Factors Impacting Ophthalmology Interest and Perception Among U.S. Medical Students

In order to better understand medical students' decision-making to pursue ophthalmology, and inform efforts to recruit more diverse and inspired ophthalmologists, we aim to characterize values and experiences of medical students pursuing ophthalmology.

Retrospective cross-sectional study.

U.S. medical students who responded to American Association of Medical Colleges (AAMC) Matriculating Student and Graduation Questionnaires (MSQ & GQ) between 2013 and 2022.

We examined survey responses pertaining to personal values, medical school experiences, and use of resources. Univariate analyses were performed to compare the odds of pursuing ophthalmology versus other specialties.

Association of values and experiences with odds of pursuing ophthalmology versus another specialty.

Among 134,723 matriculating students who completed the MSQ, those interested in ophthalmology (2425 students) were more likely to value high income (OR: 1.46, p < .001) and work-life balance (OR: 1.44, p < .001), and less likely to value social change (OR: 0.76, p < .001), leadership (OR: 0.94, p = .011), OR: creativity (OR: 0.94, p = .025). Of 98,628 graduates who completed the GQ, those pursuing ophthalmology (2150 students) valued salary (OR: 1.73, p < .001), family considerations (OR: 1.31, p < .001), and work-life balance (OR: 2.40, p < .001) more than those pursuing other specialties. Students pursuing ophthalmology rated their clerkships in neurology (OR: 1.22 [1.16-1.29], p < .001), internal medicine (OR: 1.19 [1.12-1.28], p < .001), surgery (OR: 1.18 [1.12-1.25], p < .001), psychiatry (OR: 1.16 [1.09-1.23], p < .001), and emergency medicine (OR: 1.08 [1.01-1.16], p = .02) more highly compared to other core clerkships. Students pursuing ophthalmology were more likely to perform research (OR: 4.75, p < .001) than those pursuing other fields. These students also more frequently relied on web-based resources (OR: 1.58, p < .001), group panels (OR: 1.39, p < .001), and extra electives (OR: 1.30, p < .001) for specialty information compared to other students, but not mentorship, school workshops, or AAMC-provided information.

Medical students pursuing ophthalmology valued lifestyle factors rather than leadership, creativity, or social change and were also more likely to perform research. They were more likely to rely on non-mentorship resources for specialty information. Efforts are needed to refine the perception of ophthalmology, increase focus on creativity and innovation, and improve the recruitment of diverse and inspired future ophthalmologists.