Motivating Factors and Barriers Toward Choosing a Career in Ophthalmology: A Narrative Review of the Literature.

Ophthalmology combines microsurgical precision with rapidly advancing technology, offering profound patient impact through vision-restoring interventions. Despite these compelling qualities, there are growing global concerns about the sustainability of the ophthalmic workforce in the face of rising demand for eye care. This narrative review synthesizes published evidence on the motivating factors and barriers influencing medical students and junior doctors in choosing a career in ophthalmology, drawing on studies examining both surgical career choice broadly and ophthalmology-specific literature. Key motivating factors identified include the intellectual challenge of the specialty, exposure to innovative surgical procedures, the influence of positive role models and mentors, rewarding patient outcomes, and a comparatively favorable lifestyle profile within surgery. Significant barriers include limited undergraduate exposure to ophthalmology, the perceived competitiveness of training pathways, financial burdens of training, gender and diversity inequities, and insufficient structured mentorship. Addressing these barriers through early targeted exposure, inclusive mentorship, and curriculum reform is essential to securing a sustainable ophthalmic workforce. Ophthalmology societies, medical schools, and training bodies must collaborate to communicate the specialty's unique rewards and to dismantle structural inequities in access to training. PubMed/MEDLINE, Embase, and Google Scholar were searched from January 1995 to March 2025, supplemented by manual screening of reference lists and relevant gray literature (professional body reports and workforce surveys). Search terms used were "ophthalmology", "surgery", "career choice", "specialty selection", "medical students", "mentorship", and "workforce." Ophthalmology-specific studies were prioritized where available; broader surgical career-choice literature, most notably the general surgery framework of Hossain and Hossain, was drawn upon selectively to address areas where ophthalmology-specific evidence was sparse. As a narrative rather than systematic review, study selection was not exhaustive and reflects the authors' judgment of relevance and quality rather than a predefined, reproducible screening protocol.