UNIVERSITY OF HEALTH SCIENCES
BEYOĞLU EYE TRAINING AND RESEARCH HOSPITAL
RESIDENCY TRAINING ACCREDITATION
SELF-EVALUATION REPORT
October 2019
GENERAL INTRODUCTION
University Name: University of Health Sciences
Faculty: Faculty of Medicine
Department: Ophthalmology
Rector: Prof. Dr. Cevdet Erdöl
Dean: Prof. Dr. Erdoğan Çetinkaya
Hospital: Beyoğlu Eye Training and Research Hospital
Self-Evaluation Committee members and names:
Prof. Dr. Muhittin Taşkapılı; Training officer, Hospital administrator
Assoc. Prof. Dr. Ayşe Çiğdem Altan; Training officer, Program director
Assoc. Prof. Dr. Yusuf Yıldırım; Training officer
Responsible person with whom the visiting team will communicate before the visit:
Assoc. Prof. Dr. A. Çiğdem Altan
A. SELF-EVALUATION PROCESS
Accreditation studies at the University of Health Sciences Beyoğlu Eye Training and Research Hospital Ophthalmology Clinic were initiated on April 8, 2019, by the formation of the Self-Evaluation Committee by hospital administrator and training officer Prof. Dr. Muhittin Taşkapılı, program director and training officer Assoc. Prof. Dr. Çiğdem Altan, and training officer Assoc. Prof. Dr. Yusuf Yıldırım, and a roadmap regarding the accreditation application was determined. Other training officers, chief assistants, specialists, and resident physicians were informed about the accreditation application and the preparation process in a meeting held in the conference hall.
The Self-Evaluation Commission determined the tasks to be done by dividing the work among themselves and reviewed their work by holding meetings once a month at first, and then once every two weeks in the last two months. Hospital quality unit, program director's records; operating theater, polyclinic, and inpatient clinic records, information technology center records, biomedical unit, registry records, and documents submitted by specialization students and training staff were used as data sources.
After the examination of the obtained data and records and the ation of their accuracy, the draft version of the self-evaluation report prepared by the commission was shared with the hospital management and its approval was obtained.
B. STATUS OF MEETING SPECIALIZATION TRAINING STANDARDS
The mission of UHS Beyoğlu Eye Training and Research Hospital:
To follow the continuously developing technology in the field of eye health and diseases, to adhere to ethical rules, to offer all the possibilities of modern medicine to our people and to be an institution with international respect in its field, to continuously improve the service we provide with happy employees, and to carry the human and information resources we provide to our country to the highest qualitative points we can reach.
To train competent, ethical, contemporary physicians who are integrated with society, equipped with the highest knowledge about eye diseases in our country, and who have made learning and implementing innovations a goal in their professional lives.
To contribute to national and international literature in the field of eye diseases through studies and research.
The vision of UHS Beyoğlu Eye Training and Research Hospital:
To lead scientific developments in the field of eye health and diseases; to contribute to the health of our country with high-quality, respectful, and ethical specialist physicians we train; to provide our patients with the friendly, reliable, and contemporary service they deserve with our high technological capabilities and competent medical staff.
Quality Policy of UHS Beyoğlu Eye Training and Research Hospital:
To effectively manage all our resources in order to be an institution that our employees are proud to be a part of and our patients are happy to receive service from,
To support the development of all our employees and to ensure their participation in the work to be done for this purpose in order to continuously improve our service quality,
To ensure the continuity of scientificity by closely monitoring the latest developments in our field and supporting the work of our medical staff,
We commit to being a preferred institution with its superior technological infrastructure and qualified medical staff that does not compromise on ethical values.
For this purpose, we aim to show that we maintain and even increase our standards by undergoing audits periodically by national and international accreditation institutions. We participate in trainings and audits in cooperation with the "Quality Units" available in the Directorate of Health, Ministry of Health, and our hospital. Employee satisfaction surveys are conducted for assistants and clinical staff at regular intervals, and inadequacies and issues that need development are corrected in cooperation with the hospital management.
Specialization students in medicine start their training in our clinic twice a year with the National "Examination for Specialty in Medicine - TUS". While our clinic fulfills the education standards, efforts are made to act both towards meeting the conditions of the Ministry and towards international standards.
When the specialization student starts duty, they first begin to see patients in the polyclinic under the supervision of specialists and senior assistants (usually for at least two months); during their average 2nd-4th weeks, they rotate in units for one or two days each to get to know the workflow in units and the operating theater. Again, scheduled trainings are given to newly starting assistants by expert physicians at the device, aimed at practice and examination techniques.
Assistants rotate in units every two months. Rotations are determined according to the program made by the program director every 2-4 months from the period they first started duty, in an order according to the training, needs, and residency periods of the assistants. Again, they can also do intra-unit rotations in some units. For example, in the retina unit rotation, they work within a plan according to their seniority in the inpatient service and operating theater, injection, macular diseases, surgical retina, and vascular diseases units. Based on the Medical Specialization Board Curriculum Creation and Standard Setting Commission (TUKMOS), it is aimed for all assistants to learn basic eye examination methods and general examination practices and to be able to perform treatment and other practices by combining these with their theoretical knowledge and to be competent in this subject. In line with this goal, they are evaluated by training officers and specialist physicians during polyclinic, inpatient, and unit rotations and are supported to complete their deficient aspects.
Based on TUKMOS and CEP (Core Training Programs) prepared by the T.R. Ministry of Health and the Turkish Ophthalmological Association, a curriculum is created with the approval of the UHS Curriculum Commission, and the progress of this program is ensured and controlled with assistant logbooks. Since 2018, student logbooks prepared by the University of Health Sciences Faculty of Medicine Department of Ophthalmology Measurement and Evaluation Commission have been used. At the end of each rotation, the competence is evaluated by having the relevant sections (Theoretical, practical, and surgical competencies) signed by the relevant unit specialist or training officer by the specialization student. In addition, the presentations made by the assistants, the seminars they gave, thesis information, exam grades, and the studies they participated in are also included in the logbook.
In our clinic, almost all units regarding ophthalmology (Strabismus, anterior segment, refractive surgery, contact lens, glaucoma, uvea, neuro-ophthalmology, retina, oculoplastics) are available. For "ocular oncology" and "retinopathy of prematurity" trainings arising from our hospital being a branch hospital, 4th-year assistants go on rotation on Mondays to Süleymaniye Obstetrics and Gynecology clinic and on Fridays to Cerrahpaşa Faculty of Medicine Ocular Oncology department in turn and with official assignment. In addition, assistants or specialist physicians from other clinics, especially in the fields of strabismus, refractive surgery, neuro-ophthalmology, cornea, and oculoplastics, come to our clinic for certain periods and durations to receive training.
The seminar program to be presented in the September-June period is prepared by the program director every year in August, submitted to the hospital TUEK (Medical Education Board), and announced via e-mail after the contributions of TUEK training officers. Seminar hours are held on Wednesdays between 14:00-16:30. During this period, 2 or 3 seminars are presented, and case presentations are made. The journal hour is usually planned separately. During the training year, each specialist physician presents at least one seminar, and each assistant physician presents 2 or 3 seminars controlled by their advisors; besides these, they make case and journal presentations. In addition, every Wednesday between 13:00-14:00, an interactive training hour managed by a responsible training officer or chief assistant is held. The list of these trainers is also prepared by the program director at the beginning of the training year and announced via e-mail. Every Tuesday evening, the next day's training program is reminded via e-mail. Guest speakers consisting of faculty members from other universities are invited an average of four-five times within the academic calendar year to present different views, diagnoses, treatment methods, and current practices and are ensured to give seminars/conferences.
In order to ensure that assistants take responsibility and participate in administrative duties, to convey the requests and complaints of assistants to training officers, and to establish easier communication, one person from each of the 1st, 2nd, and 3rd-year assistants serves as an "assistant representative"; this election is made among the assistants themselves. Periodic meetings are held between the training and administrative staff and assistant representatives.
For each assistant who has completed two years, a thesis advisor is determined, taking into account the field the assistant is interested in. The thesis advisor can be a specialist in the subject, an associate professor, a professor, or a chief assistant who has completed 1 year. The specialization student, who determines the thesis topic with their advisor, fills out the thesis approval form and sends it to the UHS department, and after receiving the approval of the university's thesis commission, starts the thesis work together with their advisor. 3 months before the end of the specialization period, they make a thesis presentation before a jury of three people, also formed by the university.
Before June 2018, specialization students had 4 exams a year on the dates announced at the beginning of the training year (including Retina-uvea, oculoplastics-strabismus, glaucoma-neuro-ophthalmology, and cataract-anterior segment-cornea-contact lens). However, from this date on, with the decision taken by the UHS Measurement and Evaluation Commission, a formative exam is held every January to be held separately for assistants who have completed their 1st, 2nd, and 3rd years; and a summative exam is given to every assistant who has completed 3.5 years every June. In these exams, the passing grade is 70, and a make-up exam is planned for specialization students who cannot get sufficient points or cannot take the exam. The formative exam consists of 50 multiple-choice questions according to achievement expectations and difficulty levels by years, and the summative exam consists of 100 questions. Exam questions are selected from the question bank prepared by training officers who prepare questions in their own branches from all over Turkey, and the exams are held simultaneously across the country.
Our hospital being a branch hospital and having the opportunity to see many patients and diseases and being a reference center is a great advantage for specialization students. In addition, they have the chance to see patients one-on-one and enter surgeries with specialist physicians and training officers who are competent and extremely experienced in their own branches. According to the degree of difficulty, they can perform surgery first under supervision and then on their own in surgical interventions, and efforts are made to ensure they reach and even exceed the surgical numbers determined in the training curriculum. The surgeries they perform and assist are recorded in their logbooks and audited by the responsible faculty member.
Sports, art, and cultural activities in which our training staff and specialization students participate are also frequently held in our hospital.
In the last three years, the "preceptorship" program has been successfully implemented four times in our hospital, three of which were international and one was national; our specialist physicians working in our institution had the opportunity to explain their experiences and knowledge to domestic and foreign ophthalmologists from outside the institution.
In the "Beyoğlu Eye Days" meetings, which we have organized three times in the last four years, there has been great interest from the participants in our two-day symposia where training officers working in our institution or trained in our institution and currently working in other training clinics or who are very experienced in their fields participated as speakers and current information at the assistant and general ophthalmologist level was conveyed, and many feedbacks regarding their satisfaction were received at the end of the meeting.
Our scientific journal named "Beyoglu Eye Journal", the first issue of which was published in December 2016, is published 3 times a year in December, April, and August. The goal of our journal is to publish original research at the highest clinical and scientific level as a qualified, continuous, and original periodic journal at the international level in the field of ophthalmology after being evaluated by referees. Our journal has been indexed in TUBITAK ULAKBIM TR since 2018.
Every assistant is encouraged to do research and prepare publications within the framework of the rotation program, and support is provided for them to present completed works at national and international congresses. From time to time, they are encouraged and supported to participate in statistics and other professional development courses opened within our hospital and private organizations. Trainings related to article writing are included. Our hospital has widespread internet connection (on every computer), and databases provided through Clinicalkey and the University of Health Sciences Library are used online to access scientific content (articles indexed in national/international indexes, reviews, etc.) required in the training process. Their participation in national congresses held every year and their making oral presentations are supported as much as possible by our training staff.
During assistant training, we support professional and social development by encouraging participation in both domestic and international exams and courses. In addition, faculty members improve themselves by participating in and giving training in courses and trainings prepared by the "Turkish Ophthalmological Association". Each faculty member takes part in specialization training, providing education by giving lectures, having surgeries performed, and conducting thesis supervision. All current tools and devices required for specialization student training and patient care are available in our clinic, and the infrastructure is sufficient. Assistants are encouraged to participate in BAL, BAK meetings organized by TOD, and especially participation in wet-lab applications is ensured before starting surgeries. From the 1st year on, assistants are ensured to gain experience in this regard by entering emergency cases accompanied by a senior assistant and/or a faculty member.
Specialization students coming to our hospital take part in the patient and hospital workflow in accordance with their duties and authorities, and are raised as physicians who are both professionally trained and responsible, and sufficient in terms of knowledge and experience equipment.