International experiences during United States ophthalmology residency training: Current structure of international experiences and perspectives of faculty mentors at United States training institutions

Assessment of Ophthalmology Residency Training in Switzerland: A Trainee-Based Survey

BACKGROUND

This study aimed to evaluate the current status of ophthalmology residency training in Switzerland and provide insights for enhancing training programs.

MATERIALS AND METHODS

The survey covered demographic data such as gender, age, workplace, and year of residency, as well as working conditions, current practical and diagnostic skills, interest in scientific work, and future plans. It consisted of 16 multiple choice questions (MCQ), 5 multiple select questions (MSQ), 8 free-text, 6 Net Promoter Score (NPS), and 4 Likert scale questions. All Young Swiss Ophthalmologists (YSO) members received an invitation to participate in the survey using an online form. All collected data were anonymized, and participants provided their consent for data collection, analysis, and publication.

RESULTS

The survey assessed the perspectives of 63 Swiss ophthalmology residents on their training experiences. Respondents indicated the greatest interest in specializing in cataract and vitreoretinal surgery, followed by cornea, glaucoma, refractive surgery, and lid surgery. They also expressed a great need for improved supervision, structured curricula, and alignment of clinical and research duties. While pursuing additional surgical training and private practice autonomy, residents also expressed a preference for balanced workloads that emphasize patient care over full-time academic work.

CONCLUSION

The survey indicates a need to standardize ophthalmology residency training in Switzerland to ensure comprehensive and uniform education. It also highlights specific areas for improvement, such as the absence of surgical training. Ongoing assessments are necessary to evaluate future developments.

Geographic Representation of Authorship in Ophthalmic Research from Low- and Middle-Income Countries

PURPOSE

Low- and middle-income countries (LMICs) are underrepresented in ophthalmic research, despite carrying the highest burden of visual impairment. To assess the representation of local authors in global ophthalmic research, this cross-sectional, bibliometric analysis measured the proportion of LMIC-affiliated authorship in LMIC-based ophthalmic research.

METHODS

We sampled original, primary research conducted in LMICs and published in 1 of 7 high-impact ophthalmic journals between 2017 and 2021. For each article, we extracted the number and name of country study site(s), country affiliation(s) of first and last author, proportion of LMIC-affiliated authors, funding sources, and study design.

RESULTS

Of the 1,333 studies exclusively conducted in LMICs, 89.4% of first authors and 80.6% of last authors were exclusively LMIC-affiliated. Representation of LMIC-affiliated first authors were lower in studies based in low-income countries (25.0%) or in sub-Saharan Africa (26.5%), published in journals with higher impact factors (68.0% in Ophthalmology), funded by high-income countries (HICs) (41.4%), or conducted in both LMICs and HICs (27.1%). The United States, United Kingdom, and Australia had the 3rd, 6th, and 8th largest shares of last authors. There were only 12 single-country studies conducted in low-income countries, namely Ethiopia, the Gambia, Guinea, Liberia, the Niger, and Sierra Leone. Of these countries, only three held first authorship and one held last authorship.

CONCLUSIONS

Although LMIC-based ophthalmic research has demonstrated higher local authorship representation compared to other fields, underrepresentation can be exacerbated by country income level, journal "prestige," and degree of HIC involvement. These discrepancies highlight the need for more equitable data ownership in global ophthalmic research.

Enhancing Perspective in Global Health: A Case Study on an International Ophthalmology Partnership

Introduction

Global ophthalmology opportunities are becoming increasingly popular, and international partnerships are becoming more common among academic training institutions in the United States. There is need for training in the complex relational, motivational, ethical, and logistical issues that may arise in these partnerships.

Methods

We developed a 3-hour case-based session featuring four characters in a fictitious international ophthalmology partnership scenario. Facilitators used structured questions for each of the four parts to foster interaction and discussion among learners. After the activity, participants completed an evaluation/questionnaire consisting of Likert-scale and open-ended questions.

Results

A total of 23 ophthalmology residents and seven medical students underwent the activity over four iterations. The activity was well received, with 100% of learners either strongly agreeing (90%) or agreeing (10%) when asked if the session was worthwhile and 100% of learners either strongly agreeing (87%) or agreeing (13%) when asked if the format was conducive to achieving the learning objectives. Answers to questions on how learners would change how they practice ophthalmology in their residency and in their future careers revolved around the following topics: consideration of other perspectives, humility, self- and situational awareness, complexities of partnerships, reciprocity and exchange, importance of communication, and connection of principles between international and domestic medical practice.

Discussion

While this case study explores an international ophthalmology partnership scenario, the principles and themes presented can be applicable to other fields of medicine, and can be applicable to the practice of medicine both internationally and domestically.

Ophthalmology residency training in Nigeria: The trainers' perspective

Introduction

Periodic evaluations are an indispensable part of any training programme. This study assessed ophthalmology residency training in Nigeria from the perspective of ophthalmology trainers.

Materials and Methods

This was a nationwide web-based survey of ophthalmology trainers at the 30 institutions accredited by the National Postgraduate Medical College of Nigeria from April 2021 to June 2021. Trainers were invited to complete a Google form via E-mail and WhatsApp. Data were collected on the characteristics of trainers and the training programme.

Results

One hundred and fifty-eight (71.2%) out of 222 trainers responded to the survey comprising 67 (42.4%) males and 91 (57.6%) females, amongst whom were 97 (61.4%) subspecialists. The mean age (±standard deviation) was 51.47 ± 8.61 years (range, 38-75 years). Most respondents rated human resources (trainers and support staff) as 'much more' than adequate (n = 30, 19%), the volume of surgery as 'less or much less' than adequate (n = 82, 51.9%), the conduct of examinations as 'good' or better than good (n = 120, 75.9%) and impact of emigration of ophthalmologists on training as 'very negative' (n = 36, 22.8%). Overall, 94 (59.4%) respondents rated the quality of training as 'good' or better than good. Respondents recommended improving funding and training resources, revising the current conduct of examinations, increasing the use of appropriate technology and improving remunerations and national security.

Conclusions

The majority of ophthalmology trainers rated ophthalmology residency training in Nigeria as 'good' but rated 'volume of surgery' as inadequate for training. Recommendations were made to improve the quality of training, revise examination practices and reduce the negative impact of emigration.

Global Health Curricula in Ophthalmology Residency Programs in the United States

Objective The aim of the study is to investigate the design, content, and administration of global health curricula within ophthalmology residency programs in the United States (U.S.) and share the curriculum utilized in the Department of Ophthalmology at Boston University School of Medicine (BUSM).

Design A survey designed through the Association of University Professors in Ophthalmology platform was emailed to residency program directors at 106 accredited ophthalmology residency programs.

Setting BUSM Department of Ophthalmology, Boston, MA. Tertiary clinical care.

Participants Twenty-eight ophthalmology residency program directors responded, which represent 26% of the total number of residency programs in the United States. Twenty-seven programs fully completed the survey, and one program partially completed the survey.

Results Of the respondents, three programs do not include global health curricula. The most common curricular elements included are: lectures (n = 15, 60%); wet laboratories (n = 10, 40%); and journal clubs (n = 9, 36%). In terms of annual frequency, global health activities occur: twice a year (n = 12, 46%); less than once a year (n = 10, 39%); or every few months (n = 4, 15%). Fewer than half of programs (n = 10, 42%) incorporate local outreach at least once a year into their program. Twelve programs (48%) do not incorporate ethics-related topics, while the 13 remaining programs (52%) incorporate them at least once annually. The most common curricular topic is surgical techniques, with manual small incision cataract surgery (MSICS) being the most frequently emphasized (n = 17, 68%).

Conclusion A robust global health curricula combined with a hands-on international component can contribute to a well-rounded training experience. Many ophthalmology residency programs value the importance of incorporating global health into their residents' training. The most common elements of global health curricula in U.S. ophthalmology residency programs included are teaching of surgical techniques for resource-limited settings and international electives. Further investigation into the impact of different components of a global health curriculum on both resident experience and international partnerships is warranted.