Why choose ophthalmology?

In a “Pulse” article earlier this year,1 Patrick Sullivan hypothesized that “Because the number of call hours can seriously hamper family and other activities, it is probably no coincidence that specialties with less onerous call schedules, such as dermatology and ophthalmology, tend to be oversubscribed in annual residency matches.” However, he presented no statistical information to justify this theory.

In the CMA's annual Physician Resource Questionnaire for 2002,2 only 40 ophthalmologists were surveyed. Of these, approximately 20% had more than 180 hours of call per month;2 this is only slightly less than the 25% of surgical specialists with this level of call reported by Sullivan.1

According to statistics from the Canadian Resident Matching Service, the ratio of the number of applicants whose first choice of specialty was ophthalmology to the number of spaces available was approximately 2:1 for 1998 to 2002.3 Cardiac surgery, diagnostic radiology, emergency medicine, plastic surgery and dermatology had similar ratios over the same period. Yet the on-call duties of the first 4 specialties in this list are also onerous, at least from what we have observed in our centres. The “oversubscription” Sullivan describes is therefore more likely a result of the number of residency positions in the smaller specialties being too low in relation to societal needs.

We suspect that the popularity of ophthalmology is determined by a variety of factors, such as interest in the specialty, advances in treatment, and perceived benefit to patients and society, rather than on-call duties.

Duncan Anderson President Ken Romanchuk Chair Specialty Committee in Ophthalmology Canadian Ophthalmological Society Ottawa, Ont.