthcare leadership skills, medico-legal and ethical issues, quality of patient care, and more.

Providers also are able to attend international meetings such as the ACS Clinical Congress and bring back to Egypt what they learned from these experiences. At the 2023 Watany Ophthalmology Summit, I led a panel discussion, ACS: Ophthalmic Surgery and Resident Opportunities. Through partnership with the ACS and participation in RAS, I hope to embody the motto of the ACS, “To Heal All with Skill and Trust,” by fostering international partnerships, innovation, and growth for ophthalmologists on a global scale.

Also, Dr. El Shahed was my academic support while applying for membership at the American Academy of Ophthalmology (AAO), and 3 years later, I am now a member of the AAO International Meetings Committee. I will represent the organization next month at an international meeting, discussing future retinal advances as a moderator and speaker.

I am happily working toward my career as a young ophthalmologist, subspecializing in vitreoretinal surgery and serving my patients in Egypt every day. The ACS continues to support me and other residents through webinars, CME, and volunteer opportunities that serve as reminders of the importance of coming together to maintain excellence in healthcare and eradicate inequities.

I would like to extend a special thank you to Professor Fathy Fawzy, chair of WEH, and Professor Mohey Eldine Elbanna, Governor of the ACS Egypt Chapter, for their kind support and guidance, and for facilitating the partnership between WEH and the ACS. 


Disclaimer

The thoughts and opinions expressed in this viewpoint article are solely those of the author and do not necessarily reflect those of the ACS.


Dr. Passant Abdelrahman is an ophthalmology resident at Watany Eye Hospitals in Cairo, Egypt, and a visiting physician in training at the Memorial Institute for Ophthalmic Research in Giza, Egypt. She is the RAS liaison for the Egypt Chapter of the ACS and the ACS Advisory Council for Ophthalmic Surgery.