This month's issue includes a different type of research contribution from Zadnik and Reich.1 Their article assesses the number of applicants and matriculants to optometry programs in the United States over the most recent 10-year period, and it is a thought-provoking piece. Several new training programs were launched during this time period, and the authors offer some interesting data along with possible interpretations for readers to consider. While this article is a bit of a departure from the journal's usual type of research publication, their article addresses an important topic that is directly related to training the future workforce of eye care providers and clinician scientists.
The authors found that there was a relatively stable applicant pool (0.95% increase from 2010 to 2018), whereas there was an 11% increase in matriculants over this same time period.1 In addition to the interpretations offered by the authors, there are other perspectives to consider and I sincerely hope that this publication will stimulate some meaningful discussions within the community. Historically, enrollment in higher education is correlated with macroeconomic trends.2 Economic contractions (e.g., 2008–2009 the worst in recent memory) are typically correlated with increasing enrollments as unemployment increases and wages stagnate.3 However, there are a multitude of other confounding factors and complex interactions to consider. For example, unemployment, financial aid availability, willingness to incur student debt, admission rates, future earning potential, and other factors. Zadnik and Reich provide interesting data to consider in this analysis of factors driving admissions decisions for optometry training programs in the United States of America.
Questions not considered by the authors in this article are the factors driving the expansion of schools and colleges of optometry. Is there a need for additional programs? Is there an undersupply of labor? What are the economic consequences of expanding the number of available training programs? Could the public health be better served by expanding the number of seats in existing programs rather than adding new programs?
There are, perhaps, some parallels to be drawn from scientific publishing, where there has been a steady increase in the number of journal titles (both legitimate and predatory ones). The consequences of this proliferation have primarily provided economic benefit to publishers. Nevertheless, more opportunities for authors to publish their work have not noticeably elevated the quality of published science. Yet, it may be improving access for those who may not otherwise have an opportunity to publish their work. Likewise, if candidates have an increased opportunity to matriculate, could this help improve access for individuals from underrepresented classes? Differences in standardized test performance associated with race have long been recognized, with poorer performance among underrepresented minorities.4 It would be interesting to consider how these trends in the applicant pool are influencing the demographics of the matriculants. If, as the authors assert, there are now more candidates admitted with lower GPAs and lower standardized entrance exam scores, has this altered the demographic profile of the matriculant pool? More importantly, how do these matriculants perform compared to others with respect to graduation rates and national board exams?
1. Zadnik K, Reich LN. An Analysis of the Optometric Applicant Pool Relative to Matriculants. Optom Vis Sci 2019;96.
2. Brown JR, Hoxby CM. How the Financial Crisis and Great Recession Affected Higher Education. Chicago, IL: The University of Chicago Press; 2015.
3. Table 306.10. Total Fall Enrollment in Degree-granting Postsecondary Institutions, by Level of Enrollment, Sex, Attendance Status, and Race/Ethnicity of Student: Selected Years, 1976 through 2015. National Center for Education Statistics. Available at: https://nces.ed.gov/programs/digest/d16/tables/dt16_306.10.asp
. Accessed August 5, 2019.