Journal of academic ophthalmology (2017)最新文献

[This corrects the article DOI: 10.1055/s-0043-1777413.].

Purpose  The purpose of this study was to assess the self-perceived preparedness of incoming postgraduate year 1 (PGY1) and postgraduate year 2 (PGY2) ophthalmology interns/residents to carry out core competencies in ophthalmology. Methods  An online survey was created using the Survey Monkey survey platform and distributed to all ophthalmology resident applicants to the Bascom Palmer Eye Institute from the 2021 to 2022 and 2022 to 2023 application cycles. The survey contained questions pertaining to demographics, prior ophthalmic experience, online resources that were used to prepare for ophthalmology, and self-perceived preparedness to carry out key clinical skills in ophthalmology. Results  A total of 170 responses were obtained (16.1% response rate). Of those, 119 (70%) were incoming PGY1 interns and 51 (30%) were incoming PGY2 residents for the 2022 to 2023 academic year. Most respondents (90.6%, n  = 154) reported that their ophthalmology residency was affiliated with an integrated ophthalmology intern year. Incoming PGY2s moderately agreed with the statement that they felt as prepared to see patients in ophthalmology as they do in other surgical subspecialties, whereas incoming PGY1s only mildly agreed with that statement ( p  = 0.003). Both incoming PGY1s and PGY2s felt most prepared to obtain histories relating to basic ophthalmic complaints and felt least prepared to read and interpret ophthalmic imaging studies. The most popular online resources used by respondents in order of popularity were EyeGuru (35.2%, n  = 60), EyeWiki (32.9%, n  = 56), Tim Root/OphthoBook (26.5%, n  = 45), American Academy of Ophthalmology (13.5%, n  = 23), and EyeRounds/University of Iowa (13.5%, n  = 23). Conclusion  A major challenge in integrating ophthalmic education into the medical school curricula is the gradual shift toward shorter preclinical curricula. However, having a core foundation of ophthalmic knowledge is critical for incoming ophthalmology residents to be able to maximize their specialty-specific training. Integrated ophthalmology intern years likely play a significant role in the increased self-efficacy of incoming PGY2s compared with incoming PGY1s. Adopting nontraditional teaching methods like flipped classroom learning, utilizing online medical education resources, and continuing to increase ophthalmology exposure during PGY1 year may better prepare incoming PGY2s to operate independently in ophthalmology settings.

Objective  This article determines the prevalence of physician parents among ophthalmology residency applications. Design  Retrospective, single-center cohort study. Subjects  All applicants to the University of Kentucky Ophthalmology Residency between 2018 and 2023. Methods  Residency applications were reviewed, with data collection including applicant gender, self-identified Under-Represented in Medicine (URiM) status, United States Medical Licensing Examination (USMLE) Step 1 score, USMLE Step 2 score, and whether the application identified a doctor or physician as a parent. Doctor was defined as a profession requiring a doctorate degree, and similarly, physician as a profession requiring a medical degree. Results  A total of 2,057 applications were reviewed, representing 54% of all match participants during the study period. Fourteen percent (296) of applications indicated a parent was a doctor and 12% (253) a parent was a physician. There were no differences between gender, URiM, USMLE Step 1, and Step 2 scores between applicants indicating a doctor or physician as a parent and those that did not ( p all > 0.4 and Cohen's d all < 0.02). Of the type of doctors, 85% (253) were physicians, 6% (17) optometrists, 6% (17) Doctors of Philosophy, 3% (8) dentists, 1% (1) pharmacist, and 1% (1) veterinarian. Eighty-six percent (217) of applications with a physician parent provided the type of physician, with ophthalmologist the most common (93, 43%). Ninety-eight percent (249) of applications with a physician parent provided the gender of the parent, with father (168, 68%) more common than mother (42, 17%) or both parents (39, 16%). Conclusion  Physician parents are substantially overrepresented in ophthalmology residency applicants. This raises concerns regarding diversity and inclusion efforts for recruitment in medicine.

Purpose  We examined the gender distribution and academic productivity of North American ophthalmology societies' board members. Methods  Cross-sectional and retrospective study of board members on American and Canadian ophthalmology societies. In December 2022, data was gathered from society webpages, online archives, and the Scopus database for publication information. Results  Of the identified 73 board presidents and 876 other board members, 49 (67.1%) board presidents were men and 24 (32.9%) were women, while 554 (63.2%) other board members were men and 322 (36.8%) were women ( p  = 0.53). Overall, board members who were men had significantly higher median h-indexes (men vs. women: 10 [interquartile range [IQR] = 22] vs. 7 [IQR = 12], p  = 0.03) and median publication numbers (men vs. women: 23 [IQR = 84] vs. 14 [IQR = 52.3], p  = 0.01). However, m-quotients (h-index divided by length of academic career) were not significantly different (men vs. women: 0.46 [IQR = 0.74] vs. 0.50 [IQR = 0.55], p  = 0.67). Overall, a significant increase in the proportion of women board presidents comparing periods 1942 to 1961 and 2002 to 2021 was observed for all societies combined (3.1% [2/65] to 23.6% [210/888], p  < 0.001). Conclusion  The fraction of women on the academic boards in North American ophthalmology societies has increased sevenfold over the past 83 years. The gender composition of ophthalmology society boards is consistent with the gender composition of practicing ophthalmologists in the United States. Women in board or society positions have comparable academic output to men. Existing and new efforts to sustain progress in promoting women's representation and leadership opportunities must continue.

Background  The ophthalmology match is an important step for graduating medical students that defines their future career. Residency programs demonstrate significant variability due to differences in size, location, research output, subspecialty exposure, surgical case load, and alumni fellowship/practice placement. Despite the importance of informed decision-making, applicants often find limited, inconsistent information about potential programs. Purpose  The purpose of this study was to characterize and identify gaps in the information available to residents in the 2022 to 2023 Match. Methods  The SFMatch Web site was reviewed to identify programs included as well as characteristics cited on each program's webpage. Program webpages were used to evaluate availability and consistency of data on site surgical caseload, fellowship slots, and teaching staff. Results  Of the 121 programs included on SFMatch, 23 (19%) provided no data on August 15, 2022 (15 days prior to application submission deadline) and 9 (7%) lacked program data on October 15, 2022. Though most programs provided mean cataract volume, data on volume of other procedures for graduating residents was highly variable and occasionally misleading. Programs did not provide information on several academic and social considerations that may influence match ranking choice. Conclusion  Applicants often must read "between the lines" to identify residency program strengths and weaknesses. Data crucial to informing the application process remain sparse, unavailable, or spread across resources. Limited data increases applicant dependence on word-of-mouth knowledge to inform decision-making. This might reduce diversity by limiting successful applicants to those with existing connections within the field.

Inpatient and emergency room ophthalmology consults are becoming an increasingly important issue as fewer providers are willing to provide hospital-based coverage. In this Editorial, I explore aspects of this challenge and highlight a potential solution via the role of an ophthalmic hospitalist.

Purpose  Ophthalmic surgeons are at an increased risk for musculoskeletal disorders resulting from ophthalmology-specific routines and equipment, which have become widely associated with poor posture. The purpose of this study was to observe the effect that a commercially available posture trainer, Upright Go, can have on the improvement of posture of ophthalmic surgeons. Methods  Eight ophthalmologists-in-training were studied over a period of 4 weeks during their surgical rotations between September 2020 and June 2021. Participants underwent an "observation" period, followed by a 2-week "training" period, then a final "testing" period. The percentage of time users spent upright intraoperatively pre- and posttraining was evaluated. Pre- and poststudy surveys were also administered to help measure participant satisfaction and self-reported changes in posture. Results  All eight participants demonstrated an increase in the percentage of time spent upright after the training period. Across all participants, the total average percentage spent upright in the observation period was 59.8%, while in the testing period was 87.1%, resulting in an average improvement of 27.3% of time spent in an upright position after the completion of the training period ( p  < 0.0001). The range of improvement of time spent upright was 16.0 to 46.5%. Conclusion  This cohort study utilized the Upright Go device to help determine the effect that its training could have on the improvement of posture in ophthalmic surgeons. The results indicated a significant increase in the average proportion of time spent with upright posture compared after the training period.

Purpose  This article compares applicants' perceptions of and experiences with virtual and in-person interviews for surgical retina fellowship. Methods  A survey was distributed via email to all applicants of three vitreoretinal surgery fellowship programs for the 2021 to 2022 and 2022 to 2023 application cycles. Main Outcome Measures  Participants were surveyed regarding cost; burden of scheduling; number of applications and interviews completed; ability to gain a true feel of the program, location, and preceptor; and number of work and surgical days missed. Results  Of 151 applicants contacted, 36 completed the survey (23.8% response rate). Of the respondents, 25.0% attended only virtual interviews, 19.4% attended mostly virtual interviews, 30.6% attended mostly in-person interviews, and 25.0% attended half virtual and half in-person interviews. Average expenditure was significantly lower for applicants with mostly and completely virtual interviews compared with applicants with mostly in-person and half virtual, half in-person ( p  < 0.001). Applicants with mostly virtual interviews reported a lower ability to gain a true perception of the program and the program location ( p  = 0.003 and p  < 0.001, respectively). There was no difference in burden of scheduling, number of interviews completed, or number of work and surgical days missed. When applicants were asked what type of interview format they would prefer if they could repeat the cycle, those who interviewed mostly in-person largely chose in-person as their preference (72.7%), while participants who interviewed mostly or completely virtually were evenly split between in-person, virtual, and hybrid ( p  = 0.136). Conclusion  As fellowship programs and institutions decide whether they will return to in-person interviews or maintain a virtual interview format in the long term, they must weigh the lower cost of virtual interviews with the improved ability to gain a more accurate perception of the program and location allowed by in-person interviews, as well as potentially greater satisfaction with the in-person format.

Background  The evolution of medical school curricula, characterized by truncated preclinical periods and reduced emphasis on ophthalmology, presents formidable obstacles to early exposure for aspiring medical students. The constraints imposed by the coronavirus disease 2019 pandemic further exacerbated the limitations on opportunities, compelling the implementation of innovative initiatives aimed at augmenting students' ophthalmology education through virtual means. Purpose  This article assesses the impact of an Ophthalmology Virtual Externship (OVE) on medical students' knowledge, interest, confidence, and seeking mentorship in ophthalmology. Materials and Methods  A total of 76 students voluntarily participated in the program. The OVE encompassed four virtual sessions, facilitated by 4th year medical students employing a near-peer mentorship framework. The initiative was tailored for 2nd and 3rd year medical students and was conducted under the supervision of a faculty member. All participating students completed both pre- and postexternship surveys utilizing a 7-point Likert scale to gauge their levels of interest, confidence, and inclination toward mentorship opportunities in the field of ophthalmology. Furthermore, assessments of ophthalmology knowledge were administered prior to and subsequent to the externship participation. The degree of satisfaction derived from the OVE experience was also evaluated. Results  Participation in the OVE significantly elevated confidence in knowledge ( p  < 0.001) and mentorship interest ( p  = 0.029). Ophthalmology knowledge test scores also notably improved post-OVE across all participants, irrespective of prior experience ( p  < 0.001), with the most significant increase observed among 2nd and 3rd year students ( p  < 0.0001). After OVE participation, 73% of students expressed intent to pursue ophthalmology opportunities, including mentorship or research. The OVE received an average Likert score of 6.35 out of 7 for student satisfaction. Conclusion  The OVE serves as a virtual learning instrument beneficial for 2nd and 3rd year students with a proclivity for ophthalmology, offering a means to circumvent curriculum-related constraints. Moreover, given the decline in formal ophthalmic education, our study contributes to future research assessing the effectiveness of an OVE in addressing ophthalmic knowledge gaps among all medical students.

Objective  Podcasts are a novel modality for digitally disseminating ophthalmic knowledge, yet minimal information exists on their offerings. This study sought to describe the growth of ophthalmology podcasts, characterize their features, and analyze clinically pertinent content trends. Materials and Methods  Apple Podcasts, Spotify, Google Podcasts, and Google Search were queried for English- language shows relating primarily to ophthalmology. Ninety-six podcasts and 3,594 episodes were analyzed. Results  Of the 48 currently active shows, most cover general ophthalmology topics ( n  = 25, 52.1%) and are run by multiple hosts ( n  = 29, 60.4%) in both academics and private practice. The majority of podcasts released episodes monthly ( n  = 21, 21.9%) or less frequently than monthly ( n  = 36, 37.5%). Among all episodes, procedural topics ( n  = 951 episodes, 26.4%) and clinical education ( n  = 1385, 38.5%) were the most prevalent categories. Retina was the most represented subspecialty in podcast production, while oculoplastics and neuro-ophthalmology had the fewest podcasts. Episodes on disease pathophysiology ( p  = 0.04) and published research ( p  < 0.001) each declined over time. The proportion of episodes released from 2020 to 2022 that discussed digital technologies was 33.3% greater versus 2005 to 2019 ( p  = 0.005). Personal retrospective episodes doubled, career guidance and patient perspectives tripled, and wellness and social justice topics increased fivefold (all p  < 0.001). Conclusion  In summary, the coronavirus disease 2019 pandemic coincided with a rise in ophthalmology podcasts and shifts in content. Podcasts have trended toward practical advice and technologies, reflecting their value in sharing modern, peer-to-peer pearls. Emphases on storytelling and social justice offer unique, clinically relevant perspectives compared with traditional modalities.