International experiences during United States ophthalmology residency training: Current structure of international experiences and perspectives of faculty mentors at United States training institutions

Autoři: Mona L. Camacci aff001;  Tara E. Cayton aff001;  Michael C. Chen aff001
Působiště autorů: Department of Ophthalmology, Penn State College of Medicine, Hershey, Pennsylvania, United States of America aff001
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225627



There is a high level of interest in international experiences during United States (U.S.) ophthalmology residency training among both program directors and trainees.


An electronic invitation to a 26-question survey was sent to all 114 U.S. ophthalmology residency program directors. The invitation requested that the survey be completed by the one faculty member who was most involved in overseeing the international experiences for the residents. The survey consisted of multiple choice and Likert-type scale questions. The Mann-Whitney U test was used for analysis of demographic data and Friedman’s test and Wilcoxon-Signed Rank test were used to analyze ranked responses.


Responses were obtained from 70 faculty mentors representing unique programs, yielding a response rate of 61.4%. The majority of programs that responded (88.6%, n = 62) either offered international ophthalmology experiences for residents or supported residents finding their own experiences to go abroad. International experience participation rate among residents correlated with the number of years the experiences had been offered by the programs (p = 0.001). More than half of the respondents (55.0%, n = 33) felt that the residents benefited more than the hosts during these international experiences. Approximately half of the respondents (51.6%, n = 32) believed that additional training beyond what is covered in the standard curriculum to practice ophthalmology in the U.S. is necessary for practicing ophthalmology in an international setting.


There is high interest and participation in international experiences within U.S. ophthalmology residency programs. This high participation warrants further investigation into the long-term impact of these international experiences and how U.S. residency programs can structure these experiences to maximize the benefits to both the residents and the international host communities.

Klíčová slova:

Cataract surgery – Global health – Medical education – Ophthalmic procedures – Ophthalmology – Otolaryngological procedures – Surveys – Trainees


1. Medical School Graduation Questionnaire Report: 2018. Assoc Am Med Coll Div Med Educ. 2018; Available:

2. Drain PK, Holmes KK, Skeff KM, Hall TL, Gardner P. Global health training and international clinical rotations during residency: current status, needs, and opportunities. Acad Med. 2009;84: 320–5. doi: 10.1097/ACM.0b013e3181970a37 19240438

3. Hayden SR, Valderrama CM, Xu M, Curran MA, Mazondo R, Soliman MA. Development of an International Elective in an Emergency Medicine Residency. J Emerg Med. 2016;50: 153–158. doi: 10.1016/j.jemermed.2015.06.015 26443645

4. Russ CM, Tran T, Silverman M, Palfrey J. A Study of Global Health Elective Outcomes: A Pediatric Residency Experience. Glob Pediatr Heal. 2017;4: 2333794X16683806. doi: 10.1177/2333794X16683806 28229096

5. Coombs PG, Feldman BH, Lauer AK, Paul Chan R V., Sun G. Global Health Training in Ophthalmology Residency Programs. J Surg Educ. 2015;72: e52–e59. doi: 10.1016/j.jsurg.2015.04.007 26073479

6. Bjorklund AB, Hendel-Paterson BR, Cook BA, Stauffer WM, Walker PF, Boulware DR. Impact of Global Health Residency Training on Medical Knowledge of Immigrant Health. Am J Trop Med Hyg. 2011;85: 405–408. doi: 10.4269/ajtmh.2011.10-0732 21896795

7. Thompson MJ, Huntington MK, Dan Hunt D, Pinsky LE, Brodie JJ. Educational Effects of International Health Electives on U.S. and Canadian Medical Students and Residents: A Literature Review. Acad Med. 2003;78: 342–347. Available: doi: 10.1097/00001888-200303000-00023 12634222

8. Castillo J, Goldenhar LM, Baker RC, Kahn RS, Dewitt TG. Reflective practice and competencies in global health training: lesson for serving diverse patient populations. J Grad Med Educ. 2010;2: 449–55. doi: 10.4300/JGME-D-10-00081.1 21976097

9. Sawatsky AP, Rosenman DJ, Merry SP, McDonald FS. Eight years of the Mayo International Health Program: what an international elective adds to resident education. Mayo Clin Proc. 2010;85: 734–41. doi: 10.4065/mcp.2010.0107 20675512

10. Hau DK, Dipace JI, Peck RN, Johnson WD. Global health training during residency: the weill cornell Tanzania experience. J Grad Med Educ. 2011;3: 421–4. doi: 10.4300/JGME-D-10-00204.1 22942978

11. Volsky PG, Sinacori JT. Global health initiatives of US otolaryngology residency programs: 2011 global health initiatives survey results. Laryngoscope. 2012;122: 2422–2427. doi: 10.1002/lary.23533 22965869

12. Anspacher M, Frintner MP, Denno D, Pak-Gorstein S, Olness K, Spector J, et al. Global Health Education for Pediatric Residents: A National Survey. Pediatrics. 2011;128: e959–e965. doi: 10.1542/peds.2011-0129 21911354

13. Haq C, Rothenberg D, Gjerde C, Bobula J, Wilson C, Bickley L, et al. New world views: preparing physicians in training for global health work. Fam Med. 2000;32: 566–72. Available: 11002868

14. Meara JG, Leather AJM, Hagander L, Alkire BC, Alonso N, Ameh EA, et al. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet. 2015;386: 569–624. doi: 10.1016/S0140-6736(15)60160-X 25924834

15. Farmer PE, Kim JY. Surgery and global health: a view from beyond the OR. World J Surg. 2008;32: 533–6. doi: 10.1007/s00268-008-9525-9 18311574

16. Kerry VB, Walensky RP, Tsai AC, Bergmark RW, Bergmark BA, Rouse C, et al. US medical specialty global health training and the global burden of disease. J Glob Health. 2013;3: 020406. doi: 10.7189/jogh.03.020406 24363924

17. Pascolini D, Mariotti SP. Global estimates of visual impairment: 2010. Br J Ophthalmol. 2012;96: 614–618. doi: 10.1136/bjophthalmol-2011-300539 22133988

18. Bourne RRA, Stevens GA, White RA, Smith JL, Flaxman SR, Price H, et al. Causes of vision loss worldwide, 1990–2010: a systematic analysis. Lancet Glob Heal. 2013;1: e339–e349. doi: 10.1016/S2214-109X(13)70113-X

19. Tabin G, Chen M, Espandar L. Cataract surgery for the developing world. Curr Opin Ophthalmol. 2008;19: 55–59. doi: 10.1097/ICU.0b013e3282f154bd 18090899

20. Khairallah M, Kahloun R, Bourne R, Limburg H, Flaxman SR, Jonas JB, et al. Number of People Blind or Visually Impaired by Cataract Worldwide and in World Regions, 1990 to 2010. Investig Opthalmology Vis Sci. 2015;56: 6762. doi: 10.1167/iovs.15-17201 26567788

21. Camacci M, Quillen D, Montijo M, Chen M. Applicants’ Interest in International Ophthalmology during Residency Training: Influence in Selecting U.S. Residency Programs. J Acad Ophthalmol. 2018;10: e48–e54. doi: 10.1055/s-0038-1641610

22. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42: 377–81 doi: 10.1016/j.jbi.2008.08.010 18929686

23. Sobral FA, Bowder AN, Smith L, Ravipati A, Suh MK, Are C. Current status of international experiences in general surgery residency programs in the United States. Springerplus. 2016;5: 586. doi: 10.1186/s40064-016-2270-x 27247883

24. Nathan LM, Banks EH, Conroy EM, McGinn AP, Ghartey JP, Wagner SA, et al. Global health training in US obstetrics and gynaecology residency programmes: perspectives of students, residents and programme directors. Postgrad Med J. 2015;91: 685–91. doi: 10.1136/postgradmedj-2014-133144 26508720

25. Shultz PA, Kamal RN, Daniels AH, DiGiovanni CW, Akelman E. International Health Electives in Orthopaedic Surgery Residency Training. J Bone Jt Surgery-American Vol. 2015;97: e15-1–8. doi: 10.2106/JBJS.M.01189 25653331

26. Nayar HS, Salyapongse AN, Mount DL, Bentz ML. The Current State of Global Surgery Training in Plastic Surgery Residency. Plast Reconstr Surg. 2015;136: 830e–837e. doi: 10.1097/PRS.0000000000001817 26270901

27. Baltussen R, Smith A. Cost effectiveness of strategies to combat vision and hearing loss in sub-Saharan Africa and South East Asia: mathematical modelling study. BMJ. 2012;344: e615. doi: 10.1136/bmj.e615 22389341

28. Foster A. Cataract and “Vision 2020-the right to sight” initiative. Br J Ophthalmol. 2001;85: 635–7. doi: 10.1136/bjo.85.6.635 11371475

29. Russ CM, Ganapathi L, Marangu D, Silverman M, Kija E, Bakeera-Kitaka S, et al. Perspectives of host faculty and trainees on international visiting faculty to paediatric academic departments in East Africa. BMJ Glob Heal. 2016;1: e000097. doi: 10.1136/bmjgh-2016-000097 28588960

30. Kraeker C, Chandler C. “We learn from them, they learn from us”: Global health experiences and host perceptions of visiting health care professionals. Acad Med. 2013;88: 483–487. doi: 10.1097/ACM.0b013e3182857b8a 23425985

31. Elobu AE, Kintu A, Galukande M, Kaggwa S, Mijjumbi C, Tindimwebwa J, et al. Evaluating international global health collaborations: Perspectives from surgery and anesthesia trainees in Uganda. Surgery. 2014;155: 585–592. doi: 10.1016/j.surg.2013.11.007 24612624

32. Rees CA, Keating EM, Lukolyo H, Swamy P, Turner TL, Marton S, et al. Host clinical preceptors’ perceptions of professionalism among learners completing global health electives. Int J Med Educ. 2018;9: 206–212. doi: 10.5116/ijme.5b40.6e4b 30055101

33. Accreditation Council for Graduate Medical Education. ACGME Program Requirements for Graduate Medical Education in Ophthalmology. 2017; Available:

34. Scott IU, Smalley AD, Kunselman AR. Ophthalmology residency program leadership expectations of resident competency in retinal procedures and resident experience with retinal procedures. Retina. 2009;29: 251–256. doi: 10.1097/IAE.0b013e318188c828 18854786

35. Golnik KC, Lee AG, Wilson MC. A National Program Director Survey of the Shift to Competency-Based Education in Ophthalmology. Ophthalmology. 2008;115: 1426–1430.e2. doi: 10.1016/j.ophtha.2008.01.017 18342943

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