Journal of Academic Ophthalmology
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WomenInOphthalmology: Gender Diversity in Ophthalmology Residency Program Social Media
No full textPurpose: Although women constitute a significant portion of medical students and physicians, representation of women in ophthalmology is relatively low. Residency programs are increasingly using social media to showcase and represent their program culture. The purpose of this retrospective cross-sectional study was to assess representation of gender diversity in social media posts by U.S. ophthalmology residency programs.
Methods: Instagram, Facebook, and TwitterTwitter/X accounts of ophthalmology residency programs accredited by the Accreditation Council for Graduate Medical Education were identified. Social media posts from 2019-2021 were analyzed for representation of gender diversity and/or explicit statements regarding gender diversity. Program metrics, including geographic region, gender of the program director (PD) and department chair (DC), proportion of female residents, residency and faculty size, academic affiliation, number of training sites, presence of diversity statement on the program website, and top 20 ranking were noted. Nonparametric Kruskal-Wallis H, Mann-Whitney U, chi-square, and linear regression multivariable analyses were performed with significance at a=0.05.
Results: Across Instagram, Facebook, and TwitterTwitter/X, 20580 total posts from 2019 to 2021 were analyzed. 30% of posts showed gender diversity, 2.0% explicitly addressed women in ophthalmology, and 3.4% spotlighted a female ophthalmologist. The median proportions of posts showing gender diversity (0.24 vs. 0.43, p=0.004) and posts highlighting female ophthalmologists significantly increased from 2019 to 2021 (0.08 vs. 0.13, p=0.012). The median proportion of gender diversity-showing posts was higher for programs with female PDs (0.48 vs. 0.33, p=0.010). On multivariable analysis, the Midwest was a predictor of gender diversity in posts (B=0.019, p=0.0495). The most popular hashtag used was #illooklikeasurgeon (n=115).
Discussion: Gender diversity representation in ophthalmology residency program social media is increasing over time. Institutions can utilize social media to raise awareness and promote gender diversity in ophthalmology
A Cautionary Tale: Increasing Research in Ophthalmology Residency Applications
No full textThe increasing emphasis on research productivity in ophthalmology residency applications reflects broader shifts in medical education and raises important questions about equity, authenticity, and holistic evaluation. As grading systems and standardized examinations move toward pass/fail formats, research has become one a principal way for applicants to distinguish themselves from other applicants. While this shift has increased scholarly output, it has also exacerbated disparities in access to mentoring, encouraged superficial research engagement, and may undermine diversity within the field. Evidence consistently shows that diversity among physicians improves patient outcomes and promotes equitable care, underscoring the need for the residency selection process to holistic evaluate applicants beyond publications. Programs should balance research achievements with other qualities, such as clinical acumen, leadership, service, and commitment to patient-centered care, ensuring that the next generation of ophthalmologists reflect both excellence and inclusivity
Using Google Forms to Create an Accurate, HIPAA Compliant Database for Rare and Poorly Coded Diseases in Uveitis
No full textPurpose: The International Statistical Classification of Disease and Related Health Problems, tenth revision (ICD-10) coding in electronic health record (EHR) systems is unable to accurately characterize certain uveitis subtypes. We describe our experience with coding errors in our EHR system and our experience using Google Forms to create a Health Insurance Portability and Accountability Act (HIPAA) compliant database to accurately characterize rare and poorly coded diseases in uveitis. Methods: This pilot single-center retrospective, consecutive case series included patients diagnosed with uveitis to assess the frequency of inaccurate coding in our MDI (MDIntelleSys, Nextech Systems LLC) EHR using ICD-10 codes and the feasibility of using Google Forms to create an accurate HIPAA compliant database. Electronic medical records were reviewed to collect information on patient demographics and uveitis characteristics. Results: The charts of the first 100 consecutive patients evaluated by the uveitis unit between October 1, 2015 and October 27, 2015 were reviewed. Demographic information and uveitis characteristics were manually extracted to classify various uveitis subtypes under the correct diagnosis using an organizational framework created using Google Forms. This framework allowed for efficient selection of predetermined variables for each encounter such that data entry was efficient, accurate uveitis descriptors were used, and transcriptional errors were avoided. The most common anatomic location of inflammation was anterior uveitis (58.0%), followed by posterior uveitis (16.0%), panuveitis (15.0%), intermediate uveitis (10.0%), and primary retinal vasculitis (1.0%). Ninety four percent of diagnoses were non-infectious (94.0%). Forty six percent of the uveitides were undifferentiated (46.0%), followed by HLA B27- associated (12.0%), sarcoidosis (8.0%), and birdshot chorioretinopathy (6.0%). Of the 20 uveitic diagnoses identified with extraction using Google Forms, 7 (35.0%) did not have an associated diagnosis or ICD-10 code in MDI (22 patients) and 2 (10.0%) etiologies (acute retinal necrosis and birdshot chorioretinopathy) were coded under the same diagnosis and ICD-10 code (disseminated chorioretinal inflammation, H30.13, 8 patients). Conclusions: This pilot study successfully showed that Google Forms is useful in the creation of a HIPAA-compliant database which efficiently and accurately captures data on uveitis patients, which would otherwise be inaccurately coded using our current EHR and international disease classifications
Representation Matters: Perceived Barriers to Medical Students Pursuing Ophthalmology
No full textIntroduction: Improving our understanding of the barriers that medical students perceive to pursuing ophthalmology may reveal means of increasing accessibility to the field, especially for students underrepresented in medicine (URiM).
Methods: A 25-item questionnaire was electronically distributed to United States allopathic and osteopathic medical students from April to May 2022. Subgroup analyses were conducted on respondents who selected ophthalmology as their specialty of choice, respondents who reported that they were no longer pursuing ophthalmology due to barriers, and respondents who identified as URiM.
Results: Students at 37 medical schools completed 429 questionnaires. Ophthalmology was the specialty of choice for 51 respondents (11.9%), while 26 respondents previously interested in ophthalmology reported a career change due to perceived barriers (“dropout” group). Of the students pursuing ophthalmology, 14 identified as URiM (27.5%). Ophthalmology-bound and dropout respondents favored the same four barriers to pursuing ophthalmology (overall competitiveness, necessity of research, USMLE scores, and lack of mentorship), but the dropout group was significantly more likely to cite lack of exposure to the field (50% vs 19.6%, p=0.0062) and lack of a home program (53.8% vs 29.4%, p=0.0379) compared to those still pursuing ophthalmology. Significantly more URiM students selected “lack of representation in the field of people of my race or ethnicity” as a barrier to pursuing ophthalmology compared to their non-URiM peers (64.3% vs 8.1%, p
Discussion: Medical students perceive multiple barriers to pursuing ophthalmology. Lack of representation is an important barrier to URiM students, on par with quantitative metrics such as research and exam scores. Increasing mentorship and exposure to the field, especially for URiM students and those without a home residency program, may support students in pursuing the specialty. Additional strategies should be investigated to support these students and expand diversity in eye care
Effectiveness of Novel Approaches to Ophthalmology Education in Medical Schools: A Systematic Review and Meta-Analysis
No full textPurpose
Effective teaching is often described as being the single most important indicator of student achievement. Due to global reductions in time allocated towards ophthalmology teaching in medical school there is a pressing need for more effective ophthalmology teaching. This paper aimed to investigate and analyse the effectiveness of novel ophthalmology teaching techniques in medical student populations through meta-analysis.
Method
Systematic review of databases EMBASE and Medline were performed up to July 2024. Outcomes investigated included medical student ophthalmology test scores and student satisfaction. Studies were grouped according to intervention and mean effect sizes were calculated.
Results
Database search yielded a total of 3170 articles, of which 31 were eligible for meta-analysis. Novel teaching techniques described included e-learning, flipped-classroom, team-based learning, ophthalmology intensive courses, artificial intelligence, augmented reality, peer teaching, virtual reality and novel technologies for teaching ophthalmic examinations. Of these modalities flipped-classroom teaching, team-based learning and virtual reality were shown to be the most effective modalities.
Conclusions
Flipped-classroom, team-based learning and virtual reality are the three most effective novel ophthalmology teaching methods when considering both test scores and student satisfaction. The correlation between effective teaching and these three modalities is likely related to the high level of student engagement developed through active learning tasks. Given the declining levels of junior doctor ophthalmic confidence, there must be further commitment towards implementing effective novel teaching techniques in ophthalmology
Assessing United States Ophthalmology Departments by Faculty Academic Achievement
No full textBackground: Reputation-based rankings of U.S. ophthalmology departments strongly influence trainee and faculty decision-making but rely heavily on subjective survey data. Objective, transparent methodologies for comparing academic achievement across departments are lacking.
Purpose: To assess U.S. ophthalmology departments using a novel, objective, standardized, and transparent system employing three measures of faculty academic achievement: National Institutes of Health (NIH) funding, lifetime Hirsch (h)-index, and journal impact factor (JIF)-weighted journal editorial board membership.
Methods: In this cross-sectional study, a list of ophthalmology residency-trained faculty was compiled for each U.S. ophthalmology department with an associated residency training program. Faculty member NIH funding was obtained for the period 2020-2022, and average yearly NIH funding by department was calculated. Faculty member lifetime H-indices were obtained and averaged across each department. JIF-weighted editorial board membership was calculated by cross-referencing the editorial boards of 30 top ophthalmology journals with department faculty lists to identify faculty with editorship. A total score was then calculated for each department. Departments were compared across individual and cumulative metrics.
Results: The top 5 departments according to annual NIH funding were Harvard University, University of Washington, University of California San Francisco (UCSF), Stanford University, and Johns Hopkins University (JHU). The top 5 departments according to average lifetime H-index were JHU, University of California Los Angeles (UCLA), University of Miami, University of California San Diego (UCSD), and University of Iowa. The top 5 departments according to total JIF-weighted editorial board membership were JHU, Harvard University, Thomas Jefferson University, UCLA, and University of Miami. The top 10 departments overall were JHU, Harvard University, UCLA, Stanford University, UCSD, University of Illinois Chicago, University of Michigan, UCSF, University of Miami, and University of Pennsylvania.
Conclusions: Academic department rankings have been shown to significantly influence key stakeholder preferences; however, popular ranking systems are limited by opaque methodology and/or reliance on subjective data. Herein, we demonstrate the feasibility of a transparent, standardized approach by which to assess ophthalmology departments by faculty academic achievement using three objective metrics derived from publicly available data
A Web-based Review of Global Training in United States Ophthalmology Residency Programs
No full textPurpose: To review the currently publicly available information on global ophthalmology experiences during residency training.
Methods: All 122 Accreditation Council for Graduate Medical Education (ACGME)–approved ophthalmology residency programs’ websites were evaluated.
Results: Of the 122 ophthalmology residency programs, 30 (25%) list global ophthalmology experiences on their websites. Of these 30, 21 (80%) offer electives and 12 (40%) list the experiences as a mix of clinical and surgical exposure. One-third of these programs 2 weeks or less in length; one-third of programs do not list the duration of the experience. In total, 21 programs (80%) work with partner organizations to travel to multiple countries across the world, with India being the most listed destination. These global experiences are publicly offered to senior residents for 18 programs (60%). Only 6 programs (20%) list formal curricula. Only 10 (33.3%) list funding availability for their international experience.
Conclusion: Only a quarter of ophthalmology residency programs currently list an international experience for their residents, most commonly an optional 2-week elective for senior residents
Patterns of Ophthalmology-related Interfacility Transfers to the Emergency Department by Temporal Trends
No full textBackground: Interfacility transfer patients are associated with inferior outcomes, higher costs, and emergency department (ED) overcrowding. Previous studies have analyzed the general trends influencing interfacility transfers, but the patterns affecting ophthalmology-related transfer rates remain unclear. The purpose of this study was to identify and quantify the patterns of interfacility ophthalmology-specific transfers to the ED by temporal trends and to determine the type of ophthalmic services required by the transferred population.
Methods: All patients transferred to the ED of a single level 1 trauma center because of ophthalmology-related complaints from 2016 to 2023 were analyzed retrospectively. Transfer and nontransfer patient visits were sorted by season, day of the week, time of day, and federal holiday status.
Results: A total of 2,660 patients were included. The overall volumes of ophthalmology-related interfacility transfers and direct ED visits were highest during the summer and lowest during the winter (P \u3c 0.05). Ophthalmology-related interfacility transfers were highest on weekend days and lowest on Wednesdays, representing 40% and 10.1% of total transfers, respectively (P \u3c 0.01). Nontransfer ophthalmology-related ED visits were more equally distributed throughout the week (P = 0.16). Over half of all transfers occurred during the afternoon (52.9%); however, most direct ED visits were equally distributed between mornings (44.7%) and afternoons (44.1%). Statistically significant differences regarding the time of the day were apparent in both groups (P \u3c 0.05). Additionally, the most common ophthalmic category among interfacility transfer patients was trauma to the eye (32.1%), followed by oculoplastic maladies (27.5%). Glaucoma (2.9%) and neuro-ophthalmology (0.1%) received fewer number of patients.
Conclusions: Interfacility transfer patients represent a large proportion of the ophthalmology-related ED volume on weekends and during the night shift, which could contribute to ED overcrowding and staffing shortages
Global Health Content on U.S. Ophthalmology Residency Program Websites
No full textPurpose: There is high interest among ophthalmology applicants and current trainees to participate in global health experiences. The purpose of this study was to investigate the availability of information on global healthcare opportunities for prospective ophthalmology residency applicants on program websites, and to determine whether there is a correlation between residency program characteristics and availability of global opportunities for prospective trainees. Methods: All ACGME accredited U.S. postgraduate training programs in ophthalmology were included, except those without a website. A cross-sectional review of program websites was conducted from January to March 2023 to evaluate for the presence of 11 predetermined criteria. Program characteristics including region, number of residents, affiliation, and integration of the PGY-1 year were collected and a Kruskal- Wallis test was used to determine the association between these characteristics and criteria present. Results: There were 118 ophthalmology programs eligible for inclusion. The mean number of criteria present among all programs was 1.84 ± 2.73. Forty-seven (39.8%) programs had at least one criteria present on their website. Only 22 (18.64%) programs had at least half (≥5) of the criteria present. The most frequently present criteria was information on existing opportunities for international rotations, found in 42 (35.9%) programs. The least frequently present criteria was information on opportunities for residents to create their own rotation, found in 5 (4.24%) programs. Programs in the West (3.62 ± 3.36) had a greater number of global ophthalmology criteria compared to those in the Midwest (2.51 ± 3.07), Northeast (1.02 ± 2.16), Southeast (1.92 ± 2.64), and Southwest (0.57 ± 1.51) [p = 0.0086]. Programs with more than 22 residents (3.83 ± 3.71) had more criteria present compared to programs with 5-9 (0.56 ± 1.70), 10-15 (2.03 ± 2.79), or 16-21 residents (3.40 ± 2.92) [p=0.0006]. Conclusion: Less than half of programs made any mention of global ophthalmology opportunities on their websites. However, there was a correlation between size of the residency training program and robustness of global ophthalmology opportunities listed on the programs website. This study advocates for stronger communication regarding global ophthalmology opportunities present at training institutions across the nation