Ophthalmology Training and Competency Levels in Care of Patients with Ophthalmic Complaints in United States Internal Medicine, Emergency Medicine and Family Medicine Residents

Purpose: To evaluate ophthalmic educational training and confidence levels in care of patients with ophthalmic complaints in internal, emergency, and family medicine residencies in the United States.

Methods: A 41-item cross-sectional survey was sent to 529 internal medicine, 237 emergency medicine and 629 family medicine Accreditation Council for Graduate Medical Education (ACGME)-accredited residency program directors. The survey included the number of ophthalmic education hours residents received during their respective training programs. Respondents were asked to rate their confidence levels 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% emergency medicine and 74.5% family medicine residents received less than 10 hours of ophthalmic education during their residencies. A majority of respondents (59.1% internal medicine, 76.0% emergency medicine, and 65.7% family medicine) reported that patients with ocular complaints constitute 1-5% of visits. Mean confidence levels in performing an eye exam and treating patients with ophthalmic conditions was highest in emergency medicine residency programs 2.9 (SD 0.7), followed by family medicine 2.3 (SD 0.6) and internal medicine 2.2 (SD 0.6). Reported higher number of ophthalmic education hour's received in residency was associated with greater confidence levels in emergency (P<0.001), family (P<0.001), and internal (P=0.005) medicine programs.

Conclusion: Internal, emergency ,and family medicine residents receive limited ophthalmic education and is reflected in the overall low confidence levels in performing an ophthalmic exam and treating patients with ocular complaints. An increase in ophthalmic educational hours during their respective residencies is recommended to improve upon this knowledge gap.