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 of interest because of a perceived lifestyle, career and family balance.
Although ophthalmology has historically tended to produce greater private practice opportunities1, the changing medical profession workforce (i.e., increased gender and ethnic diversity; older resident age; increased expectations for career satisfaction; as well as changing child-rearing roles for either parent) may contribute to increased interests in academic medicine or other medical practice options.
Another career factor of increased interest is the application of information and diagnostic technologies. Computer technology and mechanical devices were found to be more an interest to residency candidates than those in practice, perhaps explained by the fact that younger generations are more informed about technology.
Surprisingly, prospective female residents revealed the most interest in computer technology applications perhaps due to its time-saving efficiencies. This has additional implications for evidence-based practice and telemedicine. Patients who are better informed will use information access via the Internet and physician e-mail than ever before.5 In this way, computer based resources will benefit resident training and professional practice.
The influence of candidate family and personal values were found to be more highly rated than those in practice. Women residents appear to be concerned about balancing family and career issues for career satisfaction. Women physicians are found to have 20% fewer work hours than males.5 This may be an important consideration in resident recruitment and curriculum that allow for a balanced career-family lifestyle.
We recommend that resident faculty include career factors related to graduate medical education general competencies (e.g., Patient Care; Communications and Interpersonal Skills; Professionalism; etc.) during the recruitment interview process. Such recommendations may be of special concern to residency programs affiliated with academic health centers where shorter patient hospital stays and a lesser emphasis on teaching in out-patient clinics place added burdens on faculty to teach important career factors.10 Residency programs need to consider the critical factors that determine career satisfaction when recruiting prospective colleagues. In addition, core curriculum designs should incorporate practice management objectives related to Career and Financial Issues in clinical practice. The perceptions of Personal-Family Issues are important for both recruitment and instruction of residents as well as medical students. Career planning during medical school and residency training should be offered so that career, personal and financial issues are effectively explored. In this way, important core competencies for interpersonal communications, professionalism and medical practice are considered particular strengths associated with women candidates.
Therefore, guiding the process of career expectations assists medical students and residents towards effective career decision-making. A changing patient population by ethnicity and age demographics coupled with greater competition in the ambulatory care setting will further influence decisions for practice options. Creating experiences that include private practice role modeling may likewise create a more realistic perception of ophthalmology practice. Moreover, assessing career critical factors may fortify resident general competencies in such domains as interpersonal and communications skills; professionalism; and systems-based practice. Therefore, resident career critical factors may enhance their career satisfaction and longevity as future ophthalmologists to meet the vision care needs of a changing and diverse patient population.
Dr. Tom Prager (UT Houston) provided statistical and graphical support.