Ophthalmology Residents Research Articles

Telemedicine Curriculum in an Ophthalmology Residency Program

Abstract Background The COVID-19 pandemic has accelerated the adoption of telemedicine in the field of ophthalmology. Despite the increasing utilization of telemedicine, there is a lack of formal training in ophthalmology residency programs to ensure ophthalmologists are prepared to conduct virtual eye exams. Objective This article aims to assess the impact of an ophthalmic telemedicine curriculum on ophthalmology residents' self-reported knowledge acquisition in conducting telemedicine eye exams, perceived ability to diagnose, manage, and triage common eye diseases, and evaluate their attitudes toward the current and future use of teleophthalmology. Methods This single-center study at Massachusetts Eye and Ear used a nonvalidated pre- and postcurriculum survey conducted during the 2020 to 2021 academic year among ophthalmology residents. Participants engaged in an ophthalmic telemedicine curriculum that consisted of interactive didactic lectures and electronic postdidactic assessments. Results Twenty-four residents (100%) completed a precurriculum survey, while 23 of 24 (95.8%) residents completed both the telemedicine curriculum and a postcurriculum survey. On a five-point Likert scale, the median interquartile range (IQR) scores for confidence with setup/logistics, history taking, examination, documentation, and education increased from 2.5 (2.0–4.0) to 4.0 (3.5–4.5) (p = 0.001), 3.0 (3.0–4.0) to 5.0 (4.0–5.0) (p < 0.001), 2.0 (1.8–2.0) to 4.0 (3.5–4.0) (p < 0.001), 2.0 (1.0–2.0) to 4.0 (3.0–4.0) (p < 0.001), and 2.5 (2.0–3.0) to 4.0 (4.0–4.0) (p < 0.001), respectively. The median (IQR) scores for comfort with ethics/professionalism, disparities and conducting patient triage, diagnosis, and management increased from 2.0 (2.0–2.3) to 4.0 (3.0–4.0) (p < 0.001), 2.0 (2.0–2.0) to 3.0 (3.0–4.0) (p < 0.001) and 3.0 (2.0–3.0) to 4.0 (3.0–4.0) (p = 0.001), 2.0 (2.0–3.0) to 3.0 (3.0–4.0) (p < 0.001), and 3.0 (2.0–3.0) to 3.0 (3.0–4.0) (p = 0.008), respectively. Conclusion The implementation of an ophthalmic telemedicine curriculum increased resident confidence and self-reported knowledge across all logistical and clinical components of virtual ophthalmic care. Formal telehealth curricula can address an unmet educational need of resident trainees in an era of rapid uptake and utilization of telehealth services.

Current Trends of Research Productivity among Students Matching at Top Ophthalmology Programs.

Importance San Francisco Match publishes no data on the research output of matched applicants to an ophthalmology residency. Objective The aim of this study was to examine the temporal trends in publication volume by medical students who successfully matched into a top ophthalmology residency. Methods This retrospective case series compared all residents in the top 30 ophthalmology residency programs from the class of 2022 and 2017. Publication volume from before September 15th of the residents' fourth year of medical school was recorded using PubMed and Google Scholar. We recorded total number of publications (any authorship), first/second author publications, and ophthalmology-specific publications. Using Welch's t -test, publication volumes were statistically compared against all others. Results One-hundred sixty-one residents from the class of 2022 and 145 residents from the class of 2017 were included. Total publications per matched applicant (mean ± standard deviation) were 3.04 ± 0.35 for the class of 2022 and 1.67 ± 0.23 for the class of 2017. Mean publications in ophthalmology journals were 1.07 ± 0.20 (2022) and 0.58 ± 0.13 (2017); mean first author publications were 1.00 ± 0.13 (2022) and 0.64 ± 0.11 (2017) and mean second author publications were 0.70 ± 0.10 (2022) and 0.37 ± 0.06 (2017). Research productivity in all four metrics (total, ophthalmology journals, first author, and second author publications) was significantly higher for the class of 2022 than the class of 2017 ( p = 0.001; p = 0.03; p = 0.03; p = 0.02, respectively) supporting the trend of increasing research output among students. Applicants with PhD degrees had statistically more total and first author publications in 2017 ( p = 0.01; p = 0.045), but only more first author publications in 2022 ( p = 0.01). International applicants produced significantly more total publications in 2022 ( p < 0.001). Conclusions Overall, after a 5-year period, the authors found matched applicants had significantly increased publications compared with those at the beginning of the period. We also identified several applicant factors that may have variable effects on research publication. This analysis emphasizes the growing importance of research in the match process and can help future applicants navigate the ophthalmology match.

Translation and validation to Portuguese of a 60-item questionnaire to evaluate theoretical knowledge in fundus examination.

To translate and validate a questionnaire that evaluates the theoretical knowledge regarding fundus examination. A 60-item multiple-choice English questionnaire that investigates various aspects of knowledge regarding fundus examination was translated into Portuguese. The process involved translation, back-translation, and evaluation by an expert committee. The resulting questionnaire was applied to final-year medical students and ophthalmology residents. Each included subject answered the questionnaire twice, with an interval of one week between each application. Internal consistency, test-retest reliability, inter-rater reliability, and percentage agreement were calculated. Thirty participants were included (25 medical students and 5 ophthalmology residents). The pass-fail cutoff was calculated at 46, the theoretical false positives were 8.7% and the theoretical false negatives were 2.8%. The observed false positive and false negative rates were 0%. Among the 60 items, test-retest reliability was strong in 17 items, which one had a negative correlation, moderate in 14 items, which one had a negative correlation, and weak in 29 items; inter-rater reliability of 34 items was under 0.4, 17 items were between 0.4 and 0.6, and 8 items were above 0.6. One item had a negative kappa. Among the percent agreement, 10 items were between 40%-60% agreement, 50 were above 60% agreement, and 18 were above 80%. Cronbach's alpha was calculated as 0.674. The translated questionnaire provided a standard instrument for future research and interventions to improve medical education in ophthalmology.

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.

The Impact of COVID-19 Pandemic on Ophthalmology Residency Education.

Objectives:The aim of this study is to investigate the theoretical, practical, and academic effects of the Coronavirus disease 2019 (COVID-19) pandemic on ophthalmology residents.Methods:The web-based survey consisting of 28 questions was sent through Email to 37 educators who provides resident training. We divided the pandemic period into three, according to the severity of the pandemic and the measures, compared with pre-pandemic period (PreP), separately. Between March 2020 and June 2020 was named as P1, June 2020–October 2020 was named as P2, and October 2020–March 2021 was named as P3.Results:Responses received from 35 centers (17 university hospitals, 18 training and research state hospitals). There were totally 458 residents in the hospitals. Two hundred and forty-six of them (53.71%) worked on COVID-19 duties, with an average working time of 69.57 days. There were significant decreases in the number of patients examined by resident doctors and theoretical training time in the P1, P2, and P3 periods compared to PreP (p<0.05 for all). Furthermore, in terms of the total number of surgeries in clinics and surgeries performed by residents, there were significant decreases in P1 and P2 compared to PreP (p<0.001 for both), but there was no significant difference in P3 (p=0.109). In the examinations held in the clinic, in the 1st year of the pandemic, the grade average was lower than before the pandemic (p<0.05). Seventeen residents (3.74%) resigned or moved to another hospital.Conclusion:The COVID-19 pandemic has severely affected the theoretical, practical, and academic training of ophthalmology residents.

Factors Affecting Ophthalmology Trainees to Pursue Vitreoretinal Surgery Fellowship

Abstract Objective The aim of this study was to understand the factors that ophthalmology trainees consider in pursuing vitreoretinal surgery (VRS) fellowship training. Methods This is a prospective observational survey study. Survey invitations were disseminated to postgraduate year 4 (PGY)-4 ophthalmology residents at Accreditation Council for Graduate Medical Education-accredited residency programs and surgical retina fellows at Association of University Professors of Ophthalmology Fellowship Compliance Committee-compliant fellowship programs in the United States. Survey questions on factors related to VRS were administered employing a 5-point Likert scale. Responses from ophthalmology residents pursuing surgical retina were combined with surgical retina fellows' responses and compared with responses from PGY-4 residents not pursuing vitreoretinal surgery. Results Eighty-one resident surveys were completed. Forty-three fellow surveys were completed. Fifty-seven out of eighty-one (70.4%) residents were not pursuing surgical retina, and a total of 67 trainees (24 residents, 43 fellows) were pursuing surgical retina. The following factors were associated with pursuing VRS training: male gender (p = 0.031); having performed retina research during residency (p ≤ 0.001); enjoying surgical retina procedures (p ≤ 0.001), enjoying surgical retina patient outcomes (p ≤ 0.001), and working with vitreoretinal surgeons (p ≤ 0.001); finding surgical retina prestigious (p ≤ 0.001); perceiving their residency having a strong record of matching surgical retina (p = 0.039); liking the potential financial income from surgical retina (p ≤ 0.001); and having vitreoretinal mentors during residency (p = 0.014). A majority of trainees (31/57, 54.4%) not pursuing surgical retina disagreed or strongly disagreed with enjoying the patient outcomes in surgical retina. A third of female residents not pursuing surgical retina felt having a female surgical retina mentor would have made them more likely to pursue the field. Conclusion Longer retina rotations, encouraging resident participation in retina research, and increasing mentorship opportunities of female trainees from female retina specialists may increase resident interest in pursuing surgical retina fellowship.

A Novel Method for Teaching Laser Peripheral Iridotomy and Selective Laser Trabeculoplasty Using Video Instruction and Model Eyes

Abstract Objective The aim of the study is to describe an inexpensive and easily-constructed model eye for the purpose of teaching laser peripheral iridotomy (LPI) and selective laser trabeculoplasty (SLT) to ophthalmology residents. Methods Easily constructed, inexpensive model eyes were utilized to teach residents SLT and LPI utilizing a remote self-study module. A teaching microscope attachment allowed for video-based instruction and feedback. Results This model eye, used in conjunction with video modules is an effective low-cost teaching tool for laser surgery among ophthalmology residents. Attending ophthalmologists rated the use of these model eyes using surveys and found them to be appropriate teaching tools that could lead to improved knowledge and translate to better patient care. Conclusion Our novel method for teaching glaucoma laser surgery allows residents to learn the principles and theory behind common laser procedures while having the opportunity to practice repetitive procedures on low-cost model eyes.

Three-dimensional (3D) Visualization Educational Modeling for Ophthalmology Residents' Training: Viewpoints.

Background: Three-dimensional models are used to guide residents and physicians in accessing specific anatomical areas and types of fractures and better diagnosis of anomalies. These models are useful for illuminating complex anatomical areas, such as orbit, especially limited space with sensitive access. The aim of this study was to design a three-dimensional visualization educational modeling for ophthalmology residents' training. Methods: This study is a product-oriented application that uses radiological images of anatomy, anomalies, and orbital fractures based on actual CT scans of patients. These CT scans were carefully selected from the Picture Archiving and Communication System of Ghaem Hospital of Mashhad University of Medical Sciences. Results: To produce twelve 3D models, the CT scan files were converted to 3D printer output. Then, the models were presented to residents at a training session by an ophthalmologist. These models created all major fractures associated with the orbit area and most disorders, anomalies of this area and several normal anatomical. The features of 3D models were mentioned. The strengths and weaknesses of the educational modeling, the level of satisfaction with the use of three-dimensional models, suggestions and criticisms were assessed qualitatively by the residents. Satisfaction was reported 100% by residents. Suggestions for future 3D models were presented, and the only criticism was fear of exams and grades. Conclusion: Real-size 3D modeling help to understand the spatial and mental imagery of anatomy and orbital pathology and to touch different anatomical areas creates a clear image in the minds of residents, especially in the orbit.

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.

Implementation of teaching strategies and innovation to comply with the training competencies in an ophthalmology residency program during the coronavirus disease-19 pandemic

Purpose: The coronavirus disease (COVID)-19 pandemic put medical residency programs in a predicament, impacting clinical attention and surgical practice. This study aims to describe the adjustments applied in an ophthalmology residency program to overcome the COVID-19 pandemic restrictions.Materials and Methods: An observational, comparative, and descriptive study was performed in an ophthalmology residency program to analyze the adaptations and innovations implemented to overcome the medical attention and training restrictions enforced by the sanitary authorities due to the COVID-19 pandemic in the year 2020. The residents' record folders were analyzed yearly for academic, research, clinical, and surgical activities from 2018 to 2020. An online survey was applied to residents for congress attendance, research publications, time spent on classes, lectures, clinical cases, journal club, and surgical videos sessions during the pandemic.Results: Compared to years 2018 and 2019, during 2020, there was a significant increase in the hours destined per week to academic activities (6.04 vs. 16.42 h, P < 0.001); the monthly hours of journal club sessions (0.5 vs. 3.41 h, P < 0.001); and the number of published articles involving residents (0.4 vs. 2.52, P < 0.001). On the contrary, the hours of outpatient consultation (8 h/day vs. 4 h/day) and the number of cataract surgeries performed per resident decreased (48 vs. 15, P < 0.001) from 2019 to 2020.Conclusions: Prompt reaction and innovation were required to overcome the educational and training barriers imposed by the COVID-19 pandemic. While remote academic activities increased significantly, online patient consultation and surgical simulation were necessary to avoid hindering patient's attention and surgical training.

The Dynamic History of the Ophthalmology Residency Matching Program.

Background The ophthalmology residency matching program is the first successful medical specialty match, dating back to 1979. This article reviews the impetus for starting the match and the roles that ophthalmologists Bruce Spivey, MD, and August Colenbrander, MD, PhD, played in establishing the match and developing the machinery to make it possible. Challenges to the match's operations over the years have improved the process. Objective This article aims to research the roles of key individuals and institutions in establishing and maintaining the ophthalmology residency matching program. Methods Oral and written interviews with key participants in establishing and maintaining the match were conducted. Primary and secondary written materials were reviewed. Results Two physicians played key roles in establishing the ophthalmology residency matching program. Bruce Spivey, MD, spearheaded the drive to persuade the Association of University Professors of Ophthalmology (AUPO) to support and sponsor the match. August Colenbrander, MD, PhD, created the original match algorithm and single-handedly ran the match process in the early years. Obstacles were overcome, including resistance from the Association of American Medical College's National Resident Matching Program, a challenge to the validity of the algorithm, and the threat that antitrust laws might prohibit all graduate medical education residency match programs. The ophthalmology match evolved over time to become a more formal entity, the San Francisco Matching Program (SF Match). With continued support of the AUPO, the process of matching applicants to residency programs has flourished despite contemporary challenges related to electronic applications and social media. Conclusion The ophthalmology residency matching program has benefited applicants and teaching programs for more than four decades due to visionary founders, ongoing support of the AUPO, and strong leadership within SF Match.

Applicability of portable retinal cameras and telemedicine as facilitating tools in screening diabetic retinopathy in the COVID-19 pandemic scenario.

Diabetes mellitus is a leading cause of impaired vision. The objective of this study was to evaluate the feasibility of use of portable retinograph and remote analysis of images along with a virtual questionnaire for screening for diabetic retinopathy in basic health units in the city of Ribeirão Preto/SP during the Covid-19 pandemic. Standard Covid-19 protocol was followed during the screening. Blood pressure and capillary blood glucose were measured. Demographic and social data were collected through a standardized online questionnaire via smartphone. After pupillary dilation, fundal images were obtained with portable retinographs by trained ophthalmology residents. Two standardized 45° images were acquired: one posterior segment and another nasal to the optic nerve. Diabetic retinopathy was classified according to the Early Treatment Diabetic Retinopathy Study. A total of 350 patients (64% female; 45% aged 55-70 years; 55% Caucasian) were evaluated. For 40.5% of patients, the campaign was the first opportunity for retinal evaluation; 47.56% had diabetes mellitus for >10 years. On repeat analysis of images stored in a cloud-based repository by retinal specialist, a 7.8% difference was observed in the Early Treatment Diabetic Retinopathy Study diabetic retinopathy classification, compared to the screening findings. Mild diabetic retinopathy was observed in 12.23%, moderate diabetic retinopathy in 6.31%, and proliferative diabetic retinopathy in 2.58% patients. Macular edema was present in 4.58% patients. Diabetic retinopathy was not detected in 72.78% patients. Use of portable retinographs together with telemedicine can provide efficient alternative to traditional methods for screening and diagnosis of diabetic retinopathy.

An Analysis of the Diversity and Inclusion Content Featured on Ophthalmology Residency Program Web Sites

Abstract Introduction Ophthalmology departments have been stated to be among the least diverse clinical departments at United States medical schools. Improvement requires recruiting a pipeline of diverse trainees. Residency program Web sites represent a potential diversity and inclusion recruitment tool. This study assesses how ophthalmology residency program Web sites demonstrate a commitment to diversity and inclusion. Methods We analyzed the diversity and inclusion content of 116 ophthalmology residency program Web sites in April 2021. Main outcome measures were the presence of 12 diversity and inclusion elements on program Web sites, based on prior work and Accreditation Council for Graduate Medical Education guidelines: nondiscrimination statement, diversity and inclusion message, community resources, extended faculty or resident biographies (including hobbies, etc.), faculty photos, resident photos, additional financial resources for trainees, wellness resources, mental health resources, health disparities/community engagement, and diversity council. We used Mann–Whitney U and Kruskal–Wallis tests to assess whether residency program characteristics such as rank, size, university affiliation, and geographic location were associated with commitment to diversity and inclusion on affiliated residency Web sites. Results Ophthalmology residency program Web sites included a mean of 4.4 ± 2.1 diversity elements. Sixteen percent of programs featured more than half (7 + ) of the evaluated diversity elements. The most featured common diversity elements included resident photos (85.3%), faculty photos (78.4%), and community resources (64.3%). Extended faculty biographies (2.6%), mental health resources (9.5%), and diversity council information (11.2%) were less commonly showcased. Top-ranked programs (7.6 ± 1.8, p &lt; 0.0001) and university-based/-affiliated programs (4.7 ± 2.8, p = 0.0039) displayed more diversity elements than lower-ranked (4.1 ± 1.8) and community-based programs (2.8 ± 1.7). Conclusion Most ophthalmology residency program Web sites feature less than half of the 12 diversity and inclusion elements included in this study, suggesting room for improvement. By drawing attention to program diversity and inclusion efforts, Web sites offer a potential tool for residency programs to consider in their recruitment efforts for diverse trainees. Incorporating the diversity and inclusion elements analyzed in this study represents a low-burden way to signal a greater commitment to diversity that could help programs recruit diverse applicants.

Assessing the phacoemulsification learning curve using duration of each step.

To assess the phacoemulsification learning curve for ophthalmology residents using duration for each step. Single tertiary, training site hospital. Cross-sectional study. Emory ophthalmology postgraduate year (PGY) 3 and PGY-4 residents operating at Grady Memorial Hospital between April 2017 and February 2018 were eligible to participate. Duration in seconds for each step of surgery was calculated for incisions, continuous curvilinear capsulorhexis (CCC), hydrodissection, nucleus disassembly, quadrant removal, cortical cleanup, intraocular lens insertion, and closure, and this outcome was analyzed as a function of different experience levels. A total of 528 surgeries were included of 549 total surgeries recorded. 6 categories of experience levels were established as A to F, increasing by increments of 50. There was an overall downward trend across various steps across the 8 case categories, and several adjacent categories demonstrate statistically significant differences. The 3 most time-intensive steps early in training were nucleus disassembly (336.5 ± 16.5 seconds), quadrant removal (275.1 ± 18.0 seconds), and cortical cleanup (244.2 ± 24.6 seconds). There was a sustained drop in mean duration for all steps through at least category D, with most steps showing a drop through category F. There is a benefit to a higher caseload, well above the Accreditation Council for Graduate Medical Education-mandated 86 cases. Improvements in efficiency were observed after 250 cases, with nuclear disassembly and CCC demonstrating a significant decrease in operative time.

Rate of Posterior Capsule Rupture in Phacoemulsification Cataract Surgery by Residents with Institution of a Wet Laboratory Course

Abstract Purpose To determine if a structured surgical wet laboratory curriculum for ophthalmology residents reduced the rate of posterior capsule rupture (PCR) in phacoemulsification cataract surgery. Setting James A. Haley Veterans' Hospital, Tampa, FL. Design Retrospective cohort study. Methods The study assessed resident-performed phacoemulsification cataract cases from 2011 to 2017, after the creation of a wet laboratory course. Primary outcome measure was PCR. If present, timing of complication, dropped lens fragments, and the need for anterior vitrectomies were noted. Self-reported rates of PCR prior to institution of a wet laboratory course (2010–2011) were compared with cases done by residents who completed the course (2011–2017). Results A total of 3,445 cases were reviewed of which 2.44% (84 cases) noted PCR. Of these, 19% (16) had dropped lens fragments, and 60.7% (51) required anterior vitrectomy. Sixty-nine cases documented timing of PCR with the majority, 58%, occurring during phacoemulsification. When comparing rates of PCR in cases done prior to the presence of a wet laboratory course versus after, there was a significant reduction observed (5.20% before vs. 2.44% after). Conclusion In the presence of a wet laboratory curriculum, the rate of PCR decreased dramatically. The average rate was lower than those reported at other training programs (2.6–9.9%). Most PCR occurred during phacoemulsification, suggesting need for further focused instruction in this step.

Shortening Training Duration to Address the Insufficiency of Ophthalmologists: A Deeper Look at the China Experience.

The availability of ophthalmologists is vital to making eyecare accessible to everyone. Medical education and ophthalmology residency training in China was reduced to address the high demand for ophthalmologists. This is something the Philippines can consider to increase the number of ophthalmologists in the country. However, decreasing the duration, together with insufficient monitoring of medical education and ophthalmology residency training, were not without consequences in eyecare in China.

Cataract Surgery Numbers in U.S. Ophthalmology Residency Programs: An ACGME Case Log Analysis

ABSTRACT Purpose To describe and assess the cataract experience of ophthalmology residents throughout the United States (U.S.). Methods Cataract procedures logged by graduating ophthalmology residents nationwide and published by the Accreditation Council for Graduate Medical Education (ACGME) from 2009 to 2020 were analyzed using linear regression on log-transformed response variables with robust variance. Results As primary surgeon, average numbers logged for phacoemulsification increased yearly by an average of 4.1% prior to 2019 and then decreased by 22.1% in 2019 for an overall average yearly increase of 2.9% (95% CI: 0.5, 5.4%, p = .03), non-phacoemulsification extracapsular extraction decreased yearly by an average of 4.6% (95% CI: −7.7, −1.5%, p = .01), other cataract/intraocular lens surgeries decreased yearly by an average of 8.4% (95% CI: −10.1, −6.6%, p < .001), anterior vitrectomies decreased yearly by an average of 12.5% (95% CI: −14.9, −10.1%, p < .001), and laser capsulotomies increased yearly by an average of 6.0% prior to 2019 and then decreased by 3.0% for an overall average yearly increase of 5.3% (95% CI: 4.5, 6.2%, p < .001). As assistant, average numbers logged in all ACGME minimum categories showed decreasing trends. Conclusions Over the last decade, the average numbers of phacoemulsification and laser capsulotomies logged by residents as primary surgeon increased while other ACGME cataract minimum procedures decreased. Surgical volume in 2019–20 was lower due to the coronavirus disease-19 pandemic but higher than from 2009 to 2013.

EHCO interprofessional Eye-care guidelines: Awareness, perspectives and practice of Ontario Eye-care professionals

Interprofessional collaboration is suggested to optimize patient care and resource utilization. Our aim was to assess the awareness and perspectives of Ontario eye-care professionals and residents/students regarding the published Eye Health Council of Ontario (EHCO) collaborative guidelines. An 18-question survey about awareness and perspectives of the EHCO guidelines was distributed by email to all eye-care professionals from the Eye Physicians and Surgeons of Ontario and Ontario Association of Optometrists; ophthalmology residents at Western University, McMaster University and Ottawa University; and optometry students at the Waterloo School of Optometry and Vision Science, between February–March 2018. Of 117 respondents, 65.8% were not aware of the guidelines before starting the survey. The largest percentage in each group replied they had not read the guidelines; among those who had read the guidelines, most reported minor or no changes to their clinical practice as a result. In open-answer responses, barriers to IPC practices were identified, including lack of reimbursement and inefficient communication between professions. It is suggested that guidelines be more widely disseminated and reinforced to facilitate successful implementation of IPC practices. Strategies such as training opportunities and more open communication about perspectives, concerns, and expectations of IPC models may aid with introducing collaborative practices in Ontario. • 90% of students were unaware of the EHCO guidelines, compared to 54% of ophthalmologists and 50% of optometrists • Most optometrists and students agreed the guidelines allow professionals to provide better patient care, however most ophthalmologists were neutral • A majority of eye-care professionals reported that the guidelines did not affect their practice at all, or only affected their clinical practice in minor ways • More open discussion and better use of online clinical guidelines and updates, and training/educational opportunities can support implementation of IPC practices in Ontario

Attitudes of ophthalmology and pediatrics residents toward professionalism

Attitudes of ophthalmology and pediatrics residents toward professionalism

Delivering a modified continuous objective structured clinical examination for ophthalmology residents through a hybrid online method.

Since coronavirus disease 2019 was declared a global pandemic by the World Health Organization, it has become a challenging situation to continue medical education, including in Indonesia. The situation prohibited face-to-face (direct) educational activities in clinical settings, therefore also postponing examinations involving especially procedural skills. Adaptations were urgently needed to maintain the delivery of high-stake examinations to sustain the number of ophthalmology graduates and the continuation of eye health service. Objective structured clinical examination (OSCE) has been one of our widely used method to assess clinical competencies for ophthalmology residents, and is the one method that involves gatherings, close contact of examiners, examinees and patients, therefore the most difficult to adjust. Pandemic challenges brought technical changes in our delivering the OSCE to online, maximizing digital platforms of meetings, while still concerned to guarding the safety of candidates, patients and staffs. OSCE scenarios were also made as timely efficient as possible by changing continuous station models to a cascade one. The purpose of this article is to document our experience in conducting a feasible and reproducible OSCE in this pandemic era filled with limitations.