JMIR Publications

ABSTRACT

Background:

Ophthalmology residents take the Ophthalmic Knowledge Assessment Program (OKAP) exam annually, which provides percentile rank for multiple categories and the total score. Additionally, ophthalmology residency training programs have multiple subspecialty rotations with defined minimum procedure requirements. However, residents’ surgical volumes vary, with some residents exceeding their peers in specific subspecialty rotations.

Objective:

This study aims to identify if there is a difference in OKAP examination scores and surgical volume exposure during ophthalmology residency training between non-fellowship and fellowship applicants and among various sub-specialties.

Methods:

Retrospective review of OKAP scores and surgical procedure numbers of graduating residents in an accredited academic ophthalmology residency program in the Midwest. Data was collected for the period from 2012 to 2022.

Results:

Thirty-one residents were identified. Most residents decided to pursue fellowship training upon graduation (64.5%, 20 residents), and the rest chose to practice comprehensive ophthalmology (35.5%, 11 residents). Eighteen residents had OKAP score reports available. The fellowship group outperformed the non-fellowship group on multiple sub-sections and the total exam (p = 0.0425). Those pursuing fellowship training in glaucoma performed higher on the Glaucoma section (p = 0.0039) and the total exam (p = 0.0045). Residents pursuing Cornea performed higher on nearly all sub-sections, including External Disease and Cornea (p = 0.0238) and the total exam (p = 0.0065). The majority of the surgical volume exposure was identical between fellowship and non-fellowship groups. Those who pursued glaucoma were also found to have a greater total number of glaucoma filtering/shunting procedures (p = 0.0329). Residents going into pediatrics were the surgeon for more strabismus cases (p = 0.0117), assisted in fewer strabismus cases (p < 0.0001) and had no difference in the total number of strabismus surgeries.

Conclusions:

Overall, those pursuing fellowship training had higher OKAP scores on multiple sections and on the total exam. There was no significant difference in the overall surgical volume averages between fellowship and non-fellowship groups, but few differences existed in subspecialty procedures amongst fellowship applicants. Larger multicenter studies are needed to clarify OKAP scores relation to fellowship and subspecialty application decision nationwide.