Performance in the Duke–Elder ophthalmology undergraduate prize examination and future careers in ophthalmology

Abstract

Aims Cognitive factors (eg, academic achievement) have had a significant role in selecting postgraduate surgical trainees in the past. This project sought to determine the role of a national undergraduate ophthalmology prize examination (Duke-Elder examination) in the selection of postgraduate ophthalmology trainees. This would also serve as a quality assurance exercise for the assessment, in which the ultimate aim is to encourage trainees into ophthalmology. Methods A retrospective analysis of the top 20 ranked candidates in the Duke-Elder examination from 1989 to 2005 (except 1995) was carried out to determine which of them subsequently entered the ophthalmic training and General Medical Council Specialist Registers. Results Out of the top 20 candidates in the exam, 29.5% went into specialist training in ophthalmology. Some appeared in the top 20 more than once, with 56% of them going into ophthalmic training, but they had a similar median time to enter training as those who appeared in the top 20 once. There was no significant evidence to suggest that the overall median ranking scores between the UK medical schools differed (P ¼ 0.23; KruskalWallis test). However, there was a marked difference in frequency of top 20 candidates from each medical school, which could not be explained by the size of the medical school alone. Conclusion It is difficult to conclude from these findings the importance that the Duke-Elder examination has in the selection of trainees into ophthalmology. The role of cognitive factors in selection into postgraduate medical/surgical training is discussed, along with the potential academic criteria, which may influence interview scores.

Factors at medical school influencing students’ decisions to pursue a career in ophthalmology

“…Although the relationship may not be causal, it suggests that students attending a medical school with an ophthalmology society may have a higher chance of securing an ophthalmology training position. We were surprised to find no association between higher rates of Duke-Elder participation and higher rates of ophthalmology trainees; however, others have recently highlighted that there may be a perceived relative "unimportance" of the Duke-Elder examination during ophthalmology trainee shortlisting due to the scoring system used for shortlisting [5,6]. The points awarded for a good Duke-Elder score can be obtained elsewhere through publications, presentations, and research experience.…”

“…The points awarded for a good Duke-Elder score can be obtained elsewhere through publications, presentations, and research experience. As suggested by Joshi et al [5], this insignificant weighting in the shortlist criteria may dissuade potential candidates from participating in the Duke-Elder examination.…”

Can medical students accurately predict their learning? A study comparing perceived and actual performance in neuroanatomy

“…Entrance into medical and surgical specialties is becoming increasingly competitive in the UK, particularly for neurology and neurosurgery with competition ratios of 3–1 and 10–1 respectively (McNally, ). Applications for specialist training jobs place a value on winning competitions; in the UK the Duke Elder competition for ophthalmology is a good example of how competition success provides a competitive advantage for such applications (Joshi et al, ). In Russia, surgical Olympiads are run in stages throughout the country promoting self‐study and enhancing applications into surgical specialties (Dydykin and Kapitonova, ).…”

How does participation in a voluntary prize exam affect medical students’ knowledge and interest in ENT, plastic surgery, ophthalmology and dermatology?

“…Two studies have reviewed the impact of participation in the Duke-Elder Prize on pursuing ophthalmology as a career. One study found that participants in the Duke-Elder exam were not more likely to enter ophthalmology trainee than non-participants and that the presence of an ophthalmology undergraduate society at a medical school was correlated with a 1.37-fold increase of .29.5% of students who scored in the top 20 nationally in the Duke-Elder exam subsequently entered ophthalmology training [ 15 ]. Both studies concluded that, although the Duke-Elder exam is used as part of shortlisting criteria for ophthalmology training, there may be a perceived ‘unimportance’ of the exam in comparison to other criteria and this may dissuade students from participating in the exam [ 2 , 15 ].…”