Applicants' Interest in International Ophthalmology during Residency Training: Influence in Selecting U.S. Residency Programs

Background In recent years, the Accreditation Council for Graduate Medical Education (ACGME) Residency Committee for Ophthalmology formally recognized international health electives for credit. By engaging in international health experiences, ophthalmology residents achieve the anchors essential to the core competencies set forth by the ACGME. Objective To explore how the availability of international ophthalmology opportunities may influence applicants' selection of U.S. ophthalmology residency programs and to identify applicants' perceived goals and barriers of participation in international ophthalmology experiences. Methods For this cross-sectional study, an electronic invitation to a 22-item questionnaire was sent to all 413 applicants to the ophthalmology residency program at the Penn State Eye Center during the 2017 Match. Results Responses were received from 261 applicants, yielding a response rate of 63.2%. Nearly all respondents (95.4%) reported interest in participating in an international ophthalmology experience during residency training, with 52.1% of respondents reporting being “extremely interested.” More than half of respondents (53.6%) had previously participated in a healthcare-related experience in an international setting. The availability of international opportunities increased the interest of 67.4% of respondents when choosing which residency programs to apply to, and influenced 65.2% of respondents to rank a residency program higher, with the respondents with previous international experience more likely to be favorably influenced (p < 0.001, p = 0.04, respectively). The goal identified by the largest number of respondents as “most important” was to “offer service to the underserved” (59.0%). The most commonly identified anticipated barriers to participating in an international experience during residency training included concern about scheduling conflicts and call coverage (81.7%), followed by lack of funding (71.4%). Conclusion There is significant interest in international ophthalmology among ophthalmology residency applicants, and the availability of international opportunities during training may influence the applicants' selection of programs. Statistically significant differences were found among respondents with and without previous international healthcare-related experience. These findings warrant further investigation into how residency programs can best address this interest and integrate international ophthalmology experiences into the residency curriculum.