Comparing Intern Year Preparedness for an Integrated Ophthalmology Residency
Hou A, Mikkilineni S, and Goldman D. Comparing Intern Year Preparedness for an Integrated Ophthalmology Residency. Invest Ophthalmol Vis Sci 2019; 60(9).
Invest Ophthalmol Vis Sci
Purpose: Timely utilization of postgraduate training for ophthalmology residency is highly variable in the first year of intern training. As residency programs shift towards integrating and optimizing training time, there is no definitive guide of how to construct the first postgraduate year (PGY-1). Methods: This study is a prospective longitudinal study of new PGY-2 residents. All residents were surveyed in their first two months of ophthalmology training. Residents were asked to self-assess preparedness for ophthalmology based on their PGY1 year training curriculum. A survey was composed based on a modified assessment of training from the Accreditation Council for Graduate Medical Education (ACGME). A paired t-test model and Spearman correlation coefficient were used to determine the differences between the PGY1 training models. Results: There were 72 PGY-2 residents who responded to blinded surveys from July to August of 2017 and 2018. 39 (54%) were transitional year (TY), and 28 (39%) were preliminary internal medicine year (IM), 3 (4%) were preliminary surgery year (SY), and 2 (3%) were categorical ophthalmology (CO) year residents. CO and SY were excluded from comparison due to their low sample size. There was a statistical difference in the variable of number of ophthalmology training weeks between the IM and TY training year (p=0.027). Using weeks of ophthalmology as a control, there was a difference in preparedness for addressing the ophthalmic complaint (p=0.008) at 8 weeks of clinical ophthalmology, obtaining history and formulating diagnoses (p=0.003) at 10 weeks, performing ophthalmic exam (p=0.040) at 12 weeks, and proficiency with electronic health record (P=0.031) at 12 weeks. Conclusions: Our study shows there is no difference in perceived preparedness in comparing a TY to an IM program. However, with 8-12 weeks of clinical ophthalmology, there was a difference for preparedness in formulating ophthalmic diagnoses, performing the ophthalmic exam, obtaining adequate history, and proficiency with using electronic medical records. As additional number of months of ophthalmology do not directly improve all aspects of resident preparedness, it may be prudent to find additional solutions to maximize resident training. However, further studies are needed to compare the current paradigm to an integrated ophthalmology residency.