Ophthalmology associations serve ophthalmologists throughout their careers, including those still in residency or fellowship programs. Many Leadership Development Program participants have developed programs that focus on education for these young ophthalmologists. Recent LDP ophthalmic training projects include the following.
Evaluation of Medical Students’ Perception of an Ophthalmology Career
Adrienne W. Scott, MD, LDP XIX, Class of 2017 - National Medical Association, Ophthalmology Section
Purpose: Since an increase in underrepresented in medicine (URM) ophthalmologists may improve access to eye healthcare for minority patients, we set out to determine whether URM students’ reasons for choosing or not choosing to pursue ophthalmology residency differ from non–URM students’ reasons.
Methods: We reviewed the medical and sociological literature to identify reasons for specialty selection, particularly information relating to URM students’ reasons for feeling more or less comfortable in a given field. We developed a 7-item questionnaire asking students about their self-identified demographics, choice of specialty, factors influencing their choice of specialty, and reasons for their decisions not to pursue a career in ophthalmology, such as concern about finding a same-gender or same-race role model or mentor. 4th-year medical students from our institution were recruited in person to complete the questionnaire.
Results: Of 114 eligible students, 89 chose to complete the survey (78.1%). 16/89 self-identified as URM per the AAMC definition (18%). Insufficient interest, lack of exposure, and the field being “too specialized” were the main reasons why students, regardless of underrepresented in medicine status, did not pursue ophthalmology. Significantly more URM students than non-URM students were concerned about finding a same-gender or same-race mentor in the field of ophthalmology in their decision not to pursue ophthalmology (P=0.030). There was no statistical difference between URM and non-URM students for any other potential reason for not pursuing ophthalmology. URM students were 82% less likely than non-underrepresented in medicine students to indicate “life-work balance” as an influential factor in their specialty decision (OR=0.18; 95% CI: 0.05 to 0.64; P=0.008). There was no statistical difference between URM and non-URM students for any other evaluated factor.
Conclusions: URM students and non-URM students indicated insufficient interest and lack of exposure as major barriers to selecting ophthalmology as their career. URM students were significantly more likely than non-URM students to be concerned with finding a same-gender or same-race role model/ mentor in the field. Increasing all medical students’ exposure to ophthalmology may help facilitate recruitment of medical students to an ophthalmology residency, and increasing diversity within the ophthalmology workforce may increase recruitment of URM students into ophthalmology.
Observership for International Military Ophthalmology Residents
Rachel A. Lieberman, MD, LDP XVII, Class of 2015 - Society of Military Ophthalmologists
Purpose: To familiarize international military ophthalmology residents with clinical practice in a U.S. military hospital setting. Medical observerships provide a unique opportunity to solidify international relationships between nations, as well as to promote international standards and advance medical knowledge by investigating regional differences. During this observership, international military residents will be able to study professional communication and interaction between physicians and patients, as well as all members of the health care delivery team and hospital administration. They will also gain exposure to U.S. cultural practices, academic medicine, and electronic medical record systems.
Methods: Nations with military ophthalmology residencies were identified by contacting international LDP participants, as well as word of mouth among military ophthalmologists on overseas assignments. A discussion was led between the program directors of the four U.S. military ophthalmology residency programs (Walter Reed National Military Medical Center, San Antonio Military Medical Center, Madigan Army Medical Center in Tacoma, Washington, and Naval Medical Center San Diego) to structure the one-month observership and create guidelines. Various departments which coordinate international military training were contacted for the Army, Air Force, and Navy. Federal rules and restrictions guiding international military training were reviewed with all concerned. Funding and security agreements were also addressed.
Results: Military and civilian ophthalmologists from many nations repeatedly expressed strong support for the observership. Afghanistan, Argentina, Colombia, Hungary, Iraq, Mexico, Peru, and Turkey were identified as having ophthalmology residents in military hospitals or training programs who will serve as active duty ophthalmologists upon graduation. Due to a history of successful training partnerships with Hungary and Mexico, these two nations were selected to initiate the observership program. A review of U.S. military policy showed that both the Army and Navy have guidelines formulated for this type of observership. After careful discussion with the U.S. residency program directors and international training managers, the Army hospitals of San Antonio Military Medical Center and Madigan Army Medical Center were chosen to begin. As required by U.S. federal regulations, funding for the observership (to include transport, lodging, and the cost of training at the hospital) will be provided by the sending nation. Multiple other regulations apply, including the fact that observers must pass an English-language comprehension test and significant background checks to be eligible for the training. The authorization process for the observership is currently underway. Approval is required on many levels, starting with the U.S. Embassies in Hungary and Mexico and extending to the U.S. State Department and Surgeon General’s office.
Conclusions: Doctors around the world strongly value an observership program for international military ophthalmology residents. The observerships will educate visiting trainees in American ophthalmic practices, while also fostering cooperation and partnership between nations. Additional steps are required to send the initial observers from Hungary and Mexico, expand the observership to other sites in the U.S., and involve residents from more countries. Other specialties may also use this program as an example to start a military observership of their own.