# A Framework for Future Analysis of Ophthalmology Fellowships in Iran: Call for Action, Implications and Recommendations

## TL;DR

This paper reviews the growth of ophthalmology fellowships in Iran, highlighting challenges and proposing a 7-step framework for future planning and improvement.

## Contribution

The paper introduces a novel 7-step framework for analyzing and improving ophthalmology fellowship education in Iran.

## Key findings

- The expansion of ophthalmology fellowships has increased healthcare costs and created inequities in eye care access.
- Maintaining educational standards and graduate productivity is a key challenge in fellowship programs.
- Virtual education and expert panels are suggested as potential solutions for improving fellowship training.

## Abstract

Ophthalmology fellowship is focusing on the educational advancement, medical research progress and academic productivity by transforming general ophthalmologists into superior clinical capacities in ophthalmology. There is a vast majority of ophthalmologists who wish to undertake fellowship degrees. The fellowship programs have several benefits for ophthalmologists and medical institutions. However, the expansion of ophthalmic fellowships has resulted in a greater number of ophthalmology visits, the possibility of unnecessary subspecialty eye examinations, induced demand and increasing eye-care costs. Moreover, sub-specialized ophthalmic services are not accessible to patients in remote regions. This can lead to a degree of inequity in the provision of healthcare services in the healthcare system. The massive expansion of fellowships in ophthalmology is revitalizing the necessity for evaluation of the need for post-residency education and providing effective planning for the future of the ophthalmic human-resource for eye health.

This narrative review includes an integration and descriptive summary of the existing evidence on trends and different aspects that affect the future of ophthalmic fellowship education. Moreover, we pinpointed challenges such as maintaining standards in fellowship education, keeping an efficient production of graduates, and improving productivity in both patient care and education. We explored potential solutions to overcome these challenges. The 7-step framework for future analysis suggested here includes Determining educational needs and desired outcomes, Evaluating the current status of fellowship education, determining the gaps, and appropriate solutions, analyzing possible future trends and their impact on ophthalmology practice, investing in virtual educational technology, developing new educational horizons by foresight expert panels, and human-resource planning.