Global disparities in ophthalmology education and alignment with international council of ophthalmology guidelines among medical students: a systematic review and meta-analysis

Background Ophthalmology education is essential for equipping medical personnel to proficiently manage eye health concerns. This systematic review and meta-analysis evaluate ophthalmology education among medical students, medical schools, and physicians, identifying key gaps and areas for improvement. Methods A systematic search of electronic databases (PubMed, Cochrane Library, Web of Science, and Scopus) identified studies published between January 2006 and December 2024. Eligible studies assessed competency levels, training duration, curriculum alignment, and compliance with ICO guidelines. The Preferred Reporting Items for the PRISMA statement were used for our reporting of the study selection process. Meta-analyses were conducted using random-effects and fixed-effects models, with heterogeneity assessed using I-2 statistics. Multiple regression analyses examined predictors of ophthalmology competency. PROSPERO registration number: CRD42024604742. Results Twelve studies from seven countries, involving 2,537 participants, were included. The pooled competency estimate was 62.5% (I-2 = 96.6%), with lower competency among medical students (55.8%) compared to physicians (83.3%). Training duration varied, with pooled estimates of 1.5 weeks for medical students, 2.5 weeks for medical schools, and 2.0 weeks for physicians. Curriculum alignment with ICO guidelines was 65% (I-2 = 96.2%), reflecting institutional variability. Compliance with ICO guidelines was also inconsistent (65%, I-2 = 99.2%). Multiple regression analysis identified competency level (beta = 0.50, p < 0.001) and training duration (beta = 0.42, p = 0.003) as the strongest predictors of ophthalmology education outcomes. Conclusions Significant disparities exist in ophthalmology education. Standardized curricula, extended training, and enhanced practical skill development are needed to improve competency among medical trainees.