To describe the ophthalmology primary practice emphasis area by underrepresented in medicine (URiM) status using the American Board of Ophthalmology (ABO) Diplomates database.
Retrospective cohort study.
Retrospective review of the ABO database from 1992 to 2020. The datapoints recorded included age at time of graduation and at time of certification, gender, self-reported race/ethnicity, year of graduation and of certification, United States (US) region of practice and the self-reported primary practice emphasis area within ophthalmology. The URiM cohort included self-identified Black, Hispanic/Latinx, American Indian & Alaska Native, and Native Hawaiian & Other Pacific Islander individuals. Statistical analysis was conducted using Pearson chi-squared, student t-test, and Fisher exact tests.
Five hundred and seventy-five (10.1%) ophthalmologists self-identify as URiM vs. 5,132 (89.9%) as non-URiM. Diplomates who were URiM were more likely to be female and to be older at the time of ABO certification than those who were not URiM (p<0.001). Over time there was a steady decrease in the percentage of diplomates who were URiM (p<0.001). There was a statistically significantly higher percentage of URiM ophthalmologists who reported glaucoma as their primary area of emphasis (p=0.039), and non-URiM ophthalmologists who reported Oncology, Pathology, International or Genetics (p=0.015), but no significant differences in remaining subspecialties (p≥0.123).
There were modest differences in reported ophthalmology primary practice emphasis area between URiM and non-URiM ABO diplomates. Despite efforts to increase diversity in Ophthalmology, the percentage of graduating URiM ABO diplomates decreased over the past two decades.

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