Fellowships across Europe: Insights from the European Board of Ophthalmology Survey

Purpose: Analyse the results of a European Board of Ophthalmology (EBO) survey on post-residency training (fellowship) opportunities across Europe, providing insights from ophthalmic educators on the current landscape. Methods: A cross-sectional study was conducted using an anonymous 31-question online survey distributed to educators in all EBO-affiliated countries. Results: The response rate was 61% with participation of 392 ophthalmic educators. Despite broad participation, Southwestern Europe was overrepresented, while Northern and Central Europe were underrepresented, affecting regional balance. Respondents had a mean age of 51 ± 11 years, with 37.8% as professors and 46.6% as department heads. Most (54.1%) were affiliated with university hospitals. The reported median percentage of residents pursuing post-residency training was 25%, varying between 15% and 100%, with 15.3% of respondents uncertain about their existence, especially in non-university hospitals. Post-residency training durations were predominantly 1 or 2 years. National diplomas were highly valued except in the United Kingdom; language proficiency was required in 84.2% of countries. Respondents reported a median of three positions per department, with 60% filled by local residents. Surgical activity accounted for 65%, with regional variations, whereas 40% of positions involved research. Observerships remained rare (10%). Financial compensation was provided in 67% of cases. A national medical licence was deemed essential, whereas the EBO diploma and letters of recommendation were moderately valued, especially in Northern Europe. Fellowships were highly recommended by 76.2%, while 63% believed that grants would improve access to positions. Conlusion: This survey represents the largest data set on post-residency training in Europe. Results highlight a lack of cohesion in fellowship opportunities, with many respondents uncertain about national programmes. A national medical licence remains the primary requirement, while language proficiency and financial support are key factors influencing access. Institutional support for medical educators is increasing, yet challenges persist regarding time, resources and funding. Focusing on subspecialty training and research, fellowships are crucial for career progression. Expanding training opportunities through international initiatives could further enhance accessibility and standardisation across Europe.