Exploring the Benefit of an Integrated Ophthalmology Internship (PGY-1)—Perceived Preparedness and the Recommended Duration of Training

Abstract

Objective The effective utilization of intern training for ophthalmology residency is undermined by its variability across postgraduate programs. As residency programs shift toward integrating the first postgraduate year (PGY-1) into the ophthalmology-training curriculum, there are no definitive guidelines to build upon.

Methods This is a retrospective cross-sectional study of new second postgraduate year (PGY-2) ophthalmology residents. Residents were surveyed in their first 2 months of ophthalmology training. Residents were asked to self-assess preparedness for ophthalmology based on their PGY-1 curriculum. A survey was composed and modified from the Accreditation Council for Graduate Medical Education's assessment of resident training. The Wilcoxon's rank-sum test was used to evaluate survey differences between the transitional year (TY) versus preliminary internal medicine (IM) year and compare survey responses between residents who were below versus above optimal cut points for weeks of ophthalmic training.

Results There were 72 PGY-2 residents who responded to blinded surveys collected from July to August of 2017 and 2018. Thirty-nine (54%) residents graduated from a TY, 28 (39%) from preliminary IM, 3 (4%) from preliminary surgery, and 2 (3%) from a categorical ophthalmology year. Both categorical ophthalmology and surgery year were excluded from training year comparison due to low sample size. Using weeks of ophthalmology training as the control variable, there were significant increases in preparedness for addressing the ophthalmic complaint (p = 0.003) with at least 8 weeks of clinical ophthalmology, ability to perform ophthalmic exam (p = 0.018) with at least 12 weeks, ophthalmology medical knowledge (p = 0.005) with at least 10 weeks, and proficiency with hospital electronic health record (p = 0.003) with at least 12 weeks.

Conclusion While our study did not find significant differences in perceived preparedness for ophthalmology residency based on the type of PGY-1 programs completed, there were statistically significant associations for specific ophthalmology tasks. These findings suggested a potential merit of integrating 12 weeks of clinical ophthalmology training as a benchmark for resident preparedness.

Keywords

residency - accreditation - internship - ophthalmology - education - curriculum - training - development

• References

• 1 ACGME. Common Program Requirements. Available at: https://www.acgme.org/What-We-Do/Accreditation/Common-Program-Requirements . Accessed: March 1, 2019
• 2 The Ophthalmology Milestone Project. Available at: https://www.acgme.org/Portals/0/PDFs/Milestones/OphthalmologyMilestones.pdf . Accessed: March 1, 2019
• 3 Oetting TA, Alfonso EC, Arnold A. , et al. Integrating the internship into ophthalmology residency programs: association of university professors of ophthalmology American Academy of Ophthalmology White Paper. Ophthalmology 2016; 123 (09) 2037-2041
• 4 Pfeifer CM. Evolution of the preliminary clinical year and the case for a categorical diagnostic radiology residency. J Am Coll Radiol 2016; 13 (07) 842-848
• 5 Thomsen ASS, la Cour M, Paltved C. , et al. Consensus on procedures to include in a simulation-based curriculum in ophthalmology: a national Delphi study. Acta Ophthalmol 2018; 96 (05) 519-527
• 6 Roohipoor R, Yaseri M, Teymourpour A, Kloek C, Miller JB, Loewenstein JI. Early performance on an eye surgery simulator predicts subsequent resident surgical performance. J Surg Educ 2017; 74 (06) 1105-1115
• 7 Daly MK, Gonzalez E, Siracuse-Lee D, Legutko PA. Efficacy of surgical simulator training versus traditional wet-lab training on operating room performance of ophthalmology residents during the capsulorhexis in cataract surgery. J Cataract Refract Surg 2013; 39 (11) 1734-1741
• 8 Puri S, Srikumaran D, Prescott C, Tian J, Sikder S. Assessment of resident training and preparedness for cataract surgery. J Cataract Refract Surg 2017; 43 (03) 364-368
• 9 Liu EY, Li B, Hutnik CML. Canadian ophthalmic microsurgery course: an innovative spin on wet lab-based surgical education. Can J Ophthalmol 2016; 51 (05) 315-320