Understanding perceptions of ophthalmology residents on pursuing a uveitis fellowship

Purpose: To investigate factors influencing the decision of ophthalmology residents in the United States to pursue a uveitis fellowship. Methods: A 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. Results: Of 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). Conclusions: Improving 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.