About

Susan Culican, MD, PhD, is a Professor in the Department of Ophthalmology and Visual Neurosciences at the University of Minnesota. She serves as the Senior Associate Dean of Graduate Medical Education and Co-Leader of the Office of Medical Education. Dr. Culican previously held positions at Washington University School of Medicine, where she was an Associate Professor in the Department of Ophthalmology and Visual Sciences, as well as the Director of Medical Education and Residency Training for Ophthalmology. Her educational work includes the development of ophthalmology milestones and data-driven residency assessment. Her practice centers on eye conditions in children, and she also treats adults for strabismus. Dr. Culican is a Diplomate of the American Board of Ophthalmology and a Fellow of the American Academy of Ophthalmology. Her professional service includes a 15-year tenure on the Graduate Medical Education Committee at Washington University, with involvement in the Resident Wellness subcommittee. She has been recognized on 'The Best Doctors in America' list for her contributions to the field.

Research topics

• Surgery
• Medicine
• Environmental health
• Pathology
• Family medicine
• Psychology
• Pediatrics
• Ophthalmology
• Demography
• Physical therapy

Selected publications

• Geschlechtsspezifische Unterschiede im Fallvolumen bei Assistenzärzten der Ophthalmologie, 2014–2023

  Kompass Ophthalmologie · 2025-11-17

  articleOpen access1st authorCorresponding

  Bedeutung: Eine frühere multizentrische Studie ergab geschlechtsspezifische Unterschiede bei der Gesamtanzahl der Katarakt- und chirurgischen Eingriffe in den amerikanischen Assistenzarztprogrammen. Ob dies für alle Assistenzärzte der Ophthalmologie in den USA repräsentativ war, ist unklar. Ziel: Festzustellen, ob das gemeldete chirurgische Volumen unter den amerikanischen Absolventen der Facharztausbildung für Ophthalmologie je nach selbst angegebenem Geschlecht oder dem Status einer Unterrepräsentation in der Medizin (URiM) variierte. Design, Umfeld und Teilnehmer: Retrospektiv beobachtende Langzeit-Kohortenstudie von anonymisierten chirurgischen Protokolldaten des Accreditation Council for Graduate Medical Education (ACGME) für alle Absolventen von amerikanischen Ophthalmologie-Facharztausbildungsprogrammen aus den Jahren 2014–2023, verglichen nach selbst angegebenem Geschlecht oder URiM-Status. Die chirurgische Erfahrung wurde aus dem Fallprotokoll des ACGME-Akkreditierungsdatensystems für Assistenzärzte gewonnen. Die Daten wurden von November 2023 bis April 2024 analysiert. Wichtigste Ergebnisse und Messgrößen: Das wichtigste Ergebnis war ein Unterschied im mittleren gemeldeten Operationsvolumen zwischen den Vergleichsgruppen nach Geschlecht oder URiM-Status für Kataraktoperationen oder alle Operationsverfahren. Die sekundären Ergebnisse waren Unterschiede in sonstigen chirurgischen Kategorien nach Geschlecht oder URiM-Status. Ergebnisse: Von 4811 Absolventen der Facharztausbildung waren 41,6% (1999) weiblich und 58,4% männlich (2812); 7,1% (343) identifizierten sich selbst als URiM. Bei den Kataraktfällen zeigte sich eine mittlere Differenz von –4,4% (–8,3 von 189,2) (95%-Konfidenzintervall (KI) –6,4% bis –2,4%; p < 0,001) weniger Operationen bei Assistenzärztinnen als bei Assistenzärzten über die 10-jährige Studie, und bei den gesamten Verfahren bestand eine mittlere Differenz von –7,4% (–43,4 von 587,3) (95%-KI –9,7% bis –5,1%; p < 0,001) weniger Operationen bei weiblichen als bei männlichen Assistenzärzten über die 10-jährige Studie. Der URiM-Status im gleichen Zeitraum war nicht mit einem Unterschied bei den Kataraktoperationen verbunden, aber mit einer mittleren Differenz von −5,3% (−31,5 von 587,3) (95%-KI −9,8% bis −0,9%; p = 0,02) weniger an Verfahren insgesamt.

  PublisherOA PDFDOI

• Gender Differences in Case Volume Among Ophthalmology Resident Graduates, 2014-2023

  JAMA Ophthalmology · 2025-05-01 · 3 citations

  letterOpen access1st authorCorresponding

  Importance: A previous multisite study found gender differences in cataract and total surgical volume among US residency programs. Whether that was representative of all ophthalmology residents in the US is unclear. Objective: To determine whether reported surgical volume among US ophthalmology resident graduates varied by self-reported gender or by underrepresented in medicine (URiM) status. Design, Setting, and Participants: Retrospective observational longitudinal cohort study of deidentified Accreditation Council for Graduate Medical Education (ACGME) surgical log data for all graduates of US ophthalmology residency programs from the years 2014-2023 compared by self-reported gender or URiM status. Surgical experience was obtained from the ACGME Accreditation Data System resident case log. Data were analyzed from November 2023 to April 2024. Main Outcomes and Measures: The main outcome was a difference in mean reported surgical volume between comparison groups by gender or URiM status for cataract or total surgical procedures. The secondary outcomes were differences for other surgical categories by gender or URiM status. Results: Of 4811 resident graduates, 41.6% (1999) were female and 58.4% were male (2812); 7.1% (343) self-identified as URiM. Cataract cases had a mean difference of -4.4% (-8.3 of 189.2) (95% CI, -6.4% to -2.4%; P < .001) fewer surgeries for female residents than male residents over the 10-year study, and total procedures had a mean difference of -7.4% (-43.4 of 587.3) (95% CI, -9.7% to -5.1%; P < .001) fewer surgeries for female than male residents over the 10-year study. URiM status over the same time period was not associated with a difference in cataract surgeries but was associated with a mean difference of -5.3% (-31.5 of 587.3) (95% CI, -9.8% to -0.9%; P = .02) fewer total procedures. Conclusions and Relevance: In this study, female residents reported fewer cataract procedures than male residents from 2014-2023. Female and URiM residents reported fewer total procedures than their nonfemale or non-URiM colleagues. Future studies to assess the causes of these disparities are warranted.

  PublisherOA PDFDOI

• Structural MRI alterations in children with form-deprivation amblyopia: a propensity score-matched case-control study – a commentary

  British Journal of Ophthalmology · 2025-10-24

  article
  PublisherDOI

• “But Why?”: Explanatory Feedback Is a Reliable Marker of High-Quality Narrative Assessment of Surgical Performance

  Academic Medicine · 2025-01-31 · 3 citations

  articleOpen accessSenior author

  PURPOSE: This study examines the quality of short narrative comments collected using an online workplace-based assessment (WBA) tool. METHOD: The quality of comments collected by a WBA tool at the UPMC Ophthalmology Residency Training Program was evaluated between July 2017-June 2020. A randomized rating exercise involving 10 meta-raters from 6 institutions was performed to evaluate the value of narratives from deidentified WBAs. The tool captured a single-item entrustment competency question with brief comments. Comments were evaluated using a Quality of Assessment of Learning (QuAL) score (range, 0-5; ≥3 considered high quality) and on whether the assessor provided a feedback rationale. RESULTS: A total of 838 unique WBAs were collected from 15 attending evaluators. Comments were brief (median [interquartile range] length, 11 [7-17] words), yet 514 (61.3%) were rated as high quality (QuAL score ≥3). Of all 838 comments, 98 (11.7%) included a specific reason the evidence or suggestion was provided to the learner. Of these 98 comments, 94 (95.9%) met the high-quality feedback threshold. A higher QuAL score was associated with a higher postgraduate year (PGY) level (estimate [SE], 1.603 [0.428], P < .001 for PGY2 [reference]; 1.003 [0.389], P = .01 for PGY3; 1.079 [0.360], P = .003 for PGY4), suggesting more advanced learners receive higher-quality narrative comments. A correlation was found between a higher entrustment rating and a lower QuAL score (estimate [SE], -0.199 [0.053], P < .001). When the PGY level was controlled for, this association got stronger (estimate [SE], -0.310 [0.057], P < .001). CONCLUSIONS: Analysis of WBA comments from attending physicians evaluated using the QuAL score demonstrated that most comments were high quality despite their brevity. Residents in later training years and with lower entrustment ratings received higher-quality comments. High-quality narrative assessments were longer and addressed rationale as part of the comment.

  PublisherOA PDFDOI

• Examining Gender-Based Differences in Quantitative Ratings and Narrative Comments in Faculty Assessments by Residents and Fellows

  Journal of Graduate Medical Education · 2025-06-01 · 1 citations

  articleOpen access

  ABSTRACT Background Learner assessments of faculty are widespread in medicine, yet concerns are growing about possible biases in these assessments and their associations with gender disparities. Objective To investigate gender-based differences in how residents and fellows describe faculty (rater effect) and how faculty are described (ratee effect) in faculty assessments, and their associations with teaching effectiveness ratings. Methods We analyzed 2164 trainee assessments of University of Minnesota Medical School faculty from 2019 to 2023 with trainee and faculty gender information and narrative comments. Using natural language processing, we categorized words and 2-word groups (n-grams) into communal (eg, caring, kind), standout (eg, outstanding, amazing), and agentic/ability (eg, assertive, controlling) groups. We examined gender-based differences in n-grams used by trainees (rater effect) and received by faculty (ratee effect), and relationships between n-gram and teaching effectiveness ratings. Results Women trainees used more communal (rater effect, incidence rate ratio [IRR]=1.36; 95% CI, 1.27-1.47), standout (IRR=1.20; 95% CI, 1.08-1.34), and agentic/ability words (IRR=1.37; 95% CI, 1.26-1.49; P &lt;.001) than men trainees. Women faculty received fewer agentic/ability words than men faculty (ratee effect, IRR=0.83; 95% CI, 0.77-0.90; P &lt;.001). Women trainees used fewer communal words when describing women faculty (interaction effect, IRR=0.84; 95% CI, 0.73-0.98; P &lt;.05). Teaching effectiveness ratings correlated with faculty n-gram word frequency in standout (men: r s =0.29, women: r s = 0.28, P &lt;.001) and communal categories (men: r s =0.23, P =.003; women: r s = 0.22, P =.01). Conclusions Women trainees used more communal, standout, and agentic/ability descriptors, while women faculty had fewer agentic/ability descriptors. Women trainees used fewer communal words when describing women faculty. Standout and communal word frequency predicted teaching effectiveness ratings for both genders.

  PublisherOA PDFDOI

• Real-world assessment (RWA): validity evidence for cataract surgery with a tool your faculty will actually use

  Journal of Academic Ophthalmology · 2024-11-07 · 2 citations

  articleOpen accessSenior author

  Background: We developed and implemented a real-world assessment tool (RWA) for resident surgery. It was designed to improve utility by reducing faculty and trainee cost (completion and training time, cognitive burden). RWA uses an entrustability scale where higher scores indicate a resident’s readiness for independent surgical practice. We describe a two-phase implementation of RWA and report validity evidence for cataract surgery assessment. Methods: RWA was developed iteratively with resident and faculty input and piloted at a single residency program in phase 1. Phase 2 implemented RWA at 11 ophthalmology residency programs. The main outcome measures were 1) number of surgical assessments submitted and 2) correlation between entrustment score on resident cataract surgery assessments and time in training. Results: After implementation of RWA, completed assessments increased for all participating programs. 1384 assessments of 111 residents by 112 faculty assessors were collected. Cross-sectional analysis of the assessments that examined cataract surgical procedural competency demonstrated that higher entrustment scores correlated with postgraduate year in training in both the single site (P= Conclusions: RWA demonstrates low cost, high acceptability, construct validity and reliability for cataract surgical skills assessment. Thus, RWA has shown high utility for assessment of cataract surgery. Because it is procedure agnostic it can be used to assess resident surgical skill for any procedure. RWA provides useful data for residency programs to monitor trainee development.

  PublisherDOI

• The status of women in academic ophthalmology: Authorship of papers, presentations, and academic promotions

  Clinical and Experimental Ophthalmology · 2024-01-12 · 8 citations

  articleOpen access

  As the field of ophthalmology has evolved in the last several decades, so has the gender distribution of ophthalmologists. We conducted a narrative review to further characterise the status of women in the realm of publication, presentations, editorial positions, grants, academic promotion, and financial compensation. While the proportion of women publishing, presenting, and filling academic and editorial roles has increased over time, it still does not match that of men. Women are more likely to be first authors instead of senior authors, have lower average h-indices, and are awarded fewer grants. The magnitude of some of these differences is smaller when adjusted for women's shorter career duration on average. Despite increased representation of women in ophthalmology, women continue to receive less compensation for the same work. This review highlights that more can be done to improve gender parity in ophthalmology.

  PublisherOA PDFDOI

• 416 MRI Findings in Preterm Infants Associated with Strabismus

  Journal of Clinical and Translational Science · 2024-04-01

  articleOpen access

  OBJECTIVES/GOALS: Prematurity and perinatal brain injury are known risk factors for strabismus. In this study, we sought to understand the link between neonatal neuroimaging measures in very preterm infants and the emergence of strabismus later in life. Study findings may inform if neonatal brain MRI could serve as a prognostic tool for this visual disorder. METHODS/STUDY POPULATION: This study draws from a longitudinal cohort of very preterm infants (VPT, &lt; 30 weeks gestation, range 23 – 29 weeks) who underwent an MRI scan at 36 to 43 weeks postmenstrual age (PMA). Anatomic and diffusion MRI data were collected for each child . A subset of thirty-three patients in this cohort had records of an eye exam, which were reviewed for a history of strabismus. Patients with MRI scans demonstrating cystic periventricular leukomalacia or grade III/IV intraventricular hemorrhage were classified as having brain injury. Clinical variables with a known association to strabismus or diffusion metrics were included in a multivariable logistic regression model. Diffusion tractography metrics were screened for association with strabismus on univariable analysis prior to inclusion in the regression model. RESULTS/ANTICIPATED RESULTS: A total of 17/33 (51.5%) patients developed strabismus. A logistic regression model including gestational age, PMA at MRI, retinopathy of prematurity (ROP) stage, brain injury, and fractional anisotropy of the right optic radiation was significant at the .001 level according to the chi-square statistic. The model predicted 88% of responses correctly. Each decrease of 0.01 in the fractional anisotropy of the right optic radiation increased the odds of strabismus by a factor of 1.5 (95% CI 1.03 – 2.06; p = .03). Patients with brain injury had 15.8 times higher odds of strabismus (95% CI 1.1 – 216.5; p = .04). Gestational age (OR 1.7; 95% CI 0.9 – 3.3; p = .1) and stage of ROP (OR 0.6; 95% CI 0.2 – 2.0; p = .4) were not significant predictors of strabismus in the multivariable model. DISCUSSION/SIGNIFICANCE: Our findings suggest that strabismus in VPT patients may be related to specific changes in brain structure in the neonatal period. The identified association between neonatal optic radiation microstructure and strabismus supports the possibility of using brain MRI in very preterm infants to prognosticate visual and ocular morbidity.

  PublisherOA PDFDOI

• Perceptions of Justice in Clinical Learning Environments: Development and Validation of an Organizational Justice Measure for Medical Trainees

  Academic Medicine · 2024-02-27

  article

  PURPOSE: This study aimed to develop an instrument to measure medical trainees' perceptions of justice in clinical learning environments. METHOD: Between 2019 and 2023, the authors conducted a multiyear, multi-institutional, multiphase study to develop a 16-item justice measure with 4 dimensions: interpersonal, informational, procedural, and distributive. The authors gathered validity evidence based on test content, internal structure, and relationships with other variables across 3 phases. Phase 1 involved drafting items and gathering evidence that items measured intended dimensions. Phase 2 involved analyzing relevance of items for target groups, examining interitem correlations and factor loadings in a preliminary analysis, and obtaining reliability estimates. Phase 3 involved a confirmatory factor analysis and collecting convergent and discriminant validity evidence. RESULTS: In phase 1, 63 of 91 draft items were retained following a content validation exercise gauging how well items measured targeted dimensions (mean [SD] item ratings within dimensions, 4.16 [0.36] to 4.39 [0.34]) on a 5-point Likert scale (with 1 indicating not at all well and 5 indicating extremely well). In phase 2, 30 items were removed due to low factor loadings (i.e., < 0.40), and 4 items per dimension were selected (factor loadings, 0.42-0.89). In phase 3, a confirmatory factor analysis supported the 4-dimensional model ( χ2 = 610.14, P < .001; comparative fit index = 0.90, Tucker-Lewis Index = 0.87, root mean squared error of approximation = 0.11, standardized root mean squared residual = 0.06), with convergent and discriminant validity evidence showing hypothesized positive correlations with a justice measure ( r = 0.93, P < .001), trait positive affect ( r = 0.46, P < .001), and emotional stability ( r = 0.33, P < .001) and negative correlations with trait negative affect ( r = -0.39, P < .001). CONCLUSIONS: Results indicate the measure's potential utility in understanding justice perceptions and designing targeted interventions.

  PublisherDOI

• Child Neurology: Five-Year Update on Siblings With Riboflavin Transporter Deficiency

  Neurology · 2024-11-15 · 2 citations

  articleOpen access

  genes, resulting in RTD types 1, 2, and 3, respectively. Researchers estimate an occurrence of approximately 1 in 1,000,000. There is only one case of type 1 described in medical literature. Type 2 is characterized by muscle weakness in the arms and neck, vision loss, hearing impairment, and sensory ataxia. In type 3, vocal cord paralysis is more common and muscle weakness is more generalized. In 2018, we described a case of a 6-year-old girl with RTD type 2 who made remarkable visual recovery after initiation of treatment with oral riboflavin and coenzyme Q10 supplementation. The patient's younger brother began the same treatment regimen after genetic testing confirmed that he carried the same genetic variant. In this report, we update the visual and neurologic status in these siblings 5 years after our initial report and 7.5 years after initiation of riboflavin treatment.

  PublisherOA PDFDOI

Recent grants

• NIH Grant P41RR000954

  NIH · $8.9M · 2014

Frequent coauthors

• Michael V. Stock

  11 shared

• Bradley L. Shoss

  Washington University in St. Louis

  9 shared

• Kisha Piggott

  9 shared

• David M. Salvay

  Christie's

  9 shared

• Grace Paley

  8 shared

• Andrew R. Lee

  7 shared

• Lawrence Tychsen

  7 shared

• Courtney L. Kraus

  Johns Hopkins University

  6 shared

Awards & honors

• Fellow of the American Academy of Ophthalmology
• recognized on 'The Best Doctors in America' list