Workforce supply of eye care providers in Canada: optometrists, ophthalmologists, and subspecialty ophthalmologists

Objective: To assess the population distribution of optometrists, ophthalmologists, and subspecialist ophthalmologists in Canada. Design: Cross-sectional study. Participants: Participants were optometrists listed in optometry associations' databases and Canadian ophthalmologists listed in the Canadian Medical Association (CMA), Canadian Ophthalmological Society (COS), and American Academy of Ophthalmology (AAO) databases. Canadian population data are from Statistics Canada. Methods: Provincial optometry associations' databases and the CMA database were used to determine the number and location of currently licensed optometrists and ophthalmologists, respectively, in Canada. The COS and AAO databases were used to determine subspecialization, which was further verified by contacting subspecialty organizations. Provider ratios to a 100 000 population were determined. Results: In 2012 there were 5729 optometrists and 1164 ophthalmologists, of which 524 ophthalmologists (45%) were subspecialized, representing 4.92 optometrists per ophthalmologist. For every 100 000 Canadians there were 3.35 ophthalmologists (1.84 comprehensive and 1.51 subspecialists) and 16.48 optometrists. Of the 148 census areas, 1 (0.7%, Yellowknife) had no optometrist and 43 (29%) had no ophthalmologist. The greatest proportions of ophthalmology subspecialists were in surgical retina (20.6%) and the lowest was ocular pathology (1.5%). Conclusions: Although benchmarks regarding the ideal balance among number of optometrists, ophthalmologists, and subspecialists in relation to population are unknown, we found that all census regions had at least 1 ophthalmologist or optometrist. Fortyfive percent of ophthalmologists identified a subspecialty interest, of which the majority was surgical retina. This information may be of value to training ophthalmologists when deciding on a subspecialty and practice location.