Integrating Internship Into Ophthalmology Residency: Assessment of a National Survey and Structured Microsurgical Curriculum.

Abstract

Objective: To report the results of a national survey soliciting residency programs' microsurgical curricula for ophthalmology interns, and the efficacy of a single institution's intern microsurgical wet lab curriculum.

Design: Mixed methods study including a national survey and a prospective trial.

Setting: Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA. Tertiary care institution.

Participants: In this two-part study, an electronic survey soliciting intern microsurgical curricula was distributed to all accredited ophthalmology residency programs nationwide. Additionally, interns at the study institution (n = 10) were evaluated on speed and quality of a corneal suturing task prior to and following completion of an eight-session microsurgical curriculum. Post-curriculum intern performance was also compared to the performance of first-year ophthalmology residents (n = 5) without an internship microsurgical curriculum.

Results: Twenty-four percent of programs responded (n = 27). All programs had a microsurgical wet lab but only five (19%) had a structured curriculum for interns. Most programs described little emphasis on intern microsurgical training and a need for increased guidance on incorporating intern instruction. Interns (n = 10) showed significant improvement in time to task completion (P = 0.002, 95% CI: 0.76 to 1.51) and technical performance (P = 0.02, 95% CI: 0.44 to 3.21) after curriculum completion. Compared to PGY-2 (curriculum-naïve) residents, interns were faster and performed better, but these differences were not statistically significant.

Conclusion: Few ophthalmology residency programs offer microsurgical training during internship. Our structured microsurgical curriculum significantly improved intern microsurgical skills. Nationwide integration of the internship year into ophthalmology residency provides a valuable opportunity to commence microsurgical training.