Factors associated with resident pursuit of pediatric ophthalmology fellowship

The current shortage of pediatric ophthalmologists leaves many children without access to timely care. Almost half of pediatric ophthalmology fellowship positions go unfilled annually. The purpose of this study was to investigate residency factors associated with pursuit of a fellowship in pediatric ophthalmology. An online questionnaire designed to elicit information about residency program characteristics, exposure to pediatric ophthalmology, and resident pursuit of fellowships between 2018 and 2023 was sent to all United States ophthalmology residency program directors. Univariate logistic regression models were used to assess the factors associated with programs having at least one resident pursue a pediatric ophthalmology fellowship. The survey response rate was 54% (66/121 eligible programs). More than half (56%) reported residents' initial exposure to pediatric ophthalmology in the PGY-2 year. Mean (with standard deviation) total days of resident exposure to pediatric ophthalmology was 66.32 ± 27.90. Forty programs (61%) graduated at least 1 resident who pursued a pediatric ophthalmology fellowship during the study period. In univariate logistic regression, larger residency program size, higher number of pediatric ophthalmologists on core faculty, and presence of a pediatric ophthalmology fellowship were all significantly associated with residents pursuing a pediatric ophthalmology fellowship (all P < 0.05). Over half of programs responding to the survey had a resident pursue pediatric ophthalmology fellowship in the last 5 years. Relational factors, such as pediatric ophthalmology-specific mentorship, were the most important predictors of pediatric ophthalmology fellowship pursuit. Increasing access to faculty, connecting residents to fellows, and organizing mentorship programs could be effective strategies to foster greater interest in pediatric ophthalmology as a career.