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BACKGROUND: There has been little investigation into the attitudes and aspirations of current ophthalmology residents. The object of this study was to investigate the factors influencing career choice and to identify the future plans of Canadian ophthalmology residents. METHODS: All ophthalmology residents in English Canadian ophthalmology residency training programs were invited to complete an anonymous survey in June 2006. Data were categorized by demographic variables and basic statistics; χ2> comparative analyses were performed. RESULTS: Of 128 residents surveyed, 49 (38%) responded to the survey. Having the ability to combine medicine and surgery was the most common factor influencing the decision to pursue ophthalmology (98% of respondents), with intellectual stimulation (76%) and mentorship (50%) also emerging as important factors. The majority of residents (62%) plan on pursuing fellowship training, with medical retina, anterior segment/cataract, and cornea being the most popular choices (36%, 34%, and 32%, respectively). Most residents expressed plans of pursuing fellowships abroad, and only 22% planned on training within Canada. Fourteen percent indicated an interest in performing laser refractive surgery, female residents being significantly less likely than males to express such an interest (0% vs. 21%; p < 0.02). Most residents (71%) expressed the wish to practice in an urban or suburban setting, with only 6% intending to work in a rural community. INTERPRETATION: The appeal of the dual medical and surgical nature of ophthalmology is the most common motivating factor for pursuing an ophthalmology residency. The trends identified, including the high level of interest in subspecialty training and the desire to work in an urban setting, have important implications for the future of ophthalmology in Canada.