Importance
Ophthalmology-residency selection committees require robust metrics to review applicants. Participation in research activities is a core component of the application process for its perceived association with future academic productivity.


Objective
To evaluate the correlation between the number of preresidency peer-reviewed publications (PPPs) and subsequent peer-reviewed publications or career choices of ophthalmology residency graduates.


Design, Setting, and Participants
In this cross-sectional study, names of ophthalmology residency graduates were obtained. PubMed-indexed publication records were generated and publications were categorized as preresidency, intraresidency, and postresidency. First author and journal publications with an impact factor (IF) score of 3 or more were recorded. Current academic and community-based career statuses were designated. Names were obtained from cohort and alumni lists on residency program websites or by emailing program directors. Participants included US Accreditation Council for Graduate Medical Education-accredited ophthalmology residency graduates from 2013 to 2016.


Main Outcomes and Measures
The primary outcome measure was association of PPPs with later publications, first authorship, and journal publications with an IF score of 3 or more. The secondary outcome measure was difference in characteristics associated with academic vs community-based ophthalmologist.


Results
A total of 964 ophthalmologists (52% of graduates) were studied and most (85.5%) had PubMed-indexed publications. First authorship (ρ = 0.71; 95% CI, 0.67-0.74; P < .001) had a strong positive correlation with intraresidency publications, while journal publications with an IF score of 3 or more (ρ = 0.56; 95% CI, 0.51-0.60; P < .001) and PPPs (ρ = 0.38; 95% CI, 0.32-0.43; P < .001) had moderate and weak positive correlations, respectively. For postresidency publications, journal publications with an IF score of 3 or more (ρ = 0.86; 95% CI, 0.84-0.87; P < .001) had the strongest positive correlation followed by first authorship (ρ = 0.77; 95% CI, 0.74-0.79; P < .001) and PPPs (ρ = 0.26; 95% CI, 0.20-0.31; P < .001). Preresidency (t = 3.3; P = .001), intraresidency (t = 4.1; P < .001), postresidency (t = 7.5; P < .001), first author (t = 6.6; P < .001), and journal publications with an IF score of 3 or more (t = 5.9; P < .001) were greater for academic ophthalmologists compared with community-based ophthalmologists.


Conclusions and Relevance
Preresidency publication history is at least weakly correlated with future publications or work in an academic setting among ophthalmologists. Multiple factors associated with academic productivity were evaluated; however, adjustment for multiple analyses was not done and further testing is required to prove whether these factors are predictive.

Association Between Preresidency Peer-reviewed Publications and Future Academic Productivity or Career Choice Among Ophthalmology Residency Applicants.

Ophthalmologist Turnover in the United States: Analysis of Workforce Changes from 2014 through 2021.

Women are underrepresented in several medical specialties, including ophthalmology. Reducing disparities is critical in diversifying perspectives and increasing equity within ophthalmology, both of which can ultimately improve care delivery. We examined ophthalmic fellowship programs directors in the United States to investigate gender disparities by subspecialty.Cross-sectional study.This was a retrospective cross-sectional study of ophthalmology fellowship program directors in academic medical centers. The primary outcome measure was a descriptive analysis of current fellowship directors in 2022 when stratified by subspecialty and demographic features.Analysis was conducted on 358 fellowship directors in the United States. Twenty-nine percent of directors were women. Female directors had significantly fewer years since residency graduation compared with male peers (17 vs 24; P < .001); however, no differences were observed by program type (P = .896) or location (P = 0.104). Differences in female director representation were observed by subspecialty (P < .001), with the greatest percentage of women in pediatric ophthalmology (54%), other (oncology and pathology) fellowships (50%), and medical retina (40%). The subspecialties with the lowest percentage of female directors were oculoplastic and reconstructive surgery (13%) surgical retina and vitreous (16%).There are disparities in female representation in academic leadership positions across ophthalmic subspecialties. Addressing this difference may have critical impacts on career advancement and opportunities available for marginalized groups in medicine. 

Gender Representation Among Ophthalmology Fellowship Directors in 2022.

Abstract Background Throughout graduate and postgraduate education, trainees need to gauge the impact of training location on future institutions of practice. Objective We assessed rates of internal hiring of ophthalmology faculty at academic institutions from their same institution of training. Methods This was a cross-sectional study. We included 1,246 clinical ophthalmology faculty at the 13 top-ranked institutions listed in the 2021 U.S. News and World Report. Primary, emeritus, adjunct, and affiliate faculty were included. Publicly available information was collected from institutional websites and other online sources. Statistical analyses were conducted using t-tests or Mann–Whitney tests, chi-squared or Fisher's exact tests, and multivariate logistic regression. The main outcome measured was internal hires, defined as faculty who had completed residency and/or fellowship training at their current institution. Results In total, 47.3% of faculty were internal hires who completed residency or fellowship at the same institution. Among externally trained faculty, 27.7% completed residency and 56.0% completed fellowship at another top 13 programs. Internal hires were more frequently fellowship-trained, had a greater number of publications, and practiced in smaller departments (p &lt; 0.001, p &lt; 0.001, and p = 0.002, respectively). A greater proportion of internal hires held leadership positions (p = 0.012). Faculty practicing in the Midwest or West and with more years since residency graduation were less likely (odds ratio [OR], 0.29, 95% confidence interval [CI], 0.18–0.48; OR, 0.49, 95% CI, 0.31–0.78; OR, 0.98, 95% CI, 0.97–0.99, respectively) to be internal hires. Faculty with non-R01 National Institutes of Health funding were more likely to be internal hires (OR, 1.82, 95% CI: 1.12–2.96). Conclusions Training institution is key to determining the institution of practice. These results may be beneficial for trainees to consider when selecting a training program. 

pdf/rates-of-internal-hiring-of-ophthalmology-faculty-from-their-3emuvam0xf.pdf

Rates of Internal Hiring of Ophthalmology Faculty from their Institution of Training at Top Academic Medical Centers: A Cross-Sectional Study

PURPOSE: The purpose of this study was to address disparities between male and female Iraqi ophthalmologists in terms of personal circumstances, professional profiles, and attitudes toward work and family life. METHODS: A Google Form-based questionnaire was released on a social media platform including 500 ophthalmologists between September 1, and December 1, 2021. The survey included three domains: (1) demographic characteristics, (2) clinical practice profile, and (3) career satisfaction and work/family balance. RESULTS: The study included a total of 209 specialists, with a response rate of 45.5%. About 69.4% of them were 45 years and younger. The female-to-male ratio was 1:1.6, 188 (90%) were married and 186 (88.9%) had children. Women ophthalmologists worked fewer hours, days, and operations than male ophthalmologists (P = 0.091). Moreover, women ophthalmologists in private practice were considerably underrepresented. General ophthalmologists represented 77%. The number of women ophthalmologists with subspecialty degrees was far less 9 (11.5%) than males 38 (29.2%), P = 0.003, and they performed significantly fewer operations than male ophthalmologists (P = 0.001). Family duties were the biggest deterrent for female ophthalmologists. For males, the private clinic is an obstacle to acquiring a specialty degree in 45.6%, but for women, it is just 25.7%. Overall satisfaction was 65.1%. Women respondents were less satisfied with their practice (P = 0.009) and thought that they are facing more challenges (0.007). Men believed they had less time to spend with family, implying that women sacrifice working time/income to satisfy family obligations and expectations. Work-life balance is achieved by limiting work hours and including family members. CONCLUSION: Women ophthalmologists in Iraq might be facing greater obstacles to their professional advancement than their male counterparts. Female doctors were working fewer hours and doing fewer surgical procedures, and they were less likely to pursue subspecialty certification.

Obstacles and Challenges Facing Iraqi Women Ophthalmologists

Factors influencing career decisions and satisfaction among newly practicing ophthalmologists.

Factors Influencing Career Decisions and Satisfaction Among Newly Practicing Ophthalmologists

The Primary Tube Versus Trabeculectomy (PTVT) Study is a multicenter randomized clinical trial comparing the safety and efficacy of tube shunt surgery and trabeculectomy with mitomycin C (MMC) in eyes without previous incisional ocular surgery. This article reviews results from the PTVT Study and suggests how they may be translated to clinical practice.Tube shunt surgery had a higher failure rate than trabeculectomy with MMC in the PTVT Study, and the difference was statistically significant at 1 year but not at 3 years and 5 years. Both surgical procedures reduced intraocular pressure (IOP) to the low teens throughout 5 years of follow-up. Mean IOPs were lower after trabeculectomy with MMC compared with tube shunt implantation, and the differences were statistically significant during the first postoperative year and at 3 years. The greater IOP reduction after trabeculectomy with MMC was achieved with significantly fewer glaucoma medications relative to tube shunt placement. Surgical complications were common in the PTVT Study, but most were transient and self-limited. The incidence of early postoperative complications was significantly higher after trabeculectomy with MMC than tube shunt surgery. The rates of late postoperative complications, cataract progression, and vision loss were similar with both surgical procedures. Serious complications producing vision loss and/or requiring a reoperation to manage the complication developed more frequently after trabeculectomy with MMC compared with tube shunt surgery, and the difference was statistically significant at 1 year but not at 3 years and 5 years postoperatively.Tube shunt implantation and trabeculectomy with MMC are both viable surgical options for managing glaucoma in patients without previous incisional ocular surgery. Results from the PTVT Study support further expansion of tube shunt use beyond refractory glaucomas. 

Results from the Primary Tube Versus Trabeculectomy Study and translation to clinical practice

Précis: Glaucoma cascade screening in first degree relatives of young Haitian glaucoma patients had high yield for diagnosing manifest and suspected glaucoma in 30.8% of those screened despite modest participation. Purpose: To evaluate the outcomes of glaucoma cascade screening in first-degree relatives (FDRs; parents, siblings and offspring) of Haitian juvenile open angle glaucoma (JOAG) patients. Patients and Methods: Consecutive index patients (Haitians with JOAG) were identified, and the number/type of FDRs residing in South Florida were recorded. These FDRs were invited for free glaucoma screening, which included a comprehensive ophthalmic exam, gonioscopy, automated visual field testing and optical coherence tomographic analysis of the retinal nerve fiber layers. FDR characteristics and clinical findings from screening are reported. Results: A total of 77 FDRs were invited, 26 (33.8%) agreed to undergo screening (18 females, 9 males), which revealed 2 (7.7%) with manifest glaucoma (mean age 77.5▒y; one of whom was previously unaware of his glaucoma diagnosis), 6 (23.1%) with suspected glaucoma (mean age 29.8±18.3▒y), and 18 (69.2%) without manifest or suspected glaucoma (mean age 37.2±21.8▒y). Siblings of index patients were least likely to participate in cascade glaucoma screening when compared to index patients’ parents or offspring. FDR eyes with manifest glaucoma had significantly worse best-corrected visual acuities, higher intraocular pressures, thinner central corneal thicknesses, and thinner circumferential papillary retinal nerve fiber layer thicknesses than those without glaucoma. Conclusion: Glaucoma cascade screening of Haitian JOAG patients’ FDRs revealed that 30.8% had suspected or manifest glaucoma. Future efforts centered on provider-initiated recruitment and improving public glaucoma awareness and education may increase screening participation. 

Glaucoma Cascade Screening in a High Risk Afro-Caribbean Haitian Population: A Pilot Study

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Papers

Factors influencing career decisions and satisfaction among newly practicing ophthalmologists.

Factors Influencing Career Decisions and Satisfaction Among Newly Practicing Ophthalmologists

Results from the Primary Tube Versus Trabeculectomy Study and translation to clinical practice

Glaucoma Cascade Screening in a High Risk Afro-Caribbean Haitian Population: A Pilot Study