Purpose: To examine the effects of the COVID-19 pandemic on surgical volumes of ophthalmology residents who completed training after 2020. Methods: Aggregated average case logs of primary surgeon and surgeon + assist (S+A) procedures for graduating ophthalmology residents in the U.S. between 2012 and 2023 were gathered from the Accreditation Council for Graduate Medical Education (ACGME). Trends for primary surgeon and S+A procedures were assessed. The annual percent change in primary surgeon and S+A procedures was determined using linear regression to compare changes over three time periods: 2012-2019, 2019- 2020, and 2020-2023. Results: Total cases as a primary surgeon and in S+A roles increased each year from 2020-2023. Primary surgeon and S+A experiences exceeded pre-pandemic levels by 2023 and 2022, respectively. Recovery from pre-pandemic levels was seen in both primary surgeon and S+A for total cornea, glaucoma, and other retinal procedures. For primary surgeon and S+A procedures, the post-pandemic cohort experienced an increase in annual percent change in total procedures compared to the pre-pandemic cohort (5.1% vs 3.2%, p = .002 and 3.4% vs 1.2%, p < .001, respectively). Conclusions: Residents graduating after 2020 performed more primary surgeon and S+A procedures than their peers who graduated in 2020. The average annual percent change in total procedures for primary surgeon and S+A cases from 2020-2023 was greater than that seen from 2012-2019 for total procedures and many subcategories

Purpose Effective teaching is often described as being the single most important indicator of student achievement. Due to global reductions in time allocated towards ophthalmology teaching in medical school there is a pressing need for more effective ophthalmology teaching. This paper aimed to investigate and analyse the effectiveness of novel ophthalmology teaching techniques in medical student populations through meta-analysis. Method Systematic review of databases EMBASE and Medline were performed up to July 2024. Outcomes investigated included medical student ophthalmology test scores and student satisfaction. Studies were grouped according to intervention and mean effect sizes were calculated. Results Database search yielded a total of 3170 articles, of which 31 were eligible for meta-analysis. Novel teaching techniques described included e-learning, flipped-classroom, team-based learning, ophthalmology intensive courses, artificial intelligence, augmented reality, peer teaching, virtual reality and novel technologies for teaching ophthalmic examinations. Of these modalities flipped-classroom teaching, team-based learning and virtual reality were shown to be the most effective modalities. Conclusions Flipped-classroom, team-based learning and virtual reality are the three most effective novel ophthalmology teaching methods when considering both test scores and student satisfaction. The correlation between effective teaching and these three modalities is likely related to the high level of student engagement developed through active learning tasks. Given the declining levels of junior doctor ophthalmic confidence, there must be further commitment towards implementing effective novel teaching techniques in ophthalmology.

Background: American Association for Pediatric Ophthalmology and Strabismus (AAPOS) annual meetings provide opportunities to present research abstracts to a sub-specialty audience. However, these abstracts may undergo less rigorous peer review and may be associated with risks of non-publication or publication bias. This study aims to evaluate and analyze publication rates and potential factors that contribute to non-publication. Methods: We examined all abstracts (paper, hardboard posters, and electronic posters) accepted for presentation (n=1093) at the AAPOS annual meetings between 2015 and 2019. A comprehensive search was conducted to quantify the abstracts that were published to a peer reviewed journal within three years from presentation. Results: 41% of all presented abstracts went on to be published within three years. The most common journal was the Journal of AAPOS (31%). There were over three times more hardboard posters (n=624) than paper abstracts (n=180). Paper abstracts were published at the highest rate (53%) while electronic posters had the lowest rate (36%). The 2015 meeting had the lowest publication rate (36%) while the 2019 meeting had the highest publication rate (46%). Conclusion: There was an increasing trend in publication rates from 2015 to 2019 but a decreasing trend in publication rates into the Journal of AAPOS. Over half of the abstracts presented at AAPOS remain unpublished into peer reviewed journals within three years. Abstracts accepted as papers are more likely than other types to be published. With less than half of all abstracts being published, there is a significant opportunity to improve publication rates.

Background: Mobile applications have shown promise in enhancing medical trainee performance. In ophthalmology, a comprehensive mobile app can streamline the trainee education process by providing guidance for patient intake. Language barriers pose additional challenges impacting the quality of care for Spanish-speaking patients; literature has documented the adverse impacts of inadequate translation on quality of medical care for both trainees and patients. We aim to develop a free mobile application to guide medical trainees through the ophthalmic patient intake process and assist with Spanish-language translation. Methods: We developed EyeCheck as a free mobile application for ophthalmology trainee education with Spanish language support for iPhone and Android. We also designed a survey for student evaluation of EyeCheck’s effectiveness and usability as an educational and clinical tool. Results: Nineteen medical students used EyeCheck and found it beneficial for obtaining an ophthalmic history (Likert score: 4.3, SD = 0.65) and performing each component of the eye exam (mean score: 4.1, SD = 0.77). EyeCheck also aided understanding of ophthalmological pharmacology (mean = 4.1, SD = 0.85). Students rated EyeCheck as user-friendly (mean = 4.5, SD = 0.51) and expressed moderate interest in continued use (mean = 3.7, SD = 1.00) and recommendation to others (mean = 4.4, SD = 0.77). Conclusion: EyeCheck can be downloaded and integrated into the patient intake process, reducing the need for disaggregated educational materials and streamlining the learning process for trainees. Insights from the survey can enhance EyeCheck's content and user experience. EyeCheck can improve the training process for ophthalmological patient intake.

Purpose: To evaluate the impact of medical scribes on performance metrics in an academic ophthalmology practice across a variety of subspecialties Design: Retrospective cohort study Methods: Setting: Single center clinical practice Participants: 58,223 patient encounters from January 1, 2020 through November 10, 2023 were used. 2,269 clinic sessions were analyzed, with 686 clinic sessions without the presence of a scribe and 1,583 clinic sessions with the presence of a scribe Procedures: Metrics were compared between scribed vs unscribed encounters for each individual doctor and then further compared by subspecialty. A linear mixed-effects model was used for overall differences and differences within the cornea subspecialty. A linear regression model was used for all other subspecialties. Main Outcome Measures: Patients seen per hour, mean patient appointment time, mean patient wait time, mean chart closure time, and mean relative value units (RVUs) per hour. Results: Patients seen per hour (mean ± standard deviation) were 3.45 ± 0.23 for all scribed encounters vs 3.12 ± 0.23 for unscribed encounters (P < 0.01). There was no significant difference in patient appointment times (mean ± standard error) of 74.56 ± 4.87 minutes for scribed encounters vs 73.34 ± 4.93 minutes for unscribed encounters (P = 0.3). Patient wait time (mean ± standard deviation) was 26.94 ± 3.55 minutes for all scribed encounters vs 29.12 ± 3.57 minutes for unscribed encounters (P < 0.01). Chart closure time (mean ± standard deviation) was 105.83 ± 11.56 minutes for all scribed encounters vs 93.82 ± 11.6 minutes for unscribed encounters (P < 0.01). Epic RVUs per hour (mean ± standard deviation) were 4.48 ± 0.65 for all scribed encounters vs 3.68 ± 0.65 for unscribed encounters (P < 0.01). All reported values are standardized to a 15% proportion of new patient encounters. Conclusion: The use of scribes led to an increase in RVUs and patients seen per hour while decreasing patient wait time. While these trends varied amongst the subspecialties, all subspecialties benefited in at least one measure of efficiency in the presence of a scribe. Therefore, this study supports the utilization of scribes in an academic ophthalmology setting.

Purpose The landscape of healthcare delivery in the United States continues to evolve in reimbursement structure, emphasis on value, complexity of organizational structure, and more. A Master of Business Administration (MBA) degree may better equip ophthalmologists to meet the rising expectations to thrive in the field. This study aims to understand the utility of MBAs among ophthalmologists and as well as the perceptions of MD/MBA candidates among residency program leadership. Methods The authors distributed an online questionnaire covering perceptions & implications of an MBA to 108 MD/MBA ophthalmologists identified using AAO archives, Google search, and LinkedIn. Another online questionnaire covering perceptions of MD/MBA applicants was distributed to 120 residency program leaders via the Association of University Professors of Ophthalmology (AUPO). Results 30 ophthalmologists and 30 program leaders completed questionnaires, resulting in a response rate of 28% and 25% respectively. Most ophthalmologists did not have pre-MBA business experience and completed their MBA during medical school or 5+ years post-residency. The majority of respondents spend >50% of their time practicing clinically, but hold roles in health care administration, consulting, startups, and industry. Ophthalmologists perceive the MBA to be valuable to their clinical careers, with leadership and management skills gained, though highlight limited advantage in residency applications. A majority of program leadership reported positive perceptions of MD/MBA applicants though some voiced hesitations. Conclusions Ophthalmologists with an MBA endorse its significant value to their clinical careers and resulting ability to influence the healthcare landscape. Program directors also recognize the utility of the degree. The value of an MBA is acknowledged in the field and warrants closer evaluation as an indicator of attributes that contribute to future physician success.

Purpose To identify the top 100 (T100) cited articles on ophthalmic education and examine trends and areas of focus in ophthalmic education.Methods A literature search was conducted for articles published between 2011 and 2021 related to ophthalmic education within ophthalmology journals using the ISI Web of Science Core Collection database. The search was performed in June 2022 and was conducted using the search phrase ([educat* OR teach* OR instruct* OR train* OR “medical student*” OR residen* OR fellow* OR undergrad* OR postgrad* OR “faculty” OR “attending”] AND *ophthalm*). Results were analyzed using VOSviewer v.1.6.18 and statistical analysis was performed using Microsoft Excel.Results The majority of articles were published in theJournal of Cataract & Refractive Surgery(19%), followed byOphthalmology(12%), andEye(12%). Articles were most often published in the year 2013 (15%), followed by 2014 (12%) and 2012 (12%). Articles most commonly originated from English-speaking countries, including the United States (43%), England (14%), Canada (8%), and India (8%). Topics most often examined in ophthalmic education were resident education (51%), medical school education (21%), and surgical training (21%). The most common study types were cohort studies (22%), case series (21%), and prospective trials (16%). There were 16 institutions that produced more than one article in the T100 articles list.Conclusion The T100 articles on ophthalmic education were primarily U.S. based and focused on resident education, surgical training, and medical school ophthalmic curriculum. Further research into ophthalmic education is warranted to establish evidence-based curricula guidelines.

Purpose Despite easing restrictions on social distancing and travel since the beginning of coronavirus disease 2019 pandemic, virtual interviews remain a widely used format for ophthalmology fellowship interviews. This study aims to evaluate the relative benefits and drawbacks of in-person versus virtual interviews during a cycle where both formats were prevalent. Methods A prospective cross-sectional study surveyed all fellowship applicants ( N = 311) who applied to Wills Eye Hospital and Bascom Palmer Eye Institute during the 2022 to 2023 application cycle. Results A total of 59 (19%) applicants responded to the survey, with the majority being male (53.0%) and between the ages of 20 and 35 (91.3%). There was no statistically significant difference between the number of virtual and in-person interviews attended or the total number of interviews attended. The highest ranked limitations of the virtual interview process were limited exposure to details of the program structure, limited opportunity to exhibit applicants' strengths to the program, and limited exposure to the fellows. The highest ranked strengths were less pressure during interviews, greater scheduling flexibility, and ability to interview at more fellowship programs. The highest ranked limitations of the in-person interview process were more pressure during interviews, inability to interview at all desired fellowship programs, and decreased scheduling flexibility. The highest ranked strengths based on median rankings were greater exposure to details of the program structure, greater ability to exhibit an applicant's strengths to the program, and greater exposure to the geographic location/city. Conclusion While both in-person and virtual interviews have their own benefits and limitations, virtual interviews appear to be more cost-effective and time-efficient while in-person interviews provide better opportunities to assess program fit and culture. A hybrid format that combines the ideal aspects of both formats may be an optimal solution.

Purpose The purpose of this study was to assess the self-perceived preparedness of incoming postgraduate year 1 (PGY1) and postgraduate year 2 (PGY2) ophthalmology interns/residents to carry out core competencies in ophthalmology. Methods An online survey was created using the Survey Monkey survey platform and distributed to all ophthalmology resident applicants to the Bascom Palmer Eye Institute from the 2021 to 2022 and 2022 to 2023 application cycles. The survey contained questions pertaining to demographics, prior ophthalmic experience, online resources that were used to prepare for ophthalmology, and self-perceived preparedness to carry out key clinical skills in ophthalmology. Results A total of 170 responses were obtained (16.1% response rate). Of those, 119 (70%) were incoming PGY1 interns and 51 (30%) were incoming PGY2 residents for the 2022 to 2023 academic year. Most respondents (90.6%, n = 154) reported that their ophthalmology residency was affiliated with an integrated ophthalmology intern year. Incoming PGY2s moderately agreed with the statement that they felt as prepared to see patients in ophthalmology as they do in other surgical subspecialties, whereas incoming PGY1s only mildly agreed with that statement ( p = 0.003). Both incoming PGY1s and PGY2s felt most prepared to obtain histories relating to basic ophthalmic complaints and felt least prepared to read and interpret ophthalmic imaging studies. The most popular online resources used by respondents in order of popularity were EyeGuru (35.2%, n = 60), EyeWiki (32.9%, n = 56), Tim Root/OphthoBook (26.5%, n = 45), American Academy of Ophthalmology (13.5%, n = 23), and EyeRounds/University of Iowa (13.5%, n = 23). Conclusion A major challenge in integrating ophthalmic education into the medical school curricula is the gradual shift toward shorter preclinical curricula. However, having a core foundation of ophthalmic knowledge is critical for incoming ophthalmology residents to be able to maximize their specialty-specific training. Integrated ophthalmology intern years likely play a significant role in the increased self-efficacy of incoming PGY2s compared with incoming PGY1s. Adopting nontraditional teaching methods like flipped classroom learning, utilizing online medical education resources, and continuing to increase ophthalmology exposure during PGY1 year may better prepare incoming PGY2s to operate independently in ophthalmology settings.

Background The ophthalmology match is an important step for graduating medical students that defines their future career. Residency programs demonstrate significant variability due to differences in size, location, research output, subspecialty exposure, surgical case load, and alumni fellowship/practice placement. Despite the importance of informed decision-making, applicants often find limited, inconsistent information about potential programs.Purpose The purpose of this study was to characterize and identify gaps in the information available to residents in the 2022 to 2023 Match.Methods The SFMatch Web site was reviewed to identify programs included as well as characteristics cited on each program's webpage. Program webpages were used to evaluate availability and consistency of data on site surgical caseload, fellowship slots, and teaching staff.Results Of the 121 programs included on SFMatch, 23 (19%) provided no data on August 15, 2022 (15 days prior to application submission deadline) and 9 (7%) lacked program data on October 15, 2022. Though most programs provided mean cataract volume, data on volume of other procedures for graduating residents was highly variable and occasionally misleading. Programs did not provide information on several academic and social considerations that may influence match ranking choice.Conclusion Applicants often must read “between the lines” to identify residency program strengths and weaknesses. Data crucial to informing the application process remain sparse, unavailable, or spread across resources. Limited data increases applicant dependence on word-of-mouth knowledge to inform decision-making. This might reduce diversity by limiting successful applicants to those with existing connections within the field.