Ophthalmology Residency Programs Research Articles

Trends in female applicants to Canadian ophthalmology residency programs from 1998-2020

Background: Ophthalmology has historically been a male-dominated specialty. Despite there being a higher proportion of females in Canadian medical schools since the early 2000s, it is unknown if trends in female applicants and those accepted to ophthalmology have followed suit. This study aims to evaluate trends in gender representation of ophthalmology applicants to Canadian residency programs from 1998 to 2020 and to compare those trends to other surgical specialties. Methods: We obtained aggregate data of the annual number of male and female applicants ranking and successfully matching to ophthalmology as their first-choice specialty from the Canadian Residency Matching Service (CaRMS) database. We then carried out a retrospective cross-sectional analysis on the publicly available data. Subsequently, we compared trends in female applicants to ophthalmology, as well as female practicing ophthalmologists, to other surgical disciplines. Results: The proportion of female applicants increased from 24.3% in 1998 to 33.3% in 2020 (p = 0.001), and matched female applicants increased from 28.6% in 1998 to 40.5% in 2020 (p = 0.023). However, the incremental change in proportion did not statistically significantly increase in 2008-2012, 2013-2016, and 2017-2020. Comparison of male and female matching success rates did not reveal a significant difference (p = 0.45). Trends in female applicants to ophthalmology and female practicing ophthalmologists were similar to other surgical specialties. Conclusions: Although the proportion of female applicants is increasing, there is a recent plateau and an inability to equalize the female-to-male ratio in ophthalmology. Further studies are needed to identify potential barriers and mitigate possible residual gender biases.

Female Leadership in Pediatric Ophthalmology: A Descriptive Analysis.

To examine female representation among current chiefs of pediatric ophthalmology services of academic medical centers and children's hospitals, as well as program directors of ophthalmology residency and pediatric ophthalmology fellowship programs in the United States. Data collection for this cross-sectional study occurred between December 2023 and February 2024, using publicly available sources to compile a list of academic medical centers and children's hospitals, as well as ophthalmology residency programs and pediatric ophthalmology fellowship programs that participated in the 2023-2024 San Francisco Match. Chi-squared analyses were performed using Excel 2021 software, where a P value less than .05 was considered statistically significant. Of the dedicated pediatric ophthalmology services across academic medical centers and children's hospitals in the United States, 38.3% (64/167) are led by a female chief. Female representation was greater at children's hospitals (40.0%, 36/90) than at academic medical centers (36.4%, 28/77), although no significant difference was observed (P = .69). Gender distribution was near equivalent at both academic training program levels, with slightly more female directors of fellowship programs (45.7%, 21/46) than ophthalmology residency programs (42.3%, 52/123) (P = .33). The authors report near equivalent female representation in the leadership of academic training programs at the residency and fellowship level. However, the proportion of female pediatric ophthalmology division chiefs lags behind the actual gender composition of the workforce. Given the increasing prevalence of female pediatric ophthalmologists, promotion of concordant representation in leadership is necessary to reflect the changing sociocultural landscape and to close the gender gap. [J Pediatr Ophthalmol Strabismus. 20XX;X(X):XX-XX.].

Exploring Social Media's Influence on Ophthalmology Residency Program Selection

Exploring Social Media's Influence on Ophthalmology Residency Program Selection

Geographic Trends in Ophthalmology Resident Physician Compensation and Cost-of-Living Expenses

Given that resident physician financial strain has been associated with poor outcomes, objective metrics to forecast financial well-being may be useful to (1) applicants when evaluating ophthalmology residency programs and (2) programs when determining resident benefits. To determine and compare the relative value of ophthalmology resident stipends plus benefits when adjusted for cost-of-living expenses and to analyze program characteristics associated with greater resident net incomes. In this cross-sectional study, the American Medical Association's Fellowship and Residency Electronic Interactive Database was used to identify US Accreditation Council for Graduate Medical Education-accredited ophthalmology residency programs. Resident physician stipends and stipends plus benefits as well as residency program characteristics from the 2023-2024 academic year were noted for all eligible programs. The Massachusetts Institute of Technology's Living Wage Calculator's required annual income (RAI) was selected as a surrogate to approximate cost-of-living expenses. Residency program characteristics, including affiliation, size, ranking, presence of housing benefit, and training year. The primary outcome was the annual stipend plus benefits income surplus (SPBIS) for each residency program, defined as the resident's stipend plus benefits (SPB) minus the RAI for the county in which the residency program is located. Secondary outcomes included income surplus variation by program characteristics. Of 116 ophthalmology residency programs analyzed, 37 (31.9%) were located in the Northeast, 36 (31.0%) in the South, 29 (25.0%) in the Midwest, and 14 (12.1%) in the West. The mean (SD) postgraduate year 1 resident annual SPB was $65 397 ($8205), and the median (IQR) was $63 986 ($59 992-$69 698). After adjusting for the cost of living, the mean (SD) SPBIS was $27 459 ($5734) and the median (IQR) was $27 380 ($23 625-$31 796). Annual cost-of-living expenses varied by as much as $8628 (95% CI, $6310-$10 947) and SPBIS varied by as much as $6283 (95% CI, $3367-$9198) between regions. Resident SPB increased by a mean (SD) of 3.97% (0.98%) for each subsequent training year (range, 0.93%-7.26%). Annual SPBIS increased by a mean (SD) of 9.48% (3.60%) for each subsequent training year. After adjusting for living costs, intraregional and interregional differences in SPBIS among ophthalmology residents can vary by thousands of dollars, impacting residents' financial security. Further discussion regarding compensation may lead to innovative strategies that aim to improve resident well-being and performance.

Bridging gaps in ophthalmology residency programs: the link between practice, training and confidence in ocular examination and gonioscopy for diagnosing glaucoma, a blinding disease

BackgroundTo evaluate real-world utilization of gonioscopy for diagnosing glaucoma among ophthalmologists with diverse subspecialties, and understand current perceptions of teaching, training, and confidence in gonioscopy.MethodsA nationwide anonymous online survey was conducted among practicing ophthalmologists, querying about demographics, professional experience, practice of routine ocular examination for glaucoma and perceptions of confidence in performing them.Results136 ophthalmologists participated in the survey, with various levels of experience from residency to over twenty years of ophthalmology practice. Glaucoma specialists comprised 23 (16.9%) of the participants. Of the non-glaucoma-specialist respondents, only 33 (29.2%) expressed being highly confident in interpreting gonioscopic findings, which correlated significantly with their self-reported inadequate level of training in gonioscopy during residency (p < 0.001) and even more so with their low frequency of implementing gonioscopy in routine examinations (p < 0.001). The commonly cited reasons for the low practice of gonioscopy were insufficient time allotted to examinations and lack of experience, knowledge or equipment.ConclusionsGonioscopy is fundamental to the detection of glaucoma. This study reveals underutilization of gonioscopy in the practice of ophthalmology and its association with lower training opportunities, calling for expedited changes in the residency’s curriculum, alongside measures to promote its use in clinical practice.

The Diagnostic Accuracy of First-Year Ophthalmology Residents on Call: Considerations for Postgraduate Year 2 (PGY-2) Standardizations of Call Structure.

Background Ophthalmology is a unique specialty with limited exposure during medical school. To improve the transition to ophthalmology residency, the Accreditation Council for Graduate Medical Education (ACGME) announced in 2017 that all ophthalmology residency programs would move to a combined post-graduate year (PGY) 1 year with mandatory integration by 2023.Currently, there are no standardized guidelines from the American Board of Ophthalmology (ABO) or the Accreditation Council for Graduate Medical Education (ACGME) to address ophthalmology resident competence prior to becoming the primary contact for inpatient and emergency room (ER) consultations as a PGY-2. Novice residents may not be equipped to accurately diagnose vision or life-threatening ocular conditions. A balance between resident autonomy and supervision is required for proper training without increasing patient morbidity and mortality. Objective This study's objective is to examine the diagnostic accuracy of PGY-2 ophthalmology non-integrated residents on call to standardize supervision requirements (through buddy-call) prior to initiating indirectly supervised calls. Methods All inpatient and ER ophthalmology consults for the first seven weeks of the year evaluated by PGY-2 (junior) residents were supervised and graded as "correct" or "incorrect" by PGY-4 (senior) residents. Results One hundred forty-eight consults were seen over 30 call days over a period of seven weeks (4.93 consults per call). The percentage of correct diagnoses increased with each successive week (R2= 0.9581; correlation = 0.979). The greatest percent increase of correctly diagnosed encounters was between weeks 2 and 3 (19.14%) correlating to call numbers 10-16and 45-68 patient encounters. The mean percent accuracy surpassed 70% during weeks 3-4, and improvement continued to week 7. High-acuity diagnoses were identified consistently 100% of the time from week 5 onward. Conclusion Our analysis indicated that diagnostic accuracy was greater than 70% between weeks 3 and 4 with high-acuity diagnostic accuracy reaching 100% at week 5. It can be postulated that optimal direct senior resident supervision is needed for at least 3-5 weeks before transitioning to indirectly supervised calls by PGY-2 residents. This standardization would allow junior residents to acquire sufficient clinical experience to accurately make a diagnosis and prevent patient morbidity. Further research nationally is necessary prior to creating a standardized call structure for PGY-2 residents especially with the newly mandatory integrated ophthalmology residency programs.

Perceptions of the learning environment in ophthalmology residency training: A mixed method study

Introduction: A good learning environment (LE) will affect the quality and standard of the learning process, student performance, and the outcome of the curriculum as well as predictor of the quality of health services. Our study aims to assess residents’ perception of the LE in Ophthalmology training programs for future improvement. Methods: Mixed method with an explanatory sequential design was implemented in this study using the Post-graduate Hospital Educational Environment Measure (PHEEM) as a quantitative approach and open-ended questions collaborated with focus group discussion (FGD) as a qualitative measurement. A comparison of the quantitative data was made using parametric and non-parametric analyses. Thematic analyses were performed for qualitative data. Integration of quantitative and qualitative data was done by connecting both data. Results: Fifty-three residents participated in this survey. The mean age was 30.96±2.18 years old, 64.15% were female and 77.36% are at the internship stage. The mean score of overall PHEEM was 123.40 ±12.35, indicated an excellent LE, while the mean score of perceptions of role autonomy, perceptions of teaching, and perceptions of social support were 42.57±4.62, 47.75±4.84 and 33.08±4.15, respectively. There is no significant difference between gender and study period with the perception of LE. Thematic analysis from qualitative data reveals six positive and five negative perception themes. All discovered themes confirmed concordance with the result of LE perception. Conclusion: Learning environment perception in the ophthalmology residency program was excellent and essential for the student's skills and performance quality. Some specific areas still need improvement strategies for institutional development. Keywords: Learning Environment, PHEEM, Ophthalmology, Residency, Mixed Method

Bias Reduction Practices in Underrepresented Groups in Ophthalmology Resident Recruitment

Best recruitment practices for increasing diversity are well established, but the adoption and impact of these practices in ophthalmology residency recruitment are unknown. To describe the adoption of bias reduction practices in groups underrepresented in ophthalmology (URiO) residency recruitment and determine which practices are effective for increasing URiO residents. This cross-sectional survey study used an 18-item questionnaire included in the online survey of the Association of University Professors in Ophthalmology (AUPO) Residency Program Directors. Data collection occurred from July 2022 to December 2022. The data were initially analyzed on January 16, 2023. Participants included residency program directors (PDs) in the AUPO PD listserv database. Descriptive analysis of resident selection committee approaches, evaluation of applicant traits, and use of bias reduction tools. Primary outcome was diversity assessed by presence of at least 1 resident in the last 5 classes who identified as URiO, including those underrepresented in medicine (URiM), lesbian, gay, bisexual, transgender, queer, intersex, and asexual plus, or another disadvantaged background (eg, low socioeconomic status). Multivariate analyses of recruitment practices were conducted to determine which practices were associated with increased URiO and URiM. Among 106 PDs, 65 completed the survey (61.3%). Thirty-nine PDs used an interview rubric (60.0%), 28 used interview standardization (43.0%), 56 provided at least 1 bias reduction tool to their selection committee (86.2%), and 44 used postinterview metrics to assess diversity, equity, and inclusion efforts (67.7%). Application filters, interview standardization, and postinterview metrics were not associated with increased URiO. Multivariate logistic regression analysis showed larger residency class (odds ratio [OR], 1.34; 95% CI, 1.09-1.65; P = .01) and use of multiple selection committee bias reduction tools (OR, 1.47; 95% CI, 1.13-1.92; P = .01) were positively associated with increased URiO, whereas use of interview rubrics (OR, 0.72; 95% CI, 0.59-0.87; P = .001) and placing higher importance of applicant interest in a program (OR, 0.83; 95% CI, 0.75-0.92; P = .02) were negatively associated. URiM analyses showed similar associations. Ophthalmology residency interviews are variably standardized. In this study, providing multiple bias reduction tools to selection committees was associated with increased URiO and URiM residents. Prioritizing applicant interest in a program may reduce resident diversity. Interview rubrics, while intended to reduce bias, may inadvertently increase inequity.

The Challenge in Building Diverse Ophthalmology Residency Programs

The Challenge in Building Diverse Ophthalmology Residency Programs

Exploring Underrepresentation: The Role of Diversity Statements in Ophthalmology Residency Programs.

The underrepresentation of underrepresented minorities (URMs) in the medical field, particularly in ophthalmology, poses a critical challenge to achieving diversity and equity. While URMs constitute 19% of medical school attendees, their presence is markedly lower in ophthalmology residency programs and among practicing ophthalmologists. This study seeks to investigate the prevalence of diversity statements on ophthalmology residency program websites and their role in the underrepresentation of URMswithin the field. This observational, cross-sectional study analyzed the websites of 126 ophthalmology residency programs listed on the San Francisco (SF) Match website. Diversity statements were categorized based on their inclusion of specific underrepresented groups (race or ethnicity, gender, sexual orientation, and disability) and analyzed for correlation with program characteristics. Descriptive statistics and Chi-squared tests were utilized to assess the prevalence of diversity statements and their association with program size, ranking, geographical location, and institutional nature. Of the 126 programs analyzed, 21 (16.7%) had diversity statements specific to the ophthalmology residency program, and 115 (91.3%) featured institutional-level diversity statements. Race or ethnicity was the most commonly addressed category in diversity statements (75.3%), followed by gender (65.9%), sexual orientation (61.1%), and disability (53.2%). Statistical analyses revealed no significant correlation between program size and the presence of diversity statements. However, higher-ranked programs were more likely to mention sexual orientation and disability. Significant differences were observed at the institutional level, with public institutions more likely to include specific diversity categories. The study highlights a significant disparity in the presence and focus of diversity statements across ophthalmology residency programs. Despite a high prevalence of institutional-level diversity statements, program-specific initiatives are lacking, particularly in addressing disability inclusion. The findings suggest a need for a more comprehensive and targeted effort to address underrepresentation in ophthalmology.

An Ergonomic Risk Assessment of Ophthalmology Residents Using the Rapid Entire Body Assessment (REBA) Scale.

The healthcare industry has one of the highest rates of work-related injuries. Ophthalmologists are at particularly high risk for developing musculoskeletal disorders (MSDs), which are often the result of repetitive movements, such as performing slit lamp examinations. Previous studies used the Rapid Entire Body Assessment (REBA) scale to determine the ergonomic risk of a particular task.Higher REBA scores correlate with increased risk of injury, which ranges from negligible risk (1) to very high risk (11+). Given the long-term implications of repetitive examinations by ophthalmologists, this study aims to describe the average ergonomic risk posed to residents using the REBA scale. This descriptive case study assessed four ophthalmology residents performing slit lamp examinations between September 2022 and February 2023. Photographs were taken of residents performing slit lamp examinations. Total REBA scores, Score A, Score B, and the REBA scores for each participant were calculated and compared. The average REBA score across all participants was 4.59 (SD±0.89). The highest score was 7.00 and the lowest was 3.00. The average Score A, representing posture for the head, leg, and trunk, was 3.54 (SD±0.74) and the average Score B, representing posture for the upper arm, lower arm, and wrist, was 3.18 (SD±1.22). Our study found that residents are at increased risk for developing MSDs. Furthermore, variation in REBA scores between residents indicates that not all residents are at equal ergonomic risk. This highlights an opportunity for ophthalmology residency programs to implement ergonomics training into their curriculum.

An Analysis of Medical Student PubMed-Indexed Research Productivity and Factors Associated With Matching at Top-Ranked Ophthalmology Residency Programs.

Background Limited information exists regarding the research productivity of matched ophthalmology applicants given that ophthalmology residencies do not participate in the National Residency Match Program. Objectives This study determines the research productivity characteristics of matched ophthalmology applicants and variables associated with matching to higher-tier ophthalmology residency programs. Methods Medical school, matched residency program, and applicant-specific PubMed-indexed research productivity (including consideration for first-author publications, relevance to ophthalmology, and acceptance before application submission date) for 2020-2021 matched ophthalmology applicants were collected from publicly available websites. Statistical analysis was conducted using chi-squared tests and t-tests to compare research productivity between groups (gender, medical school tier, and ophthalmology residency program Doximity rank). Multivariate regression was used to analyze research factors associated with matching at the top 20 Doximity-ranked ophthalmology residency programs. Results Three hundred ninety-three matched ophthalmology applicants for the 2020-2021 academic year were analyzed with an average of 2.4 ± 3.1 (median: 1 {0-3}) publications, 1.0 ± 2.1 (median: 0 {0-1}) ophthalmic publications, 0.8 ± 1.4 (median: 0 {0-1}) first-author publications, and 0.5 ± 1.1 (median: 0 {0-1}) ophthalmic first-author publications. The applicants who matched at the top 20 Doximity-ranked ophthalmology residency programs were more likely to matriculate from the top 40 medical schools (63% versus 22%, p < 0.001), have more first-author publications at the time of application submission (1.1 ± 1.6 versus 0.7 ± 1.3, p = 0.044), and have more projects resulting in publications after submission (2.0 ± 2.5 versus 1.4 ± 2.3, p = 0.048). In multivariate regression, attendance at a top 40 medical school (adjusted odds ratio {aOR} = 6.07, 95% confidence interval {CI}: 3.56-10.5, p < 0.001) was a significant predictor of matching at a top 20 Doximity ophthalmology residency program, and no variables associated with research productivity were significant predictors. Conclusions There has been a consistent increase in research productivity among matched ophthalmology applicants. However, in multivariate analysis, the medical school tier was the only significant variable for matching at top-tier programs. More nuanced studies regarding the effect of research productivity on ophthalmology applicants are needed.

Characterizing the initial effects of the single accreditation system merge on the ophthalmology residency match

ABSTRACT Introduction In 2020, the American Osteopathic Association merged its residency programs into one system under the Accreditation Council for Graduate Medical Education (ACGME). The effects of this transition on the ophthalmology match is not fully understood. The purpose of this study is to assess the early impact of the transition to ACGME accreditation on MD, DO, and IMG representation in ophthalmology residency programs. Materials and Methods Information about resident medical degree and resident medical school was gathered from ophthalmology residency program websites from a resident class before and after the Transition. Additionally, the medical degree of residency program directors (PD) was collected to analyze MD vs DO leadership in ophthalmology residency programs and to further stratify resident data to identify any trends in PD preference for different medical graduates. Results Data was obtained for 915 ophthalmology residents in 110 residency programs that met the study’s inclusion criteria. Of these programs, 102 were allopathic with MD leadership, 1 was allopathic with DO leadership, 3 were osteopathic with MD leadership, and 4 were osteopathic with DO leadership. Overall, MD representation increased while DO and IMG representation decreased although not significantly. For both classes analyzed, DO and IMG representation was disproportionately low. Discussion The transition to ACGME accreditation seems to have primarily harmed DO and IMG applicants in the ophthalmology match while benefitting MDs. Various factors such as loss of protected residency positions for DO applicants and the closure of osteopathic ophthalmology residency programs are likely reasons to blame for this decrease in osteopathic representation.

Demographics and Research Activity Among 2023 Academic Glaucoma Specialists

ABSTRACT Purpose To characterize demographics, academic characteristics, and research activity of academic glaucoma specialists. Methods Faculty demographic and academic data were recorded for glaucoma specialist faculty from 99 United States ophthalmology residency programs using institutional websites, Doximity, and LinkedIn. H-index was calculated using Scopus. Mean and weighted relative citation ratio (RCR), measuring research impact and productivity, respectively, was determined with the National Institute of Health iCite tool. Results Most academic glaucoma specialists were men (0.61), located in the Southern United States (0.316), and in practice for less than or equal to 10 years in 2023 (0.324). Twenty-six percent had additional professional degrees, and 11% completed fellowship training in addition to clinical glaucoma. Assistant professor was the most common academic appointment (0.479), and almost a quarter (0.23) had additional positions. Mean h-index (13.3), mean-RCR (1.76), and weighted-RCR (84.0) were consistent with high research productivity and impact. Gender comparison found that men had significantly higher h-index (p < .001), m-RCR (p = .007), w-RCR (p < .001) as compared to women. H-index (p < .001; p < .001; p < .001), m-RCR (p = .006; p < .001; p < .001), and w-RCR (p < .001; p < .001; p < .001) also increased with career duration, academic position, and additional academic appointments, respectively. Additional training was associated with higher h-index (p = .023) and w-RCR (p = .012), but not m-RCR (p = .699). Conclusion Higher research activity is significantly associated with higher departmental positions and additional academic appointments. This illustrates the importance of research contributions for academic promotion. Variations in research activity by gender distribution may therefore affect opportunities for career advancement.

Predictors of Ophthalmology Resident Performance From Medical Student Application Materials

To determine whether elements in ophthalmology residency applications are predictors of future resident performance. This multi-institutional, cross-sectional, observational study retrospectively reviewed the residency application materials of ophthalmology residents who graduated from residency from 2006 through 2018. Resident performance was scored by 2 faculty reviewers in 4 domains (clinical, surgical, academic, and global performance). Correlation between specific elements of the residency application and resident performance was assessed by Spearman correlation coefficients (univariate) and linear regression (multivariate) for continuous variables and logistic regression (multivariate) for categorical variables. Seven ophthalmology residency programs in the US. Ophthalmology residents who graduated from their residency program. High-performing residents were a diverse group, in terms of sex, ethnicity, visa status, and educational background. Residents with United States Medical Licensing Examination Step 1 scores higher than the national average for that year had significantly higher scores in all 4 performance domains than those who scored at or below the mean (all domains P < 0.05). Residents who had honors in at least 4 core clerkships and who were members of Alpha Omega Alpha Medical Honor Society also had higher scores in all 4 performance domains (all domains P ≤ 0.04). Step 1 score (ρ=0.26, P < 0.001) and the difference between Step 1 score and the national average for that year (ρ=0.19, P = 0.009) positively correlated with total resident performance scores. Residents who passed the American Board of Ophthalmology Written Qualifying Examination or Oral Examination on their first attempt had significantly higher Step 1/2 scores (P ≤ 0.005), Ophthalmology Knowledge Assessment Program scores (P = 0.001), and resident performance scores (P ≤ 0.004). In this new landscape of increasing numbers of applicants to residency programs and changing of the Step 1 score to pass/fail, our findings may help guide selection committees as they holistically review applicants to select exceptional future residents in ophthalmology.

Analysis of Reapplicants to Ophthalmology Residency: Factors Associated with Successful Matching

ABSTRACT Background Ophthalmology residency programs are highly competitive and each year there are many unmatched reapplicants who must make time-sensitive decisions on how to prepare for their reapplication. Our analysis of reapplication factors will be the first evidence-based guide to reapplying ophthalmology. Objective To determine the components of a reapplicants application that contribute and that do not contribute to ophthalmology residency match success. Methods Eighty-eight total reapplicants to Dell Medical School’s Department of Ophthalmology residency program for the year of 2022 and 2023 were analyzed in a retrospective review in 2023 based on their San Francisco match applications. We assessed match success in the context of demographics, academic performance, cognitive measures, letters of recommendation, personal statements, and extracurricular activities. Results Of 84 reapplicants who completed the San Francisco Match, 41 matched successfully (48.8%). Factors that significantly affected match success include quantity of LORs written by ophthalmologists (P = .0143), choice of interim year activity (p = .0019), and Step 2 Clinical Knowledge score (P = .0017). Our findings demonstrate that noncontributory factors to reapplicant match rate include number of publications during research years, demographics, clinical grades, Alpha Omega Alpha (AOA) membership, LOR qualities, and Step 1 score. Conclusions Ophthalmology residency reapplicants should focus their efforts on finding a research year or established pre-ophthalmology residency program for their interim year and bolstering their letters of recommendations within the field. The quality of in-specialty relationships and letters of recommendation are more impactful than the number of publications during a research gap year. Step 2 CK score is a significant factor but would have already been determined by the time of reapplication. Metrics such as Step 1 scores, AOA status, number of volunteering experiences, and LOR and personal statement qualities had no effect on a reapplicant’s chance of matching.

Patient Demand for Ophthalmologists in the United States: A Google Trends Analysis

ABSTRACT Purpose To study geographic patterns in ophthalmologist supply and patient demand for services in the United States. Methods Google Trends data for the keywords “ophthalmology” and “ophthalmologist” between 2004 and 2019 were queried and normalized to determine relative search volumes (RSV) for each United States state. Ophthalmologist density was calculated by dividing the number of practicing ophthalmologists by the State Census Bureau population estimates. RSV values were divided by ophthalmologist density and normalized to calculate the relative demand index (RDI) for each state. The number of accredited ophthalmology programs per state was acquired through the Accreditation Council for Graduate Medical Education. Results Ophthalmologist concentration was highly heterogeneous across the country. The states with the highest concentration of ophthalmologist per 10,000 people were Washington, DC (1.42), Maryland (0.94), Massachusetts (0.87), and New York (0.86), while the lowest were Wyoming (0.19), Idaho (0.36), New Mexico (0.38), and Nevada (0.39). RSVs ranged from 36 (Alaska and North Dakota) to 100 (Michigan). The highest RDI was found in South Dakota (100), Delaware (84), Michigan (66), and Arizona (56). The lowest RDI was in Washington, DC (0), Hawaii (7), Oregon (8), and Montana (14). The highest number of ophthalmology residency programs were in New York (18), Texas (9), and California (9), whereas 12 states lacked residency programs altogether. Conclusions In this study, we found a wide range in the geographic distribution of ophthalmologists and residency programs in the United States. States with the highest relative demand index may represent areas most at risk of unmet medical needs.

Ophthalmology residency programs on social media.

With the transition from away rotations and in-person interviews during the COVID-19 pandemic came a search for alternative methods to represent and promote residency programs. We investigated utilization of social media by ophthalmology residency programs in response to the pandemic. Social media accounts of accredited ophthalmology residency programs were found through a manual search on Facebook, Instagram, and Twitter. Each program's geographical region (Northeast, Midwest, South, or West) was identified, and year of account creation (2009-2021) was noted. An exponential regression model was used to model total number of social media accounts over time. Comparisons of total number of social media accounts before/after the pandemic and by region, stratified by social media platform, were evaluated through chi-square analysis. Of 125 ophthalmology residency programs, 63% (n = 79) had at least one account on a social platform. 142 acc. Instagram held the most accounts (45%, n = 64), followed by Facebook (29%, n = 41) and Twitter (26%, n = 37). From 2009 to 2021, there has been an exponential increase in social media accounts (R2 = 0.962). 45% (n = 65) of all accounts were created after March 2020. Instagram increased the most, with 45 ophthalmology residency accounts created after the pandemic as compared to 19 created prior (p < 0.001). The number of social media accounts did not vary by region. Based on current trends, the presence of ophthalmology residency programs on social media will likely continue expanding, with major social platforms becoming a vaster source of information for ophthalmology residency applicants.

Evaluating complications in cataract surgeries performed by resident trainees at a tertiary care hospital in Rajkot district of Gujarat

Cataract surgery is an important part of the ophthalmology residency program. By providing residents with the opportunity to develop surgical skills, ophthalmology programs can ensure that their residents are well-prepared for successful careers in the field. While most cataract surgeries are successful, complications can occur like infection, inflammation, corneal edema, and posterior capsule opacification, however, rates may differ with surgeon’s experience. This study aims to determine the types and rates of various complications in cataract surgery performed by resident trainees.: This was a retrospective hospital based observational study that included patients operated for cataracts by manual SICS at a Tertiary care hospital in Rajkot. Postoperative outcomes were evaluated into three groups: surgeries performed during residents in the first year of training (group 1), surgeries performed during the second year (group 2), and surgeries performed during the third year (group 3). The outcome was the rate of postoperative complications in each group and collected data were entered in a Microsoft Excel sheet. Qualitative data were presented as frequency and percentages and compared by the chi-square test. The P-value of ≤0.05 was considered significant. A total of 492 patients were evaluated in the study, in which 102 patients (20.7%) were operated on by first-year residents (group1), 189 patients (38.4%) were operated on by second-year residents (group 2) and 201 patients (40.9%) were operated by third-year residents(group3). The overall rate of the intraoperative complication in our study was 32.3% with the incidence of intraoperative complications being 17.4%(n=86/492) and postoperative complications being 14.8% (n=73/492). The most common intraoperative complication was PCR with vitreous loss (10.4%) and the most common postoperative complication was corneal edema seen in 6.5% of patients.: Resident trainees showed a better performance in the form of decreased postoperative complications and surgical competency was also found to improve as surgical experience increased. Incorporating surgical training as part of a routine curriculum can improve the residents' learning curve.

Analysis of Publication Productivity and Academic Rank of Ophthalmology Residency Program Directors in the United States.

Female ophthalmologists are underrepresented in the field of ophthalmology. This study aimed to analyze the gender differences among ophthalmology residency program directors (PDs) in the United States with respect to academic rank, number of publications, and h-index. This cross-sectional study evaluated 120 ophthalmology residency PDs from 120 ophthalmology residency programs during the 2022 San Francisco Match. The gender information was collected from institutional websites. The information regarding the state of each institute, academic rank, degree (MD or DO), age, and publication productivity was also recorded. From the 120 residency programs, 120 ophthalmology residency PDs were identified. Most PDs had an MD degree (118 out of 120, 98.3%), while only a few had a DO degree (2 out of 120, 1.7%). Only 31 (25.8%) out of 120 residency PDs were female. There was a statistically significant difference between female residency PDs and male residency PDs (p<0.0001). Male PDs had a higher h-index (15.2 ±1.2) compared to their female counterparts (11.9 ± 0.97) (p=0.003). Regarding academic rank, male PD number was higher in each category, including assistant professor, associate professor, and full professor. United States ophthalmology residency programs have a smaller portion of females compared to male PDs. Furthermore, full professors are more likely to be male, and males have higher publication productivity in terms of h-index.To promote equality among ophthalmologists, future initiatives should focus on addressing the gender disparities in ophthalmology residency programs and the selection of residency PDs.