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Factors Influencing Career Choices in Ophthalmology

Specialty training in medicine has become an important issue in recent years. A consensus has developed that specialist physicians will be in serious oversupply and that many more primary care physicians will be needed to meet future health care needs in the United States. This survey, sent to graduating ophthalmology residents, by Steven J. Gedde, M.D., and colleagues at Bascom Palmer Eye Institute in Miami, contained questions regarding demographic information, medical education and residency training, career goals, and factors influencing ophthalmologists' career choices.

The study concluded that there will be a substantial excess of subspecialist ophthalmologists in all subspecialty areas by the year 2010 if the rate of subspecialty training continues at the same rate as in the mid-1990s. The following are the researchers' findings:

After completion of residency training:

► 64% of responders were pursuing subspecialty training

► 36% planned to practice comprehensive ophthalmology

Lifestyle considerations seem to be more important to residents choosing comprehensive ophthalmology as a career. Anticipated work hours and preferred geographic location were rated as significantly more important by responders planning to practice comprehensive ophthalmology than by those seeking subspecialty training.

Factors that predicted subspecialty training included:

► a desire to acquire special skills (96% of fellowship students found this "very" to "moderately" important)

► challenging diagnostic problems (81%)

► perceived more favorable job market (51%)

► prestige (37%)

Predictors of a career in comprehensive ophthalmology included:

► anticipated work hours (50%)

► practice in a preferred geographic location (48%)

Residents choosing comprehensive ophthalmology careers were more likely to plan to practice in a group private practice, while those seeking subspecialty training were more likely to intend to practice in a university setting or were undecided in their future practice type.

► Subspecialty training was a more common career choice than comprehensive ophthalmology for both men and women.

► Women statistically were more likely than men to choose careers in comprehensive ophthalmology.

► Men were more likely than women to pursue fellowship training.

► Residents who graduated medical school as members of the Alpha Omega Alpha Honor Medical Society statistically were more likely to pursue subspecialty training than comprehensive practice positions.

► The type of degree held did not correlate with the decision to pursue fellowship training or comprehensive ophthalmology as a career choice.

►A Residents seeking fellowship training statistically were more likely to practice in an urban setting, whereas those not entering fellowships were more likely to practice comprehensive ophthalmology in a suburban setting.

The factors that were rated as "very important" or "moderately important" in the decision to pursue or not to pursue fellowship training by at least half of the total group of responders included:

► acquisition of special skills

► challenging diagnostic problems

► having role models or mentors

► rotation(s) in the subspecialty area

► type of patient problems.

About these Data: An anonymous survey commissioned by the American Academy of Ophthalmology was sent to each graduating ophthalmology resident in the United States between Feb. 1, 2003, and Feb. 28, 2003. Demographic data and information relating to medical school and residency training, career goals, and factors influencing career choices were collected from the surveys. The individual response rate was 50.8% (222/437), while 74.1% (86/116) of residency training programs responded to the survey.

Survey results first appeared in Ophthalmology. 2005;112:1247-1254.