Abstract Purpose The main purpose of this article is to characterize methods for preparing first-year ophthalmology residents for call and to evaluate the association between call structure and anxiety levels. Methods Data on call structure and preparatory courses were collected by a national online survey of residency program directors and first-year residents in 2016 and 2017. Anxiety was assessed using the Endler Multidimensional Anxiety Scale, and confidence in evaluating and managing critical diagnoses on call was evaluated using a modified Likert-type scale. Results In 2016, 132 first-year ophthalmology residents (28% of 465 total) responded to the survey, and in 2017, 103 first-year residents (22% of 469 total) responded, for a total of 235 residents participating. About 97.4% of residents reported that their residency program had a buddy call system, and 73.2% reported that their residency offered a preparatory course at the beginning of residency. In the resident cohort from 2017, there was a statistically significant association between length of buddy call duration and cognitive worry anxiety level (p = 0.01) with the lowest mean anxiety scores reported among those whose buddy call system lasted between 9 and 12 weeks. Higher confidence in making critical diagnoses on call was significantly associated with lower anxiety scores (p
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