One hundred and twenty-two qualified applications were received for the entering class of 2003. Electronic responses to the survey were received by 40 applicants with two returned by the postal system for a total of 42 (34.4 %). There were 18 (43 %) female and 24 (57%) male participants with a mean age of 27.54 years. Figure 1 illustrates the reported ethnic background of the respondents.
Resident candidates (n= 42) revealed career interests among several categories. Nearly one third (35.7 %) sought careers in academic medicine while most (55 %) held private practice interests with the remaining (7 %) expressing research career interests. There were 2.3% who were undecided in their career interests.
Perceptions in the following critical factors were found to be significant (p < 0.05) by a one-sample t-test: Patient Interaction Time, Continuity, Routine/Diversity, Expertise, Physician Interaction, Manual/Mechanical Activities, Pressure, Responsibility, Security, Status, Computer/Technology, and Family Influence (See Table 1).
Career Issues represented the most striking difference between ophthalmology resident applicants and practicing ophthalmologists among career perception categories. In particular, most resident candidates perceived that they would spend lesser amounts of time with their patients on a less regular (mean = 7.97), continuous, basis. They likewise perceived a lower level of expertise (mean = 7.10) in a teamwork setting with other physicians (mean = 6.39). Moreover, they rated a career in ophthalmology as having greater status (mean = 7.87) than other subspecialties. Yet, they underestimated the pressures of dealing with crises and patient decisions (mean = 3.52). Finally, among Career Issues, they perceived that significant amounts of their time would be spent performing highly skilled manual/mechanical activities along with computer technology applications (mean = 7.95).
Residency candidates perceived several Personal-Family Issues as being significant. They expected greater diversity in job skills (mean = 6.97), lesser degrees of sole responsibility in their profession (mean = 8.44), and greater family influences on career decisions than that of practicing physicians (mean = 7.39).
Only one Financial Issue was found to be significant for residency candidates. Although reported on a reversed scale (e.g., Likert-scale rating where greater security was rated a “1” as demonstrated by the significantly lower mean value of 3.14) they expected greater levels of professional security (mean = 3.15), although lower income expectations than experienced by practicing physicians (mean = 6.29).
Critical Factors were then analyzed concerning different career perceptions based upon applicant gender (See Table 2). Female residency candidates indicated two factors that were significantly different from their male counterparts: time spent directly caring for patients (p = 0.054) and using computer-related technology (p = 0.001).
Qualitative findings from open-ended survey questions were provided by most (n = 38) of the respondents. Their classifications are described in the Discussion section.
Two open-ended questions provide added insight into individual residency candidate career perceptions. In particular, they were asked to describe the most and least appealing aspects of their chosen profession. Several themes emerged. These were classified from the candidate’s perspective, or viewpoint. The most cited comments were categorized into themes. The predominant theme regarding the question on the ‘most appealing’ nature of the ophthalmology profession was revealed by six subjects who indicated the professions’ “highly specialized medical and surgical” career attribute. Other appealing career aspects were expressed by two subjects who reported the specialties’ “specific expertise, clinical and technical skills, and continuity of patient care”. The ‘least appealing aspects’ of the profession were revealed by three subjects regarding “insurance and medical care cost reimbursement” concerns. Other ‘least appealing’ aspects were cited by two subjects who cited concerns for “procedural/legal risk” and competition from optometrists. Thus, many of the concerns and comments expressed by the candidates are supported by these research results for aspects of the ophthalmology profession (e.g., financial, legal, and competition).