Ophthalmology Residency Training Programs Research Articles

Impact of Ophthalmic Knowledge Assessment Program Scores and Surgical Volume on Subspecialty Fellowship Application in Ophthalmology Residency: Retrospective Cohort Study

Abstract Background Ophthalmology residents take the Ophthalmic Knowledge Assessment Program (OKAP) exam annually, which provides percentile rank for multiple categories and the total score. In addition, ophthalmology residency training programs have multiple subspecialty rotations with defined minimum procedure requirements. However, residents’ surgical volumes vary, with some residents exceeding their peers in specific subspecialty rotations. Objective This study aims to identify if there is a difference in OKAP examination scores and surgical volume exposure during ophthalmology residency training between nonfellowship and fellowship applicants and among various subspecialties. Methods A retrospective review of OKAP scores and surgical procedure numbers of graduating residents in an accredited academic ophthalmology residency program in the Midwest United States was conducted. Data were collected from 2012 to 2022. Results A total of 31 residents were identified. Most residents decided to pursue fellowship training upon graduation (20/31, 65% residents), and the rest chose to practice comprehensive ophthalmology (11/31, 35% residents). A total of 18/31 residents had OKAP score reports available. The fellowship group outperformed the nonfellowship group in multiple subsections and the total exam (P=.04). Those pursuing fellowship training in glaucoma performed higher on the Glaucoma section (P=.004) and the total exam (P=.005). Residents pursuing cornea performed higher on nearly all subsections, including External Disease and Cornea (P=.02) and the total exam (P=.007). The majority of the surgical volume exposure was identical between fellowship and nonfellowship groups. Those who pursued glaucoma fellowship performed more glaucoma filtering and shunting procedures (P=.03). Residents going into pediatrics fellowship were primary surgeons in more strabismus cases (P=.01), assisted in fewer strabismus cases (P<.001), and had no difference in the total number of strabismus surgeries. Conclusions In our program, residents pursuing fellowship training had higher OKAP scores on multiple sections and the total exam. There was no significant difference in the overall surgical volume averages between fellowship and nonfellowship groups, but few differences existed in subspecialty procedures among fellowship applicants. Larger multicenter studies are needed to clarify the relationship between OKAP scores and ophthalmology fellowship decisions nationwide.

Evaluation of commitment to equity, diversity, and inclusion on Canadian ophthalmology residency program websites

ObjectifLes sites Web des programmes de résidence jouent un rôle de premier plan pour ce qui est de présenter les attraits de ceux-ci aux résidents candidats. Notre article examine à quel point les sites Web des programmes de résidence en ophtalmologie du Canada démontrent leur engagement envers l’équité, la diversité et l'inclusion (EDI) et identifie les zones à améliorer. MéthodesNous avons procédé à une analyse transversale des sites Web affiliés aux 15 programmes accrédités de résidence en ophtalmologie au Canada. Chaque site s'est vu attribuer un score en fonction de 16 éléments relevant de l'EDI conformément à la littérature récente. On a ainsi examiné la façon dont chaque site tenait compte d’éléments relevant de l'EDI en lien avec la langue, la géographie et la diversité de la population régionale. RésultatsSur les 15 programmes de résidence en ophtalmologie du Canada, 12 (80 %) respectaient au moins 1 des 16 éléments relevant de l'EDI, le score moyen par programme se chiffrant à 2,4 (é.-t. : 1,92). Le programme qui a obtenu le score le plus élevé respectait 7 des 16 éléments en question. Les programmes anglophones ont obtenu un score moyen plus élevé (2,92; é.-t. : 1,78) que les sites francophones (0,33; é.-t. : 0,58; p = 0,023). Aucune différence significative n'a été observée entre les programmes de l'ouest du Canada, de la région centrale ou de l'est du Canada (p = 0,86). La proportion de minorités régionales associées à chaque programme n'a pas eu d'effet sur les scores (p = 0,088). ConclusionsLes sites Web des programmes de résidence en ophtalmologie du Canada abordaient rarement les éléments relevant de l'EDI. Nous proposons des recommandations dans 4 domaines: mise en valeur de la diversité de l’équipe, transparence au chapitre du recrutement, ressources en matière d'inclusion et organisation du programme. L'amélioration de la visibilité de l'EDI des programmes figurant sur les sites Web grâce à la révision de sites existants ou à la création de nouveaux sites promotionnels pourrait favoriser le recrutement d'une population diversifiée de résidents.

Artificial intelligence-based pathologic myopia identification system in the ophthalmology residency training program.

Background: Artificial intelligence (AI) has been successfully applied to the screening tasks of fundus diseases. However, few studies focused on the potential of AI to aid medical teaching in the residency training program. This study aimed to evaluate the effectiveness of the AI-based pathologic myopia (PM) identification system in the ophthalmology residency training program and assess the residents' feedback on this system. Materials and Methods: Ninety residents in the ophthalmology department at the Second Affiliated Hospital of Zhejiang University were randomly assigned to three groups. In group A, residents learned PM through an AI-based PM identification system. In group B and group C, residents learned PM through a traditional lecture given by two senior specialists independently. The improvement in resident performance was evaluated by comparing the pre-and post-lecture scores of a specifically designed test using a paired t-test. The difference among the three groups was evaluated by one-way ANOVA. Residents' evaluations of the AI-based PM identification system were measured by a 17-item questionnaire. Results: The post-lecture scores were significantly higher than the pre-lecture scores in group A (p < 0.0001). However, there was no difference between pre-and post-lecture scores in group B (p = 0.628) and group C (p = 0.158). Overall, all participants were satisfied and agreed that the AI-based PM identification system was effective and helpful to acquire PM identification, myopic maculopathy (MM) classification, and "Plus" lesion localization. Conclusion: It is still difficult for ophthalmic residents to promptly grasp the knowledge of identification of PM through a single traditional lecture, while the AI-based PM identification system effectively improved residents' performance in PM identification and received satisfactory feedback from residents. The application of the AI-based PM identification system showed advantages in promoting the efficiency of the ophthalmology residency training program.

Objective Resident Characteristics Associated with Performance on the Ophthalmic Knowledge Assessment Program Examination.

Background To determine objective resident characteristics that correlate with Ophthalmic Knowledge Assessment Program (OKAP) performance, as well as to correlate OKAP performance with Accreditation Council for Graduate Medical Education (ACGME) milestone assessments, written qualifying examination (WQE) scores, and oral board pass rates. Methods Review of administrative records at an ACGME-accredited ophthalmology residency training program at an urban, tertiary academic medical center. Results The study included data from a total of 50 resident physicians who completed training from 2012 to 2018. Mean (standard deviation) OKAP percentile performance was 60.90 (27.51), 60.46 (28.12), and 60.55 (27.43) for Years 1, 2, and 3 examinations, respectively. There were no statistically significant differences based on sex, marital status, having children, MD/PhD degree, other additional degree, number of publications, number of first author publications, or grades on medical school medicine and surgery rotations. OKAP percentile scores were significantly associated with United States Medical Licensing Examination (USMLE) Step 1 scores (linear regression coefficient 0.88 [0.54-1.18], p = 0.008). Finally, continuous OKAP scores were significantly correlated with WQE ( r s = 0.292, p = 0.049) and oral board ( r s = 0.49, p = 0.001) scores. Conclusion Higher OKAP performance is correlated with passage of both WQE and oral board examinations during the first attempt. USMLE Step 1 score is the preresidency academic factor with the strongest association with success on the OKAP examination. Programs can utilize this information to identify those who may benefit from additional OKAP, WQE, and oral board preparation assistance.

A Characterization of Ophthalmology Residency Program Social Media Presence and Activity

Abstract Objective To determine the presence and activity of ophthalmology departments associated with residency programs on social media platforms and the use of these social media platforms by residency applicants. Design Cross-sectional online assessment of ophthalmology training program departments' presence and activity on Facebook, Twitter, and Instagram. Participants A total of 120 accredited ophthalmology residency training programs and 498 ophthalmology residency applicants. Methods Each department was evaluated by (1) searching for social media links on the department's Web site, (2) searching for the department on Facebook, Twitter, and Instagram, and (3) searching on Google. A simultaneous survey was conducted to assess social media platform use of 2019 to 2020 ophthalmology residency application cycle candidates. Main Outcomes The presence of ophthalmology departments on Facebook, Twitter, and Instagram, as well as the total number of followers and posts during January 2020. Results Of 120 programs evaluated, 45 programs (37.5%) had a Facebook page, 29 (24.3%) were on Twitter, and 22 (18.3%) had an Instagram page. Among top 20 Doximity-ranked ophthalmology programs, 80% had at least one social media page on Facebook, Twitter, or Instagram compared with 33% among the remainder of programs (chi-square test = 15.2, p &lt; 0.001). Top 20 programs also had more followers compared with others on Facebook (4,363 vs. 696, respectively, p &lt; 0.0001) and Twitter (3,673 vs. 355, respectively, p = 0.007) but not on Instagram (1,156 vs. 1,687, respectively, p = 0.71). Among 498 residency applicants to Bascom Palmer Eye Institute from the 2019 to 2020 cycle, 159 (31.9%) responded to a survey regarding their use of social media during the application process. In total, 54 (34%) responded that they used social media to evaluate residency programs. Conclusion Departments of top 20 ophthalmology residency had both a greater presence and following on social media compared with other departments. While Facebook was the most used platform by ophthalmology departments, applicants most commonly used Instagram. As applicants come to use these social media resources more frequently, ophthalmology residency programs may increasingly benefit from maintaining an active social media page.

Ophthalmology residency training program at the University of Montreal

Ophthalmology residency training program at the University of Montreal

Image acquisition with smart phone applied in ophthalmology residency training program

Image acquisition with smart phone applied in ophthalmology residency training program

Clinical evaluation exercises and direct observation of surgical skills in ophthalmology

Ophthalmology residency training programs need authentic methods of assessment to show that trainees have learned and can do what is expected upon graduation. Written and oral examinations are necessary to assess knowledge but other methods are needed to assess skill. Workplace-based assessments (WPBAs) should be utilized to observe resident skill in the clinic and during surgery. Several such assessment tools have been published and validated. These tools have the additional benefit of facilitating specific formative feedback and thus can be used for both teaching and assessing.

Competency-Based Education Assessment Tools for Laser Capsulotomy, Peripheral Iridotomy, and Selective Laser Trabeculoplasty

To produce Competency-Based Education Assessment Tools (C-BEAT) for performance of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy, laser peripheral iridotomy (LPI), and selective laser trabeculoplasty (SLT) on an artificial eye model that can be used in competency-based medical education (CBME) of ophthalmology residents. Survey. Eight content experts (residency program director and faculty members involved in ophthalmology resident training). Task-specific checklists were created to assess the performance of Nd:YAG capsulotomy, LPI, and SLT on artificial eye models designed for each of these procedures, as well as a global rating scale (GRS). A modified Delphi process was used to establish face and content validity of the C-BEAT for lasers. Eight content experts participated in the Delphi process, and the consensus was achieved after 4 rounds. Survey responses. Final versions of checklists for Nd:YAG capsulotomy, LPI, and SLT, and a GRS for these laser procedures were produced with face and content validity. Modifications to the energy settings and the number of applications in the capsulotomy and peripheral iridotomy were implemented into the checklist and instructions, because the artificial models were not identical in their responses to the laser applications compared with real tissue. The C-BEAT for lasers can be used in an examination setting within ophthalmology residency training programs to establish competency in these procedures before performing them on real patients. These tools help to meet the demand for assessment modalities within a CBME model that is being implemented into residency training worldwide. To establish interrater and construct validities, further studies are required.

Emergency Department Ophthalmology Consultations in a Tertiary Care Hospital

Objective The main objective of this article is to characterize ophthalmology consultations in the emergency department (ED) of a tertiary care hospital and identify specific ways to modify the curriculum for ophthalmology and emergency medicine residency programs to train residents to effectively manage eye-related consultations. Design This is a retrospective chart review study of ED encounters between January 1, 2008 and January 1, 2017 during which ophthalmology was consulted. Setting Single-center urban tertiary care center. Participants All adult patients who were seen by the ophthalmology consultation service in the ED during the study time period. Main Outcome Measured We identified the reason for and timing of ophthalmology consultation; diagnoses made in the ED and follow-up ophthalmology clinic visit; procedures resulting from consultation; and communication with a senior resident, fellow, or attending. Results We identified 3,583 consecutive ED encounters with an ophthalmology consultation over a 9-year period. About 51.1% of patients were female and mean age of patients was 49 years. Blurry vision/vision loss was the most common reason for consultation (24.8%) and posterior vitreous detachment was the most common diagnosis made in the ED by the ophthalmology team (11.0%). Of the patients with documented follow-up ophthalmology clinic visits, 96.7% of diagnoses made at the first ophthalmology clinic visit were the same as those determined in the ED. About 12.7% of visits resulted in a procedure with the most common being eyelid laceration repairs, pars plana vitrectomy, and laser retinopexy. Overall, 40.4% of visits required communication with a senior resident, fellow, or attending. The frequency of residents seeking assistance from more senior ophthalmologists decreased over the course of the academic year (p &lt; 0.0001). Conclusions This study provides data that ophthalmology residency training programs can use to more effectively prepare residents for consultations in the ED. Furthermore, identifying the reasons for consultation and subsequent diagnoses can guide the education of emergency medicine physicians to improve their ability to diagnose and triage ophthalmologic presentations.

Future ophthalmology practice pattern: A survey of Saudi Board of Ophthalmology residents

PurposeThe main purpose of the study was to examine and identify factors that influence the future practice pattern of Saudi Board of Ophthalmology residents as well as their academic goals. This study also aimed to compare the plans and career goals of the current Saudi ophthalmology residents with a former cohort of Saudi ophthalmology residents. MethodsAll current residents of Saudi Board of Ophthalmology were invited to complete an anonymous online survey in March 2017. Residents were contacted by email. The survey contained questions on demographics, plans and factors influencing career choice of the residents in their future. Data were categorized by gender. Chi-square was used to assess the effect of gender on outcomes where appropriate. ResultsOf 150 residents surveyed, 91 (61%) responded to the survey. Having the ability to combine medicine and surgery was the most motivating factor for pursuing an ophthalmology residency training program (81% of respondents). Most residents expressed an interest in providing refractive surgery (62%), being involved in research activities (85%) and working part-time in the private sector (73%). The majority (81%) expressed a desire to practice in an urban setting as well as pursuing fellowship training (81%). Anterior segment (31%) and surgical retina (15%) were the most popular choices for fellowship training. ConclusionIncreasing interest in joining fellowship training programs (mostly in surgical subspecialties) and being involved in research activities among current generation of ophthalmology residents have been observed compared to a previous cohort study in the same country.

Impact of virtual reality simulation on learning barriers of phacoemulsification perceived by residents.

ObjectiveTo identify residents’ perceived barriers to learning phacoemulsification surgical procedures and to evaluate whether virtual reality simulation training changed these perceptions.DesignThe ophthalmology residents undertook a simulation phacoemulsification course and proficiency assessment on the Eyesi system using the previously validated training modules of intracapsular navigation, anti-tremor, capsulorrhexis, and cracking/chopping. A cross-sectional, multicenter survey on the perceived difficulties in performing phacoemulsification tasks on patients, based on the validated International Council of Ophthalmology’s Ophthalmology Surgical Competency Assessment Rubric (ICO-OSCAR), using a 5-point Likert scale (1 = least and 5 = most difficulty), was conducted among residents with or without prior simulation training. Mann–Whitney U tests were carried out to compare the mean scores, and multivariate regression analyses were performed to evaluate the association of lower scores with the following potential predictors: 1) higher level trainee, 2) can complete phacoemulsification most of the time (>90%) without supervisor’s intervention, and 3) prior simulation training.SettingThe study was conducted in ophthalmology residency training programs in five regional hospitals in Hong Kong.ResultsOf the 22 residents, 19 responded (86.3%), of which 13 (68.4%) had completed simulation training. Nucleus cracking/chopping was ranked highest in difficulty by all respondents followed by capsulorrhexis completion and nucleus rotation/manipulation. Respondents with prior simulation training had significantly lower difficulty scores on these three tasks (nucleus cracking/chopping 3.85 vs 4.75, P = 0.03; capsulorrhexis completion 3.31 vs 4.40, P = 0.02; and nucleus rotation/manipulation 3.00 vs 4.75, P = 0.01). In multivariate analyses, simulation training was significantly associated with lower difficulty scores on these three tasks.ConclusionResidents who had completed Eyesi simulation training had higher confidence in performing the most difficult tasks perceived during phacoemulsification.

Neuro-ophthalmology Training in Ophthalmology Residency Programs in the United States

Background The status of neuro-ophthalmology education in ophthalmology residency training in the United States is unknown. There are numerous articles in the literature detailing resident outcomes for surgical procedures; however, there are no articles detailing teaching of a nonprocedural specialty. There are no specific Accreditation Council for Graduate Medical Education (ACGME) requirements for neuro-ophthalmology training within ophthalmology residency. Each program determines the amount of neuro-ophthalmology training and level of training within ophthalmology residency. There are no publications that detail the extent of neuro-ophthalmology training during ophthalmology residency. Objective To determine the status of neuro-ophthalmology education in ophthalmology residency training programs in the United States. Methods A survey was sent in 2014 to residency directors and neuro-ophthalmologists of all ophthalmology residency programs who participated in the Ophthalmology Residency Matching Program in the United States to determine the amount of neuro-ophthalmology training that residents receive. Results From a total of 113 ophthalmology residency programs in the United States utilizing the Ophthalmology Residency Matching Program, 104 surveys were returned (92% response rate). Duration of neuro-ophthalmology training ranged from 1 to 112 days, with an average of 34.5 days. Most rotations occurred within postgraduate year 2 or 3. Conclusion This is the first evaluation of the amount of neuro-ophthalmology training within ophthalmology residencies participating in the matching program in the United States, which demonstrates large variability among the different programs. Future studies could ascertain if there is a correlation between resident satisfaction in neuro-ophthalmology training and the amount of training.

Trends in cataract surgery training curricula

To evaluate trends in cataract surgery training curricula and factors affecting timing of resident participation as a primary surgeon. Pennsylvania State College of Medicine, Hershey, Pennsylvania, USA. Cross-sectional study of anonymous survey results. A description of the study and link to an online survey was e-mailed to program directors of each ophthalmology residency training program accredited by the Accreditation Council for Graduate Medical Education (ACGME). Fifty-one (44%) of the 116 program directors completed the survey. First-year, second-year, and third-year residents performed a mean of 2, 25, and 155 phacoemulsification surgeries, respectively, as a primary surgeon. Only 1 program (2%) required residents to perform extracapsular cataract extraction (ECCE) before performing phacoemulsification. Clear corneal phacoemulsification was the first technique taught to trainees at 91% of programs. More than two thirds (71%) of program directors indicated that their program had a cataract surgery training curriculum designed to transition residents gradually to the operating room. These curricula included structured wet laboratory (92%) and lecture (89%) components. Inadequate resident knowledge and surgical skill base (57%) and anticipation of increased surgical complication risk (37%) were the most commonly reported factors impeding earlier exposure to phacoemulsification in residency. Results show that residents today begin surgical training with phacoemulsification rather than ECCE, perform a higher number of phacoemulsification surgeries than is required by the ACGME, and begin performing phacoemulsification as early as their first or second year of residency. Despite these evolutions, 29% of respondent ACGME-accredited ophthalmology residency programs reported not having a formal cataract surgery training curriculum.

Predictors of performance in an ophthalmology residency program

ObjectiveTo assess the value of current selection criteria and additional factors as predictors of performance in an ophthalmology residency training program. DesignA retrospective study. ParticipantsData were collected from the files of 166 residents who were collectively trained in an ophthalmology residency program from 2000 to 2013. MethodsThe program’s selection criteria included medical school grade point average (GPA), Saudi licensing examination (SLE) score, multiple-choice question ophthalmology selection (MCQ) examination score, and interview mark. Indicators of performance included average scores in the promotion examination for 4 years of training (average R), King Saud University fellowship examination (KSU) score, and Saudi Board in Ophthalmology examination (SBO) score. An average of KSU and SBO scores was also used as a performance indicator. Times of program completion and average performance score across all years in the residency program were used as second-level indicators of performance. ResultsThere were strong correlations between the MCQ examination score and each training performance indicator (average R, KSU score, SBO score, and average of KSU and SBO scores; p = 0.002, 0.008, 0.05, and 0.002, respectively). The interview mark correlated well with average R (p = 0.001) but not with other indicators. The MCQ examination score and the interview mark were the only predictors of second-level indicators of performance (p = 0.009 and 0.029, respectively). ConclusionsThe MCQ examination score and interview mark were the 2 best predictors of performance as an ophthalmology resident. GPA and SLE score were poor predictors of performance.

Improving the Teaching Skills of Residents in a Surgical Training Program: Results of the Pilot Year of a Curricular Initiative in an Ophthalmology Residency Program

To design and implement a teaching skills curriculum that addressed the needs of an ophthalmology residency training program, to assess the effect of the curriculum, and to present important lessons learned. A teaching skills curriculum was designed for the Harvard Medical School (HMS) Residency Training Program in Ophthalmology. Results of a needs assessment survey were used to guide curriculum objectives. Overall, 3 teaching workshops were conducted between October 2012 and March 2013 that addressed areas of need, including procedural teaching. A postcurriculum survey was used to assess the effect of the curriculum. Massachusetts Eye and Ear Infirmary, a tertiary care institution in Boston, MA. Overall, 24 residents in the HMS Residency Training Program in Ophthalmology were included. The needs assessment survey demonstrated that although most residents anticipated that teaching would be important in their future career, only one-third had prior formal training in teaching. All residents reported they found the teaching workshops to be either very or extremely useful. All residents reported they would like further training in teaching, with most residents requesting additional training in best procedural teaching practices for future sessions. The pilot year of the resident-as-teacher curriculum for the HMS Residency Training Program in Ophthalmology demonstrated a need for this curriculum and was perceived as beneficial by the residents, who reported increased comfort in their teaching skills after attending the workshops.

Impact of Fellowship Training on Research Productivity in Academic Ophthalmology

To assess whether scholarly impact of academic ophthalmologists, as measured using the h-index, is affected by fellowship training status and to further characterize differences in productivity among the various subspecialties and by departmental rank. A descriptive and correlational design was used. In total, 1440 academic ophthalmologists from 99 ophthalmology training programs were analyzed. The h-index data were obtained from the Scopus database. Faculty members were classified by academic rank and grouped into 10 categories based on fellowship training: anterior segment, corneal and external disease, glaucoma, uveitis and ocular immunology, vitreoretinal disease, ophthalmic plastic surgery, pediatric ophthalmology, neuro-ophthalmology, ophthalmic pathology, and "other." A one-way analysis of variance or Student t test using Microsoft Excel and "R" statistical software were used for comparison of continuous variables, with significance set at p < 0.05. Faculty working in academic ophthalmology residency training programs in the United States whose information is stored in the American Medical Association's Fellowship and Residency Electronic Interactive Database. Fellowship-trained ophthalmologists had significantly higher research productivity, as measured using the h-index, than non-fellowship-trained ophthalmologists in this study (p < 0.0005). Academic ophthalmologists trained in vitreoretinal disease or ophthalmic pathology had the highest scholarly productivity compared with those in other ophthalmology subspecialties (p < 0.05). There was a significant increase in scholarly productivity with increasing academic rank from Assistant Professor to Professor (p < 0.05). A significant difference in productivity between fellowship-trained and non-fellowship-trained ophthalmologists existed individually only at the level of Assistant Professor (p < 0.0005). Academic ophthalmologists with fellowship training have significantly higher scholarly output than non-fellowship-trained ophthalmologists do, as measured using the h-index. Research productivity increases with departmental academic rank from Assistant Professor to Professor.

Trabeculectomy Versus ExPRESS Shunt Surgery in Residency Training

The core curriculum for an ophthalmology residency training program should include surgical procedures relevant to a comprehensive ophthalmologist. Considerations include outcomes (success and complications), technical skill required, applicability to a wide range of disease, and cost. Using these metrics, trabeculectomy should be favored over ExPRESS shunt surgery.

The crisis in ophthalmology residency training programs

The crisis in ophthalmology residency training programs

Teaching and Assessing Competency in Retinal Lasers in Ophthalmology Residency

The Accreditation Council for Graduate Medical Education has mandated that residency programs teach and assess six specific competencies (ie, medical knowledge, patient care, communication and interpersonal skills, professionalism, practice-based learning, and systems-based learning). To the authors' knowledge, there is no standardized and widely used curriculum for teaching and assessing resident competencies in retinal lasers. The pertinent literature on resident education in retinal lasers is reviewed and specific "good practices" for teaching and assessing laser competency are presented. Development and deployment of educational tools that teach and assess laser competency simultaneously; are reliable, reproducible, and valid; have low faculty time burden; and are affordable, generalizable, and fair are recommended. Retinal laser competency can be taught and assessed in ophthalmology residency training programs. Future research will be needed to provide evidence that these teaching and assessment tools produce improved educational and patient outcomes and provide verifiable, reliable, and valid evidence of resident competence in retinal lasers.