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. 2022 Dec 20;10(4):E1067-E1078.
doi: 10.9778/cmajo.20210319. Print 2022 Oct-Dec.

Supply and demographic characteristics of Ontario's ophthalmologists from 2010 to 2019: a population-based analysis

Aman P Sayal  1 , Yusuf Ahmed  1 , Marko M Popovic  1 , Matthew Schlenker  1 , Robert J Campbell  1 , Jasmin Kantarevic  1 , Joanna Nadolski  1 , Karen D'Souza  1 , Sherif El-Defrawy  2
Affiliations

Supply and demographic characteristics of Ontario's ophthalmologists from 2010 to 2019: a population-based analysis

Aman P Sayal et al. CMAJ Open. .

Abstract

Background: With an aging population in Ontario, ophthalmologists provide most of their care to older adults, which has prominent human resource implications. In this study, we sought to investigate the supply and demographic characteristics of Ontario's ophthalmologists.

Methods: In this retrospective, population-based analysis, we evaluated cohort demographics, including sex and career stage, of Ontario's ophthalmologists from 2010 to 2019, which we reported using descriptive statistics. Similarly, we detailed ophthalmologist supply within different areas of care using descriptive statistics.

Results: Over the study period, a median of 464 ophthalmologists were practising in Ontario each year. The proportion of female ophthalmologists increased from 18.7% in 2010 to 24.1% in 2019. The proportion of late-career ophthalmologists (aged > 55 yr) significantly increased by 6.4% over the study period and constituted 45.3% of the workforce in 2019. Comprehensive cataract surgery was the most common area of care. Although the number of ophthalmologists per 100 000 people remained stable over the study period (3.27 ophthalmologists/100 000 people in 2019), the number of ophthalmologists per 100 000 people aged 65 years and older fell by 18.4% from 2010 to 2019. The greatest supply reduction was among moderate-volume comprehensive cataract surgeons (-20.2% overall and -35.4% relative to the population aged ≥ 65 yr).

Interpretation: Between 2010 and 2019, the overall number of ophthalmologists in Ontario remained stable; however, we observed declines in the number of ophthalmologists per 100 000 people aged 65 years and older for most areas of care. Nearly half of the ophthalmology workforce is now older than 55 years and female representation is increasing.

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Conflict of interest statement

Competing interests: Marko Popovic declares institutional funding from the PSI Foundation and Fighting Blindness Canada. Matthew Schlenker reports funding from Trillium Health Partners, the Canadian Glaucoma Society and the Canadian Institutes of Health Research, as well as consulting fees and honoraria from AbbVie, Alcon, Bausch Health, Labtician, Glaucoma and Ivantis. No other competing interests were declared.

Figures

Figure 1:
Figure 1:
Number of female and male ophthalmologists practising from 2010 to 2019 in Ontario.
Figure 2:
Figure 2:
Trends in the proportion of female ophthalmologists practising in noncomprehensive surgical (i.e., corneal surgeons, glaucoma surgeons, oculoplastic surgeons and retinal surgeons), general medical and comprehensive surgical areas of care from 2010 to 2019 in Ontario. *Pediatric ophthalmology was not considered as a surgical subspecialty because nonsurgical pediatric ophthalmologists were also included in this cohort.
Figure 3:
Figure 3:
Trends in the proportion of early-career ophthalmologists practising in noncomprehensive (i.e., neuro-ophthalmologists, corneal surgeons, glaucoma surgeons, retina medical ophthalmologists, retinal surgeons, oculoplastic surgeons, pediatric ophthalmologists and low-vision rehabilitation ophthalmologists), general medical and comprehensive surgical areas of care from 2010 to 2019 in Ontario.
Figure 4:
Figure 4:
Trends in the proportion of middle-career ophthalmologists practising in noncomprehensive (i.e., neuro-ophthalmologists, corneal surgeons, glaucoma surgeons, retina medical ophthalmologists, retinal surgeons, oculoplastic surgeons, pediatric ophthalmologists and low-vision rehabilitation ophthalmologists), general medical and comprehensive surgical areas of care from 2010 to 2019 in Ontario.
Figure 5:
Figure 5:
Trends in the proportion of late-career ophthalmologists practising in noncomprehensive (i.e., neuro-ophthalmologists, corneal surgeons, glaucoma surgeons, retina medical ophthalmologists, retinal surgeons, oculoplastic surgeons, pediatric ophthalmologists and low-vision rehabilitation ophthalmologists), general medical and comprehensive surgical areas of care from 2010 to 2019 in Ontario.
Figure 6:
Figure 6:
The number of ophthalmologists per 100 000 people practising in all areas of care from 2010 to 2019 in Ontario. The number of low-vision rehabilitation ophthalmologists for 2010 was less than 5 and cannot be reported for privacy reasons.
Figure 7:
Figure 7:
The number of ophthalmologists per 100 000 people aged 65 years and older practising in all areas of care from 2010 to 2019 in Ontario. The number of low-vision rehabilitation ophthalmologists for 2010 was less than 5 and cannot be reported for privacy reasons. Given the nature of this analysis, pediatric ophthalmology was not analyzed.
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