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Cross-sectional survey of 115 US ophthalmology residents identifies factors influencing decisions to pursue or forgo uveitis fellowshipsWhy do so few eye doctors choose to specialize in uveitis?

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Key Takeaway
Note that perceived complexity and limited surgical exposure significantly influence ophthalmology residents' decisions to pursue uveitis fellowships.

A cross-sectional survey of 115 ophthalmology residents in the United States evaluated factors influencing the decision to pursue or forgo a uveitis fellowship. The study population consisted of residents across various programs, with the primary outcome being the identification of specific influences on fellowship selection. Secondary outcomes included perceptions of field complexity, job market views, mentor influence, surgical opportunities, salary expectations, and program resources such as the number of uveitis-trained faculty.

Among the 115 residents surveyed, 14 (12.2%) chose to pursue a uveitis fellowship. For those not pursuing a fellowship, 26.7% indicated they decided before the PGY3 year, compared with 14.3% of those pursuing one (P = 0.041). Key factors influencing the decision to not pursue included perceived complexity of the field (21.6%), job market perceptions (19.6%), and mentor influence (15.7%). Reasons for not choosing included perceptions regarding surgical opportunities (17.6%), beliefs about the field's complexity (15.1%), and salary expectations (13.2%).

Residents not pursuing a fellowship reported having 1.90 uveitis-trained faculty at their program versus 1.14 for those pursuing one (P = 0.002). Additionally, 75% (87 residents) felt the uveitis rotation time was inferior compared to other subspecialties. Surgical exposure with uveitis-trained faculty was higher in those pursuing the fellowship (64.3%) versus those not pursuing (56.4%) (P = 0.018). A substantial proportion, 43.6%, indicated they would reconsider if the fellowship were combined with another subspecialty.

This cross-sectional survey identifies structural and perceptual barriers to uveitis fellowship recruitment. Limitations inherent to the observational design include the inability to establish causality between specific program features and fellowship pursuit decisions. Improving recruitment may require residency curriculum adjustments that emphasize earlier rotations and increased surgical exposure with uveitis faculty. Strengthening mentorship programs can address concerns regarding compensation along with surgical and research opportunities to foster an interest in current residents.

Imagine finishing your medical training and facing a choice: specialize in uveitis or move on. A recent survey asked 115 ophthalmology residents in the United States exactly this question. Only 14 out of 115 residents, or about 12%, decided to pursue a fellowship in this specific field. For the others, the reasons were clear and often discouraging. Many felt the uveitis rotation was shorter and less valuable than rotations in other eye specialties. Others worried they would miss out on important surgical experiences with experienced faculty members.

The biggest barriers were not just about the disease itself, but how the field is perceived. Over 21% of residents cited the perceived complexity of uveitis as a major factor in their decision not to specialize. Job market fears and salary expectations also played a role. Interestingly, nearly half of the residents said they might reconsider if the fellowship combined uveitis training with another subspecialty. This suggests that flexibility could open doors for more doctors.

The data shows a stark difference in training environments. Programs with more uveitis-trained faculty were more likely to attract residents who pursued the fellowship. Conversely, those who did not pursue it often came from programs with fewer than two such faculty members. Residents also noted that they decided on their career path much earlier than expected, often before their third year of residency. To change this, programs must adjust their curriculum to offer more hands-on surgery and stronger mentorship earlier in training.

What this means for you:
Fixing uveitis recruitment needs more faculty, better rotations, and earlier mentorship for residents.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
PurposeTo investigate factors influencing the decision of ophthalmology residents in the United States to pursue a uveitis fellowship.MethodsA cross-sectional survey, with prospective data collection, study. From December 2023 to July 2024, an anonymous survey was distributed via the Association of University Professors of Ophthalmology (AUPO) to all United States ophthalmology residents. The survey was distributed a second time, between May 2024 and July 2024, through the American Uveitis Society listserv to distribute to residents. The primary outcome was to determine factors influencing ophthalmology residents’ decisions to pursue or forgo a uveitis fellowship.ResultsOf 115 ophthalmology resident respondents, 14 (12.2%) chose to pursue a uveitis fellowship. Key factors influencing the decision to pursue a uveitis fellowship included the perceived complexity of the field (21.6%), job market perceptions (19.6%), and mentor influence (15.7%). Conversely, the main reasons for not choosing a uveitis fellowship were perceptions regarding surgical opportunities (17.6%), beliefs about the field’s complexity (15.1%), and salary expectations (13.2%). Residents not pursuing uveitis subspecialization were more likely to decide before their PGY3 year (26.7% vs. 14.3%, P = 0.041) and 43.6% indicated they would reconsider if the fellowship were combined with another subspecialty. Additionally, 75% (N = 87) felt their uveitis rotation time was inferior compared to other subspecialties. Residents pursuing uveitis subspecialization had more surgical exposure with uveitis-trained faculty than those who did not (64.3% vs. 56.4%, P = 0.018). Residents not pursuing a uveitis fellowship had a higher number of uveitis-trained faculty at their program compared to residents who pursued a fellowship in uveitis (1.90 vs. 1.14, P = 0.002).ConclusionsImproving recruitment into uveitis fellowship may require residency curriculum adjustments that emphasize earlier rotations and increased surgical exposure with uveitis faculty. While didactic and research opportunities are valuable, other factors may play a more determinative role in a resident’s decision to pursue a uveitis fellowship. Strengthening mentorship programs can address concerns compensation along with surgical and research opportunities to foster an interest in current residents.
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