Racial Disparities in Ophthalmology in Training and Practice: A Systematic Review

IF 4.2 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology Pub Date : 2026-04-01 Epub Date: 2026-01-14 DOI:10.1016/j.ajo.2026.01.008

Angel Gao , Tasha Miller , Arturo Ortin-Martinez , Radha P. Kohly

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引用次数: 0

Abstract

Topic

Ophthalmology remains one of the least diverse medical specialties, with persistent racial and ethnic disparities throughout training and practice. This review examines experiences of individuals from underrepresented racial minorities (URiM) in ophthalmology within high-income countries, focusing on barriers to representation, discrimination, and equity initiatives.

Clinical Relevance

Identifying and addressing barriers faced by URiM in ophthalmology is essential to advancing workforce diversity, equitable patient care, and institutional inclusivity. Understanding where inequities persist can inform systemic interventions.

Methods

A systematic review of the literature was conducted in MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, and Cochrane Library from inception to November 2024. Eligible studies included English-language publications from 2000 onwards focusing on racial or ethnic minority individuals in ophthalmology. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Newcastle-Ottawa Scale and Joanna Briggs Institute Checklist. Data were synthesized descriptively and thematically. The protocol was registered on PROSPERO (CRD42025640520).

Results

Forty-one eligible studies involving 500,823 responses were included. Most studies were cross-sectional, published after 2021 and conducted in the United States. Across all career stages, URiM individuals were underrepresented and faced structural barriers. In medical school, fewer URiM students pursued ophthalmology, citing lack of mentorship and role models. Minority representation among applicants has increased modestly, particularly among Hispanic students, though overall growth remains limited.

During residency and fellowship, racial disparities persisted in research access, fellowship application outcomes, and interview offers. URiM trainees reported negative experiences related to program culture and inclusivity. In practice, racialized ophthalmologists reported higher discrimination rates, reduced advancement into leadership, and underrepresentation on faculty and editorial boards.

While URiM match rates have improved, progress has been uneven. Asian representation has approached parity, while Black, Native American, and Pacific Islander individuals remain severely underrepresented. National ophthalmology mentorship programs have demonstrated high match success and participation. Residency programs that implemented structured interviews, holistic review and targeted equity strategies reported improved URiM representation, though implementation varied.

Conclusion

Racial and ethnic disparities remain pervasive in ophthalmology. While overall progress has occurred, gains have been concentrated among Asian individuals. Coordinated systemic reforms are urgently needed for a more representative, inclusive, and supportive professional environment in ophthalmology.

查看原文本刊更多论文

眼科培训与实践中的种族差异：系统回顾。

主题眼科仍然是最不多样化的医学专业之一，在整个培训和实践中存在持续的种族和民族差异。本综述考察了高收入国家中代表性不足的少数民族（URiM）在眼科的经历，重点关注代表性障碍、歧视和公平倡议。临床相关性识别和解决URiM在眼科面临的障碍对于促进劳动力多样性、公平的患者护理和机构包容性至关重要。了解不平等存在的地方可以为系统性干预提供信息。方法系统回顾MEDLINE、Embase、PsycINFO、CINAHL、Web of Science和Cochrane Library自成立以来至2024年11月的文献。符合条件的研究包括2000年以来的英语出版物，重点关注眼科中的种族或少数民族个体。两位审稿人独立筛选研究，提取数据，并使用纽卡斯尔-渥太华量表和乔安娜布里格斯研究所检查表评估偏倚风险。对数据进行了描述性和主题性的综合。协议在PROSPERO上注册（CRD42025640520）。结果纳入41项符合条件的研究，涉及500,823项应答。大多数研究都是横断面的，在2021年之后发表，并在美国进行。在所有职业阶段，URiM个体的代表性不足，面临结构性障碍。在医学院，攻读眼科专业的URiM学生较少，理由是缺乏指导和榜样。申请人中少数族裔的比例略有增加，尤其是在西班牙裔学生中，尽管总体增长仍然有限。在住院医师和奖学金期间，种族差异在研究机会、奖学金申请结果和面试机会方面持续存在。URiM学员报告了与项目文化和包容性相关的负面经历。在实践中，种族化的眼科医生报告了更高的歧视率，晋升到领导层的机会减少，在教师和编辑委员会中的代表性不足。虽然uri匹配率有所提高，但进展并不均衡。亚裔代表人数已经接近平等，而黑人、美洲原住民和太平洋岛民的代表人数仍然严重不足。国家眼科导师项目已经显示出很高的匹配成功率和参与率。实施结构化访谈、整体审查和目标股权策略的住院医师项目报告称，尽管实施情况各不相同，但URiM的代表性有所提高。结论眼科的种族差异仍然普遍存在。虽然总体上取得了进步，但收益集中在亚洲个人身上。迫切需要协调的系统改革，以建立更具代表性，包容性和支持性的眼科专业环境。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.