Hertel Amanda Kay, Ajlan Radwan S
University of Kansas School of Medicine, 7400 State Line Road, Prairie Village, KS, 66208-34444, United States, 1 913-588-6600, 1 913-588-0888.
JMIR Med Educ. 2024 Nov 13;10:e60940. doi: 10.2196/60940.
Ophthalmology residents take the Ophthalmic Knowledge Assessment Program (OKAP) exam annually, which provides percentile rank for multiple categories and the total score. In addition, ophthalmology residency training programs have multiple subspecialty rotations with defined minimum procedure requirements. However, residents' surgical volumes vary, with some residents exceeding their peers in specific subspecialty rotations.
This study aims to identify if there is a difference in OKAP examination scores and surgical volume exposure during ophthalmology residency training between nonfellowship and fellowship applicants and among various subspecialties.
A retrospective review of OKAP scores and surgical procedure numbers of graduating residents in an accredited academic ophthalmology residency program in the Midwest United States was conducted. Data were collected from 2012 to 2022.
A total of 31 residents were identified. Most residents decided to pursue fellowship training upon graduation (20/31, 65% residents), and the rest chose to practice comprehensive ophthalmology (11/31, 35% residents). A total of 18/31 residents had OKAP score reports available. The fellowship group outperformed the nonfellowship group in multiple subsections and the total exam (P=.04). Those pursuing fellowship training in glaucoma performed higher on the Glaucoma section (P=.004) and the total exam (P=.005). Residents pursuing cornea performed higher on nearly all subsections, including External Disease and Cornea (P=.02) and the total exam (P=.007). The majority of the surgical volume exposure was identical between fellowship and nonfellowship groups. Those who pursued glaucoma fellowship performed more glaucoma filtering and shunting procedures (P=.03). Residents going into pediatrics fellowship were primary surgeons in more strabismus cases (P=.01), assisted in fewer strabismus cases (P<.001), and had no difference in the total number of strabismus surgeries.
In our program, residents pursuing fellowship training had higher OKAP scores on multiple sections and the total exam. There was no significant difference in the overall surgical volume averages between fellowship and nonfellowship groups, but few differences existed in subspecialty procedures among fellowship applicants. Larger multicenter studies are needed to clarify the relationship between OKAP scores and ophthalmology fellowship decisions nationwide.
眼科住院医师每年参加眼科知识评估计划（OKAP）考试，该考试会给出多个类别及总分的百分位排名。此外，眼科住院医师培训项目有多个亚专科轮转，并有明确的最低手术要求。然而，住院医师的手术量各不相同，有些住院医师在特定亚专科轮转中的手术量超过同龄人。
本研究旨在确定在眼科住院医师培训期间，非专科 fellowship 申请者与专科 fellowship 申请者之间以及不同亚专科之间，OKAP 考试成绩和手术量暴露是否存在差异。
对美国中西部一个经认可的学术性眼科住院医师培训项目中毕业住院医师的 OKAP 成绩和手术数量进行回顾性研究。数据收集时间为 2012 年至 2022 年。
共确定了 31 名住院医师。大多数住院医师毕业后决定接受专科 fellowship 培训（20/31，65%的住院医师），其余的选择从事综合眼科（11/31，35%的住院医师）。共有 18/31 的住院医师有 OKAP 成绩报告。专科 fellowship 组在多个子部分和总考试中表现优于非专科 fellowship 组（P = 0.04）。那些寻求青光眼专科 fellowship 培训的住院医师在青光眼部分（P = 0.004）和总考试（P = 0.005）中得分更高。从事角膜专科的住院医师在几乎所有子部分得分更高，包括外部疾病和角膜（P = 0.02）以及总考试（P = 0.007）。专科 fellowship 组和非专科 fellowship 组的大多数手术量暴露情况相同。那些寻求青光眼专科 fellowship 的住院医师进行了更多的青光眼滤过和分流手术（P = 0.03）。进入小儿眼科专科 fellowship 的住院医师在更多斜视病例中担任主刀（P = 0.01），协助的斜视病例较少（P < 0.001），斜视手术总数无差异。
在我们的项目中，寻求专科 fellowship 培训的住院医师在多个部分和总考试中的 OKAP 成绩更高。专科 fellowship 组和非专科 fellowship 组的总体平均手术量没有显著差异，但专科 fellowship 申请者在亚专科手术方面存在一些差异。需要更大规模的多中心研究来阐明全国范围内 OKAP 成绩与眼科专科 fellowship 决策之间的关系。
