Career Decisions and Satisfaction Among Underrepresented in Medicine Ophthalmologists

Objective: To describe the career choices and satisfaction of newly practicing ophthalmologists who are underrepresented in medicine (URiM). Design: Secondary analysis of a cross-sectional study. Methods: An electronic survey was distributed in 2013 to 2145 ophthalmologists who completed training within the prior 5 years. The survey included questions about demographic information, medical education, current practice, factors affecting career choices, and career satisfaction. Statistical comparisons were made between the URiM group (self-identified as Black/African American, Hispanic/Latino, American Indian/Alaskan Native, or Native Hawaiian/Pacific Islander) and non-URiM group. Results: Surveys were completed by 671 (31.3%) eligible ophthalmologists, including 46 in the URiM group and 625 in the non-URiM group. Fellowship training was completed by 30 (65%) respondents in the URiM group. The decision to pursue subspecialty training was made earlier during residency in the URiM group (PGY 1 or 2 in 81% vs 49%, P = 0.002). A higher percentage of the URiM group practiced in an urban location (68% vs 45%, P = 0.01) and in the South (51% vs 33%, P = 0.02). Types of patient problems more strongly influenced the career decisions of the URiM group (mean Likert score 4.3 vs 3.9, P = 0.007). A positive level of happiness with work was reported by 31 (84%) URiM respondents. Conclusions: A large proportion of URiM ophthalmologists subspecialized, and the decision to pursue fellowship training was made earlier during residency compared with their non-URiM counterparts. URiM ophthalmologists were more likely than non-URiM ophthalmologists to practice in areas of greater racial and ethnic diversity. The career choices of URiM ophthalmologists were more strongly influenced by types of patient problems, which may include social determinants of health. URiM ophthalmologists had a high degree of career satisfaction.