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Osteopathic Ophthalmology
general issues
As an osteopathic ophthalmology applicant I found it very frustrating that there is not better (or any) information about osteopathic training programs. Most programs require that you rotate with them if you wish to interview, it is impossible to rotate at all programs and it wasn’t until was in the middle of rotations that I was able to get information about that program, sometimes even rotating with a program wasn’t completely helpful in learning what that program offered or didn’t. I hope to help those coming after me that they may be better prepared, I also hope to bring out some of the challenges programs have in order that there may be more pressure on improving programs. Disclaimer: Some of this information is first-hand, most is gathered from conversations with residents and fellow applicants. Anything I write I have cause to believe is true and not pure speculation, that said I leave it to readers to verify any and all information. Information can change rapidly, I wish to publish this because much of what info exist is outdated and no longer correct, be aware that by the time you read this situation may have changed. As a general comment, osteopathic ophthalmology programs are mostly resident run with Attendings serving as sideline supervisors, thus the didactics, surgical quality and numbers, and program flavor can fluctuate greatly year to year. Genesys Regional Med Ctr-Health Park - not taking residents. decide to shift funding positions away from Ophtho, ENT, ER and Derm to max out its IM positions and help fund a cardiology fellowship as part of its quest to be a frontrunner in ACO style managed care. Hillsdale Community Health Center Did not match last year or this. maybe shutting down the program. this is said to come from either a staffing shortfall as residency hour regulation demand more staff coverage and the cost that entails or from being highly selective in the resident the program director is willing to train Didactics- are conducted by the program director, a very smart doctor who practices very comprehensive ophthalmology. While informal, didactics are said to be rigorous. Structure- intern and 1st year are in Hillsdale, a small town working one-on-one with the program director, 2nd and 3rd years are spent at various locations around Michigan, and possible out of state at sub-speciality practices and sites with higher surgical volume. Residents have noted that this the freedom in setting up 2nd and 3rd year rotations can help get you into desired fellowships Surgical volume- low, Call- little call due to small hospital coverage in a small town, but with unfilled position there is also less help to go around Pros/what works- small person program with lots of flexibility Cons/deficiencies- lots of travel, program uncertainty, flexibility = lots of logistic work Oakwood Healthcare System Osteo Div - new program no senior residents yet, takes two people, structured after st john program with a resident clinic and rotation with many of Detroit's sub-specialists, covers the more rural area south of Detroit and southern area of urban Detroit which is economically stagnant Attendings- st john’s program graduates St John Providence Health System-Osteo Div oldest program, well establish ties with community and sub specialists, rumored to be getting shared access to cataract simulator Didactics- sits in on lecture with Kresge eye in Detroit, otherwise resident run Structure- resident clinic with rotations in Detroit, shares some subspecialist attending with Beaumont and Kresge Attendings- long time attendings, maybe looking for replacements in the next couple years, daughter is resident in training Surgical volume- good, with two residents with 3 every 4th year. the risk of thin surgical number is higher, Call- take call at 4 hospitals, can be busy Pros/what works- all in all a rather solid program financially stable but not strong, resident have some good connections to big name programs and there attendings, will take residents that don’t rotate there but rotations are encouraged, (good) usmle scores are advantageous Cons/deficiencies- lots of travel between consults and clinic, some didactics are in east Lansing (1hr away), clinic is located just outside of Detroit (better than being in Detroit), better parts of town to live are 15-45 minutes away from clinic. Program is prideful about thinking they are the best. Attending coverage can be thin, patients often transferred to MD programs due to lack of attending backup. Metro Health Hospital - not taking residents TUCOM/Valley Hospital Medical Center -Residency closed, hospital able to make more money off of orthopedics and shifted funding to increase orthopedic slots and then was able to negotiate to reopen funding for 1 position although the future funding of that position remains in probation. Didactics- student run, there is an oculopathologist attending so pathology rounds are excellent. Residents attend the Houston course. Neuro must be done out of state usually in Michigan. structure-residents have a half day resident clinic, most clinic time is spend at attendings offices seeing attendings patients, so you have a full community mixture of patients, and operations are at the full pace of an operating practice. surgical volume- good, surgical cases come from resident clinic as well as attending practices, with the program shrinking to 1 resident, and possible expansion of sites in the city there is a solid volume of surgical cases. call- call coverage is at valley hospital and at the county hospital, which are near each other. other hospitals will transfer patient to valley for eye related issues so the catchment for patients is 5-6 hospitals large. pros- good volume of clinic and surgery, attendings have broad subspecialty coverage. call is sufficient, while minimizing travel, solid training all around. cons- funding issues and hospital support of program remains in question St John's Episcopal Hospital South Shore This program does not directly take applicants, applicants must apply to the traditional internship year, upon successful completion of that year they may be admitted to the ophthalmology program but must do an extra year of pgy-2 level training in family med, IM or surgery prior to starting ophthalmology. it has be said that in the past 3 interns were accepted and only 2 matriculated into the ophthalmology program, but in the past couple years this competitive practice has not happened. Why they do this? Who knows, rumored that it is so they can get the full 5 years of medicare residency funding. it has also been said that the program has poor financial support and that on top of a relatively low (for new york) salary that residents are expected to pay out of pocket for all their educational, licensure (in multiple states in order to do rotations there), and administrative costs can run 10-20,000 a year. Didactics- are with the manhattan consortium Surgical volume- poor, historically resident have gone to other programs to get adequate surgical volume as well as to India to get enough volume to feel competent. Some of these options are becoming limited and stability of the program has often expressed Pros/what works- a few connections to bigger name New York programs Cons/deficiencies- lots of travel between far rockaway hospital, hospital in Brooklyn and manhattan daily in new your traffic literally eat away hours of your day, cost of living and poor financial support. Unfounded 2-year pre-residency setup. Poor surgical training. OUCOM Doctors Hospital Didactics - didactics are with the Ohio state university which has several distinguished facility. DO residents are treated mostly as equals although mds sit on one side of the room and dos on the other. Structure - resident clinic near doctors hospital, 2nd year with attendings in Columbus, some rotations shared with OSU residents. Attendings- mostly nice, laid back Surgical volume- mod, not great but not in jeopardy Call- light, only cover doctors and grant hospital, ER cases from doctors hospital are transferred to grant and evaluated by ER doc there prior to having ophtho consult. grant is level 1 but both are small sized hospitals Pros/what works - well established, decently funded for a DO program, has decent resources to educational material, and administrative help. Columbus is a pretty nice and affordable place to live compared to other residency options and is economically stable. All rotations are in Columbus and are reasonable close without much traffic issues Cons/deficiencies- clinic, call, and surgical volumes can be unsteady toward the weaker side. Program doesn’t any major deficits, but doesn’t have any glowing educational benefits either. OUCOM/Grandview Hosp & Med Ctr Didactics- resident run, however has a history of producing high OKAP scores, this is due to a culture of self-study and inter-resident pimping. Structure- resident clinic, rotations are in the general dayton area with some being in cincinnati. take call at several hospitals (5?) in the general area (some an hour apart) Surgical volume- mod-good (for a DO program), they have a surgical simulator so residents feel that they concur the initial learning curve faster. Call- heavy, due to coverage at several hospitals over a decent sized area Pros/what works- well-organized program, has a set method to learning and advancing in surgery. Get to do significant minor surgery (laser work) in 1st year of program. Probably the best funded DO program due to the numerous hospitals that are covered thus they have good equipment, an educational/equipment stipend. No competing residency programs in town. Residents are smart Cons/deficiencies- because most patients come to the clinic as ER follow up channels or are uninsured, the pt population is highly tilted toward acute care. Call can be rough. Dayton is a dying town, nicer areas of town are some distance from the clinic. Some students that rotate through have felt that the educational/pimping culture of the residents is rather malignant. This is another program that things they are the best and they are not ashamed to repetitively mention that “fact,” which is a point of arrogance hard to swallow while in a dank cramped basement office also listening how they spent 3 hours driving from one ER to another the night before to check a corneal abrasion. Despite having good OKAP scores, didactics are mostly focus on test material which is great for test but leaves a lot wanting with regards to up-to-date and coming-down-the-pipeline treatments that you tend to get at university eye institutes. Oklahoma State University Medical Center - Didactics- resident run, guided by a semi-retired retina doctor that worked in academic medicine for a time. Still didactics are sufficient but lacking Structure- resident clinic 10min from hospital, surgery in Muskogee one day a week which is hour away, neuro-ophth must be arranged and done out of Tulsa, usually out of state. The rest is in Tulsa, they cover 3 hospitals which are within 15-20 min drive Surgical volume- high, residents get to participate in surgery with patients from resident clinic as well as with the program director’s busy practices. Residents often reach required cataract numbers in their 1st year. impressive for any program including MD but all surgery done with the program director are partial surgery meaning the resident perform >50%, enough to qualify as a numbered surgery but rarely if ever do they perform the complete surgery. Thus, residents are excellent at phacoing, chopping, but capsulorrhexis skills are on par with everyone else. Call- moderate, not over worked but enough go get good experience, hospitals are close to each other and reasonable places to live Pros/what works- have a full time salaried staff doctor that oversees the resident clinic. Early and high volume of surgery experience. more exposure to “advanced” techniques like limbal relaxation, phaco-chop, contact lens implants, toric. Talk of developing a DO multispecialty eye institute. Moderately decent place to live. Cons/deficiencies- resident clinic pt volume can be low at times. neuro out of state. the program director has really carried this program, as he gets older there is some question as to the future direction of the program at least in regard to the high surgical exposure. Millcreek Community Hospital - Didactics- resident run Structure- general rotations are in Erie, peds is in Erie, other rotations are in other towns in Pennsylvania and in other states, these rotations repeat ever year so residents are constantly moving and finding subleases for 1-3 months for. One resident stated they moved over 20 times in 3 year. Surgical volume - low to mod Call - low Pros/what works- small friendly town it that works for you it works for you, highly esteemed peds attending. Cons/deficiencies- travel and moving, young program that seems to still be trying to land on its feet. Hospital turf battles and osteopathic egotism end up limiting pt volume and program funding. hospital has tendency to match outside of the formal match process. Philadelphia College Osteopathic Med - Didactics- done at Will’s eye, so you can’t get much better Structure- Resident clinic that operates at different attendings offices throughout the week such that you are usually on a general service but at different multispecialty practices. If you need to consult with say a plastics doctor you walk down the hall and consult with him/her. But you not strictly on a plastics rotation. Attendings- many are Will’s eye affiliated doctors that practice in outside clinics to the Will’s eye hospital. Surgical volume- low-mod Call - resident cover 3? hospitals but most anything eye related that in Philadelphia gets send to the Will’s eye emergency room, so residents are limited in ER exposure (this is a challenge for philly MD programs too) Pros/what works- great didactics, a great “phone book” of attendings to consult Cons/deficiencies- program has struggled with funding, only able to support 1 resident/year for several years and some difficulty at maintaining that one position. patient volume can be low. clinic sites are spread out and can be 45 min apart. Schedule is such that you can be in one clinic Monday morning, somewhere else Monday afternoon, and somewhere else the next day. Housing can be expensive and/or have longer commute times. Many students report program disorganization and frustration with communication; this may be a transient or more continuous problem. Did not match this year. The program was up for re-accreditation so there are rumours as to whether they failed accreditation, if there is funding issues, or something else. Larkin Hospital, Miami- new program this year, went up in ERAS pretty late, I'm sure most applicants didn't even know about it. Those who know more please comment. |
Gotta say I thought this was gonna be another post where my response was gonna be "search fx". But no, this actually has a wealth of info, thanks for sharing!
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Very appropriate assessment, unfortunatley the funding issues is so variable year to year that the minute you hit post on this thread it began to be outdated. Question for "EnemaCure" Did you match into ophthalmology or are you going for MD? PCOM had funding issues but ended up matching someone after that was resolved.
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thanks Enema, good luck to you in your search for a residency i hope you get into one!
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Also idk where you got they are low paid. The residents there (my cousin included) are always saying how even though the hospital is in a crappy neighborhood, the pay is amazing. I believe they start at 50K or 51K as interns, which is huge pay for intern year. I didnt compare that stat to what it says on opportunities though, but my cousin (And my conversations with interns) imply its just over 50K. The rest of the stuff, including about not covering your costs is all true. The FP program covers everything, and are super generous, but ophtho and surgery leave your costs up to you to handle. I would heavily downplay your concerns about distances you travel. If you go FP-> ophtho you do very little traveling. Surgery-> ophtho does lead to a lot of traveling as the surgery sites are all around. The ophtho hospitals (SJEH, All Saints or whatever its called, NY Eye and Ear) are all super easily accessible, especially if you live in western queens or western brooklyn. Theyre all right along highways that dont get too busy at all. Which is rare for NY, but literally if you're going to pick highways to be on, its the belt and the FDR. But of course all it takes is one car accident to turn a snappy quick commute into a crawl. No way around admitting that. Overall you're right on target. Just had a few completely incorrect points buried in a mostly correct assessment. Probably due to either miscommunication or confusing SJEH with another program. |
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Thanks, all. I really appreciate your advice. Any opinions about where to do auditions?
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Do any of you know any residents(their contact info) I can contact at Oakwood, St. Johns, or really any program for that matter? If so PM me please. Thanks.
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One more question. If my school won't change my schedule for me, and the programs won't accommodate the only days I have available, is it okay to contact the program director through email and explain my situation and see if I could go possibly rotate with them? Thanks.
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Corrections
I rotated at most of the DO ophthalmology programs and am a senior resident at one of the programs listed. Unfortunately most of what the person who started the thread is factually inaccurate.
One thing that should be noted is that the DO programs have more variation from program to program vs their MD counterparts. DO programs have the same surgical and didactic requirements as the MD programs with the only exception being cataract surgery. DOs require 50 surgeries by graduation. MDs require 85. All the programs hit those numbers, some a lot higher than others. All the DO programs provide out months for their residents. So about 6 months during the full 3 years are out/travel months for them to do any rotation at any institution. So let's starts comparing: NY: The strongest from a didactic standpoint by far. As a PG2 you will be required to attend daily lectures at all the grand rounds around town. So one day it will be at NYEE, one at Columbia, one at Cornell, one at Suny. Almost all are after work from 6 to 9 pm. That could get old really quick. But you are learning with the best. Down fall is no time to read. Most rotations are around town, exception being Peds done in Erie. They live in NY doesn't get better than that. NY is a union state so all the residencies pay the same, $50k plus. They are required to go to India for surgery as a senior. It costs the residents $15 to $20k, which is not reimbursed. That make things tough as a senior because applying for fellowships will also cost $10k w travel and lodging, generally. One big down fall is you were required to do extra year as a surgery or family medicine resident. But I hear they are getting rid of that since now they are having a better time matching at those specialties. Oklahoma: The strongest from a surgical stand point. Residents on average do 300 to 400+ cataract surgeries. Its remarkable how much surgery their residencies do. Tulsa is a nice mid size city. One big down fall is they don't have many didactic oriented attendings on a daily basis. But it looks like that's changing. They've recruited a Cornea and Glaucoma specialist. Overall good program. St. John/POH: The oldest program. Its an okay program all the way around. Run by a husband and wife team. They get didactic at Wayne State and Beaumont. But they are never acknowledged their. Its like the residents were outcasts intruding in someone else's home. Weird to say the least. They cover 2 hospitals. Most of their rotations is within the metro Detroit area. Erie: Good all the way around. Starting off as first years they go to Wills Eye to do a full month crash course in ophthalmology. This is repeated during their mid second year going to Columbia Eye for a full month for review. Didactics is resident run, but done well on a daily basis. They cover 3 hospitals in town, one is a trauma center. Their base clinic is a resident run clinic. Moderate to high amount of cataract and pediatric surgery. Rotations mostly in the state of PA. Down fall is living in Erie, PA. Their interview process can be intimidating. High COMLEX scores a must i'm told. OH programs: Both have excellent didactics and both consistently score the highest on the OKAPS. Moderate amount of surgery. Didactics done with OSU counterparts, which embrace them and are friendly with each other. Hillsdale: Moderate to high amount of surgery. As a PGY2 he will have you doing cataract surgery. The down fall and strengths of the program are related to the program director. He's a one man show, and its a one clinic show. But very strong didactics run by him. They have a cataract simulator that all the residents use. The program director is very very picky on who he accepts. He only ranks a couple people that he wants to train, if he doesn't get them he will just not accept anyone for that year. Kinda weird. The other programs I don't know much about. Best of luck :) |
Can anyone share their experiences or any information they have about the new program in Larkin Hospital in Miami? I know its a new program and they would be working out the kinks, but is there enough going on in the resident clinic and ORs to be educationally sufficient for 3 residents per year? How are there didactics?
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