An electronic survey was delivered to resident applicants qualified for review to the University of Texas Medical Branch at Galveston (UTMB), Department of Ophthalmology and Visual Sciences, for the entrance year 2003. The survey was based upon a validated and administered survey of Critical Career Factors among practicing ophthalmologists developed by the American Medical Association (AMA). Modifications in the survey were made to measure anticipated perceptions without changing the original survey’s intent. The instrument consisted of twenty items using a Likert-type rating scale on a 10-point continuum (e.g., “1” having lesser value to “10” having greater value) as well as five open-ended questions added to the original instrument. The modified survey was piloted among similar resident respondents for clarity, appropriateness, and comprehension. IRB approval was obtained in accordance with established ethical standards for expedited institutional research. This study was a cross-sectional survey of residency candidates using an e-mailed questionnaire with survey responses stored within the departmental web page.
The Critical Factors assessed by the survey included:
- Autonomy – amount of autonomy;
- Time – the amount of time applicant expected to spend directly seeing and caring for patient:
- Continuity – the degree of continuity of care anticipated with patients;
- Routine/Diversity – extent to which similar or different tasks are preferred;
- Family/Leisure – amount of time spent with family or in leisure activities;
- Expertise – anticipated level of expertise (i.e., general or sharply defined);
- Income – income level compared to other specialties;
- Innovation – amount of innovation required;
- Intellectual – specific versus theoretical problem solving approach preferred;
- Physician Interaction – amount of time interacting with other physicians;
- Manual/Mechanical – extent to which manual/mechanical activities are preferred;
- Pressure – amount of pressure anticipated dealing with crises, scheduling conflicts, and patient decisions;
- Responsibility – degree of responsibility expected to assume;
- Schedule – regularity of work hours;
- Security – anticipated job security and confidence in income;
- End Results – extent to which work provides opportunity to see end results;
- Status – rating of status compared to other specialties;
- Computer/Technology – extent to which computer based technologies will impact work; and
- Family Influence – extent to which family and personal values determine career decisions.
Critical Factors were divided into four broad categories: Career-oriented issues; Personal-family issues; Financial issues; and Gender-related issues. Career-oriented issues included time, continuity, expertise, physician interaction, manual/mechanical, pressure, schedule, end results, status, and computer/technology. Personal-family issues consisted of autonomy, routine/diversity, family/leisure, innovation, intellectual, responsibility, and family influence while Financial issues included income and job security.
An initial e-mail survey was sent April 2002 with a second e-mail submission to non-responders by June 2002. Responses by the residency candidates (n= 42) were then compared to the responses of practicing ophthalmologists (n = 56) who completed the original instrument administered by the AMA. Regrettably, no other data was available regarding AMA practicing physician scores (e.g., demographics; practice patterns; etc.). A one-sample t-test was used to compare means for critical factor scores between the two groups (e.g., candidates and practicing physicians). A two-sample t-test was used to measure gender differences on each critical factor among residency candidates. Means and Standard Deviations were calculated using Excel with data analyzed from the resident applicants at the 0.05 level (< p). A Bonferonni Adjusted Probability was used to determine the critical value of the t-test.