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Four years of ophthalmology training. Has its time come?

For the last 6 years at the annual Association of University Professors of Ophthalmology meeting, a lively discussion has taken place regarding the possible need to increase ophthalmologic training from 3 years to 4 years of required residency education (unpublished data, minutes of the Association of University Professors of Ophthalmology). One of the major reasons this subject has been so actively pursued is the rapid expansion of ophthalmic knowledge in the last decade. Approximately 50% of residents currently take an additional year of fellowship training. At least one of the major reasons for the additional training year is the perception that they need more ophthalmic or subspecialty training before going into practice or beginning an academic career. If one of ophthalmology's major goals is to train the comprehensive ophthalmologist, then perhaps a 4-year residency program emphasizing the training of a broadly based ophthalmologist with fewer subspecialists is appropriate. A comprehensive