Ophthalmology resident surgical competency: a national survey.

Full Abstract

PURPOSE:
To describe the prevalence, management, and career outcomes of ophthalmology residents who struggle with surgical competency and to explore related educational issues.

DESIGN:
Fourteen-question written survey.

PARTICIPANTS:
Fifty-eight program directors at Accreditation Council on Graduate Medical Education-accredited, United States ophthalmology residency programs, representing a total of 2179 resident graduates, between 1991 and 2000.

METHODS:
Study participants completed a mailed, anonymous survey whose format combined multiple choice and free comment questions.

MAIN OUTCOME MEASURES:
Number of surgically challenged residents, types of problems identified, types of remediation, final departmental decision at the end of residency, known career outcomes, and residency program use of microsurgical skills laboratories and applicant screening tests.

RESULTS:
One hundred ninety-nine residents (9% overall; 10% mean per program) were labeled as having trouble mastering surgical skills. All of the programs except 2 had encountered such residents. The most frequently cited problems were poor hand-eye coordination (24%) and poor intraoperative judgment (22%). Most programs were supportive and used educational rather than punitive measures, the most common being extra practice-laboratory time (32%), scheduling cases with the best teaching surgeon (23%), and counseling (21%). Nearly one third (31%) of residents were believed to have overcome their difficulties before graduation. Other residents were encouraged to pursue medical ophthalmology (22%) or to obtain further surgical training through a fellowship (21%) or a supervised practice setting (12%); these residents were granted a departmental statement of satisfactory completion of residency for Board eligibility. Twelve percent were asked to leave residency. Of reported career outcomes, 92% of residents were practicing ophthalmology, 65% as surgical and 27% as medical ophthalmologists. Ninety-eight percent of residency programs had microsurgical practice facilities, 64% had a formal teaching course, and 36% had mandatory practice time. Most programs (76%) did not perform applicant vision or dexterity screening tests; questions existed about the legality and validity of such tests.

CONCLUSIONS:
The issue of ophthalmology residents who struggle to develop surgical competency appears common. Although many problems appear to be remediable with time, practice, and dedicated, patient teachers, more specific guidelines for a statement of surgical competency are likely necessary to standardize the Board certification process.

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Author information

Author/s: Binenbaum, Gil (G); Volpe, Nicholas J (NJ);

Affiliation: Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Journal and publication information

Publication Type: Journal Article

Journal: Ophthalmology (Ophthalmology), published in United States. (Language: eng)

Reference: 2006-Jul; vol 113 (issue 7) : pp 1237-44

Dates: Created 2006/07/03; Completed 2006/07/20; Revised 2007/04/12;

PMID: 16725202, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: Ophthalmology. 2006 Dec;113(12):2380-1. (PMID: 17157154)

CommentIn: Ophthalmology. 2007 Apr;114(4):829-30; author reply 830. (PMID: 17398335)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Career Choice
Clinical Competence - standards; statistics & numerical data
Education, Medical, Graduate
Employment - statistics & numerical data
Humans

Internship and Residency - statistics & numerical data
Ophthalmologic Surgical Procedures - education
Ophthalmology - education
Questionnaires
United States

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