Gender Distribution and Trends of Ophthalmology Subspecialties, 1992-2020

To describe the gender trends in ophthalmology primary practice areas using the American Board of Ophthalmology (ABO) diplomates.

A trend study plus a cross-sectional study of the ABO's database.

The de-identified records of all (N = 12,844) ABO-certified ophthalmologists between 1992 and 2020 were obtained. The year of certification, gender, and self-reported primary practice for each ophthalmologist was recorded. Subspecialty was defined as the self-reported primary practice emphasis. Practice trends of the entire population and the subpopulation of subspecialists were explored based on gender and were then visualized using tables and graphs and analyzed using the χ² or Fisher exact test.

A total of 12,844 board-certified ophthalmologists were included. Nearly half (47%) reported a subspecialty as their primary practice area (n = 6042), of whom the majority were male (65%, n = 3940). In the first decade, men outnumbered women reporting subspecialty practices by more than 2:1. Over time, the number of women subspecialists increased whereas the number of men remained stable, such that by 2020 women comprised almost half of new ABO diplomates reporting subspecialty practice. When all subspecialists were compared within gender, there was not a significant difference (P = .15) between the percentage of male (46%) and female (48%) ophthalmologist reporting a subspecialty practice. However, a significantly greater proportion of women than men reported primary practice in pediatrics (20.1% vs 7.9%, P < .001) and glaucoma (21.8% vs 16.0%, P < .0001). Alternatively, a significantly greater proportion of men reported primary practice in vitreoretinal surgery (47.2% vs 22.0%, P < .0001). There was no significant difference between the proportion of men and women reporting cornea (P = .15) or oculoplastics (P = .31).

The number of women in ophthalmology subspecialty practice has increased steadily over the past 30 years. Men and women subspecialize at the same rate, but significant differences exist between the types of ophthalmology practiced by each gender.