To the Editor:

We read with interest the paper published by Zamorano-Martin et al. [1], and we are in complete agreement on the importance and need for research training during ophthalmology traineeship. Several studies have shown that healthcare organisations engaged with more clinical research activities have better patient outcomes [2, 3]. The ability to critically appraise published literature serves as an essential skill for practicing evidence-based medicine, which can be acquired through research training, for example the free online Cochrane Eyes and Vision course [4]. That said, participation in research among ophthalmology trainees is desirable yet not mandatory during ophthalmic specialist training in the United Kingdom (UK) and many other countries.

Lack of time, insufficient research skills and lack of mentor support are the most common impediments to research participation among trainees across different specialties and grades [5, 6]. To address this, the Ophthalmology Specialty Group of the National Institute for Health Research (NIHR) Clinical Research Network established 15 local ophthalmic trainee research networks (TRNs), aligned geographically to the NIHR clinical research networks [7, 8], across England in 2016–2017. We have previously highlighted a strong positive attitude among ophthalmology trainees towards the establishment of TRN [9], and have demonstrated its potential as an effective model for promoting research experience, training, outputs, and collaborations among the ophthalmology trainees (Fig. 1) [10,11,12].

Fig. 1: Set up of trainee research network (TRN) and its benefits.
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Infographics highlighting the essential workforce, resources and support required to set up a trainee research network (TRN), and the benefits that can be gained through the network.

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Compared to the general surgery specialties [13], the research productivity and potential of TRN within ophthalmology remains to be fully explored and utilised. Already however, several of the Ophthalmology TRNs have conducted and published a number of observational studies [10,11,12]. Among all TRNs, the surgical trainee-led West Midlands Research Collaborative (WMRC) is by far the most established model (http://wmresearch.org.uk/). The successful completion of several multicentre, randomised controlled trials, including the ROSSINI Trial and the DREAMS Trial, have showcased the potentials of TRN in contributing to high-impact research outputs and shaping clinical practice [14, 15]. More recently, COVIDSurg and COVIDSurg-Cancer, which included WMRC, were established by an international group of surgeons and anaesthetists from ~90 countries to gather real-world data on various surgical aspects related to COVID-19 pandemic [16]. Their ongoing success has certainly served as a role model and inspiration for many other TRNs in the UK (Table 1).

Table 1 A tabulated summary of trainee research networks (TRNs) in the UK. Information were gathered from TRNs websites and PubMed (this is not an exhaustive list).
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Based on our experience and many other successful examples demonstrated within and beyond ophthalmology, we believe that TRN is the way forward in effectively promoting research training, engagement and scholarly outputs among medical and surgical trainees globally.