In 1994, the King Khaled Eye Specialist Hospital launched the ambitious project of developing its own Fellowship Training Program, which is joined by physicians after successfully completing a subspecialty Residency Training Program. The goals were to provide advanced subspecialty training in each major area of ophthalmology resulting in graduates who would: Provide similar teaching to residents in the three integrated programs monitored by them Saudi Board of Ophthalmology Provide specialized services throughout the Kingdom Conduct clinical research into problems unique to their patient populations The program has grown considerably since its inception. The first two years produced 4 and 6 graduates, respectively, with significant gaps in subspecialties offering training. During the subsequent years, up to 22 graduates per year were trained with representatives from each ophthalmic division. In addition, King Khaled Eye Specialist Hospital is now affiliated with the Wilmer Eye Institute, of the Johns Hopkins Medical Institute, since 2011. KKESH has granted certification to subspecialized ophthalmologists who meet a series of accredited training requirements in ophthalmology, sign a practice pledge indicating their intent to practice with compassion, integrity and respect for human dignity, and complete an intensive evaluation process which includes monthly evaluation of their clinical, surgical and research skills conclude with end of the year examinations.