Journal of academic ophthalmology (2017)最新文献

Purpose  This article evaluates the relevance of social media to ophthalmology residency applicants in the setting of virtual interviews, the types of information sought by applicants, and the impact of rebranding of an institutional and departmental social media account. Design  Cross-sectional survey. Participants  Ophthalmology residency applicants from the 2020 to 2021 cycle. Methods  A voluntary survey was emailed to 481 applicants to the University of Louisville Department of Ophthalmology residency during the 2020 to 2021 application cycle to gauge the impact of social media on their perspectives of residency programs, especially with regards to a new departmental social media account. Main Outcome Measures  Applicants' use of social media platforms and specific components of departmental social media accounts found most useful. Results  The 13-question survey was completed by 84/481 applicants (17.5% response rate). Social media was used by 93% of respondents. Of those respondents reporting social media use, the most common platforms utilized included Instagram (85%), Facebook (83%), Twitter (41%), and LinkedIn (29%). Sixty-nine percent of respondents specifically used Instagram to learn more about residency programs. With regards to the rebranded Instagram account at the University of Louisville, 58% of respondents reported being influenced, with all asserting that the account positively encouraged them to apply to the program. The most informative elements of the account related to current resident profiles, resident life, and living in Louisville. Conclusion  A majority of responding ophthalmology residency applicants utilized social media to search for program information. A newly developed social media profile at a single institution positively influenced applicant impressions of the program, with the most importance assigned to information provided about current residents and typical resident life. These findings suggest key areas where programs should continue to dedicate online resources with targeted information to better recruit applicants.

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  < 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.

[This corrects the article DOI: 10.1055/s-0042-1756133.].

Objective  This article characterizes the resources used by ophthalmology residency applicants when deciding where to apply, interview, and rank. Design  Cross-sectional, online survey. Participants  All applicants to the University of California-San Francisco ophthalmology residency program during the 2019 to 2020 and 2020 to 2021 application cycles. Methods  A secure, anonymous, 19-item post-match questionnaire was distributed to participants inquiring about demographic information, match outcomes, and resources used to learn and make decisions about residency programs. Results were analyzed using qualitative and quantitative methods. Main Outcome Measures  Qualitative ranking of resources used to decide where to apply, interview, and rank. Results  One hundred thirty-six of 870 solicited applicants responded to the questionnaire, for a response rate of 15.6%. Digital platforms were ranked as more important resources than people (i.e., faculty, career advisors, residents, and program directors) when applicants were deciding where to apply and interview. Digital platforms became far less important when applicants were formulating their rank lists, at which time the program's academic reputation, perceived happiness of residents and faculty, interview experience, and geographic location were more important. When learning about residency programs, 100% of respondents engaged with program Web sites, and the majority engaged with program emails ( n =88 [85.4%]), Doximity ( n =82 [79.6%]), Reddit ( n =64 [62.1%]), Instagram ( n =59 [57.3%]), the FREIDA residency program database ( n =55 [53.4%]), and YouTube ( n =53 [51.5%]). All 13 digital platforms included in the survey were utilized by at least 25% of respondents, largely passively (i.e., reading rather than producing content). Respondents indicated that the most important topics to include on program Web sites were the number of residents accepted per year, current resident profiles, and resident alumni job/fellowship placement. Conclusion  Applicants engage heavily with digital media in deciding where to apply and interview but rely heavily on their personal experiences with the program in deciding where to rank. Ophthalmology programs may facilitate recruitment of applicants by optimizing their digital media platforms.

Background  Longitudinal Integrated Clerkships (LICs) are innovative educational models that allow medical student continuity with patients, preceptors, colleagues, and health care systems. Given their benefits, the number of LICs continues to increase. We share a pilot model for an ophthalmology LIC curriculum at the University of Colorado School of Medicine targeted for students to see patients through transitions of care. Methods  A needs assessment was performed including literature search, interviews with expert faculty, and a precurricular student questionnaire. Based on our findings, we developed a pilot two-part curriculum consisting of an introductory lecture and a half-day clinical experience designed to integrate patient eye care into the LIC model. At the end of the year, students completed a questionnaire assessing attitude, confidence, and knowledge. Precourse data were collected from students in the academic year (AY) 2018/2019 to aid with the needs assessment. Postcourse data were collected after completion of the curriculum from students in AY 2019/2020. Data from questionnaire were intended to improve our curricular experience. Results  Our curriculum was piloted between the 2019 and 2020 AY. The completion rate of our curriculum was 100%. The questionnaire response rate was 90% in pre- and postcurricular groups ( n =15/17 and n =9/10, respectively). Hundred percent of students from both groups responded that it is "very important"/"important" for all physicians to be able to identify when ophthalmology referral is indicated. After the intervention, there were significant differences in the rate of students responding that they were "confident" diagnosing acute angle-closure glaucoma (36 vs. 78%, p =0.04), treating a chemical burn (20 vs 67%, p =0.02), and diagnosing viral conjunctivitis (27 vs. 67%); 90% of students reported increased confidence in longitudinal care of patients in the eye clinic. Conclusions  Medical students believe in the importance of ophthalmic education regardless of their specialty of choice. We present a pilot model to introduce ophthalmology within an LIC model. Future studies with a larger sample are needed to determine the impact of this model in terms of knowledge acquisition and relationship between curriculum and ophthalmology interest among students. Our curriculum can be adapted to other underrepresented specialties in the medical school curriculum and is easily exportable to other LICs.

Purpose  We investigate trends in cornea fellowship positions filled over time and applicant characteristics associated with matching into cornea fellowship. Methods  Characteristics of cornea fellowship applicants were assessed using deidentified 2010 to 2017 San Francisco (SF) Match data. Publicly available SF Match cornea fellowship data including the number of participating programs, number of positions offered, number of positions filled, percentage of positions filled, and number of vacancies from 2014 to 2019 were also analyzed as data from 2010 to 2013 were unavailable. Results  From 2014 to 2019, the number of cornea fellowship programs increased by 11.3% (mean 2.3% per year, p  = 0.006) and the number of positions offered increased by 7.7% (mean 1.4% per year, p  = 0.065). Of 1,390 applicants from 2010 to 2017, 589 (42.4%) matched into cornea. After controlling for potential covariates, graduation from a U.S residency program (odds ratio [OR]: 6.15, 95% confidence interval [CI]: 4.05-9.35, p  < 0.001) and a greater number of interviews completed (OR: 1.35, 95% CI: 1.29-1.42, p  < 0.001) were associated with increased odds of cornea fellowship match. A greater number of applied programs (OR: 0.97, 95% CI: 0.95-0.98, p  < 0.001) was associated with decreased odds of matching into cornea fellowship. The proportion of applicants matching into cornea fellowship increased until 30 applications. Conclusions  The number of cornea fellowship programs and positions increased from 2014 to 2019. Graduation from a U.S residency program and a greater number of interviews completed were associated with an increased likelihood of cornea fellowship match. Unlike applying to any ophthalmology subspecialty fellowship, applying to greater than 30 cornea fellowship programs was associated with decreased odds of matching.

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's 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 < 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' experience. Additional studies from other residencies with formal mentorship programs are warranted to identify, strategize, and foster high-quality mentorship.

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  < 0.001), and academic career ( p  < 0.001) were all associated with higher pre-/post-residency mean publication difference. Pursuing fellowship training also was associated with higher total publications ( p  < 0.001). Of all pre-residency degrees, PhD had the greatest odds of high postgraduate publications (defined as > 4). There was a positive correlation between both pre-residency/residency and post-residency publications (rho = 0.441; p  < 0.001) and between mean difference of pre-residency/post-residency publications for residents at a program and that program's Doximity rank (rho = 0.497; p  < 0.001). Multivariate logistic regression revealed, academic career choice (odds ratio [OR] = 3.38; p  < 0.001), Heed fellowship (OR = 3.12; p  = 0.031), > 2 residency publications (OR = 2.89; p  < 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 > 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.

Purpose  In this pilot study, we aimed to investigate the efficacy of an electronic medical record (EMR) order set for lubricating ointment (four times daily) in the prevention of exposure keratopathy in ventilated patients in the intensive care unit (ICU) at the University of Utah. We attempted to capture the magnitude of morbidity, cost, and care burden in ventilated patients, as well as the utility of a systematic EMR-based preventative lubrication protocol in the ICU setting. Methods  After implementation of the order set, a retrospective chart review was performed to capture all ventilated ICU patients pre- and postintervention. Three separate study periods were used: (1) Six months prior to coronavirus disease 2019 (COVID-19) and prior to the ocular lubrication intervention; (2) the subsequent 6-month period including COVID-19 patients but prior to any intervention; and (3) the subsequent 6-month period postintervention, including COVID-19 patients. The primary endpoint of ointment use per day was analyzed with a Poisson regression model. Secondary endpoints including rates of ophthalmologic consultation and exposure keratopathy were compared with Fisher's exact test. A poststudy survey of ICU nurses was included. Results  A total of 974 ventilated patients were included in the analysis. Ointment use per day increased by 155% (95% confidence interval [CI] 132-183%, p  < 0.001) following the intervention. Rates also increased 80% (95% CI 63-99%, p  < 0.001) during the COVID-19 study period but prior to intervention. The percentage of ventilated patients requiring a dilated eye exam for any indication was 3.2, 4, and 3.7% in each of the study periods, respectively. There was an overall down trend in the rate of exposure keratopathy which was diagnosed in 33.3, 20, and 8.3% of those receiving ophthalmologic consultation, though these rates were not statistically significant. Conclusion  These preliminary data show a statistically significant increase in the rates of lubrication in mechanically ventilated patients using an EMR-based order set in the ICU setting. There was no statistically significant decrease in the rates of exposure keratopathy. Our preventative protocol with lubrication ointment was of minimal cost burden to the ICU. Further longitudinal and multicenter studies are needed to better assess the efficacy of such a protocol.

Introduction  The ophthalmology residency match remains competitive. Several prior studies have examined various factors that contribute to a successful match into an ophthalmology residency program; however, the role of geographic location in the ophthalmology residency match process is unclear. The purpose of our study was to evaluate geographic trends in the ophthalmology residency match and to determine whether geographic trends vary based on program level factors such as program rank or funding source and/or applicant factors such as year of training, gender, and medical degree earned. Specifically, we assessed associations with residents training at the residency program affiliated with their medical school and/or within the same geographic region as their medical school, using data obtained through publicly available sources and residency program surveys. Methods  We used the American Medical Association's Fellowship and Residency Electronic Interactive Database database to identify accredited ophthalmology residency programs. Residency program Web sites and email inquiries were used to collect demographic and geographic information for residents in the graduating classes of 2021 to 2023. Statistical analysis included χ ² testing and multivariate logistic regression. Results  In total, 1,378 residents were included from 110 ophthalmology residency programs and 218 medical schools. Residents who matched at the residency program affiliated with their medical school (18%) were evenly distributed among the Midwest, Northeast, South, and West regions ( p  = 0.2236). Residency programs in the West (31.7%) matched fewer regional medical students compared with programs in the South (61.2%), Midwest (57.4%), and Northeast (58.4%) ( p  < 0.0001). Attending a publicly funded medical school was associated with higher odds of matching into a regional residency program (odds ratio [OR], 1.45; 95% confidence interval [CI], 1.10-1.90; p  = 0.0001) and attending a privately funded medical school was associated with higher odds of matching into a top-ranked residency program (OR, 1.53, 95% CI, 1.34-1.82; p  = 0.0002). Conclusions  The majority of current ophthalmology residents trained at programs in the same geographic region as their medical schools, with nearly 20% of residents training at their medical school-affiliated program. Geographic differences in match results were observed based on resident gender, medical school characteristics, and residency program region.