The Best Phaco Fellowship in India

What Makes a Good Cataract Fellowship?

Simply put, it should have 4 levels of training.

Level 1- SICS training

Level 2- Phaco training in basic cataracts (NS 2-3, well dilated pupils)

Level 3- Phaco training in advanced cataracts (hard cataracts, mature cataract, PXF, small pupil etc)

Level 4- Training to manage your complications (sulcus IOLs, iris claws, anterior vitrectomy etc)

You can add a 5th (based on what many corporate hospitals are asking for these days)

Level 5- Training to do topical phacos (phaco under topical anesthesia)

So if someone asked you what's the best phaco fellowship out there, your reply should be- the one that trains you in all 5 levels.

Now for the bad news.

The reality of cataract fellowships in India?

Most of them train you to be a level 2 surgeon.

The reality of hospitals in India?

They want level 4 surgeons.

So clearly there’s a gap between what most fellowships are churning out and what the market actually wants.

The good news is that not all fellowships are like this.

And that’s one way to decide which fellowship is better.

The more levels of training a fellowship offers, the better it is.

So a fellowship that trains you to level 3 is any day better than the one that refuses to go past level 2.

Ok, Is That All?

There's something else many beginners fail to see.

To acquire level 4 or 5 proficiency, you can't be looking at 1 year or 1.5 year programs.

Many beginners want surgical independence on a short timeline.

That’s not how it works.

If you’re an SICS newbie, you cannot expect full surgical maturity from a 1 year fellowship or worse, a few months of short-term phaco training.

Time is your strongest ally. Time is what gives quality. Time is what makes you a surgeon.

If you’re looking to be a phaco surgeon, lesser fellowship duration means all that happens is you get trained in steps of phaco (level 2). And that's what many trainees settle for.

Now there are many young (and old) doctors whose life circumstances make it difficult for them to commit to long cataract fellowships. Realities like pregnancy or a baby at home or financial struggles.

But barring those real circumstances, majority of trainees settle for shorter fellowships simply because they are averse to the thought of spending another 2 or 3 years for fellowships… especially when they already gave that much time for PG.

But you can't let PG nostalgia get in the way of making important decisions. If your aim is to be a market-ready surgeon, everything has its price.

And time commitment.

I Have a Better Plan. I’ll Do a Short Phaco Course and Then Join a Hospital to Refine My Skills.

Yea, you can learn SICS and Phaco by doing some 20 or 30 cases.

But that's not going to make you a surgeon. It only trains you in technique.

If your plan is to just learn technique and then refine it elsewhere (maybe your own setup), then good.

But if your plan is to do shorter fellowships or do short term phaco training and hope the next hospital you apply to will hire you,

then you're fooling yourself.

See, hospitals are very clear on what they want.

They want someone who can

• operate all kinds of cataract.

• manage his/ her own complications.

If you can't do both, you're not a surgeon (to them) and you won't qualify.

That’s it.

Most hospitals won’t hire you with just short training and freely give you their patients. Hospitals are not that generous.

Even when they hire someone who has had short term training, they are hesitant.

They will not give cases freely.

They will not give cases regularly.

But let’s say you’re ok working for such a hospital.

Even if you get just 3-4 cases a week (and assuming they have mercy on you and increase case numbers by second or third year), it will take anywhere from 3-5 years with that hospital for it to train you to be a level 4 surgeon.

Meanwhile, you reach level 4 or level 5 proficiency with a long term fellowship in WAY LESSER TIME. Or at max, 3 years (going by the longest IOL fellowship out there).

They may be called long fellowships but they’re actually the fastest way to become a market-ready surgeon in shortest time (even if the shortest time is 1.5 years or 3.)

Think about it.

So whether you’re looking at reviews on the site or talking to past fellows or directly asking a fellowship coordinator about their program, always look at what training level is their end point and then decide if the cataract fellowship will be suited to your needs.