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Original Investigation
September 23, 2021

Analysis of Sex Diversity Trends Among Ophthalmology Match Applicants, Residents, and Clinical Faculty

Author Affiliations
  • 1Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 2Department of Surgery, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
  • 3Department of Surgery, Krieger Eye Institute, Sinai Hospital of Baltimore, Baltimore, Maryland
  • 4Department of Surgery, McGovern Medical School at UT Health, Houston, Texas
  • 5Department of Medical Education, University of Illinois College of Medicine, Chicago
  • 6Johns Hopkins Surgery Center for Outcomes Research, Johns Hopkins University, Baltimore, Maryland
  • 7Department of Ophthalmology, Rush Medical College, Chicago, Illinois
  • 8Department of Ophthalmology, Weill Cornell Medicine, New York, New York
JAMA Ophthalmol. 2021;139(11):1184-1190. doi:10.1001/jamaophthalmol.2021.3729
Key Points

Question  How have the demographic characteristics of female ophthalmology residency applicants, residents, and medical school clinical faculty changed in recent years?

Findings  In this cross-sectional study, the percentage of women in the field of ophthalmology across all levels of training remained lower than that of the general population. Most notably, the percentage of female residents has been decreasing since 2011.

Meaning  This study provides evidence that the underrepresentation of women in the field of ophthalmology extends from trainees to faculty; more efforts are needed to remedy this disparity.


Importance  The proportion of women in the field of ophthalmology in the US trails the proportion of women in the general population. Sex diversity trends have been studied in other specialties, but there is a dearth of such literature in ophthalmology.

Objective  To investigate trends in the proportion of female ophthalmology match applicants, residents, and clinical faculty.

Design, Setting, and Participants  This cross-sectional study examined data from the San Francisco Match, the Association of University Professors of Ophthalmology, Accreditation Council for Graduate Medical Education, Association of American Medical Colleges, and American Academy of Ophthalmology (AAO) from January 1, 2011, to December 31, 2019. Data from ophthalmology match applicants, residents, clinical faculty at US medical schools, and AAO members were collected.

Main Outcomes and Measures  The proportion of female applicants, residents, and medical school clinical faculty in ophthalmology.

Results  Data were obtained from a total of 2807 ophthalmology applicants (35.3% female), 1 004 563 residents (43.8% female), 463 079 clinical faculty members (42.5% female), and 78 968 AAO members (26.1% female). Male ophthalmology residency applicants outnumbered female applicants by a ratio of 1.6:1 from 2016 to 2019. The percentage of female matched applicants in 2016 (41% [168/406]) and 2019 (42% [184/436]) differed by 1% (percent change, 0.99; 95% CI, −1.12 to 3.1; P = .36). There was a 2.3% increase (percent change, 0.34; 95% CI, 0.24-0.43; P < .001) in the percentage of female residents across all surgical specialties from 2011 (39.7% [8710/21 985]) to 2019 (42% [10 951/26 082]) but a 2.5% decrease (percent change, −0.45; 95% CI, −0.84 to −0.06; P = .02) in the percentage of female residents in ophthalmology from 2011 (41.5% [589/1419]) to 2019 (39% [575/1473]). The percentage of female ophthalmology clinical faculty differed by 2% (percent change, 1.02; 95% CI, −0.21 to 2.24; P = .10) from 2017 (38% [1179/3102]) to 2019 (40% [1225/3060]). From 2016 to 2019, male practicing ophthalmologists in the AAO outnumbered female practicing ophthalmologists by a ratio of 3:1.

Conclusions and Relevance  This study found that the percentage of women in the field of ophthalmology remains lower than percentages in other specialties, and the percentage of female ophthalmology residents has decreased in recent years. More efforts are needed to improve female representation in ophthalmology.

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