Ophthalmology Residency Programs Research Articles

Job Satisfaction, Well-Being, and Burnout among Ophthalmology Educators.

Purpose This article assesses the prevalence of burnout among ophthalmology educators and identifies opportunities to improve well-being in this population. Methods The research team conducted a cross-sectional study using an institutional review board-exempt survey addressing the domains of the Maslach Burnout Inventory, intent to leave, and interest in wellness activities. Survey participants included ophthalmology residency program directors (PDs) and associate PDs (APDs) who are members of the Association of University Professors of Ophthalmology (AUPO). Analysis involved a top-box approach. Results Surveys were sent to 175 members with a response rate of 38.9%. Percentages of survey respondents reporting either (1) "never" or (2) "less than a few times per year" when asked to self-assess for certain manifestations of burnout are as follows: "considering residents as impersonal objects" (95.2%), "becoming more callous towards people" (90.3%), and "becoming emotionally hardened" (80.6%). Approximately 65% of ophthalmology educators reported never considering or rarely considering leaving their position in the year prior to completing the survey. For wellness promotion among AUPO educators, the greatest interest was in small group mentoring sessions (85%) and webinars on wellness-related topics (70%). Conclusion The prevalence of burnout symptoms among ophthalmology educators compares favorably to educators from other specialties. Ophthalmology PDs and APDs demonstrate a greater degree of personal accomplishment than do their cohorts within other specialties, suggesting a decreased likelihood of burnout onset among ophthalmology educators. Furthermore, our study's job satisfaction data reveal a high degree of satisfaction among ophthalmology PDs and APDs.

Resident Vitreoretinal Procedure Volume: Effect of Intravitreal Injections, Region, Program Size, and Vitreoretinal Fellowship and Veterans Affairs Affiliation.

Purpose To analyze resident vitreoretinal procedure volume across Accreditation Council of Graduate Medical Education (ACGME) accredited ophthalmology residency programs. We assessed the effect of the increase in intravitreal injections (IVI), geographic region, program size, and Veterans Affairs (VA) and vitreoretinal fellowship affiliation on vitreoretinal procedures. Methods A request was sent to all residency programs in 2018 for their graduating residents' ACGME case logs. Vitreoretinal procedures were defined by ACGME case log categories and included vitreoretinal surgery, peripheral retinal lasers, and IVI. Procedures were categorized by Current Procedural Terminology (CPT) code. Programs were studied by geographic region, program size, and by VA and vitreoretinal fellowship affiliation. Results A total of 38 of 115 (33.0%) programs responded, and 167 residents logged 32,860 vitreoretinal procedures. The median number of retina procedures per resident was 146 (range 36-729). Programs with a vitreoretinal fellowship had a higher average number of vitreoretinal procedures per resident (208.3 vs. 125.0; p = 0.002), but there was no difference between the average number of non-IVI vitreoretinal procedures (60.0 vs. 64.2; p = 0.32). For IVI, VA affiliation (146.6 vs. 71.1; p = 0.02) and vitreoretinal fellowship (149.4 vs. 60.8; p < 0.001) were associated with a greater number. More IVI strongly correlated with a larger total volume of retinal procedures ( r = 0.98), and there was no difference across programs for total retinal procedures when IVI was removed. Conclusions The presence of a vitreoretinal fellowship at a residency program had a positive effect on resident total vitreoretinal case volume, but their residents performed more IVI. Programs without vitreoretinal fellowships completed on average more non-IVI procedures.

Learning Curve of Ophthalmic Postgraduate Students During Training in Manual Small Incision Cataract Surgery (MSICS): A Cross-sectional Study

Introduction: Ophthalmology residency programs play a critical role in training surgeons to perform cataract surgery. A fundamental component for developing competency in cataract surgery is undergoing a structured surgical training program. There is an inverse relationship between the number of surgeries performed by a resident and adverse surgical outcomes. Aim: To assess the learning curve of Manual Small Incision Cataract Surgery (MSICS) performed by postgraduate students during their residency tenure by estimating the difficulties encountered and intraoperative and postoperative complications during surgical training. Materials and Methods: A hospital-based cross-sectional study was conducted in the Department of Ophthalmology, Hassan Institute of Medical Sciences (HIMS) Teaching Hospital, Hassan, Karnataka, India, from July 1st 2020 to January 1st 2023. Study included 249 patients undergoing MSICS by three postgraduates, who enrolled in the Master of Surgery (MS) Ophthalmology course and received hands-on training in a wet lab were selected. They performed MSICS in a stepwise manner under the supervision of a trained ophthalmologist. Surgeries were recorded and discussed in surgical audits, and intraoperative and postoperative complications were analysed. The collected data was statistically analysed using descriptive statistics such as frequency and percentage. Results: A total of 249 patients, including 135 (54.2%) females and 114 (45.7%) males, with a mean age of 68.4 years, were included in the study. The majority (47%) of cases were senile immature nuclear sclerotic cataracts grade 3-4. Difficulties encountered during the surgeries were tunnel formation (24.6%), capsulotomy (4.5%), nucleus delivery (21.5%), cortical wash (34.3%), and Intraocular Lens (IOL) insertion (14.8%). Intraoperative complications observed were premature entry (46.3%), roof tear (16.1%), Descemet's membrane detachment (7.3%), iridodialysis (7.3%) and Posterior Capsular Rent (PCR) (22.1%). Postoperative complications included wound gaping (0.4%), anterior chamber reaction (10.8%), corneal oedema (25.4%), striate keratopathy (58%) and raised intraocular pressure (5.1%). Conclusion: The most common difficulty encountered during the first year of residency was tunnel formation, while the most common difficulty encountered during the second and third years was cortical wash. The most common intraoperative complication was premature entry, and the most common postoperative complication was striate keratopathy. Stepwise learning by the resident under continuous monitoring by a consultant lowers complications and gives confidence to postgraduate students.

Assessment of the Web Site Availability and Content of Pediatric Ophthalmology Fellowship Programs: A Cross-Sectional Nationwide Study.

Background Fellowship program Web sites are a crucial source of information for prospective pediatric ophthalmology applicants, especially in light of the restrictions on in-person interactions due to the coronavirus disease 2019 pandemic. Objective This study examined all pediatric ophthalmology fellowship Web sites for availability and presented recruitment and training content. Methods A full list of all pediatric ophthalmology and strabismus (POAS) fellowship programs were compiled from the Association of University Professors of Ophthalmology (AUPO) directory and the San Francisco Match (SFMatch) application listing. Each fellowship was queried by Google Internet search to identify the program's corresponding Web site. The content of Web sites was evaluated using 20 predetermined recruitment and training criteria. All data were collected in February 2022. Kruskal-Wallis and Mann-Whitney U tests were constructed to examine differences by geographic location, program size, number of teaching faculty, and affiliation with a top ophthalmology residency program. Results There were 45 pediatric ophthalmology fellowships identified from the AUPO and SFMatch. All pediatric ophthalmology fellowships had an available program Web site. However, there was significant variability in content, and the average Web site had approximately half of the evaluated criteria. POAS Web sites reported a greater number of recruitment criteria than program training criteria. There were no differences by program size, number of faculty, affiliation with a top residency program, or geographic location in the number of observed criteria. Conclusions This study provides data to drive efforts to improve pediatric ophthalmology fellowship Web sites. Pediatric ophthalmology fellowship Web sites are missing important information, and there are opportunities to improve program Web sites, regardless of program size, number of faculty, affiliation with a top residency, and geographic location. Informative, accurate Web sites may attract qualified candidates, and as a result, elevate the likelihood that interviewed candidates are well-suited to the program. As such, improvements to fellowship Web sites can streamline the application process and increase a program's success rate in the match.

Learning From the 2021 Ophthalmology Match: Virtual Residency Matching During the COVID-19 Pandemic.

The effect of virtual interviews on residency match outcomes during the COVID-19 pandemic is unknown. Examining the ophthalmology match may help inform all specialties undergoing virtual interviews. To determine the impact of allopathic applicant match characteristics in the first year of the virtual residency Match process. Using the Association of University Professors of Ophthalmology match database, a retrospective review was conducted of all allopathic applicants to ophthalmology residency programs in the United States from the 2016 through the 2021 match cycles. Demographic information, interview numbers, and match outcomes were compared between the 2016-2020 (in-person) and 2021 (virtual) cycles. A total of 3343 allopathic applicants were analyzed. Applicants in the 2021 Match applied to significantly more programs than 2016-2020 applicants did (78.7±23.6 vs 73.1±22.7, P<.001). Among matched and unmatched applicants, there was no significant difference in the number of interviews granted or completed. There was a significant reduction in the match rate between the 2016-2020 and 2021 Match cycles (81.3% vs 76.6%, P=.0009). A subanalysis of applicants who went to medical schools with ophthalmology residency programs (N=2308) found that the home institution match rate was significantly higher for the 2021 Match compared to the aggregate 2016-2020 Matches (26.1% vs 20.6%, respectively, P=.015). Significantly more applicants to ophthalmology residency programs matched at their home institutions in the 2021 virtual match cycle compared to the previous 5 years without influencing the interview numbers granted and attended.

Factors Influencing Fellowship Training Among Ophthalmology Residents: A Pilot Study.

There has been an increase in ophthalmology fellowship training programs and applicants. The current ophthalmology literature lacks any recent study examining factors influencing residents' decisions to pursue subspecialty fellowship training. An anonymous, 16-item survey was distributed to residents from a convenience sample of ophthalmology residency programs by their program directors or administrators. A total of 72 residents and 9 interns from 9 distinct programs completed the survey. Eighty-two percent of respondents reported they have either applied or will apply for a fellowship position. Gender and race showed no significant association with fellowship application. Respondents perceived that obtaining a fellowship position would be easier (61%) than obtaining an ophthalmology residency. The desire for additional clinical and surgical training were the 2 primary factors for the pursuit of fellowship training. Half of those pursuing fellowship training (49%) indicated they still desired to practice comprehensive ophthalmology. None of the respondents indicated they wished to practice in a rural area. The data collected in this pilot study elicited factors and variable associations that provide a sound basis for informing revisions and improvements to the data collection tool for a follow-up prospective, longitudinal study involving all ACGME ophthalmology training programs. The results indicate some of the essential factors associated with the pursuit of fellowship training by the current generation of residents. The results also highlight potential trends related to residents' views of their training and desired practice patterns.

Ophthalmology Resident Oculofacial Surgery Case Exposure: An ACGME Case Log Analysis.

The authors quantified trends in resident oculofacial surgery exposure between 2009 and 2018, reviewed specific procedure volume, and correlated procedure volume with program characteristics. The authors requested de-identified case logs of residents graduating US ophthalmology residency programs in 2018 from all 118 programs. Current Procedural Terminology codes of all oculofacial procedures were analyzed. Current Procedural Terminology codes were grouped into 25 unique categories that the authors created in addition to the 11 Accreditation Council for Graduate Medical Education categories. One hundred and sixty-six of 488 (34%) US ophthalmology residents graduating in 2018 provided case logs (32.2% of programs). According to Accreditation Council for Graduate Medical Education case logs, residents graduating in 2018 completed significantly fewer eye removal/implant procedures, lacrimal surgeries, "other orbital" procedures, entropion/ectropion repairs, and temporal artery biopsies as primary surgeon than residents graduating in 2009, yet significantly more eyelid laceration repairs, chalazion excisions, tarsorrhaphies, ptosis repairs, and blepharoplasty/reconstruction procedures ( p < 0.05). No difference was found between the total number of oculofacial cases between 2009 and 2018 ( p = 0.051). The most frequently logged procedure per resident in the sample was blepharoplasty/reconstruction (17.2 ± 15) followed by "other oculoplastic" (12.7 ± 10.6). The least commonly performed procedures included temporal artery biopsy (1.5 ± 2.2) and "other orbital" (1.9 ± 3.1). Program size, location, and presence of oculofacial fellowship program all impacted case volume. Oculofacial surgery has the second highest case number requirement for residents per Accreditation Council for Graduate Medical Education guidelines. However, resident exposure to oculofacial surgery cases greatly varies in each ophthalmology residency program.

Use of Machine Learning to Assess Cataract Surgery Skill Level With Tool Detection

To develop a method for objective analysis of the reproducible steps in routine cataract surgery. Prospective study; machine learning. Deidentified faculty and trainee surgical videos. Consecutive cataract surgeries performed by a faculty or trainee surgeon in an ophthalmology residency program over 6 months were collected and labeled according to degrees of difficulty. An existing image classification network, ResNet 152, was fine-tuned for tool detection in cataract surgery to allow for automatic identification of each unique surgical instrument. Individual microscope video frame windows were subsequently encoded as a vector. The relation between vector encodings and perceived skill using k-fold user-out cross-validation was examined. Algorithms were evaluated using area under the receiver operating characteristic curve (AUC) and the classification accuracy. Accuracy of tool detection and skill assessment. In total, 391 consecutive cataract procedures with 209 routine cases were used. Our model achieved an AUC ranging from 0.933 to 0.998 for tool detection. For skill classification, AUC was 0.550 (95% confidence interval [CI], 0.547-0.553) with an accuracy of 54.3% (95% CI, 53.9%-54.7%) for a single snippet, AUC was 0.570 (0.565-0.575) with an accuracy of 57.8% (56.8%-58.7%) for a single surgery, and AUC was 0.692 (0.659-0.758) with an accuracy of 63.3% (56.8%-69.8%) for a single user given all their trials. Our research shows that machine learning can accurately and independently identify distinct cataract surgery tools in videos, which is crucial for comparing the use of the tool in a step. However, it is more challenging for machine learning to accurately differentiate overall and specific step skill to assess the level of training or expertise. The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Exposure of Ophthalmology Residents to Cornea and Keratorefractive Surgeries in the United States

Abstract Purpose To describe the cornea and keratorefractive surgeries experience of U.S. ophthalmology residents. Methods Deidentified case logs of residents graduating in 2018 were collected from ophthalmology residency program directors in the United States. Using Current Procedure Terminology codes, case logs were reviewed in the categories of cornea and keratorefractive surgeries. Accreditation Council for Graduate Medical Education national graduating resident surgical case logs on cornea procedures published from 2010 to 2020 were also analyzed. Results Case logs were received for 152/488 (31.1%) residents from 36/115 (31.3%) ophthalmology residency programs. The most common procedures logged by residents as primary surgeons were pterygium removal (4.3 ± 4.2) and keratorefractive surgeries (3.6 ± 6.2). Residents logged an average of 2.4 keratoplasties as primary surgeon, performing an average of 1.4 penetrating keratoplasties (PKs) and 0.8 endothelial keratoplasties (EKs). As assistants, the most common procedures logged were keratorefractive surgeries (6.1 ± 4.9), EKs (3.8 ± 3.3), and PKs (3.5 ± 2.3). Medium or large residency class size was associated with higher cornea procedural volumes (odds ratio: 8.9; 95% confidence interval: 1.1–75.6; p &lt; 0.05). Conclusion The most common cornea surgeries performed by residents include keratoplasty, keratorefractive, and pterygium procedures. Larger program size was associated with greater relative cornea surgery volume. More specific guidelines for logging of procedures could provide a more accurate assessment of resident exposure to critical techniques such as suturing as well as reflect trends in current practice such as the overall increase in EKs.

Relative Importance of Applicant Characteristics in Ophthalmology Residency Interview Selection: A Survey of Program Directors.

Introduction Ophthalmology residency positions remain competitive. A lack of clarity regarding which residency selection criteria are prioritized by program directors can heighten the stress associated with the match process. While surveys of program directors in several other medical specialties have been conducted to identify the most important residency selection criteria, there is limited data on selection criteria used by ophthalmology residency program directors. The purpose of our study was to survey ophthalmology residency program directors to identify the current state of interview selection decisions-the factors currently considered most important in determining whether to extend an interview invitation to residency applicants. Methods We developed and distributed a Web-based questionnaire to all U.S. ophthalmology residency program directors. Questions evaluated program demographics and the relative importance of 23 different selection criteria used by ophthalmology residency program directors when evaluating applicants for residency interviews (Likert scale 1-5, with 1 being "not important" and 5 being "very important"). Program directors were also asked to identify the one factor they felt was most important. Results The overall residency program director response rate was 56.5% (70/124). The selection criteria with the highest average importance scores were core clinical clerkship grades (4.26/5) followed by letters of recommendation (4.06/5), and United States Medical Licensing Examination (USMLE) Step 1 score (4.03/5). The most frequently cited single most important factor for interview selection was core clinical clerkship grades (18/70, 25.7%), with USMLE Step 1 score (9/70, 12.9%) and rotations at the program director's department (6/70, 8.6%) also commonly reported. Conclusion Our results suggest that core clinical clerkship grades, letters of recommendation, and USMLE Step 1 scores are deemed the most important selection criteria by ophthalmology residency program directors as of a 2021 survey. With changes in clerkship grading for many medical schools and changes in national USMLE Step 1 score reporting, programs will face challenges in evaluating applicants and the relative importance of other selection criteria will likely increase.

In the Mind of the Ophthalmology Residency Applicant: Deciding Where to Apply, Interview, and Rank

Abstract Objective This article characterizes the resources used by ophthalmology residency applicants when deciding where to apply, interview, and rank. Design Cross-sectional, online survey. Participants All applicants to the University of California–San Francisco ophthalmology residency program during the 2019 to 2020 and 2020 to 2021 application cycles. Methods A secure, anonymous, 19-item post-match questionnaire was distributed to participants inquiring about demographic information, match outcomes, and resources used to learn and make decisions about residency programs. Results were analyzed using qualitative and quantitative methods. Main Outcome Measures Qualitative ranking of resources used to decide where to apply, interview, and rank. Results One hundred thirty-six of 870 solicited applicants responded to the questionnaire, for a response rate of 15.6%. Digital platforms were ranked as more important resources than people (i.e., faculty, career advisors, residents, and program directors) when applicants were deciding where to apply and interview. Digital platforms became far less important when applicants were formulating their rank lists, at which time the program's academic reputation, perceived happiness of residents and faculty, interview experience, and geographic location were more important. When learning about residency programs, 100% of respondents engaged with program Web sites, and the majority engaged with program emails (n=88 [85.4%]), Doximity (n=82 [79.6%]), Reddit (n=64 [62.1%]), Instagram (n=59 [57.3%]), the FREIDA residency program database (n=55 [53.4%]), and YouTube (n=53 [51.5%]). All 13 digital platforms included in the survey were utilized by at least 25% of respondents, largely passively (i.e., reading rather than producing content). Respondents indicated that the most important topics to include on program Web sites were the number of residents accepted per year, current resident profiles, and resident alumni job/fellowship placement. Conclusion Applicants engage heavily with digital media in deciding where to apply and interview but rely heavily on their personal experiences with the program in deciding where to rank. Ophthalmology programs may facilitate recruitment of applicants by optimizing their digital media platforms.

Impact of Social Media on Applicant Perspectives of Ophthalmology Residency Programs.

Purpose This article evaluates the relevance of social media to ophthalmology residency applicants in the setting of virtual interviews, the types of information sought by applicants, and the impact of rebranding of an institutional and departmental social media account. Design Cross-sectional survey. Participants Ophthalmology residency applicants from the 2020 to 2021 cycle. Methods A voluntary survey was emailed to 481 applicants to the University of Louisville Department of Ophthalmology residency during the 2020 to 2021 application cycle to gauge the impact of social media on their perspectives of residency programs, especially with regards to a new departmental social media account. Main Outcome Measures Applicants' use of social media platforms and specific components of departmental social media accounts found most useful. Results The 13-question survey was completed by 84/481 applicants (17.5% response rate). Social media was used by 93% of respondents. Of those respondents reporting social media use, the most common platforms utilized included Instagram (85%), Facebook (83%), Twitter (41%), and LinkedIn (29%). Sixty-nine percent of respondents specifically used Instagram to learn more about residency programs. With regards to the rebranded Instagram account at the University of Louisville, 58% of respondents reported being influenced, with all asserting that the account positively encouraged them to apply to the program. The most informative elements of the account related to current resident profiles, resident life, and living in Louisville. Conclusion A majority of responding ophthalmology residency applicants utilized social media to search for program information. A newly developed social media profile at a single institution positively influenced applicant impressions of the program, with the most importance assigned to information provided about current residents and typical resident life. These findings suggest key areas where programs should continue to dedicate online resources with targeted information to better recruit applicants.

Evaluation of Resident Satisfaction Towards Cataract Surgery Training in Nepalese Ophthalmology Residency Programs

Introduction: Although cataract surgery training is considered an integral part of all ophthalmology residency programs in Nepal, there is no literature about the training patterns and its effectiveness. The objective was to study the perspectives of young ophthalmologists towards the patterns and quality of cataract surgery training in their residency programs. Materials and methods: An anonymous web-based survey was conducted among MD Ophthalmology graduates completing their residency between January 2018 and December 2020 in Nepal. Results: A total of 74 respondents included graduates from all 13 medical colleges under four universities/ academic bodies. All the respondents were primarily trained in Manual Small Incision Cataract Surgery technique (MSICS) with 28.4% (n=21) also having limited exposure to phacoemulsification. Overall, 62.1 % (n=46) of respondents had some exposure to wet lab training. Around 42% (n=31) had performed less than 25 cataract surgeries as a primary surgeon during residency and only 36.5 % (n=27) felt confident enough to perform cataract surgery independently after completion. More than 47 % (n=35) graded their cataract surgery training experience to be poor or below average. Conclusions: Ophthalmology residency programs may need to reassess their surgical training methods as the majority of recently graduated ophthalmologists from Nepal feel inadequately trained in cataract surgeries.

Presence of Diversity or Inclusion Information on US Ophthalmology Residency Program Websites

Groups historically underrepresented in medicine also remain underrepresented within ophthalmology. Prospective applicants, in particular women and racial and ethnic minority groups, consider program factors related to gender diversity, ethnic diversity, and program culture more than nonminority groups. A prospective applicant's decision to apply to a particular residency program may be influenced by the information presented on the program's website. To evaluate for presence of diversity or inclusion information on US ophthalmology program websites. This quality improvement study, conducted from May 1 to June 2, 2021, included a cross-sectional review of ophthalmology program websites. Ophthalmology program websites were reviewed for the presence of 6 predetermined diversity or inclusion information criteria. The presence of 6 predetermined diversity or inclusion information criteria. Association between program size and ranking with presence of diversity or inclusion information criteria was assessed. Of the 121 US program websites reviewed, 29 (24%) met at least 1 of the 6 predetermined criteria. Programs with more than 12 residents (odds ratio [OR], 3.58; 95% CI, 1.39-9.55; P = .004) and programs ranked within the top 20 best hospitals for ophthalmology (OR, 3.28; 95% CI, 1.05-10.1; P = .02) were more likely to have at least 1 of the diversity or inclusion information criteria on their website. Results of this quality improvement study suggest that the majority of US ophthalmology residency programs do not have information regarding diversity or inclusion on their websites. Although this investigation cannot determine how an ophthalmology residency program's website reflects the diversity and inclusion within the program, these findings suggest that there is a gap in the information that prospective applicants can collect when evaluating ophthalmology residency program websites.

Ophthalmology Resident Ophthalmic Trauma Case Exposure: Trends Over Time and an ACGME Case Log Analysis.

PurposeTo describe ophthalmology resident experience with ophthalmic trauma cases in the U.S. MethodsWe analyzed Accreditation Council for Graduate Medical Education (ACGME) case log data and de-identified case logs from US ophthalmology residency programs for residents graduating in 2018. Current Procedural Terminology (CPT) codes documented as “Globe Trauma” and trauma-related “Oculoplastic and Orbit” codes including lid lacerations and lateral canthotomies were analyzed.Results38 residency programs provided case logs (response rate: 32.2%). Residents performed an average of 7.24±4.37 open globe repairs, 8.66±6.94 lid laceration repairs, 0.49±1.4 orbital fracture repairs, 1.22±1.81 lateral canthotomies, and 0.28±0.69 anterior chamber washouts as primary surgeon. On average, the most logged “Globe Trauma” procedure was open globe repair as primary surgeon. The more common trauma-related “Oculoplastic and Orbit” procedure was lid laceration repair as primary surgeon. 42.8% of residents did not log any lateral canthotomy procedures. Medium programs performed significantly more canthotomies than large programs (F(2166) = 6.35, p = 0.002), and large programs performed significantly more orbital fracture repairs than small and medium programs (F(2166) = 4.45, p = 0.013).ConclusionSignificant variation in globe trauma volume exists across programs. ACGME guidelines require a minimum of four globe trauma procedures for graduation, but procedures like anterior chamber paracentesis count towards this requirement. Open globe repairs, simple lid lacerations, and lateral canthotomies are basic skills every graduating resident should be competent in. Updating ACGME case log requirements for ophthalmic trauma and increasing opportunities for wet lab simulations may assist in ensuring graduating ophthalmology residents’ competency in performing these procedures.

An update on the novel approaches towards skills assessment of ophthalmology residents in the Indian scenario.

An essential part of the teaching-learning paradigm is assessment. It is one of the ways to achieve feedback for the various methods that have been used to impart a particular skill. This is true of ophthalmology training, where various clinical and surgical skills are learned as part of the residency program. In preparation for residents to become proficient ophthalmologists, both formative and summative assessments are of paramount importance. At present, assessment is primarily summative in the form of a university examination, including theory and practical examinations that are conducted at the end of the three years of residency. A formative assessment can make course corrections early on, allowing for an improved understanding of the subject and the acquisition of clinical and surgical skills. Formative assessments also allow us to customize the teaching methodology considering individual residents’ learning capabilities. In addition, formative assessments have the advantage of alleviating the stress of a “final” examination, which could sometimes result in a less-than-optimum performance by the residents. The COVID-19 pandemic has forced us to adopt new teaching methods, which has led to the adoption of changes in assessment. In this regard, we discuss the different assessment tools available, their pros and cons, and how best these tools can be made applicable in the setting of an ophthalmology residency program.

Demographics, clinical interests, and ophthalmology skills confidence of medical student volunteers and non-volunteers in an extracurricular community vision screening service-learning program

BackgroundMedical school curricular hours dedicated to ophthalmology are low and declining. Extracurricular ophthalmology activities, such as participation in community vision screenings, may serve an important adjunctive role in medical school curricula. The Johns Hopkins University (JHU) Vision Screening In Our Neighborhoods (ViSION) Program is an example of a voluntary medical student-directed community service-learning program.MethodsWe used a mixed-methods cross-sectional approach, including an online survey and semi-structured interviews. JHU School of Medicine students enrolled in MD or MD/PhD programs during the 2019–2020 academic year were surveyed regarding demographics, career and service interests, involvement in ophthalmology-related activities, and confidence in their ophthalmology-related skills. Survey responses were compared between ViSION volunteers and non-volunteers using Fisher’s exact chi-square tests. Semi-structured interviews were conducted via webconference with 8 prior or current ViSION volunteers and responses analyzed using inductive thematic analysis. Data were collected when ViSION volunteers were in variable stages of their medical education and involvement with the ViSION program.ResultsA total of 118 medical students were included, representing an overall response rate of 24.6% of JHU medical students. ViSION volunteers reported greater involvement in ophthalmology-related research (42% vs. 4%, p < 0.001), intent to apply to ophthalmology residency programs (35% vs. 1%, p = 0.001), and confidence with multiple ophthalmology knowledge and clinical skill domains. In particular, ViSION volunteers were more likely to feel confident estimating cup-to-disc ratio using direct ophthalmoscopy (20% vs. 0%, p < 0.001). In open-ended survey and interview questions, most volunteers attributed at least some degree of their ophthalmology skill development and desire to pursue ophthalmology and public health careers to their ViSION experience.ConclusionsMedical students who volunteered with a student-led community vision screening program were more likely to have a prior interest in ophthalmology than those who did not volunteer, but only 1/3 of volunteers planned to pursue a career in ophthalmology. Overall, volunteers reported higher confidence performing ophthalmology-related clinical skills, suggesting that student-led community vision screening programs may provide an important avenue for medical students to explore public health aspects of ophthalmology, while practicing ophthalmology exam skills and learning about common ophthalmic pathologies, regardless of their career intentions.

The impact of COVID-19 on ophthalmology resident surgical experience: a retrospective cross-sectional analysis

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic caused significant disruption to in-office and surgical procedures in the field of ophthalmology. The magnitude of the impact of the pandemic on surgical training among ophthalmology residents is not known. This study aims to quantify changes in average case logs among United States (U.S.) ophthalmology residency graduates prior to and during the COVID-19 pandemic.MethodsRetrospective, cross-sectional analysis of aggregate, national data on case logs of U.S. ophthalmology residency graduates from 2012 to 2020. The yearly percent change in the average number of procedures performed in the Accreditation Council for Graduate Medical Education (ACGME) ophthalmology resident case logs were analyzed using linear regression on log-transformed dependent variables. The average percent change from 2019 to 2020 was compared to the average yearly percent change from 2012 to 2019 for procedures performed as the primary surgeon, and primary surgeon and surgical assistant (S + A), as well as procedures for which there are ACGME minimum graduating numbers.ResultsAcross all procedures and roles, average case logs in 2020 were lower than the averages in 2019. While average total cases logged as primary surgeon increased yearly by 3.2% (95% CI: 2.7, 3.8%, p < 0.001) from 2012 to 2019, total primary surgeon case logs decreased by 11.2% from 2019 to 2020. Cataract (-22.0%) and keratorefractive (-21.1%) surgery experienced the greatest percent decrease in average primary surgeon cases logged from 2019 to 2020. Average total cases logged as S + A experienced an average yearly increase by 1.2% (95% CI: 0.9,1.6%, p < 0.001) prior to 2020, but decreased by 9.6% from 2019 to 2020. For ACGME minimum requirements, similar changes were observed. Specifically, the average case logs in YAG, SLT, filtering (glaucoma), and intravitreal injections had been increasing significantly prior to 2020 (p < 0.05 for all) but decreased in 2020.ConclusionsThese findings demonstrate the vulnerability of ophthalmology residency programs to a significant interruption in surgical volume. There is a critical need for development of competency-based, rather than volume-based, requirements to evaluate readiness for independent practice.

Characteristics of First-Year Residents in Top-Ranked United States Ophthalmology Residency Programs.

Objective The aim of the study is to investigate the characteristics of first-year residents associated with attending a top-ranked United States (U.S.) ophthalmology residency program over the past decade. Methods First-year ophthalmology residents in 2009, 2013, 2016, and 2019 were identified from institutional websites, Doximity, LinkedIn and the Wayback Machine. Publications were obtained from Scopus and Google Scholar; research productivity was measured using the h -index, and medical school region based on U.S. Census Bureau designations. Medical school and ophthalmology training program rankings were based on U.S. News & World Report (U.S. News) rankings and National Institutes of Health (NIH) funding. One-way ANOVA, Wilcoxon rank sum, χ 2 , and t -tests were used to analyze trends, and odds ratios (ORs) were calculated using logistic regression. Results Data were obtained on 81% (1,496/1,850) of the residents; 43% were female; 5% were international medical graduates (IMGs); and 10% had other graduate degrees. Over the decade, the mean h -index increased (0.87-1.26; p <0.05) and the proportion of residents who attended a top 20 medical school decreased (28-18%; p <0.05). In a multivariate logistic regression model, characteristics associated with being a first-year resident in a top 20 program ranked by U.S. News were female gender [OR: 1.32, 95% CI: 1.02-1.72], having a Master's degree [OR: 2.28, 95% CI: 1.29-4.01] or PhD [OR: 2.23, 95% CI: 1.32-3.79], attending a top 20 [OR: 5.26, 95% CI: 3.66-7.55] or a top 40 medical school by NIH funding [OR: 2.45, 95% CI: 1.70-3.54], attending a medical school with a mean USMLE Step 2 score above 243 [OR: 1.64, 95% CI: 1.01-2.67] or located in the Northeast [OR: 2.00, 95% CI: 1.38-2.89] and having an h -index of one or more [OR: 1.92, 95% CI: 1.47-2.51]. Except for gender, these characteristics were also significantly associated with matching to a top 20 ophthalmology program by NIH funding. Conclusion Female gender, graduate degrees, research productivity, and attending a medical school with high research productivity, high mean USMLE Step 2 score or in the Northeast were key characteristics of first-year residents in top-ranked U.S. ophthalmology residency programs.

Adoption and Use of Social Media Platforms by Ophthalmology Programs during the COVID-19 Pandemic.

Purpose The aim of this study was to determine whether the coronavirus disease 2019 (COVID-19) pandemic influenced the presence of ophthalmology residency programs on social media platforms. Methods The presence of all accredited ophthalmology residency programs on Twitter and Instagram was assessed for January 2020 and August through March 2021 through an online search. The number of followers and posts per month during these periods was collected for each program. The presence of programs on social media was compared between the two time periods. Results The percentage of programs on Instagram rose from 18% in January of 2020 to 57% in March of 2021 ( p < 0.001). On Twitter, the percentage of programs rose from 24 to 37% ( p < 0.001). From January 2020 to March 2021, the mean number of Instagram followers increased from 265 to 649 ( p < 0.0001), while the mean number of Twitter followers increased from 421 to 532 ( p < 0.0001). The top ten ophthalmology residency programs in 2021 according to Doximity all had Instagram pages, while 57 (53%) of remaining programs had pages ( p = 0.005). Meanwhile, 7 top ten programs (70%) were on Twitter compared with 36 (34%) of the remaining programs ( p = 0.036). Conclusions The presence of ophthalmology residency programs on Instagram and Twitter increased significantly after the onset of the COVID-19 pandemic. Social media represents an evolving platform through which programs can connect with prospective residents.