The New Ophthalmology Internship: A Trainee Curricular Survey

Abstract

Background The American Academy of Ophthalmology, in conjunction with the Accreditation Council of Graduate Medical Education (ACGME), has mandated the creation of a linked ophthalmology internship year for all programs by 2021. This mandate provides a unique opportunity to tailor a curriculum specific to the ophthalmology trainee. This study reports the results of a national survey of ophthalmology residents and fellows regarding the relevance and applicability of extramural content to their ophthalmology training.

Methods Using the online portal SurveyMonkey, an anonymous survey was sent to 119 ACGME-accredited ophthalmology residencies. It consisted of nine questions formulated to measure the perceived applicability and relevance of other specialties to ophthalmology training. Responses were summarized with descriptive statistics. Outcomes were compared by one-way analysis of variance with Tukey's post hoc analysis for between group differences and Benjamini–Hochberg for multiple comparisons.

Results Ninety-four respondents (residents and fellows) completed the survey (January–February 2020); 52.1% completed an internal medicine internship, 42.6% transitional, and 5.3% general surgery. Overall, prior internship experience was rated favorably. Otolaryngology and radiology were deemed the most relevant to ophthalmology training. Intensive care unit (ICU) was considered the least beneficial, followed by general surgery, primary care, and pediatrics. Neuroradiology was overwhelmingly preferred over general radiology. The majority of respondents reported minimal exposure to oral and maxillofacial surgery (OMFS) in medical school/internship. When choosing a reason for inclusion in the new curriculum, respondents reported a high level of surgical overlap with otolaryngology, OMFS, and plastic surgery; clinical overlap with neurology; and ophthalmic consultation with emergency medicine.

Conclusion Several specialties—notably otolaryngology, radiology, and neurology—were considered highly relevant but lacking in preresidency exposure. The preference for neuroradiology was almost unanimous. In contrast, general surgery and ICU were found to be minimally relevant. Overall, ophthalmology residents reported a high level of satisfaction with their internship experience, an important consideration when building a curriculum that will appeal to potential applicants. The findings of this survey provide a framework to build a curricular plan based on current resident and fellow experience.

Keywords

curriculum - internship - Accreditation Council of Graduate Medical Education - survey - residency - ophthalmology training - interdisciplinary - extramural

Publikationsverlauf

Eingereicht: 26. April 2020

Angenommen: 17. Juli 2020

Artikel online veröffentlicht:
08. September 2020

• References

• 1 Oetting TA, Alfonso EC, Arnold A. , et al. Integrating the internship into ophthalmology residency programs: Association of University Professors of Ophthalmology American Academy of Ophthalmology white paper. Ophthalmology 2016; 123 (09) 2037-2041
• 2 Osguthorpe JD. An otolaryngology residency: the evolution continues. Otolaryngol Head Neck 2004; 131: 795-796
• 3 Kovatch KJ, Harvey RS, Prince MEP, Thorne MC. National trends in otolaryngology intern curricula following Accreditation Council for Graduate Medical Education changes. Laryngoscope 2018; 128 (08) 1811-1816
• 4 Gong D, Winn BJ, Beal CJ. , et al. Gender differences in case volume among ophthalmology residents. JAMA Ophthalmol 2019; 137 (09) 1015-1020
• 5 2019 Ophthalmology Residency Match Summary Report. Association of University Professors of Ophthalmology 2019
• 6 Lee AG, Johnson MC, Policeni BA, Smoker WR. Imaging for neuro-ophthalmic and orbital disease - a review. Clin Exp Ophthalmol 2009; 37 (01) 30-53
• 7 Cremers SL, Lora AN, Ferrufino-Ponce ZK. Global rating assessment of skills in intraocular surgery (GRASIS). Ophthalmology 2005; 112 (10) 1655-1660
• 8 Wilson MR, Wooten F, Williams J. Frequency and characteristics of ocular trauma in an urban population. J Natl Med Assoc 1991; 83 (08) 697-702
• 9 Rizzuti AE, Vastardi M, Hajee M, Lazzaro DR. Scope of resident ophthalmology consultation service and patient follow-up rates at a level 1 trauma center in Brooklyn, New York. Clin Ophthalmol 2013; 7: 643-647
• 10 Heiferman MJ, Khanna S, Gu D, Agron S, Eichinger SE, Bryar PJ. Emergency department ophthalmology consultations in a tertiary care hospital. J Acad Ophthalmol 2019; 11 (01) e25-e29
• 11 Devi S. New York moves to tackle shortage of primary-care doctors. Lancet 2008; 371 (9615): 801-802
• 12 Haggerty JL, Roberge D, Pineault R, Larouche D, Touati N. Features of primary healthcare clinics associated with patients' utilization of emergency rooms: urban-rural differences. Healthc Policy 2007; 3 (02) 72-85
• 13 Kroneman M, Verheij R, Tacken M, van der Zee J. Urban-rural health differences: primary care data and self reported data render different results. Health Place 2010; 16 (05) 893-902
• 14 Logothetis HD, Pyatetsky D, Baqai JA, Volpe NJ. Ophthalmology residents' internship selection and initial trainee confidence: an observational study. J Acad Ophthalmol 2018; 10 (01) e72-e78