Enhancing Māori and Pasifika graduate interest in ophthalmology surgical training in New Zealand / Aotearoa: Barriers and opportunities.

Importance Improving the representation of indigenous ophthalmologists in New Zealand. Background Maori, indigenous to New Zealand/Aotearoa and Pacific Peoples indigenous to Pacific Island Nations living in New Zealand, experience poorer health outcomes across several ophthalmic conditions. The Royal Australian and New Zealand College of Ophthalmologists have identified indigenous workforce development as a priority. Design Mixed-methods study, utilizing retrospective analysis of Medical Schools Outcomes Database and Longitudinal Tracking Project responses, and prospective interviews with Maori/Pasifika medical graduates. Participants This study involved 64 medical graduates from the University of Auckland (UoA) and the University of Otago, and six Maori/Pasifika medical postgraduates in New Zealand. Methods Retrospective analysis of medical graduate responses who ranked ophthalmology among their top-three preferred specialties in the Medical Schools Outcomes Database and Longitudinal Tracking Project. Prospective semi-structured interviews with Maori/Pasifika medical postgraduates. Main Outcome Measures Specialty training influencing factors and prevocational ophthalmology experience. Results A total of 64 (6.7%) out of 954 medical graduates from the UoA and University of Otago ranked ophthalmology among their top-three preferred training specialties (2012-2017). Of the 64 graduates, six (9.3%) identified as Maori/Pasifika. No significant difference in influencing factors between Maori/Pasifika and non-Maori/Pasifika students was identified. Both groups ranked intellectual content, procedural skills, specialty exposure and mentorship as highly influential. Qualitative interviews with Maori/Pasifika graduates highlighted positive experiences in ophthalmology but limited exposure overall. Negative anecdotes and unclear training pathways discouraged Maori/Pasifika interest in Ophthalmology training. Conclusions and Relevance Maori/Pasifika graduate interest in ophthalmology training was relatively low. Valuable insights include enhancing specialty exposure, mentor development, promoting Maori/Pasifika connections and clarifying training pathways for future graduates.