Applicants' Interest in International Ophthalmology during Residency Training: Influence in Selecting U.S. Residency Programs

Abstract

Background In recent years, the Accreditation Council for Graduate Medical Education (ACGME) Residency Committee for Ophthalmology formally recognized international health electives for credit. By engaging in international health experiences, ophthalmology residents achieve the anchors essential to the core competencies set forth by the ACGME. Objective To explore how the availability of international ophthalmology opportunities may influence applicants' selection of U.S. ophthalmology residency programs and to identify applicants' perceived goals and barriers of participation in international ophthalmology experiences. Methods For this cross-sectional study, an electronic invitation to a 22-item questionnaire was sent to all 413 applicants to the ophthalmology residency program at the Penn State Eye Center during the 2017 Match. Results Responses were received from 261 applicants, yielding a response rate of 63.2%. Nearly all respondents (95.4%) reported interest in participating in an international ophthalmology experience during residency training, with 52.1% of respondents reporting being “extremely interested.” More than half of respondents (53.6%) had previously participated in a healthcare-related experience in an international setting. The availability of international opportunities increased the interest of 67.4% of respondents when choosing which residency programs to apply to, and influenced 65.2% of respondents to rank a residency program higher, with the respondents with previous international experience more likely to be favorably influenced (p < 0.001, p = 0.04, respectively). The goal identified by the largest number of respondents as “most important” was to “offer service to the underserved” (59.0%). The most commonly identified anticipated barriers to participating in an international experience during residency training included concern about scheduling conflicts and call coverage (81.7%), followed by lack of funding (71.4%). Conclusion There is significant interest in international ophthalmology among ophthalmology residency applicants, and the availability of international opportunities during training may influence the applicants' selection of programs. Statistically significant differences were found among respondents with and without previous international healthcare-related experience. These findings warrant further investigation into how residency programs can best address this interest and integrate international ophthalmology experiences into the residency curriculum.

International experiences during United States ophthalmology residency training: Current structure of international experiences and perspectives of faculty mentors at United States training institutions

“…Previous studies have suggested that interest in international ophthalmology is high among both U.S. residency program directors and applicants [5,21]. This study further confirms this sentiment by showing that not only is interest high, but participation in international experiences is also high, as 88.6% of ophthalmology residency programs represented in this study offer or support international experiences.…”

“…Although not statistically significant, faculty mentors who had traveled to the international host sites were more likely to believe that additional training is necessary as compared to those who had not. These findings are similar to the findings of a previous study in which ophthalmology applicants who had previously participated in a healthcare-related experience in an international setting were more likely to believe that additional training was necessary [21]. The healthcare system at an international site may differ in aspects such as resource availability, healthcare coverage, socioeconomics, cultural factors, clinical pathologies, and surgical techniques.…”

“…Within a residency training paradigm where education is a primary goal, it may be expected that the residents would be the primary beneficiaries of an international experience rather than the other parties involved, including the hosts. Interestingly, this majority perspective among faculty mentors differs from the majority perspective of ophthalmology residency applicants in a previous study, where 59.0% of respondents ranked “offer service to the underserved” as the most important goal of an international experience, over learning goals such as “learn from national eye care provider(s) in the country visited” and “learn about another eye care system” [21]. This suggests that there exists a disconnect between the goals and objectives that faculty mentors intend for residents and the trainee expectations of what an international experience will provide.…”

“…REDCap electronic data capture tool hosted at Penn State Hershey Medical Center was used to collect and manage the study data [22]. Survey questions were developed based on questions from previously published international ophthalmology surveys [5,21] as well as new questions designed with the input of faculty, residents, and medical students at the Penn State College of Medicine involved in international health. The survey was pilot tested on nine faculty members, representing six academic departments within the Penn State College of Medicine, who had personal experience in international health and/or experience supervising medical trainees in international health experiences.…”

“…A study conducted by Coombs et al found that 83% of programs represented in their survey participated in global health, with 54% of residency programs developing international electives [5]. Similarly, a recent survey of applicants to U.S. ophthalmology residency programs showed that nearly all respondents (95.4%) reported an interest in participating in an international experience during residency [21].…”