Scott JR, Gunderson CA. A study of prospective ophthalmology
residents’ career perceptions.
Interestingly, residency candidates’ Personal-
Family Issues were found to be similar to those of
practicing ophthalmologists. Both groups consistently
viewed autonomy, innovation and intellectual
development in much the same manner. Specifically,
they expressed considerable motivation for
autonomy, innovation or intellectual problem-solving
expression in their medical practice. This observation
may suggest that both groups realize that they are not
independent from healthcare influences and that
ophthalmology practice may involve a fair degree of
routine, lack true innovation with intellectual
development in a non-research environment
remaining somewhat limited. Similarly, both groups
felt that family and leisure were important for their
quality of personal and professional life expectations.
Financial Issues - Among financial issues, only
security was indicated as a significant ophthalmology
professional attribute. Residency candidates
anticipated a significantly lesser amount of certainty
in the profession and its related income potential than
those in practice. Moreover, both groups agreed that
higher income, when compared to other specialties,
was not a determining factor in their career
expectations. This may be attributable to an
awareness of evolving practice management patterns
and healthcare financial reforms. Higher income
levels than other subspecialties may not materialize
given the tumult in healthcare financial reform
measures. Limitations in insurance reimbursement
and rising malpractice costs in a more competitive
healthcare marketplace continue to fuel practicing
physician concerns. Applicants have yet to
experience these challenges and may overestimate
the degree of security that this profession provides.
Therefore, residency-training programs ought to
consider interventional strategies that improve the
work environment for residents that promote career
satisfaction.8
Gender-related Issues - When residency
candidates were compared by gender, the data reveal
that time spent with patients and the applications of
computer technology were the only factors where
there were statistically significant differences.
Female candidates expected to spend greater amounts
of time in the patient-physician encounter. They
likewise anticipated greater use of computer
technologies in their eventual practice as compared to
their male counterparts.
The number and proportion of women
graduating medical schools in the United States has
risen from 5.0% in 1961 to 42.4% in 2000. This has
implications for life-style issues in both primary and
Med Educ Online [serial online] 2003;8:9. Available from
http://www.med-ed-online.org
specialty care specialties.9. changing enrollments
indicate differing values and skills that may affect
residency training and the world of practice.
Furthermore, women primary care physicians “are
more influenced than men by both personal and
family values” and “are more often in dual-career
families and/or are less motivated by financial
aspirations, or are more altruistic” in their career
decisions.10 Societal expectations that “women
handle the responsibility of child rearing to a greater
extent than men” are deeply engrained.6 These
dynamic factors may play a significant role in the
career decisions by participants in this study.
There were several limitations in the study. Only
prospective residency candidates who applied to the
department were surveyed through their e-mail
addresses. A cover letter indicated that although not
anonymous, the survey results and subjects would
remain confidential. Only AMA member physicians
provided data in the original survey. All data are self-
reported by the research subjects. In an attempt to
eliminate conflict of interest concerns for prospective
residency applicant acceptance, the survey was
administered to the qualified applicants after the
residency match results were released. This was done
so that applicants understood that survey completion
had no bearing on their eventual residency program
selection. The study was based upon assumptions that
career decisions include objective and subjective
criteria. In addition, it is assumed that poor career
choices yield job dissatisfaction and reduced quality
of patient care delivery.
Conclusions
This study provides evidence that residency
candidate career perceptions differ from those of
practicing ophthalmologists. Our results suggest that
prospective ophthalmologists are of the opinion that
once into their medical practice; they would have
opportunities to spend more time in a continuous
medical relationship with their patients. Similarly,
they foresaw their careers being diverse in terms of
work tasks. Sharing their expertise among fellow
physicians were particular ambitions held by
candidates. Although job pressure was not considered
excessive, they did feel that they’d encounter
considerable job responsibility associated with vision
care, although in a less secure environment.
The increasing numbers of women medical
graduates will likely mean additional women
residency applicants, thus altering the role of women
in the medical field. Ophthalmology careers may be