Chhoa John, Jawiche John, Uppal Priya A, Arunachalam Thilaka, Nguyen Mytien, Eggan Branden, Mason Hyacinth, Busingye Jacqueline
Albany Medical College, Albany, New York.
Yale School of Medicine, New Haven, Connecticut.
J Acad Ophthalmol (2017). 2023 Jan 28;15(1):e24-e35. doi: 10.1055/s-0043-1760834. eCollection 2023 Jan.
The field of ophthalmology must become more reflective of the increasingly diverse U.S. population. This study characterizes students intending to pursue ophthalmology and practice in an underserved area versus other surgical and nonsurgical fields. Deidentified responses from 92,080 U.S. MD students who matriculated in the academic years beginning from 2007 to 2011 were obtained from the Association of American Medical Colleges (AAMC) Graduation Questionnaires. Study participants were those who fully completed the AAMC Graduation Questionnaire. Chi-squared and multivariate logistical regressions were used for analyses. Ophthalmology intending graduates (OIG; = 1,177) compared with other surgical intending graduates ( = 7,955) were more likely to be female (adjusted odds ratio [aOR]: 1.46; 95% confidence interval [CI]: 1.28-1.66), Asian (1.71 [1.46-2.01]), and have conducted a research project with a faculty member (1.58 [1.26-1.98]). OIG compared with nonsurgery intending graduates ( = 35,865) were more likely to have completed a research project with a faculty member (4.78 [3.86-5.92]), to be Asian (1.4 [1.21-1.62]), and have received scholarships (1.18 [1.04-1.34]). OIG were less likely to be female (0.64 [0.57-0.73]) and Black/African American (0.5 [0.33-0.74]). Among OIG, Black/African American students and multiracial students were more likely than non-Hispanic (NH) White students to report intention to practice in underserved areas (IPUA; 14.29 [1.82-111.88] and 2.5 [1.06-5.92]), respectively. OIG with global health experience were more likely to report IPUA (1.64 [1.2-2.25]). Females and underrepresented in medicine (URM), respectively, were more likely to be nonsurgery intending graduates than OIG, which, if not addressed, may lead to a persistent underrepresentation of these groups in the field. In addition, URM students, including African American students, were more likely to report IPUA, which further emphasizes the importance of more URM students entering the field to address these growing gaps in medical care. Finally, we recommend increased mentorship to help address these disparities.
眼科领域必须更能反映出美国人口日益增长的多样性。本研究对打算从事眼科工作并在服务欠缺地区执业的学生与其他外科和非外科领域的学生进行了特征描述。
从美国医学院协会（AAMC）毕业调查问卷中获取了92080名在2007年至2011年学年入学的美国医学博士学生的匿名回复。
研究参与者为完全填写了AAMC毕业调查问卷的学生。采用卡方检验和多变量逻辑回归进行分析。
与其他打算从事外科工作的毕业生（n = 7955）相比，打算从事眼科工作的毕业生（OIG；n = 1177）更有可能为女性（调整后的优势比[aOR]：1.46；95%置信区间[CI]：1.28 - 1.66）、亚洲人（1.71 [1.46 - 2.01]），并且曾与教员开展过研究项目（1.58 [1.26 - 1.98]）。与打算从事非外科工作的毕业生（n = 35865）相比，OIG更有可能与教员完成过研究项目（4.78 [3.86 - 5.92]）、为亚洲人（1.4 [1.21 - 1.62]），并且获得过奖学金（1.18 [1.04 - 1.34]）。OIG为女性（0.64 [0.57 - 0.73]）和黑人/非裔美国人（0.5 [0.33 - 0.74]）的可能性较小。在OIG中，黑人/非裔美国学生和多族裔学生比非西班牙裔（NH）白人学生更有可能报告有在服务欠缺地区执业的意向（IPUA；分别为14.29 [1.82 - 111.88]和2.5 [1.06 - 5.92]）。有全球健康经验的OIG更有可能报告有IPUA（1.64 [1.2 - 2.25]）。
女性和医学领域中代表性不足的群体（URM）分别比OIG更有可能成为打算从事非外科工作的毕业生，若不解决这一问题，可能会导致这些群体在该领域持续缺乏代表性。此外，包括非裔美国学生在内的URM学生更有可能报告有IPUA，这进一步强调了更多URM学生进入该领域以解决医疗服务中不断扩大的差距的重要性。最后，我们建议增加指导以帮助解决这些差异。
