Improving the Transition to Ophthalmology Residency: A Survey of First-Year Ophthalmology Residents

Abstract

Purpose The objective of this study is to quantify the impact of the transition from internship to ophthalmology residency and to identify practices that help ease this transition.

Methods An online questionnaire was developed with 21 questions focusing on areas felt to impact the transition to ophthalmology residency. This was sent to all program directors of accredited ophthalmology residency programs in the United States for distribution to their first-year trainees. Responses were tabulated and evaluated for associations using comparative statistics.

Results Ninety-one first-year residents responded. Fifty-five identified the transition to ophthalmologic training as more stressful than internship. Independent preparation (p < 0.01) and doing an ophthalmology rotation during internship (p = 0.04) significantly reduced stress, and those doing a transitional PGY-1 year were significantly more likely to do either (p < 0.01). Additionally, orientations dedicating more time to exam skills (p < 0.01) were associated with significantly lower stress, while residents who had relatively shorter buddy-call systems (p = 0.02) were significantly more stressed.

Conclusion This study identified the transition to ophthalmology residency as highly stressful for trainees. Time spent preparing for ophthalmology residency is crucial to easing this transition, and a transitional year affords more opportunity for such preparation. Orientations which provide more hands-on experience reduce stress among new residents, as do longer buddy-call systems.

Keywords

residency - stress - orientation

• References

• 1 Brennan N, Corrigan O, Allard J , et al. The transition from medical student to junior doctor: today's experiences of Tomorrow's Doctors. Med Educ 2010; 44 (5) 449-458
• 2 Flynn SP, Hekelman FP. Reality shock: a case study in the socialization of new residents. Fam Med 1993; 25 (10) 633-636
• 3 Schneider SE, Phillips WM. Depression and anxiety in medical, surgical, and pediatric interns. Psychol Rep 1993; 72 (3, Pt 2): 1145-1146
• 4 Hurst C, Kahan D, Ruetalo M, Edwards S. A year in transition: a qualitative study examining the trajectory of first year residents' well-being. BMC Med Educ 2013; 13: 96
• 5 Teunissen PW, Westerman M. Opportunity or threat: the ambiguity of the consequences of transitions in medical education. Med Educ 2011; 45 (1) 51-59
• 6 Shah M, Knoch D, Waxman E. The state of ophthalmology medical student education in the United States and Canada, 2012 through 2013. Ophthalmology 2014; 121 (6) 1160-1163
• 7 Paice E, Rutter H, Wetherell M, Winder B, McManus IC. Stressful incidents, stress and coping strategies in the pre-registration house officer year. Med Educ 2002; 36 (1) 56-65
• 8 Antonoff MB, Swanson JA, Green CA, Mann BD, Maddaus MA, D'Cunha J. The significant impact of a competency-based preparatory course for senior medical students entering surgical residency. Acad Med 2012; 87 (3) 308-319
• 9 Meier AH, Henry J, Marine R, Murray WB. Implementation of a Web- and simulation-based curriculum to ease the transition from medical school to surgical internship. Am J Surg 2005; 190 (1) 137-140
• 10 Laack TA, Newman JS, Goyal DG, Torsher LC. A 1-week simulated internship course helps prepare medical students for transition to residency. Simul Healthc 2010; 5 (3) 127-132
• 11 Mushin IC, Matteson MT, Lynch EC. Developing a resident assistance program. Beyond the support group model. Arch Intern Med 1993; 153 (6) 729-733
• 12 SF Match Residency and Fellowship Matching Services. Ophthalmology residency match report. Available at: https://www.sfmatch.org/SpecialtyInsideAll.aspx?id=6&typ=2&name=Ophthalmology . Accessed March 19, 2014
• 13 Spivey BE. Ophthalmology for medical students: content and comment. Arch Ophthalmol 1970; 84 (3) 368-375
• 14 Stern GA ; The Association of University Professors of Ophthalmology Education Committee. Teaching ophthalmology to primary care physicians. Arch Ophthalmol 1995; 113 (6) 722-724
• 15 Jacobs DS. Teaching doctors about the eye: trends in the education of medical students and primary care residents. Surv Ophthalmol 1998; 42 (4) 383-389
• 16 Quillen DA, Harper RA, Haik BG. Medical student education in ophthalmology: crisis and opportunity. Ophthalmology 2005; 112 (11) 1867-1868
• 17 Department of Ophthalmology & Visual Sciences, University of Utah. Residency program. Available at: http://medicine.utah.edu/ophthalmology/education/residency/index.php . Accessed March 19, 2014
• 18 University of Iowa Health Care - Ophthalmology Residency. Integrated internship. Available at: http://www.uihealthcare.org/GME/InsidePages.aspx?id=241830&taxid=225135 . Accessed March 19, 2014
• 19 The Department of Ophthalmology at California Pacific Medical Center Residency Program. The staggered start. Available at: http://www.cpmc.org/professionals/education/residencies/ophthalmology/apply.html . Accessed March 19, 2014
• 20 Passalacqua SA, Segrin C. The effect of resident physician stress, burnout, and empathy on patient-centered communication during the long-call shift. Health Commun 2012; 27 (5) 449-456
• 21 Beckman TJ, Reed DA, Shanafelt TD, West CP. Resident physician well-being and assessments of their knowledge and clinical performance. J Gen Intern Med 2012; 27 (3) 325-330
• 22 West CP, Shanafelt TD, Cook DA. Lack of association between resident doctors' well-being and medical knowledge. Med Educ 2010; 44 (12) 1224-1231
• 23 Campbell J, Prochazka AV, Yamashita T, Gopal R. Predictors of persistent burnout in internal medicine residents: a prospective cohort study. Acad Med 2010; 85 (10) 1630-1634
• 24 Cummings SM, Savitz LA, Konrad TR. Reported response rates to mailed physician questionnaires. Health Serv Res 2001; 35 (6) 1347-1355