INTERVIEW: Can Virtual Reality Overcome Africa’s Surgical Training Bottlenecks?

In this interview with Impact Newswire, Richard Vincent, Co-Founder of London-based Fundamental XR, discusses how virtual reality is transforming ophthalmic surgical training and helping address one of Africa’s biggest healthcare challenges: the shortage of skilled eye surgeons. As healthcare systems increasingly adopt immersive technologies to accelerate medical education, Vincent explains how VR simulation enables trainee surgeons to repeatedly practice complex procedures in a risk-free environment before entering the operating room, improving surgical readiness while reducing dependence on scarce mentors, operating theaters and laboratory resources.

Virtual reality (VR) is increasingly reshaping medical education as healthcare systems seek faster, safer and more scalable ways to train clinicians amid growing workforce shortages. Advances in immersive technologies, artificial intelligence and haptic feedback are enabling surgeons to practice complex procedures repeatedly in realistic virtual environments before operating on patients, reducing reliance on costly laboratory training and expanding access to specialist education.

The technology has gained traction in ophthalmology, where cataracts remain the world’s leading cause of blindness despite being treatable through surgery. Many low- and middle-income countries continue to face shortages of trained ophthalmic surgeons, limited access to surgical mentors and scarce training resources, contributing to long waiting lists and preventable vision loss. Simulation-based training is increasingly being viewed as a way to shorten learning curves while improving patient safety by allowing trainees to master surgical techniques in a risk-free environment.

Africa faces particularly acute challenges. The continent carries a disproportionate burden of avoidable blindness while many teaching hospitals have limited opportunities for residents to perform enough supervised procedures during training. As a result, international health organizations, academic institutions and medical technology companies are investing in digital training platforms that can supplement traditional surgical education, particularly in countries with constrained healthcare infrastructure.

Recent advances in VR simulation have made it possible to recreate highly detailed surgical environments that provide instant performance feedback, objective assessment and unlimited opportunities for practice. Supporters argue that these platforms not only improve surgical confidence and technical proficiency but can also reduce training costs by minimizing the use of consumables during wet laboratory sessions and allowing faculty to focus on advanced mentoring rather than basic procedural instruction.

Against this backdrop, global blindness prevention organization Orbis International and medical simulation company Fundamental XR have partnered to expand VR-based ophthalmic surgical training across Africa. The program is currently deployed in Rwanda, Ethiopia, Zambia and Ghana, where early-stage ophthalmologists use immersive simulation to practice cataract surgery before entering the operating room. 

Early results suggest the approach is improving surgical readiness, increasing trainee engagement and reducing errors during subsequent hands-on training. In this interview, representatives from Orbis International and Fundamental XR discuss how immersive simulation is transforming ophthalmic education, the measurable impact observed across participating institutions, and the role VR could play in addressing Africa’s shortage of skilled eye surgeons.

Faustine Ngila spoke with Richard Vincent, Co-Founder of Fundamental XR, about how immersive simulation is transforming ophthalmic education, the measurable impact of VR training across Africa, and its potential to help address the continent’s shortage of skilled eye surgeons. Here is the full interview:

1. The program has now expanded to 22 partner institutions across nine countries. What measurable improvements have you observed in surgical competency, patient outcomes, or training completion rates compared with traditional ophthalmology training methods?

The clearest measurable improvement is in how competency builds. The platform scores every session, so progression is tracked objectively rather than through recall or a trainer’s impression, and it gives residents graded repetition at a volume wet lab or live cases can’t offer.

The pattern holds across Orbis’ African partners. In Rwanda and Ghana, residents now arrive at the wet lab already fluent in the surgical sequence, shifting faculty time from teaching basic steps to mentoring on surgical nuance. There are efficiency gains too, one documented workshop estimated up to half as many practice eyes needed with VR in the mix.

This all rests on strong adoption: more than 1,100 training hours and 400+ active users across 22 institutions in nine countries, all captured from the software’s own session data rather than survey or self-report. That adoption has also drawn external recognition, a national Digital Health Excellence Award for our India partner in 2025 and a Brandon Hall Group Gold Award for the program overall.

2. The Ghana program has emerged as one of your strongest performers. What specific factors made it so successful, and how can that model be replicated in other African countries?

In Ghana, Korle Bu Teaching Hospital’s success comes down to how the hospital and Orbis’s clinical team deployed the simulator. They built it into the curriculum as a compulsory, gated pathway rather than an optional extra. 

Three decisions made the difference: a gate score residents have to hold across consecutive sessions before advancing to the wet lab, simulation written into formal duty hours so it’s treated as a duty rather than an add-on, and a named coordinator who owns the program and takes accountability.

3. One of the biggest challenges in surgical education across Africa is limited access to operating theaters, mentors, and equipment. How does VR address these structural barriers, and where does it still fall short?

The core barrier in surgical training is that learning a procedure normally requires a patient, a mentor and a theater available all at once, and in most African settings all three are scarce. The simulator breaks that dependency. A resident can practice a full procedure as many times as they need, at any hour, without a patient or a free theater, and each attempt is scored objectively.

That changes what scarce resources are spent on. Because residents arrive already fluent in the surgical sequence, wet lab and mentor time shifts from teaching basic steps to refining technique, the part that genuinely needs an expert in the room. It also cuts waste, since fewer basic errors mean less tissue used.

Where it falls short is worth being clear about: VR can’t replace live surgical judgement, the unpredictability of a real patient, or the mentorship live cases demand. It gets a resident to the theater far better prepared. It doesn’t replace the theater.

4. You believe in cost savings through reduced tissue waste and more efficient wet lab training. Can you quantify these savings or share data on the economic return for hospitals adopting the platform?

The savings show up in a few places: less tissue, viscoelastic and suture material as residents reach the wet lab making fewer basic errors, senior surgeon time freed from teaching fundamentals, and fewer complications to manage. One documented MSICS workshop estimated up to half as many practice eyes needed once VR was part of the training mix, though that’s a trainer’s estimate rather than an independently measured figure. 

5. Cataracts remain one of the leading causes of preventable blindness globally, particularly in low- and middle-income countries. How do you see immersive simulation contributing to efforts to reduce the cataract surgery backlog across Africa?

The cataract backlog is partly a diagnosis and screening challenge and partly a surgeon shortage, and it’s the second half Fundamental XR’s technology speaks to. There aren’t enough trained cataract surgeons to clear it, and the traditional route to training one is slow because it depends on scarce theaters, mentors and supervised cases. 

Simulation shortens that path: a resident builds core surgical competency through repeated, scored practice long before they’d otherwise reach a patient, which lets training capacity grow far faster than conventional routes allow. Removing the bottleneck in training capacity is the piece Fundamental XR is responsible for.

6. Virtual reality hardware and software can be expensive. How is this initiative being funded, and what is the long-term sustainability plan once donor support or pilot funding ends?

Affordability was a founding mission for both FXR and Orbis. Surgical simulators have historically carried a high price tag, which puts them out of reach for many of the institutions we work with. We built our hardware and software specifically to bring that cost down to a level institutions could realistically afford, and made the simulator portable so one unit can be shared across several hospitals rather than each site needing its own.

Within this program, Orbis funds the hardware, so partner institutions aren’t carrying that cost at all. But the affordability is built into the technology itself, which is what makes it sustainable beyond any single funding arrangement. Our job is making sure the cost of the technology is never the reason a program stops.

7. Artificial intelligence is increasingly being integrated into healthcare training. Is Fundamental XR incorporating AI into its simulation platform, and if so, how does it enhance the learning experience?

Yes. The scoring and analytics engine at the core of the platform already uses AI, and it’s where we see the most potential. Because it’s a haptic simulator, it captures how a trainee moves, the path and control of every instrument, not just whether the outcome was right. That’s data conventional training simply can’t see. We’re developing AI that uses this movement telemetry to give each surgeon personalized feedback: not just a score, but specific guidance on how they’re handling the instruments and how to refine it.

8. What have been the biggest implementation challenges across African markets?

The most consistent challenge isn’t the technology itself, it’s turning an installed simulator into genuine, sustained use. A device in the corner of a room doesn’t train anyone; what does is embedding it in the daily routine of a program. That’s the hardest part, and where the partnership has learned the most.

What works is consistent across every successful site: one named person who owns the program and follows up on missed sessions, protected time so simulation is timetabled rather than bolted on, and usage data that feeds into real accountability like reviews and progression. Those are institutional decisions rather than things the technology imposes, but we’ve built the platform to make them possible, clean session-level reporting a coordinator can hold residents to.

9. Looking ahead, are there plans to expand the platform beyond ophthalmology into other surgical specialties in Africa? If so, which areas are the priority and why?

Ophthalmology is our focus with Orbis in Africa right now, but the platform isn’t specialty-locked. The simulation engine and analytics layer are built to extend. We have deployed with other partners in multiple other specialties as varied as cardiology and robotics.”  

10. Five years from now, what would success look like for Fundamental XR’s work in Africa? 

Success, on the technology side, is a platform that’s continually smarter about how it trains, richer data and analytics that turn every session into individualized feedback, so a surgeon isn’t just scored but coached on exactly how to refine their technique. That’s where we’re focused, and it’s what makes the platform more valuable the more it’s used.

Within the Orbis program, country-by-country expansion is Orbis’s roadmap to set. But the simulator isn’t limited to that partnership, part of what success looks like is the technology being accessible enough that institutions and countries beyond the Orbis network can adopt it too.”

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