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At the 1988 meeting of the Association of University Professors of Ophthalmology, a motion was proposed to increase the duration of training in ophthalmology by mandating a year of postresidency fellowship. At the 1989 meeting I presented an analysis of that proposal. The proposal is a fascinating one because it forces us to confront a number of very pertinent issues. These include the generic desirability of an increase in the duration of training, some of the specific impacts of widespread fellowship education, and the interaction between resident and fellow training. The very detailed proposal challenges us to squarely address many critical issues and assumptions of training, its purpose, and its impact.
The proposal begins by noting that ophthalmology training requires the fewest years of residency in specialty of any surgical discipline and that about 40% of graduating ophthalmology residents take at least 1 additional year of fellowship training. All