Ophthalmology training and competency levels in caring for patients with ophthalmic complaints among United States internal medicine, emergency medicine, and family medicine residents

Abstract

Purpose: To evaluate ophthalmic educational training and confidence in caring for patients with ophthalmic complaints among internal, emergency, and family medicine residents in the United States. Methods: A 41-item cross-sectional survey was sent to the directors of 529 internal medicine, 237 emergency medicine, and 629 family medicine residency programs, who distributed it to residents in those programs. The survey included the number of ophthalmic education hours residents received. Respondents were asked to rate their confidence in performing an ophthalmic exam and treating patients with ocular conditions using a 5-point Likert scale ranging from “not confident” to “very confident.” Results: In total, 92.5% of internal medicine, 66.8% of emergency medicine, and 74.5% of family medicine residents received less than 10 hours of ophthalmic education during residency. Most respondents (internal medicine, 59.1%; emergency medicine, 76.0%; family medicine, 65.7%) reported that patients with ocular complaints constituted 1%-5% of visits. Mean±standard deviation confidence levels in performing an eye exam and treating patients with ophthalmic conditions were highest in emergency medicine residency programs (2.9±0.7), followed by family medicine (2.3±0.6) and internal medicine (2.2±0.6). A higher reported number of ophthalmic education hours in residency was associated with greater confidence among emergency (P<0.001), family (P<0.001), and internal (P=0.005) medicine residents. Conclusion: Internal, emergency, and family medicine residents receive limited ophthalmic education, as reflected by their overall low confidence levels in performing an ophthalmic exam and treating patients with ocular complaints. An increase in ophthalmic educational hours during their residencies is recommended to improve upon this knowledge gap.