Competency-Based Medical Education in Ophthalmology: Perspectives of Residency Program Directors

Objective: To assess ophthalmology program directors' (PDs) knowledge, attitude, and perceptions regarding the adoption of Competency-Based Medical Education (CBME) and Entrustable Professional Activities (EPAs) in residency training. Design: Cross-sectional study. Setting: An anonymous online survey was distributed across the Association of University Professors of Ophthalmology (AUPO) PDs directory over a two-month period. The survey assessed familiarity with CBME and EPAs, perceived barriers to implementation, and opinions on essential competencies for ophthalmology training. Participants: Ophthalmology Residency PDs across the U.S. Results: 55 complete responses were received. While 65.5% of PDs reported being familiar with CBME, only 43.6% felt confident explaining EPAs. Currently, only 22% of residency programs utilize EPA-based assessment. 60% of PDs agreed that better assessment tools are needed. 43.6% reported having extended training for at least one resident, and 60% indicated that some residents were competent to graduate early. Cataract surgery and Nd:YAG capsulotomy were ranked as the most essential surgical competencies, while strabismus surgery was ranked the lowest. Conclusion: PDs demonstrated overall support for integrating CBME and adopting EPA-based guidelines in ophthalmology residency training. These findings highlight the need for structured assessment frameworks and suggest that further research is needed to assess the impact of these initiatives on patient outcomes and resident performance.