Department of Ophthalmology, University of Texas at Southwestern Medical Center, Dallas, TX, US.
Texas A&M University School of Medicine, Bryan, TX, US.
Semin Ophthalmol. 2023 Nov;38(8):773-776. doi: 10.1080/08820538.2023.2223295. Epub 2023 Jun 12.
Prior research has shown that ophthalmology residents improve their cataract surgery competency as they perform additional surgeries beyond the 86 minimum cases mandated by the Accreditation Council for Graduate Medical Education (ACGME). Therefore, cataract surgery volume is an important benchmark for ophthalmology programs. Understanding the possible influence of residency program characteristics on resident cataract surgery volume may help educators in identifying areas for improvement and aid applicants in choosing between programs. The aim of this study was to assess residency program characteristics associated with higher mean cataract surgery volume for ophthalmology residents.
We conducted a retrospective, cross-sectional analysis of the San Francisco Match Program Profile Database to assess various program characteristics from the 113 listed ophthalmology residency programs. The associations between program characteristics and the mean cataract surgery volume per graduating resident (CSV/GR) over years 2018-2021 were analyzed using multiple linear regression.
Out of 113 listed residency programs, 109 (96.5%) were included in our study. Across all programs, the mean (SD) CSV/GR was 195.9 (56.9) cases with a range of 86 to 365 cases. In multiple linear regression analysis, the presence of a Veteran Affairs (VA) training site (β = 38.8, = .005) and the number of approved fellows per year (β = 2.9, = .026) were positively correlated with higher mean CSV/GR. The 85 (78.0%) programs with VA training sites had a higher mean (SD) CSV/GR of 204.1 (55.7) cases compared to 166.7 (52.7) cases in the 24 (22.0%) programs without VA sites ( = .004). The mean CSV/GR increased by 2.9 cases for each additional fellow slot after adjusting for other factors. The number of approved residents per year, affiliation with a medical school, and the number of faculty were not significantly associated with CSV/GR.
All ophthalmology residency programs included in this study currently meet or exceed the ACGME requirements for cataract surgery case numbers. The presence of a VA training site and a higher number of fellowship positions were associated with higher mean resident cataract surgery volumes. Residency programs may consider further investing in these areas when seeking to improve resident surgical education. Additionally, residency applicants prioritizing cataract surgery volume may consider these factors when evaluating programs.
先前的研究表明，眼科住院医师在完成美国毕业后医学教育认证委员会（ACGME）规定的 86 例最低要求之外的额外手术时，其白内障手术能力会有所提高。因此，白内障手术量是眼科项目的一个重要基准。了解住院医师计划特征对住院医师白内障手术量的可能影响，可能有助于教育工作者确定改进领域，并帮助申请人在项目之间做出选择。本研究旨在评估与眼科住院医师较高平均白内障手术量相关的住院医师计划特征。
我们对旧金山匹配计划档案数据库进行了回顾性、横断面分析，以评估 113 个列出的眼科住院医师培训计划的各种计划特征。使用多元线性回归分析评估了计划特征与 2018 年至 2021 年期间每位毕业住院医师的平均白内障手术量（CSV/GR）之间的关系。
在列出的 113 个住院医师培训计划中，有 109 个（96.5%）纳入了我们的研究。在所有计划中，平均（SD）CSV/GR 为 195.9（56.9）例，范围为 86 至 365 例。在多元线性回归分析中，VA 培训基地的存在（β=38.8，P=0.005）和每年批准的研究员人数（β=2.9，P=0.026）与较高的平均 CSV/GR 呈正相关。在有 VA 培训基地的 85 个（78.0%）计划中，CSV/GR 的平均（SD）为 204.1（55.7）例，而在没有 VA 基地的 24 个（22.0%）计划中，CSV/GR 为 166.7（52.7）例（P=0.004）。在调整了其他因素后，每增加一个研究员职位，CSV/GR 就会增加 2.9 例。每年批准的住院医师人数、与医学院的附属关系以及教员人数与 CSV/GR 无显著相关性。
本研究纳入的所有眼科住院医师培训计划目前均符合或超过 ACGME 对白内障手术例数的要求。VA 培训基地的存在和更多的研究员职位与较高的住院医师白内障手术量相关。住院医师计划在寻求改善住院医师手术教育时，可以考虑在这些领域进一步投资。此外，在评估项目时，优先考虑白内障手术量的住院医师申请人可能会考虑这些因素。
