Perceptions and Career Expectation in Ophthalmology among Saudi Undergraduate Medical Students

The Influence of Gender on Choosing Ophthalmology as a Career Among Medical Students and Interns in Madinah, Saudi Arabia

Introduction The field of ophthalmology has become increasingly popular among medical students and interns in recent years. However, there may be gender-based differences in the factors influencing the choice of ophthalmology as a career path. This study aimed to investigate the influence of gender on the decision to pursue ophthalmology as a career among medical students and interns in Madinah, Saudi Arabia. Methods This cross-sectional study involved medical students and interns in Madinah, Saudi Arabia. A self-administered questionnaire was used to collect data from the participants at two medical colleges from March to May 2023. The questionnaire examined potential factors that would influence the students to choose or eliminate ophthalmology as a future career and whether there is a gender difference. Result A total of 449 medical students were included. Two hundred eighteen were males, and 231 were females. The mean age was 22; around (30%) of the participants were in the fourth year of medical school, and most respondents (63%) had no prior exposure to ophthalmology. Fewer working hours was the driving factor among the males to choose ophthalmology as a speciality (58%); in contrast to females, interest in eye anatomy and physiology was the main factor (60%). Being already passionate about other specialties was the main factor that deterred the students from choosing ophthalmology as a career among both males and females, with a p-value of 0.033. Conclusion Our study has shown that gender plays no significant role in influencing medical students' choice to pursue ophthalmology as a future career. Teaching students in early medical years about ophthalmology as an option may lead to significant contributions to understanding and determining their future path.

Ophthalmology as a career choice among medical students in Eastern India - A cross-sectional study

Purpose

Several factors influence medical students to choose a specialty branch for post-graduate training, and it is important to understand them so that strategies can be made to make it more attractive and hence the shortage in the workforce can be addressed. This study aimed to identify the factors that influenced under-graduate medical students to choose ophthalmology as their specialty for post-graduate training.

Methods

It was a descriptive, cross-sectional, questionnaire-based study, carried out among medical students at a tertiary academic institute in eastern India. In this survey tool, 25 questions were divided into different sections: demographic data, factors influencing the choice and perceptions about ophthalmology as a career option, and the impact of rotatory internship posting on the choice of subject. The various factors were then scored and indexed appropriately.

Results

There were 515 participants. The median age was 23 years. The major influencing factor for choosing ophthalmology was "adequate time" (52.04%), and the discouraging factor was "steep learning curve" (58.64%). Age had an odds ratio of 0.781, showing that the lower the age, the higher the chances of being positively inclined toward ophthalmology as a career choice. Similarly, major deciding factors, perceptions, and experiences in ophthalmology had odds ratios of 1.841, 1.725, and 2.057, respectively, showing a positive inclination.

Conclusion

The study states that a steep learning curve, personal attitudes, and misconceptions may dissuade the students from taking this subject, but adequate clinical exposure and experience, as well as role models during the internship, can create a positive impact on career choice.

A Third-Year Medical School Ophthalmology Curriculum for a Longitudinal Integrated Clerkship Model

Background Longitudinal Integrated Clerkships (LICs) are innovative educational models that allow medical student continuity with patients, preceptors, colleagues, and health care systems. Given their benefits, the number of LICs continues to increase. We share a pilot model for an ophthalmology LIC curriculum at the University of Colorado School of Medicine targeted for students to see patients through transitions of care.

Methods A needs assessment was performed including literature search, interviews with expert faculty, and a precurricular student questionnaire. Based on our findings, we developed a pilot two-part curriculum consisting of an introductory lecture and a half-day clinical experience designed to integrate patient eye care into the LIC model. At the end of the year, students completed a questionnaire assessing attitude, confidence, and knowledge. Precourse data were collected from students in the academic year (AY) 2018/2019 to aid with the needs assessment. Postcourse data were collected after completion of the curriculum from students in AY 2019/2020. Data from questionnaire were intended to improve our curricular experience.

Results Our curriculum was piloted between the 2019 and 2020 AY. The completion rate of our curriculum was 100%. The questionnaire response rate was 90% in pre- and postcurricular groups (n=15/17 and n=9/10, respectively). Hundred percent of students from both groups responded that it is “very important”/“important” for all physicians to be able to identify when ophthalmology referral is indicated. After the intervention, there were significant differences in the rate of students responding that they were “confident” diagnosing acute angle-closure glaucoma (36 vs. 78%, p=0.04), treating a chemical burn (20 vs 67%, p=0.02), and diagnosing viral conjunctivitis (27 vs. 67%); 90% of students reported increased confidence in longitudinal care of patients in the eye clinic.

Conclusions Medical students believe in the importance of ophthalmic education regardless of their specialty of choice. We present a pilot model to introduce ophthalmology within an LIC model. Future studies with a larger sample are needed to determine the impact of this model in terms of knowledge acquisition and relationship between curriculum and ophthalmology interest among students. Our curriculum can be adapted to other underrepresented specialties in the medical school curriculum and is easily exportable to other LICs.

Undergraduate Ophthalmology Teaching in Saudi Arabia: Assessment, Analysis, and Comparisons

BACKGROUND

The International Council of Ophthalmology (ICO) considers ophthalmology a core curriculum subject for medical students. To date, there is no unified guideline assessing the efficacy of ophthalmology curricula in Saudi medical schools. Hence, we aimed to investigate the adequacy of undergraduate ophthalmology education in Saudi Arabia compared with the ICO guidelines.

METHODS

In this cross-sectional study, an online questionnaire was distributed randomly to medical graduates in different Saudi medical schools. We reached 31 medical schools (public and private) in different regions of Saudi Arabia.

RESULTS

From medical schools across Saudi Arabia, 317 participants were enrolled in the study. Our study outcomes followed the ICO guidelines in multiple areas, including having ophthalmology training during medical school (93.4%), ophthalmology course duration of 2 weeks (56.2%), necessary knowledge for patients' referral (55.8%), competency in most basic ophthalmic skills, and participants receiving different teaching methods (theoretical lectures and clinical settings). In addition, 58.7% of the participants considered ophthalmology education a significant factor in choosing a future residency program.

CONCLUSION

In our study, most Saudi medical schools followed the ICO guidelines, as numerous graduates are competent in many basic ophthalmic skills. A structured national guideline must be established to ensure that future general practitioners can deal with ophthalmic patients and to establish a Saudi gold-standard eyesight health program.

Medical Schools' Ophthalmology Course: An Appraisal by Ophthalmology Residents

Objective

To investigate the perception and satisfaction of ophthalmology residents with the currently provided ophthalmology curricula to medical students.

Methods

A cross-sectional survey involving first to fourth year ophthalmology residents (N = 106) from all regions of Saudi Arabia was conducted between December 2018 and February 2019. An online questionnaire explored opinions about the ophthalmology course regarding three dimensions. Firstly, adequacy in covering essential parts of the specialty; secondly, improvements required; and thirdly, effectiveness. A score (0–21) was calculated, indicating the overall suitability of the ophthalmology course. In addition, factors of good overall suitability (score ≥10) were analyzed.

Results

Regarding adequacy, respondents opined that the ophthalmology course did not reasonably cover the basic part (35.8%), clinical part (61.3%), common disease (26.4%), and emergencies (39.6%). Concerning improvements required, more than 80% of the participants expressed that the course required to be improved for all its features, including duration (80.2%), objectives (85.8%), content (82.1%), organization (83.0%), and supervision (81.1%). As to effectiveness, half of them deemed the course unhelpful in familiarizing general practitioners with common ophthalmic diseases and emergencies. Overall, the ophthalmology course was generally deemed suitable (score ≥10) for only 27.4% of the participants, with no differences across gender, level, or region.

Conclusion

Ophthalmology residents perceived multiple deficits in the current Saudi ophthalmology teaching course. Significant improvements in ophthalmologic curricula are required, besides coping with unprecedented technological advancement in the ophthalmological field.

Multi-purpose Disinfecting Solutions only Partially Inhibit the Development of Ocular Microbes Biofilms in Contact Lens Storage Cases

PURPOSE

Certain ocular resident or pathogenic microbes may remain viable in the presence of multi-purpose disinfectant solutions (MPDSs), subsequently developing biofilms inside contact lens storage cases (CLSCs) which pose a risk of infection to wearers. This study evaluated the formation of ocular microbiota biofilms exposed to three top selling MPDS.

METHODS

Crystal violet assay was carried out for the verification of biofilm formation. The in vitro assays evaluated Pseudomonas aeruginosa UFPEDA 416 and Staphylococcus aureus UFPEDA 02 exposure of 48 h to MPDS, as well as the use of 40 KHz ultrasound at the beginning and with 24 h immersion in the MPDS. Subsequently, in vivo assays evaluated the formation of microbial biofilms on the CLSC walls containing silicone-hydrogel contact lenses immersed in MPDS from 15 healthy volunteer patients, who had been wearing the lenses for 7 days.

RESULTS

Biofilms were inhibited by 26%-98% in the in vitro assays, with a statistically significant difference only for P. aeruginosa UFPEDA 416 exposed to diluted MPDS. Most inhibitions occurred moderately and weakly. In addition, adherent cells were detected in more than 90% of the tests. Biofilm was not inhibited in more than one third of the results, nor was it disturbed, especially with the ultrasound treatments. The average of obtained optical densities at 590 nm was between 0.6 and 0.8 in the in vivo assays. The results were similar between the CLSC right and left wells. There was a correlation between microbial biofilm formation and the type of MPDS tested, with statistical difference between the three treatments.

CONCLUSION

MPDS promoted a partial inhibition of microbial biofilm formation but only one MPDS proved to be more effective in vitro and in vivo. This study, however, could not distinguish the effect of possible errors in the good hygiene practices of the users.

Factors Influencing Choice of Medical Specialty among Ophthalmology and Non-Ophthalmology Residency Applicants

Objective The study aimed to investigate factors influencing choice of specialty among ophthalmology and non-ophthalmology residency applicants.

Patients and Methods Anonymous, web-based surveys were distributed through REDCap to the 2019 to 2020 residency applicants to the Penn State Department of Ophthalmology and, as a control group, Penn State medical students applying to non-ophthalmology residencies for the 2019 to 2020 cycle. The primary outcome was factors that influenced specialty choice among ophthalmology versus non-ophthalmology applicants. Secondary outcomes include hours of exposure to applicants' selected specialty in the medical school preclinical curriculum, and proportion of ophthalmology versus non-ophthalmology applicants who decided on, or developed a strong interest in, their specialty prior to clinical rotations.

Results Surveys were completed by 203/441 (46.0%) ophthalmology and 85/139 (61.1%) non-ophthalmology applicants. Fewer than 20 hours of exposure to an applicant's selected specialty were provided in the medical school preclinical curriculum for 86.7% of ophthalmology and 42.4% of non-ophthalmology applicants (p < 0.001). Ophthalmology applicants decided on, or developed a strong interest in, their selected specialty before clinical rotations at a similar rate to non-ophthalmology applicants (60.6 vs. 58.8%, respectively). Factors influencing specialty choice cited most commonly by ophthalmology applicants include professional satisfaction (94.1%), performing surgeries/procedures (92.6%), personal fit with specialty (91.1%), work-life balance (91.1%), and ability to see patients in a clinic setting (90.6%), compared to personal fit with specialty (95.3%)%, clinical rotation in selected specialty (95.3%), professional satisfaction (91.8%), intellectual stimulation (89.4%), and subinternship or away rotation (89.4%) among non-ophthalmology applicants.

Conclusion Professional satisfaction and personal fit with specialty were among the most commonly cited factors influencing specialty choice for both groups. Other factors cited most frequently by ophthalmology applicants include performing surgeries/procedures, work-life balance, and ability to see patients in a clinic setting. Despite limited ophthalmology exposure in medical school preclinical curricula, ophthalmology applicants decided on, or developed a strong interest in, their selected specialty before clinical rotations at a rate similar to non-ophthalmology applicants.