Solomon Alexander M, Patel Vivek R, Francis Courtney E
Department of Ophthalmology (AMS, CEF), University of Washington School of Medicine, Seattle, Washington; USC Roski Eye Institute (VRP), Keck School of Medicine of the University of Southern California, Los Angeles, California; and Department of Neurological Surgery (CEF), University of Washington School of Medicine, Seattle, Washington.
J Neuroophthalmol. 2022 Mar 1;42(1):56-61. doi: 10.1097/WNO.0000000000001239. Epub 2021 Mar 23.
The number of ophthalmology-trained residents applying to neuro-ophthalmology fellowships has not increased despite a trend toward seeking fellowship training after residency. This study sought to identify factors affecting the choice to pursue or not pursue neuro-ophthalmology fellowship training by graduating ophthalmology residents and recently graduated neuro-ophthalmology fellows.
An anonymous survey was sent to Association of University Professors of Ophthalmology residency directors to distribute to post-graduate Year 4 (PGY4) ophthalmology residents graduating in either 2018 or 2019. A second anonymous survey was distributed via the North American Neuro-Ophthalmology Society (NANOS) Young Neuro-Ophthalmologists listserv to ophthalmology-trained neuro-ophthalmology fellows. A total of 147 respondents, including 96 PGY4 ophthalmology residents not going into neuro-ophthalmology and 51 practicing neuro-ophthalmologists are included.
The most common reasons for residents to choose to not pursue further training in neuro-ophthalmology included a stronger interest in other fields, types of patients seen, no intraocular surgery, and the assumption that it is a nonsurgical discipline. The leading factors influencing graduated, ophthalmology-trained fellows to choose neuro-ophthalmology included interest in the clinical diseases treated, interaction with other specialty fields, and a supportive NANOS culture. Interestingly, despite perceptions of graduating residents, two-thirds of the neuro-ophthalmologists surveyed perform surgery. There were no differences between the 2 groups with respect to the degree of exposure to neuro-ophthalmology in medical school, presence of a dedicated neuro-ophthalmology rotation in residency, or timing of the rotation.
There are a variety of factors influencing decisions regarding pursuing neuro-ophthalmology fellowship among ophthalmology residents. The perceived lack of surgical opportunities in neuro-ophthalmology is a deterrent for many. However, a significant number of neuro-ophthalmologists continue to perform surgery, including intraocular surgery. Repeated exposure later in residency may provide an opportunity to reconsider the field and to re-emphasize opportunities to remain surgically involved as a neuro-ophthalmologist. Exposure to the practice patterns of recently graduated neuro-ophthalmologists offers residents in training excellent exposure to the contemporary practice of neuro-ophthalmology. Hence, ensuring trainees receive a balanced exposure to practicing neuro-ophthalmologists across the spectrum of seniority and scope of practice may promote greater interest among ophthalmology residents to pursue a career in neuro-ophthalmology.
尽管住院医师培训后有寻求专科培训的趋势，但申请神经眼科专科培训的眼科住院医师数量并未增加。本研究旨在确定影响即将毕业的眼科住院医师和刚毕业的神经眼科专科医师选择是否追求神经眼科专科培训的因素。
向眼科大学教授协会的住院医师培训主任发送了一份匿名调查问卷，以便分发给2018年或2019年毕业的四年级眼科住院医师（PGY4）。通过北美神经眼科学会（NANOS）年轻神经眼科医师邮件列表向接受过眼科培训的神经眼科专科医师分发了第二份匿名调查问卷。总共包括147名受访者，其中包括96名不打算从事神经眼科的PGY4眼科住院医师和51名执业神经眼科医师。
住院医师选择不进一步接受神经眼科培训的最常见原因包括对其他领域更浓厚的兴趣、所诊治的患者类型、无眼内手术以及认为这是一个非手术学科。影响已毕业的、接受过眼科培训的专科医师选择神经眼科的主要因素包括对所治疗临床疾病的兴趣、与其他专科领域的互动以及支持性的NANOS文化。有趣的是，尽管即将毕业的住院医师有这样的看法，但接受调查的神经眼科医师中有三分之二进行手术。两组在医学院接触神经眼科的程度、住院医师培训中是否有专门的神经眼科轮转或轮转时间方面没有差异。
有多种因素影响眼科住院医师关于是否追求神经眼科专科培训的决定。神经眼科中手术机会的明显缺乏对许多人来说是一个阻碍。然而，相当数量的神经眼科医师继续进行手术，包括眼内手术。住院医师培训后期的反复接触可能提供一个重新考虑该领域的机会，并再次强调作为神经眼科医师继续参与手术的机会。接触刚毕业的神经眼科医师的执业模式能让接受培训的住院医师很好地了解当代神经眼科的实践。因此，确保受训者在不同资历和执业范围内均衡接触执业神经眼科医师，可能会提高眼科住院医师对从事神经眼科职业的兴趣。
