[Resident training in ophthalmology: can the German system learn from the Malawian one?]. / Weiterbildung zum Facharzt für Augenheilkunde: Kann das deutsche vom malawischen System lernen?

BACKGROUND: Training regulations in Germany and Malawi are compared. One German "Facharztausbildungsordnung" was compared with the syllabus of the Malawian Master of Medicine Degree in Ophthalmology. Germany nowadays has got 7000 ophthalmologists, Malawi nine; population in Germany 80 million, in Malawi 14 million. METHODS: We present a written comparison underlined with one illustrative table. RESULTS: Modalities in resident training are very different. Training period: Germany 60 months, Malawi 48 months. Training manner: In Germany mostly theoretical private studies at hospitals and in private practices. Practical advice comes from senior residents, specialists and consultants. It is qualitywise and quantitatively very different within the country. The Malawian syllabus is very structured according to teaching in theory and practice. There are 250 hours of regular teaching each year. Lecturers are especially paid for teaching from outside the country. Training aim in Germany is mainly a medical ophthalmologist whereas in Malawi it is an ophthalmic surgeon. Exams: Germans take part in an oral exam of 30 minutes after 60 months training. Malawian residents take exams every two years: written, oral, practical. Furthermore they are supposed to take part in exams of the ICO (International Council of Ophthalmology) - until now with 100% success for the first attempts. CONCLUSION: German residents have lots of academic freedom during their training. It is non-uniform. Training aim in Germany is mainly a medical ophthalmologist whereas in Malawi it is an ophthalmic surgeon. The Malawian postgraduate training is uniform with scheduled instructions. That is why quality among candidates can be better compared.

[The influence of the HIV pandemic on the incidence of malignant ocular tumours in Southern Malawi (Blantyre)]. / Einfluss der HIV-Pandemie auf die Inzidenz maligner Augentumoren im südlichen Malawi (Blantyre).

BACKGROUND: The HIV pandemic in Southeast Africa is a challenge to the poorly staffed and poorly financed health systems of the affected countries. A dramatic increase of HIV-associated ocular malignancies has been observed in Malawi. This study investigated the frequency of malignant ocular tumours at the only eye hospital in the south of Malawi. METHODS: A retrospective analysis of all patients who underwent removal of conjunctival growth suspicious for malignancy was performed for the period from 1989 to 2006. In addition a consecutive group of 49 patients with malignant ocular tumours was offered an HIV test. RESULTS: The number of patients undergoing surgery for suspected ocular surface squamous neoplasia (OSSN) increased from 32 cases in 1989 to 467 in 2006. Of the patients with malignant ocular tumours, 80% (39 of 49) had OSSN, and 76% of the patients with OSSN were HIV positive. CONCLUSIONS: OSSN has become the most frequent malignant ocular tumour in the south of Malawi. The incidence of OSSN seems to have increased dramatically from 1989 to 2006--in parallel to increasing HIV infection rates.