Subspeciality Interests Among the Ophthalmology Residents: A Mixed-Methods Study.

OBJECTIVE: To determine the popular subspeciality choices among ophthalmology residents, to explore the factors affecting that choice, and to identify the obstacles that they face while selecting a subspeciality fellowship. STUDY DESIGN: Mixed-methods study. Place and Duration of the Study: Department of Ophthalmology of Hayatabad Medical Complex and Lady Reading Hospital, Peshawar, from 1st September to 30th November, 2021. METHODOLOGY: The qualitative (1st) phase comprised of focussed group discussion (FGD) followed by an online in-depth interview (IDI). Quantitative (2nd) phase was conducted as online survey and consisted of currently enrolled FCPS-ophthalmology residents. Themes were generated and used to modify the pre-designed questionnaire. Questionnaire was piloted and necessary adjustments were made. In the 2nd phase, the online link of the questionnaire was shared with the eligible participants all over the country. For the association between categorical variables, the Pearson Chi-square test was used with significance at p-value <0.05.   Results: Nine participants were recruited in the first phase and three themes were generated. In the second phase, a total of 138 responses were received, among which mean age was 29.37 + 3.9 years, and 74 (53.6%) participants were males. The top three subspeciality choices were cataract and refractive surgery (n = 31, 22.5%), vitreoretinal surgery (n = 30, 21.7%) and orbit and oculoplasty (n = 13, 9.4%). Sixty-two (48.8%) participants stated interest in the career to be the main reason to choose a particular fellowship, and 54 (42.5%) participants identified challenging subspeciality as the main obstacle. An association between gender and the intended subspeciality showed significant results (p = 0.029). CONCLUSION: Ophthalmology residents of Pakistan have different approaches and motivations for selecting a fellowship programme. Professional needs and scientific reasons are their main motivations. KEY WORDS: Ophthalmology, Fellowship, Motivations, Career choices, Mentor, Pakistan.

Comparison of Changes in Speciality Choices and Future Career Plans between Public and Private Medical Students Over Five Years of Medical Studies.

This study aimed to compare medical students' satisfaction with their choice of the medical field in their fifth year to their first year of MBBS and to compare speciality choices and career plans between public and private medical students. It was an online survey conducted from December 2020 to April 2021. Two consecutive classes of final-year medical students from five medical schools (2 public and 3 private) were included. They were asked about their satisfaction with the medical profession, intentions to practice abroad, intended speciality, and career plans in the final year and the first year of medical school via a 24-item semi-structured pre-piloted questionnaire. Of 468 responses (34.41% response rate), 331 (70.7%) were females. There was a significant change (p = 0.002) in the intention of students to practice abroad, however, no significant change (p=0.11) in their satisfaction with the medical profession was observed. Key Words: Career choices, Medical students, Medical schools, Personal satisfaction, Pakistan.

Comparison of HIV-related Ocular Involvement in HAART-naive and HAART-treated Patients.

OBJECTIVE: To compare the HIV-related ocular manifestations between HAART-naïve (Highly active antiretroviral therapy) and HAART-treated patients. STUDY DESIGN: Observational (comparative) Study. Place and Duration of the Study: Department of Ophthalmology and Family Care Centre of Hayatabad Medical Complex, Peshawar, Pakistan, from October 2019 to July 2021. METHODOLOGY: HIV-infected patients, who were receiving HAART treatment as well as HAART-naïve, were recruited. A complete ocular examination was performed to check for HIV-related ocular manifestations. Anterior and posterior segment findings were recorded and compared between the two groups. RESULTS: Of the 80 participants (40 in each group), 62 (77.5%) were males and 18 (22.5) were females with no significant difference between the groups for either gender (p=1.0). A significant difference, between the two groups, was found in the mean duration (838.64 + 908.16 days) of HIV infection at the time of recruitment (p<0.001). HIV-related ocular manifestations were found in 6 (7.5%) with no statistically significant difference between the two groups (p=1.0). Similarly, the involvement of systemic co-infections was found in 6 (7.5%) with no statistically significant difference between the groups (p=0.675). CONCLUSION: There was no difference in both groups when analysed for HIV-related ocular manifestations or systemic co-infections. The authors' finding contradict with some of the previously published data. Therefore, it is recommended that further research should be carried out to reach definite conclusion. KEY WORDS: HIV, Eye manifestations, Acquired immunodeficiency syndrome, Highly active antiretroviral therapy, HIV-related opportunistic infections, Pakistan.

Optical Coherence Tomography Macular Findings after Successful Scleral Buckling in Eyes with Compromised Visual Status.

OBJECTIVE: To determine the optical coherence tomography (OCT) macular findings after successful scleral buckling in eyes with compromised visual status. STUDY DESIGN: Descriptive cross-sectional study. PLACE AND DURATION OF STUDY: Department of Clinical Ophthalmology, Khyber Institute of Ophthalmic Medical Sciences, Postgraduate Medical Institute, Hayatabad Medical Complex, Peshawar, Pakistan, from February 2015 to November 2016. METHODOLOGY: Patients with postoperative best corrected visual acuity (BCVA) less than 6/6, successful scleral buckling, and flat macula clinically, aged 18-70 years, were included. OCT scan (OCT-Spectralis, Heidelberg Engineering, GmbH 69121) of central 30 degrees around fovea was performed three months postoperatively. Foveal detachment, epimacular membrane (EMM) and cystoid macular edema (CME), were studied on OCT after successful buckling surgery in eyes with compromised visual status. RESULTS: A total of 164 eyes of 164 patients (92 males 72 females) were assessed with OCT. Foveal detachment (FD) was present in 54 cases (32.9%), cystoid macular edema (CME) in 30 (18.3%), and epimacular membrane (EMM) in 11 cases (6.7%); while no abnormality was detected in 69 (42.1%) cases on OCT. CONCLUSION: OCT is very helpful in identifying the cause of limited visual recovery after successful retinal detachment (RD) surgery.