Training Pathways to Academic Neuro-Ophthalmology: A Comparative Study of Ophthalmology and Neurology Residencies

Although neuro-ophthalmology specialists must complete a fellowship following either an ophthalmology or neurology residency, the impact of these distinct residency training pathways on professional characteristics, academic advancement, and research productivity remains underexplored. This analysis examines demographic, academic, leadership, and research trends among neuro-ophthalmology specialists based on their residency training type, aiming to determine whether training type(s) correlate with future career development in academic neuro-ophthalmology.

Data were collected from publicly accessible websites of US academic institutions and verified using the Fellowship and Residency Electronic Interactive Database. Variables included demographics (sex, additional advanced degrees, years since residency graduation), academic rank, leadership positions, and research productivity (publications, citations, and h-index). Statistical comparisons between training groups were conducted using chi-square tests for categorical variables and Kruskal-Wallis tests for continuous variables.

Among 312 neuro-ophthalmology specialists, 224 (71.8%) were trained in ophthalmology residencies and 88 (28.2%) in neurology residencies. Most were male (64.1%) with no significant differences in sex between the groups. Ophthalmology-trained specialists had more years since residency (median: 19 vs 11, P = 0.003) and were more likely to have completed additional fellowships (36.2% vs 3.4%, P < 0.001). Since 2010, neurology-trained neuro-ophthalmologists have comprised a growing proportion of new practicing neuro-ophthalmologists. Academic rank distribution was similar between the groups, but leadership roles were more often held by ophthalmology-trained specialists (43.8% vs 30.7%, P = 0.20). Research productivity metrics, including publication count, citations and h-index, were comparable between the groups.

This study underscores differences in training, career entry, and leadership roles between ophthalmology- and neurology-trained neuro-ophthalmologists, offering insights for workforce planning amid ongoing physician shortages.