Ergonomics and Injury Prevention Education in Canadian Ophthalmology Residency Programs: A Survey of Program Directors

Background: Work-related musculoskeletal disorders (WMSDs) are common among ophthalmologists. WMSDs are particularly associated with microscope use, awkward surgical postures, and nonergonomic equipment design. Symptoms can begin early in residency and may negatively affect trainees’ long-term musculoskeletal health, surgical performance, and career longevity. Methods: A cross-sectional survey of all 15 Canadian ophthalmology residency program directors (PDs) was conducted, with follow-up emails sent at 2- and 3-week intervals. The questionnaire was designed to elicit information on program characteristics, existing ergonomics education, instructional methods, barriers to implementation, and perspectives on future curriculum development. Results: Twelve of 15 program directors (80%) responded to the 9 closed-ended questions. Three programs (25%) reported having implemented an ergonomics and injury prevention curriculum covering topics such as operating room and clinic ergonomics (3/3) and work-related musculoskeletal disorders (2/3). No programs included training on injury reporting or requesting accommodations. Common barriers to curriculum implementation included lack of departmental expertise in ergonomics (5/9), lack of training in curriculum development (5/9) and competing priorities in the academic curriculum (4/9). All respondents considered ergonomics education important, with varying preferences for curriculum frequency. Most PDs (9/12) supported the development of a standardized curriculum by national organizations, such as the Royal College of Physicians and Surgeons of Canada (RCPSC) and the Canadian Ophthalmological Society (COS). Conclusions: Formal education in ergonomics and injury prevention is lacking in most ophthalmology residency programs in Canada and elsewhere. Professional organizations and regulatory bodies that oversee residency education have an important role to play in collaborating with training programs to codevelop standardized ergonomics and injury prevention curricula. Stakeholder engagement in ergonomics and injury prevention education has the potential to produce significant ergonomic improvements, reduce WMSDs, promote career longevity, reduce physician burnout, and improve patient care outcomes.