Journal of Academic Ophthalmology
Not a member yet
320 research outputs found
Sort by
Ophthalmology Medical Student Directors, Associate Residency Program Directors, and Program Directors: A Benchmarking Study of Work and Life Metrics
No full textAbstract
Introduction During a time of increased interest in physician well-being, this study benchmarks current work life, home life, and burnout scores for ophthalmology medical student directors (MSD), associate program directors (APD), and program directors (PD).
Methods An anonymous cross-sectional survey was disseminated through the Association of University Professors of Ophthalmology (AUPO) listserve, with queries regarding leadership positions, work time allotment, extracurricular activities, family life, and burnout. Answers were analyzed descriptively through Fisher\u27s exact test, Kruskal–Wallis test, and Poisson regression models.
Results Nineteen percent of listed MSD, 15% of APD, and 29% of PD queried responded to the survey. MSD, APD, and PD are statistically similar in terms of work and home life, with the exception of time spent performing administrative tasks for the position. PD spend more time on administrative tasks, and are paid more. All groups score positively on burnout surveys.
Conclusion This benchmarking survey demonstrates that MSD, APD, and PD are intensively involved in both their work and home lives, with a seemingly high correlation of sense of worth both personally and in their careers
Perceived Barriers to Increasing Diversity within Oculofacial Plastic Surgery
No full textAbstract
Purpose Physician diversity is limited in ophthalmology and oculofacial plastic surgery. Determination of barriers within the application process for oculofacial plastic surgery may help target efforts to improve the recruitment of underrepresented groups. This study aimed to illuminate perceived barriers to increasing diversity in oculofacial plastic surgery trainees, according to the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) fellows and fellowship program directors (FPDs).
Methods During the month of February 2021, we sent surveys out to 54 current oculofacial plastic surgery fellows and 56 FPDs at 56 oculofacial plastic surgery programs recognized by the ASOPRS nationwide using a 15-question Qualtrics survey.
Results Sixty-three individuals (57%) responded to the survey: 34 fellows (63%) and 29 FPDs (52%). Eighty-eight percent of fellows and 68% of FPDs identified as non-underrepresented in medicine (UiM). Forty-four percent of fellows and 25% of FPDs identified as men. FPDs most commonly noted, “Not enough minorities applying to our program” and “The objective data (Ophthalmic Knowledge Assessment Program score, United States Medical Licensing Examination Step scores, clinical honors, Alpha Omega Alpha status, letter of recommendation) for minority applicants often do not meet the threshold required to offer an interview or to be ranked to match” as barriers. Among fellows, the lowest-rated considerations when applying to oculofacial plastic surgery were “Racially/ethnically diverse faculty” and “Perceptions of minority candidates by fellowship programs,” whereas “Likelihood of matching in program of choice” was ranked highest in considerations. Fellows identifying as men indicated greater concern for “Financial factors related to fellowship (e.g., loans, salary, cost of living, or cost of interviewing)” compared to fellows identifying as women who noted greater concern for “Program or preceptor acceptance of starting or having a family during fellowship.”
Conclusion Responses from FPDs suggest that efforts focused on recruiting and supporting diverse students to medicine and ophthalmology, mentoring applicants interested in oculofacial plastic surgery, and restructuring the application process to decrease bias, may improve diversity within the subspecialty. The lack of UiM representation in this study, 6% fellows and 7.4% FPDs identified as UiM, shows both the stark underrepresentation and the need for further research into this topic
Exposure of Ophthalmology Residents to Cornea and Keratorefractive Surgeries in the United States
No full textAbstract
Purpose To describe the cornea and keratorefractive surgeries experience of U.S. ophthalmology residents.
Methods Deidentified case logs of residents graduating in 2018 were collected from ophthalmology residency program directors in the United States. Using Current Procedure Terminology codes, case logs were reviewed in the categories of cornea and keratorefractive surgeries. Accreditation Council for Graduate Medical Education national graduating resident surgical case logs on cornea procedures published from 2010 to 2020 were also analyzed.
Results Case logs were received for 152/488 (31.1%) residents from 36/115 (31.3%) ophthalmology residency programs. The most common procedures logged by residents as primary surgeons were pterygium removal (4.3 ± 4.2) and keratorefractive surgeries (3.6 ± 6.2). Residents logged an average of 2.4 keratoplasties as primary surgeon, performing an average of 1.4 penetrating keratoplasties (PKs) and 0.8 endothelial keratoplasties (EKs). As assistants, the most common procedures logged were keratorefractive surgeries (6.1 ± 4.9), EKs (3.8 ± 3.3), and PKs (3.5 ± 2.3). Medium or large residency class size was associated with higher cornea procedural volumes (odds ratio: 8.9; 95% confidence interval: 1.1–75.6; p \u3c 0.05).
Conclusion The most common cornea surgeries performed by residents include keratoplasty, keratorefractive, and pterygium procedures. Larger program size was associated with greater relative cornea surgery volume. More specific guidelines for logging of procedures could provide a more accurate assessment of resident exposure to critical techniques such as suturing as well as reflect trends in current practice such as the overall increase in EKs
Factors Associated with Early Career Research Productivity after Ophthalmology Residency
No full textAbstract
Background Few studies have evaluated associations between ophthalmology trainee characteristics and performance with postgraduate research productivity.
Purpose This article evaluates factors associated with post-residency research productivity among U.S. ophthalmology graduates.
Methods Publicly available information of residents graduating between 2009 and 2014 from 30 randomly selected U.S. ophthalmology programs was collected from June to September 2020. Differences in publications between the 5 years post-residency and pre-residency/residency period were used as metrics of productivity. Residents with incomplete records were excluded.
Results A total of 758 of 768 residents, 306 females (40.4%) and 452 males (59.6%), met inclusion criteria. The mean (standard deviation [SD]) number of pre-residency publications was 1.7 (4.0), residency was 1.3 (2.2), and post-residency was 4.0 (7.3). Mean (SD) H-index was 4.2 (4.9). Top-ranked residency (p = 0.001), Alpha Omega Alpha (AOA) medical honor status (p = 0.002), U.S. medical school graduates (p \u3c 0.001), and academic career (p \u3c 0.001) were all associated with higher pre-/post-residency mean publication difference. Pursuing fellowship training also was associated with higher total publications (p \u3c 0.001). Of all pre-residency degrees, PhD had the greatest odds of high postgraduate publications (defined as \u3e 4). There was a positive correlation between both pre-residency/residency and post-residency publications (rho = 0.441; p \u3c 0.001) and between mean difference of pre-residency/post-residency publications for residents at a program and that program\u27s Doximity rank (rho = 0.497; p \u3c 0.001). Multivariate logistic regression revealed, academic career choice (odds ratio [OR] = 3.38; p \u3c 0.001), Heed fellowship (OR = 3.12; p = 0.031), \u3e 2 residency publications (OR = 2.89; p \u3c 0.001), AOA status (OR = 2.0; p = 0.004), and top-ranked residency programs (OR = 1.89; p = 0.007), had greatest odds of \u3e 4 postgraduation publications.
Conclusion Higher post-residency productivity was associated with multiple factors, with choice of an academic career, Heed fellowship, and residency productivity playing key roles
Outcomes of a Five-Year Formal Ophthalmology Residency Mentorship Program
No full textAbstract
Objective This article describes a formal ophthalmology residency mentorship program, identifies its strengths and weaknesses over 5 years of implementation, and proposes strategies to improve qualitative outcomes of the mentorship program.
Design Cross-sectional anonymous online survey.
Subjects All current and former mentees and mentors at the Casey Eye Institute (CEI) residency program from 2016 to 2021.
Methods All eligible participants were contacted via email to complete a survey to describe and analyze their experiences with the CEI\u27s formal residency mentorship program.
Results Of the 65 surveyed participants, 82% preferred in-person meetings and met up from 2 to 3 times (44%) to 4 to 6 times (38.5%) annually at 15 minutes to 1 hour (48%) or 1 to 2 hours (42%) duration. Sixty-two percent of meetings were initiated by mentors, 8% by mentees, and 32% shared responsibilities equally. Participants also identified the three most important qualities for successful mentor-mentee relationship as personality (33.6%), communication styles (29.2%), and extracurricular interests/hobbies (16.8%). Mentees valued career advising, networking, and wellness support over academic and research mentorship. Subjective outcomes showed 25% of the mentee and 43% of the mentors agreed the mentorship program was a valuable experience. Comparably, 14% of the mentees and 38% of the mentors prioritized the relationship. There was a strong correlation between participants who prioritized the relationship and acknowledged it as a valuable experience (p \u3c 0.01). Eighteen percent of the mentees and 43% of the mentors found the relationship effective and met their expectations. Twenty-one percent of the mentees and 38% of the mentors believed they had the tools and skills necessary to be effective in their respective roles.
Conclusion Our survey identified that weaknesses of the mentorship program include ineffective communications, inadequate preparation in their respective roles, and lack of priority focus on the relationship. We propose strategies to strengthen our program through creating workshops to clarify roles and responsibilities, emphasizing accountability with a contract statement, and implementing a new matching algorithm to customize participants\u27 experience. Additional studies from other residencies with formal mentorship programs are warranted to identify, strategize, and foster high-quality mentorship
Accuracy of Ophthalmology Clinic Follow-Up in the Incarcerated Patient Population
No full textAbstract
Purpose Incarcerated patients represent a uniquely vulnerable population in the outpatient ophthalmology setting, and the reliability of follow-up in this group is undetermined.
Methods This was a retrospective, observational chart review of consecutive incarcerated patients evaluated at the ophthalmology clinic of a single academic medical center between July 2012 and September 2016. For each encounter the following were recorded: patient age, gender, incarcerated status at the time of encounter (a subset of patients had encounters before/after incarceration), interventions performed, follow-up interval requested, urgency of follow-up, and actual time to subsequent follow-up. Primary outcome measures were no-show rate and timeliness, which was defined as follow-up within 1.5× the requested period.
Results There were 489 patients included during the study period, representing a total of 2,014 clinical encounters. Of the 489 patients, 189 (38.7%) were seen once. Of the remaining 300 patients with more than one encounter, 184 (61.3%) ultimately did not return and only 24 (8%) were always on time for every encounter. Of 1,747 encounters with specific follow-up requested, 1,072 were considered timely (61.3%). Factors significantly associated with subsequent loss to follow-up include whether a procedure was performed (p \u3c 0.0001), urgency of follow-up (p \u3c 0.0001), incarcerated status (p = 0.0408), and whether follow-up was requested (p \u3c 0.0001).
Conclusion Almost two-thirds of incarcerated patients in our population requiring repeat examination were lost to follow-up, particularly those who underwent an intervention or required more urgent follow-up. Patients entering and exiting the penal system were less likely to follow-up while incarcerated. Further work is needed to understand how these gaps compare to those in the general population and to identify means of improving these outcomes
Predictive Factors of Research Productivity among Ophthalmology Residents: A Benchmark Analysis
No full textAbstract
Introduction Positive and negative associations between prior publications and future research productivity is described in other fields, but no such analysis exists for ophthalmology. We conducted a study to determine characteristics of residents exhibiting research productivity during residency.
Methods Using San Francisco Match and Program Web sites, a roster of ophthalmology residents in 2019 to 2020 was compiled, and publication data was collected via PubMed and Google Scholar on a random sample of 100 third-year residents.
Results The median number of publications generated by ophthalmology residents before residency is 2 (range 0–13). Thirty-seven, 23, and 40 residents had zero, one, and two or more papers published during residency, respectively, with a median of 1 (range 0–14). On univariate analysis, compared with residents who published zero or one paper, those who published ≥ 2 were more likely to have more preresidency publications (odds ratio [OR] 1.30; p = 0.005), attend a top-25 ranked residency program by multiple metrics including Doximity reputation (OR 4.92; p \u3c 0.001), and have attended a top-25 ranked medical school program by U.S. News and World Report (OR 3.24; p = 0.03). However, on adjusted analyses, the only factor that remained significant for predicting publications in residency was whether the residency program attended was top 25 ranked (OR 3.54; p = 0.009).
Discussion/Conclusion With the advent of the United States Medical Licensing Examination Step 1 pass/fail system, greater emphasis will be placed on other metrics, including research. This is the first benchmark analysis examining factors predictive of publication productivity in ophthalmology residents. Our study suggests that the residency program attended, not the medical school attended or prior publication history, plays an influential role in the number of publications produced during residency, highlighting the importance of factors to support research on the institutional level, such as mentorship and funding, rather than historical factors in research productivity by the resident
Impact of COVID-19 on the Ophthalmology Residency Home-Institution Match Rate
No full textAbstract
Purpose The aim of this study was to evaluate the ophthalmology residency match results to determine changes in the rate of home-institution matches during the coronavirus disease 2019 (COVID-19) pandemic.
Methods Aggregate deidentified summary match result data from 2017 to 2022 was obtained from the Association of University Professors of Ophthalmology and the San Francisco (SF) Match. A chi-squared test was performed to determine if the rate of candidate matching to the home residency program in ophthalmology was higher in the post-COVID-19 compared with pre-COVID-19 match years. A literature review using PubMed was performed of other medical subspecialty match rates to home institution during the same study period.
Results A chi-squared test for difference in proportions confirmed a significantly higher chance of matching to the home program for ophthalmology in the post-COVID-19, SF Match year of 2021 to 2022 compared with 2017 to 2020 (p = 0.001). Other medical specialties including otolaryngology, plastic surgery, and dermatology also showed similar increased home institution residency match rates during the same time period. Although neurosurgery and urology also had increased trend rates for home institution match rates, these results did not reach statistical significance.
Conclusions The ophthalmology home-institution residency SF Match rate was significantly increased during the COVID-19 pandemic year 2021 to 22. This mirrors a trend reported in other specialties including the otolaryngology, dermatology, and plastic surgery in the 2021 match. Additional study will be required to identify factors leading to this observation
Evaluation of the Content of Ophthalmology Fellowship Program Web sites
No full textAbstract
Purpose To assess the availability and content of fellowship program Web sites (FPWs) among ophthalmology subspecialties.
Design This is a cross-sectional study.
Subjects Web sites of all Association of University Professors of Ophthalmology-accredited fellowship programs in five subspecialties (i.e., surgical retina and vitreous; cornea, external disease, and refractive surgery; glaucoma; neuro-ophthalmology; and pediatric ophthalmology).
Methods FPWs were assessed for the presence of 26 key content criteria encompassing program demographics (n = 13), features (n = 10), and social life (n = 3). The presence of each content criterion as well as the content criteria groups were compared across subspecialties.
Main Outcome Measures The main outcome measured is the average percentage of key content criteria present among ophthalmology fellowship Web sites.
Results Among 266 accredited fellowship programs, 240 (90.2%) had Web sites. On average, Web sites reported 14.9 of 26 key content criteria (57.2%), 8.29 of 13 demographic criteria (63.8%), 5.84 of the 10 program features criteria (58.4%), and 0.705 of the 3 social life criteria (23.5%). Significant differences were identified among subspecialties in the presence of program description (p = 0.046), hospital affiliation (p \u3c 0.001), names of current fellows (p = 0.004), case diversity (p = 0.001), and surgical statistics (p = 0.015). The average number of key criteria differed between subspecialties (p \u3c 0.001).
Conclusion There is significant heterogeneity in program fellowship Web site content among ophthalmology subspecialties. Information regarding social life, such as wellness programs and community information, was largely absent across all disciplines. Addressing missing information on ophthalmology FPWs may help optimize program-applicant fit
A Novel Interactive Virtual Medical Student Clinical Rotation for Ophthalmology
No full textAbstract
Objective This article describes a novel clinical rotation that uses technology to create a remote ophthalmology learning experience with the goal of improving virtual exposure to medical and surgical ophthalmic training for medical students.
Methods Our unique curriculum incorporates mobile-mounted tablets which allow students to virtually participate in inpatient consults, clinic, and ophthalmic surgery. An adaptable mounting device attached to the slit lamp allows students to observe examinations in real time, enhancing recognition of ocular pathologies. Students participate in a robust curriculum that includes independent learning modules, video lectures, interactive modules, podcasts, and surgical video rounds. Students engage with residents and faculty in interactive-guided lectures and case-based discussions that focus on the American Academy of Ophthalmology white paper teaching objectives. Students are mailed surgical instruments and participate in surgical modules and faculty-led virtual wet laboratories.
Results Our unique virtual curriculum combines didactic learning, interactive content, and novel technology applications such as mobile tablets, slit lamp-mounted devices, and faculty-led virtual wet laboratories.
Conclusion Virtual technologies can be utilized to enhance ophthalmology medical student education in a safe and effective way during the coronavirus disease 2019 pandemic, and to improve educational access in the future