JUN 27, 2023
Comprehensive Ophthalmology, Oculoplastics/Orbit
A dedicated, resident-centric chalazion incision and drainage clinic can be a boon to ophthalmology training, giving residents self-confidence in performing a specialized surgical procedure.
A weekly half-day chalazion clinic was implemented at the Massachusetts Eye and Ear Infirmary during the 2019–2020 academic year, when PGY2–PGY4 residents rotated through the clinic. During the following academic year, only PGY2s rotated through. Gradual autonomy was granted throughout the rotation after observing the supervising physician for a few procedures on the first day. The ACGME resident case logs were assessed for the three 2018–2021 academic years.
The average number of chalazion incision and drainages performed by PGY2s increased from 2.1 per year in 2018–2019 to 22.3 per year in 2020–2021, an almost 10-fold increase. The median number of chalazion procedures performed per PGY2 resident was 2.0, 4.5, and 24.0 for each respective academic year. There was a statistically significant yearly increase in the number of procedures performed per resident over the 3-year period of study (incident rate ratios: 3.89 for PGY2s and 1.75 for all residents).
The study did not address the discussions with the patient prior to the procedure and the patient perspective of having their procedure performed by an ophthalmologist in training. Due to a consistent procedure day, some of the increase in cases may be attributed to more consistent logging on the part of the residents. The small sample size may have skewed the statistical analysis.
Early and consistent exposure with direct supervision throughout residency to such a foundational procedure within ophthalmology will only enhance the quality of care and outcomes for patients and boost the confidence of residents, which should transfer to other skills/procedures.
Financial Disclosures: Dr. Nikisha Richards discloses financial relationships with Horizon Therapeutics (Consultant/Advisor).