Competency in Basic Ophthalmology Among Medical Interns: A Prospective Pre-Post Educational Assessment of Self-Reported Skills and Their Determinants

Background: Despite mandated clinical exposure, the effectiveness of short ophthalmology rotations in improving domain-specific competencies remains insufficiently understood. This study assessed competencies among medical interns across key ophthalmic domains during a compulsory 15-day rotation and identified factors associated with skills improvement. Methods: A prospective pre-post educational assessment study was conducted among 150 medical interns completing a compulsory 15-day ophthalmology rotation at a tertiary teaching hospital. Competency across four domains, history taking and ocular examination, anterior-segment diagnosis, fundus disease recognition, and ocular-emergency identification, was assessed pre- and post-rotation using a validated 28-item questionnaire. Demographic and contextual variables were collected at baseline and post-rotation. Domain-level proportional scores were compared using paired analyses, and multivariable linear regression was used to examine associations between competency improvement and contextual factors including supervision quality, prior interest, equipment access, and overall satisfaction. Results: Significant improvements were observed across all domains ( p < 0.001). The largest gains occurred in history-taking and examination (+35.9 percentage points) and anterior-segment diagnosis (+36.2 percentage points). Fundus disease recognition (+22.9 percentage points) and ocular-emergency identification (+26.2 percentage points) showed smaller yet meaningful absolute increases. Good or excellent supervision ( p = 0.015 and p = 0.005), strong prior interest ( p = 0.007), and high satisfaction ( p = 0.009) were independently associated with greater overall improvement, while sex and equipment access were not significant predictors. Conclusion: A brief, structured ophthalmology rotation substantially improves self-reported foundational and anterior-segment competencies, though gains in fundus and emergency skills remain modest. Enhancing supervision quality and providing more structured exposure to posterior-segment findings and emergency scenarios may help address persistent competency gaps.