Purpose:To determine factors that contribute to current salary differences among ophthalmologists employed by the Veterans Health Administration (VHA). Methods:We performed a cross-sectional analysis of full-time equivalent salaries of Veterans Health Administration ophthalmologists who received a federal salary in 2021. Differences in average salary with respect to various demographic variables were analyzed. Results:Data for 632 salaried VHA ophthalmologists (262 females [41.5 %]) were included. Although biological sex alone did not have a crude, statistically significant effect on average VHA ophthalmologist salary (p = 0.116), a substantial discrepancy was noted in adjusting for other significant demographic variables, including years spent at the VHA. There was a significant interaction effect between sex and years at the VHA: female ophthalmologists initially earned substantially and significantly less than their male counterparts (-$9726 [p = 0.018]). Regarding other variables, chief status and paygrade had the greatest effect on median overall salary, with an average increase of $33,673 for chiefs (p = 5.52e-11) and $28,472 for full-time VHA physicians (p = 1.96e-23). Years since residency (p = 3e-4) and h-index (p = 0.03) were each positively and significantly correlated with overall salary. All Veterans Integrated Services Network (VISN) regions, especially the Northeast region, were associated with significantly lower salaries compared with the Southern region. Conclusion:Female sex is associated with a significantly lower initial compensation for ophthalmologists employed by the VHA when adjusting for chief status, paygrade, VISN region, complexity level, academic rank, and years at the VHA. Although several factors could be involved in the apparent salary disparities found within this study, policy changes may be important to ensure compensation is equitable across VHA centers.
Purpose:The exponential growth of ophthalmology research can be challenging to keep up with for trainees, researchers and clinicians and little has been done to identify core ophthalmology journals. We thus applied Bradford's law to characterize core journals in ophthalmology. Design:Cross-sectional bibliometric analysis. Methods:Two sets of top 10 National Library of Medicine indexed ophthalmology journals based on h-index and impact factor (IF) were combined to create top 14 journals used for analysis. The references from all articles published in these journals in one randomized quarter were compiled into a citation database. Bradford's law was applied to identify zonal distribution of journals. Results:A total of 3093 journals containing 34,633 articles were cited in ophthalmology literature from July-Sept 2022. Under linear regression, IF was significantly associated with h-index for the top 20 journals (P < 0.001) and top 10 ophthalmology journals (P = 0.017). H-index was significantly associated with number of citations for top 10 ophthalmology journals (P < 0.001). Three zones obeying Bradford's law were identified, with zone 1 (core) containing six journals and 8410 citations, zone 2 containing 27 journals and 8359 citations, zone 3 containing 154 journals and 8419 citations. A linear relationship between the log journal rank for zones 1-3 and cumulative number of citations was found (R2 = 0.996), validating Bradford's law. Conclusions:Six core ophthalmology journals were identified: American Journal of Ophthalmology, Investigative Ophthalmology & Visual Science, Ophthalmology, JAMA Ophthalmology, British Journal of Ophthalmology, Journal of Cataract & Refractive Surgery. These highly cited core journals may serve as high-yield resources for describing the latest advances in ophthalmology research and may guide ophthalmology trainees and educators with their learning and teaching.
Purpose:Situational Judgment Tests (SJTs) are increasingly utilized in medical trainee recruitment decisions yet little is known of their potential biases. This study was designed to evaluate the Computer-Based Assessment for Sampling Personal Characteristics (CASPer) SJT scores of ophthalmology residency applicants and compare these to Step 1 and Step 2 scores in different demographic groups. Methods:All applicants to the ophthalmology residency match completed CASPer during the 2022-2023 recruitment cycle. Applicant scores were cross-referenced within the SF Match Residency Application System to collect data on applicant gender, self-identified Under-Represented in Medicine (URiM) status, and International Medical Graduate (IMG) status, as well as Step 1 and Step 2 scores. Results:A total of 760 of 765 (99.3%) of applicants with CASPer scores were identified in SF Match, 41% of which were female, 15% URiM, and 11% IMG. Males scored slightly higher on all three tests, with the mean difference in Step 1 (4.3) reaching a statistical significance (Cohen's d = 0.29, p < 0.001). When comparing URiM and IMG applicants, these groups scored significantly lower than their counterparts on all three tests (p all <0.001), with the magnitude of mean difference greater for CASPer than Step 1 or 2. There were no differences between genders in CASPer percentile scores; however, URiM applicants performed on average 17% and IMG applicants 32% lower than their counterparts. Conclusions:The CASPer SJT demonstrated significant bias against URiM and IMG ophthalmology residency applicants. This bias was even greater than Step 1 and Step 2 performance, suggesting the continued need for caution when utilizing any standardized testing in recruitment decisions.
Objective:To report the results of a national survey soliciting residency programs' microsurgical curricula for ophthalmology interns, and the efficacy of a single institution's intern microsurgical wet lab curriculum. Design:Mixed methods study including a national survey and a prospective trial. Setting:Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA. Tertiary care institution. Participants:In this two-part study, an electronic survey soliciting intern microsurgical curricula was distributed to all accredited ophthalmology residency programs nationwide. Additionally, interns at the study institution (n = 10) were evaluated on speed and quality of a corneal suturing task prior to and following completion of an eight-session microsurgical curriculum. Post-curriculum intern performance was also compared to the performance of first-year ophthalmology residents (n = 5) without an internship microsurgical curriculum. Results:Twenty-four percent of programs responded (n = 27). All programs had a microsurgical wet lab but only five (19%) had a structured curriculum for interns. Most programs described little emphasis on intern microsurgical training and a need for increased guidance on incorporating intern instruction. Interns (n = 10) showed significant improvement in time to task completion (P = 0.002, 95% CI: 0.76 to 1.51) and technical performance (P = 0.02, 95% CI: 0.44 to 3.21) after curriculum completion. Compared to PGY-2 (curriculum-naïve) residents, interns were faster and performed better, but these differences were not statistically significant. Conclusion:Few ophthalmology residency programs offer microsurgical training during internship. Our structured microsurgical curriculum significantly improved intern microsurgical skills. Nationwide integration of the internship year into ophthalmology residency provides a valuable opportunity to commence microsurgical training.
Background Gap years following medical school graduation have become more common, but research into their tangible career benefit is lacking. Examining the impact of gap years on resident scholarly productivity in ophthalmology may provide insight generalizable to all specialties. Objective To evaluate whether a gap year following medical school graduation significantly predicts scholarly productivity during ophthalmology residency. Methods In December 2021, residents were recorded from 110 publicly available American ophthalmology residency program webpages. They were included if educational history was listed on publicly accessible academic and social media profiles. Residents were then stratified into gap year and nongap year cohorts. Publication data were recorded from Scopus and PubMed. Pearson's chi-square, independent sample t -tests, and multivariable regression were performed. Results A total of 1,206 residents were analyzed, with 1,036 (85.9%) residents taking no gap year and 170 (14.1%) residents with at least one gap year. Gap year residents were predicted to have increase in the likelihoods of publishing at least one, two, or five total articles during residency, in addition to at least one article in a high-impact journal. There was no significant relationship between gap years and publications with senior authors affiliated with either the resident's medical school or residency program. Conclusion Residents taking gap years following graduation may publish more during residency, but these publications are not associated with senior authors at their institutions. Future investigations should continue to evaluate the significance of gap years in medical education.
Background Studies in several fields of medicine have found that women published less during the COVID-19 pandemic, potentially due to an increase in domestic responsibilities. This study examines whether a similar pattern exists for female authorship in ophthalmology. Purpose To compare the proportions of female authorship published in high-impact ophthalmology journals before and during the COVID-19 pandemic. Methods A cross-sectional study analyzing authorship gender of articles published during the COVID-19 pandemic (between July and September 2020) compared with matched articles published in the same journals before the COVID-19 pandemic (between July and September 2019). Gender of the first and last authors was analyzed using an online gender determination tool. Results A total of 577 articles and 1,113 authors were analyzed. There was no significant difference in the average number of publications by male and female authors before and during the COVID-19 pandemic. There was a significant increase in the percentage of female first authorship from the prepandemic period (32%) to during the COVID-19 pandemic (40%; p = 0.01), but no significant increase in the last authorship (p > 0.05). When analyzing only research articles, a similar increase in female first authorship was noted when comparing the publications before (31%) and during the COVID-19 pandemic (43%; p = 0.02). No significant differences were noted when analyzing the editorials (p > 0.05). Conclusion While disparities continue to exist between male and female authorship, an increase in female first authorship was noted during the COVID-19 pandemic for overall articles as well as research articles. Precis During the COVID-19 pandemic, female authorship as first and last authors of peer-reviewed articles in high-impact ophthalmology journals was below 50%. However, while the overall rates of female authorship were unchanged, female first authorship significantly increased during the pandemic. These results differ from studies published in other medical fields that demonstrated a decrease in female authorship during the COVID-19 pandemic.
The interview process has long been an important part of residency and fellowship applications. The coronavirus disease 2019 (COVID-19) pandemic fundamentally altered this aspect of the process when the American Medical Association, Association of American Medical Colleges, and Accreditation Council for Graduate Medical Education all recommended rotations be halted and residency interviews be conducted virtually, a recommendation that affected both the 2020–2021 and the 2021–2022 match cycles.[1] [2] Virtual interviews introduce factors not previously considered during interview preparation but that may have a real and significant impact on the perception of interviews and applicant outcomes. Over the past two interview cycles, the Ophthalmology Department at Yale School of Medicine opted to redirect student guidance to help prepare their residency and fellowship applicants specifically for this situation by conducting mock virtual interviews with self-reflective and faculty feedback, allowing students to feel better prepared and more confident going into the uncharted territory of the COVID era of resident and fellowship application cycles.
Introduction We created a virtual rotation to facilitate the exposure of ophthalmology to medical students and serve as a pilot program to help attract students from under-represented in medicine (URM) backgrounds. In addition to the rotation eliminating the financial burdens associated with in-person away rotations, we offered a not-for-credit (i.e., drop-in) option that included sessions outside the typical clinic hours. This option reduced scheduling conflicts as a barrier to enrollment and allowed junior medical students and postgraduates to participate and hopefully further develop an interest in ophthalmology. Methods Before the rotation, participants completed a pre-test and a survey to collect data on learners' backgrounds and interest in applying for ophthalmology residency. The rotation included live lectures, case-based discussions, chart reviews, and guided self-study. Following the rotation, participants completed a post-test and a survey to query applicants on the online rotation's utility and delivery. Results Eleven learners enrolled in the course and completed the prerotation survey and test. Approximately one-third (4/11; 36%) were URM students and two-thirds (7/11; 64%) were female. All responded they were planning to apply for ophthalmology residency. All responded they strongly agreed that the rotation increased their general knowledge in ophthalmology, and 89% (9/11) strongly agreed that it improved their ability to diagnose and manage actual patients. Nearly all (7/8; 87.5%) strongly agreed the rotation provided the opportunity to seek support for the residency application process, and all found the online platform reliable and easy to access. Exam scores improved significantly from pre- to post-tests (60 vs. 79%; p < 0.01). Conclusions The rotation attracted a substantial proportion of URM students. Learners reported that the virtual rotation effectively taught and supported their endeavors to become ophthalmologists. Virtual rotations for visiting students can reduce barriers such as travel, financial costs, and time constraints that might otherwise hinder exposure to specialty training that is not offered or is underrepresented at students' home institutions. Increasing exposure and offering mentorship through this novel platform deserves further study to enhance diversity and inclusion in medicine.
Objective The aim of this study is to describe a cost-effective and portable surgical training module for ophthalmology trainees and demonstrate its effectiveness in building confidence and reducing stress with conjunctival closure. Methods A total of 29 trainees (fourth year medical students, postgraduate year (PGY) 1 ophthalmology residents, PGY2 ophthalmology residents) participated in the module during July 2022. They completed a Pre-Module and Post-Module Questionnaire, with some questions assessing their confidence level and other questions assessing their stress level with conjunctival closure. A Likert scale of 1 to 10 was used to evaluate their level of confidence or stress (with 1 indicating low confidence or low stress and 10 indicating high confidence or high stress). Results Prior to completing the module, participants had an average conjunctival suturing skills confidence level score of 2.6 ± 1.6, which increased significantly to 5.6 ± 1.6 after completing the module (p < 0.001). Participant's stress level score with performing conjunctival closure on live patients significantly decreased from 7.5 ± 2.4 to 5.6 ± 1.5 (p < 0.001) after completion of the module. When participants were separated into two groups, participants in the PGY1 residents/medical students group had an average conjunctival suturing skills confidence level score of 2.7 ± 1.8, which rose significantly to 5.1 ± 1.5 after completing the module (p = 0.008), whereas PGY2 residents had an average conjunctival suturing skills confidence level score of 2.6 ± 1.6, which rose significantly to 5.8 ± 1.7 after completing the module (p < 0.001). Participant's stress level scores with performing conjunctival closure on live patients did not show significant results in the PGY1 residents/medical students group but significantly decreased from 7.2 ± 2.2 to 5.2 ± 1.3 (p < 0.001) in PGY2 residents. Participants agreed that the video presented was effective for learning the surgical skill and that the module was engaging and prepared them well to learn more advanced conjunctival suturing techniques. Conclusion Our surgical training module is an effective teaching tool for ophthalmology trainees to increase confidence and decrease stress about performing conjunctiva closure. It provides an opportunity for trainees to repetitively practice key surgical techniques on an inexpensive and reusable training model.
Purpose To analyze resident vitreoretinal procedure volume across Accreditation Council of Graduate Medical Education (ACGME) accredited ophthalmology residency programs. We assessed the effect of the increase in intravitreal injections (IVI), geographic region, program size, and Veterans Affairs (VA) and vitreoretinal fellowship affiliation on vitreoretinal procedures. Methods A request was sent to all residency programs in 2018 for their graduating residents' ACGME case logs. Vitreoretinal procedures were defined by ACGME case log categories and included vitreoretinal surgery, peripheral retinal lasers, and IVI. Procedures were categorized by Current Procedural Terminology (CPT) code. Programs were studied by geographic region, program size, and by VA and vitreoretinal fellowship affiliation. Results A total of 38 of 115 (33.0%) programs responded, and 167 residents logged 32,860 vitreoretinal procedures. The median number of retina procedures per resident was 146 (range 36-729). Programs with a vitreoretinal fellowship had a higher average number of vitreoretinal procedures per resident (208.3 vs. 125.0; p = 0.002), but there was no difference between the average number of non-IVI vitreoretinal procedures (60.0 vs. 64.2; p = 0.32). For IVI, VA affiliation (146.6 vs. 71.1; p = 0.02) and vitreoretinal fellowship (149.4 vs. 60.8; p < 0.001) were associated with a greater number. More IVI strongly correlated with a larger total volume of retinal procedures ( r = 0.98), and there was no difference across programs for total retinal procedures when IVI was removed. Conclusions The presence of a vitreoretinal fellowship at a residency program had a positive effect on resident total vitreoretinal case volume, but their residents performed more IVI. Programs without vitreoretinal fellowships completed on average more non-IVI procedures.
Objective The accelerated involvement of private equity (PE) in ophthalmology has many potential implications for the future of the field. The aim of this study was to evaluate trainee perspectives on PE's impact on ophthalmology. Methods An electronic survey was sent to trainees via an online ophthalmology research newsletter. The survey assessed for career goals and perspectives on the involvement of PE and its impact across a variety of attributes. Results A total of 41 United States-based respondents responded to the survey, 68% were medical students and 32% were residents or fellows. Seventy-eight percent of respondents reported they would not consider working for a PE-owned practice. There was a negative perceived impact of PE for physician autonomy, long-term physician income, career advancement, and quality of care. There was a positive perceived impact for the number of physician extenders, more referral sources, financial support, bargaining with insurance companies, starting physician salary, and administrative burden. All respondents agreed (76% strongly agree, 24% somewhat agree) that education about practice options and ownership structures is important to include in residency program education, with preferred modalities of small group discussions and on-site learning. Conclusions Trainees broadly perceive PE to negatively impact the practice of ophthalmology. While there were attributes perceived to be positively impacted by PE, these were not felt to be as important as those which may be negatively affected. New modalities for education about practice ownership options are necessary, and small group discussions and on-site learning may be of the highest yield for trainees.
Objective Although the purpose of community eye screening programs is to reduce health care disparities, the effectiveness of these programs is limited by the follow-up adherence of their participants. The aim of this review is to investigate factors that may promote or hinder participants from attending follow-up ophthalmological exams after community eye screenings and identify interventions to increase follow-up rates. Methods For literature review, PubMed, Web of Science, Embase, Proquest/Global Health Library, and Google Scholar databases were searched to identify studies of community eye screenings published between January 2000 and May 2023. Data from these articles were analyzed to identify barriers and facilitators of follow-up adherence after community eye screenings in the United States and to examine strategies used to increase follow-up rates. Only published manuscripts were included. We excluded studies of school screenings and clinic-based screenings. Results A total of 28 articles were included. Follow-up rates ranged from 12.5 to 89%. Nineteen articles reviewed facilitators and barriers to follow-up. Eighteen articles were non interventional and seven (see Table 1 and 2 , respectively) articles described interventions that were tested to improve follow-up rates after screening. Interventions included prescheduled appointments, transportation assistance, patient education, and patient navigators. Conclusion Several interventions are promising to increase follow-up adherence in community eye screenings, but more evidence is needed. Future research should focus on randomized trials of isolated interventions to improve follow-up adherence of disadvantaged populations, although this may be limited given ethical considerations and documented lack of follow-up after screening.
Purpose The aim of this study was to determine whether a patient navigator program can address patient-reported barriers to eye care and to understand patient perceptions of a patient navigator program in ophthalmology. Design This is a retrospective cohort study and cross-sectional patient survey. Subjects and Methods A cohort of patients was recruited from a single academic ophthalmology department in the Mid-Atlantic region. Patients included in the study had received referral to the patient navigator program in the first quarter of 2022. Our patient navigator program provided patients with resources to address barriers to care such as transportation and financial assistance. Outcomes of the study included indications for referral, case resolution rate, and patient satisfaction. Results In total, 130 referrals for 125 adult patients were included. The mean ± standard deviation age was 59 ± 17 years, 54 (44%) were male, 77 were white (62%), and 17 patients (14%) were uninsured. Common reasons for referral were transportation (52, 40%), insurance (34, 26%), and financial assistance (18, 14%). Among the 130 cases referred, 127 (98%) received an intervention from the patient navigator, who was able to resolve the referring issue in 90% of cases (117/130). Among 113 patients contacted for a follow-up telephone survey, 56 (50%) responded. Patients rated the program highly at a mean Likert rating of 4.87 out of 5. Moreover, 72% (31/43) of respondents stated their interactions with the patient navigator assisted them with taking care of their eyes. Conclusions A patient navigator program can address barriers to eye care by connecting patients with community resources.
Given the low rates of under-represented minority (URM) residents[1] and practicing physicians[2] in ophthalmology, ophthalmology training programs in the United States have been charged with increasing diversity to better represent our population. There have been great efforts from the Association of University Professors of Ophthalmology and the American Academy of Ophthalmology to expand the pipeline, particularly through the Minority Ophthalmology Mentoring program.[3] Other groups such as the Rabb Venable Research Foundation and the Student National Medical Association have also been crucial in encouraging and supporting URM students. Initiatives such as the Einstein Enrichment Program for 7th to12th graders and the Diversity Student Summer Research Opportunity Program for college juniors and seniors at our institution work to encourage URM students to go into medicine and biomedical sciences at an earlier stage. However, once URM students are in the pipeline as potential future ophthalmologists, they may encounter barriers in the admissions process based on traditional metrics such as United States Medical Licensing Examination (USMLE) step scores and selection into Alpha Omega Alpha.[4] We believe it is the responsibility of residency program leadership to conduct the admission process with an eye toward matching qualified URM students. In our program at Montefiore Medical Center/Albert Einstein College of Medicine, we have successfully increased representation in our residency program. We would like to share our process as a potential model for this endeavor.
Purpose The aim of this study is to identify and characterize women professors in ophthalmology to enhance professional development and equity of women in academic ophthalmology. Design Cross-sectional descriptive survey study. Participants Participants in the survey were women in ophthalmology departments who have obtained full professor rank at their respective institutions. Methods A cross-sectional study was conducted using data from an electronic survey of women ophthalmologists and researchers who had obtained full professorship rank in ophthalmology. The survey included questions about degree obtained, training path, fellowship, length and trajectory of academic career, family or medical leave participation, previous positions, and mentorship involvement. Statistical comparisons were made based on response. Main Outcome Measures Survey responses to questions pertaining to three domains: education and training, academic career, and mentorship. Results Women that obtained the professor title within ophthalmology largely held Doctor of Medicine/Doctor of Osteopathic Medicine degrees, were more likely to have completed fellowship training, and on average took 11 to 15 years to obtain the full professor title. The participants held a variety of other positions and titles throughout their academic careers. The vast majority of women reported having between 1 and 3 mentors during their careers with the majority also noting they currently participate in mentoring programs. Surveys were completed by 62 (30% response rate) women full professors of ophthalmology. Conclusion The experiences women have along the academic path to professorship are described in this survey and can help to inform junior faculty. Literature review highlights the importance of mentorship for work productivity, retention, and promotion within academic medicine which is an element seen in the vast majority of our participants' career paths. Guided by the identification of women professors within departments of ophthalmology and characterization of their experiences, a new initiative called Women Professors of Ophthalmology was formed under the Association of University Professors of Ophthalmology's organizational structure in 2021. This group that is tailored for women professors of ophthalmology to foster peer mentorship and guidance is poised to increase the retention and promotion of women in academic ophthalmology.
Background The ophthalmology match is an important step for graduating medical students that defines their future career. Residency programs demonstrate significant variability due to differences in size, location, research output, subspecialty exposure, surgical case load, and alumni fellowship/practice placement. Despite the importance of informed decision-making, applicants often find limited, inconsistent information about potential programs. Purpose The purpose of this study was to characterize and identify gaps in the information available to residents in the 2022 to 2023 Match. Methods The SFMatch Web site was reviewed to identify programs included as well as characteristics cited on each program's webpage. Program webpages were used to evaluate availability and consistency of data on site surgical caseload, fellowship slots, and teaching staff. Results Of the 121 programs included on SFMatch, 23 (19%) provided no data on August 15, 2022 (15 days prior to application submission deadline) and 9 (7%) lacked program data on October 15, 2022. Though most programs provided mean cataract volume, data on volume of other procedures for graduating residents was highly variable and occasionally misleading. Programs did not provide information on several academic and social considerations that may influence match ranking choice. Conclusion Applicants often must read "between the lines" to identify residency program strengths and weaknesses. Data crucial to informing the application process remain sparse, unavailable, or spread across resources. Limited data increases applicant dependence on word-of-mouth knowledge to inform decision-making. This might reduce diversity by limiting successful applicants to those with existing connections within the field.
The coronavirus disease 2019 (COVID-19) pandemic led to an abrupt transition to nearly exclusive virtual learning modalities, bringing about a revolution in ophthalmic education.[1] [2] [3] Born out of a necessity to maintain a high standard of education in the midst of the need for social distancing to reduce viral transmission, virtual learning systems have changed the way we teach the next generation of ophthalmologists. As we continue to face COVID-19-related barriers to delivering training in conventional manners, virtual learning has etched a place to stay in our training paradigms. Though distance learning has identified some exciting new educational opportunities, challenges remain integrating traditional teaching practices so as not to lose the nuanced value of personal interactions for young trainees.
Objective In medical school and residency training, there is little emphasis on the administrative and business aspects of running a clinical practice as either an employee or a business owner. However, by the first day of practice, young ophthalmologists need to have a basic understanding of the business of medicine to be successful in clinical practice and to avoid common pitfalls. Areas such as risk management, negotiation, financial health, lawsuits, marketing, coding, and professionalism are particularly important for practicing ophthalmologists to grasp. We instituted a formal practice management course to increase the early exposure of our trainees to the business aspects of ophthalmology. Methods Ophthalmology trainees engaged in 11, 1-hour sessions over 3 weeks during a practice management course covering 10 of the most relevant business topics for early career ophthalmologists. A precourse needs assessment, and a postcourse satisfaction and outcomes survey were administered. Results Of the 24 trainees who completed the presurvey, 96% of respondents had no previous training in contract negotiation, 88% lacked training in lawsuits, and 88% had no training in liability insurance. 96% had no inpatient coding education, and 88% had no outpatient coding training. Seventeen trainees completed the postsurvey, and statistically significant improvements in confidence ratings were found in all domains including coding, malpractice claims, and building a practice. 88% of trainees reported that the course improved their ability to code, and 100% agreed that the course improved their understanding of lawsuits, ability to negotiate a contract, and their understanding of the business of ophthalmology. Conclusion A formal, targeted business of ophthalmology course improved the knowledge of trainees on essential business concepts. This course can serve as a model for other programs looking to meet this educational need.
Over the last several years, attention has been drawn to the role of race, bias, and discrimination across many facets of society. Medicine, in particular, has a long history of racialization, including overt bias, racial disparities in care and outcomes, and race-based medicine. Ophthalmology is, in many ways, at the forefront of medicine, with rapid advancement in technology, drug delivery, and surgical techniques. Unfortunately, our field lags behind in efforts to push forward the diversity and social progress needed in medicine. Racially, the ophthalmology workforce, departments, and residencies remain less diverse compared with medicine as a whole as well as the U.S. population. In fact, in a recent survey of U.S. residency programs' racial diversity, ophthalmology ranked last.[1] However, increasing racial diversity alone will not automatically result in a complete understanding of and reckoning with the role of race in our field. This requires a more intentional effort and greater conversation around how race impacts the ways we think and practice and how race-based ophthalmology can weaken the care we provide for our patients.
