Ophthalmology Forum FAQ & Applying to Ophthalmology Residency Programs

[Andrew_Doan]

What are the differences between ophthalmologists, optometrists, and opticians? (Contributed by r_salis)

Ophthalmologists, Optometrists, and Opticians are all eye care providers whose scopes of practice are defined by the types of training they receive.

An Ophthalmologist is a physician -- an MD or DO -- who has completed a four year undergraduate degree, a four-year medical degree followed by a 1-year internship and 3-year (or more) residency in ophthalmology.

Ophthalmologists (MD or DO) can:
-- prescribe glasses and contact lenses
-- diagnose eye abnormalities and disease
-- treat all eye conditions and disease, including those of the surrounding flesh, bones, and muscle with surgery (conventional and laser surgery), medications, etc.
-- diagnose other conditions and illnesses based on symptoms evident in the eyes and refer patients to another appropriate physician for treatment
--fit, adjust and dispense eyeglasses
_______________________________
An Optometrist is not a medical doctor, but receives the degree of OD at a 4-year optometry school after completing four (or sometimes three) years of undergraduate study.

Optometrists (OD) can:
-- prescribe glasses and contact lenses
-- diagnose eye abnormalities and disease
-- treat some types of eye disease
-- diagnose other conditions and illnesses based on symptoms evident in the eyes and refer patients to another appropriate physician for treatment
--fit, adjust and dispense eyeglasses
_______________________________
An Optician is a technician who has either earned a 2-year optician degree from a community college or has learned while on the job.

Opticians can:
--fit, adjust and dispense eyeglasses

Can optometrists do minor surgeries, laser surgeries, or intraocular surgeries?

In 49 of 50 states, it is illegal for optometrists to do any of the above. In Oklahoma, because of aggressive optometry lobbying, optometrists (OD) may perform some laser procedures. A recent OK bill will permit OK optometrists to become ophthalmologists with the Optometry Board deciding which surgeries can and cannot be done. This sets a dangerous precedent for a non-surgical specialty to form its own surgical board. In the VA, OK optometrists were performing laser procedures and minor surgeries on veterans. Ophthalmologists must stand together and fight this now and in the future. We should be involved at the state and federal level. Any new optometry surgical bill need to be fought aggressively at the state level. Please give money to your local ophthalmology society, OPHTHPAC, and the new Surgical Scope Fund.

Sign-in on www.aao.org first, then load this page.

http://www.aao.org/aao/advocacy/ophthpac/index.cfm

http://www.aao.org/aao/advocacy/state/ssf.cfm


What are the different sub-specialties in ophthalmology?

General ophthalmologists can treat the majority of eye diseases medically and surgically. If fellowship training is desired, there are several different sub-specialties including:
- Cataract / General
- Cornea
- Glaucoma
- Lasik / Refractive
- Neuro
- Ocular Pathology
- Oculoplastics
- Pediatric
- Vitreo-retinal

After fellowship, physicians may concentrate solely on their sub-specialty or practice general ophthalmology with an emphasis on their trained sub-specialty. For instance, ocular pathologists usually practice general ophthalmology, perform surgery, and concentrate on pathology.

For more information about the different sub-specialties please visit here:
http://www.eyemdlink.com/Specialties.asp

I am interested in pursuing a career in ophthalmology. Where should I start?

In medical school, talk to the medical student rotation director for ophthalmology. Arrange to do an ophthalmology elective during the end of your third year. This will allow you to explore the field and build relationships with attendings and staff who can write a letter of support for your application. Doing your first ophthalmology elective as a fourth year is too late because applications should be submitted to the Central Application Service before September of your fourth year of medical school.

Read the Pearls in Ophthalmology Newsletter: http://www.medrounds.org/ophthalmology-pearls/

Subscribe to the newsletter: http://www.medrounds.org/ophthalmology-pearls/2006/12/subscribe-to-free-pearls-in.html

Should I do a rotation at a different program as a medical student?

This is a great idea if you're interested in doing a residency at a specific program. Completing a rotation at an outside institution will allow the faculty to know you better and increase your chances of being recognized during the selection process. However, this experience may also work against you if you're not liked.

Contribute to or search the EyeRounds.org database of ophthalmology rotations: http://www.eyerounds.org/rotations.htm

Is there a good book to teach me about examination techniques?

I recommend these books published by the American Academy of Ophthalmology:

"Practical Ophthalmology, A Manual for Beginning Residents"

Edited by Fred M Wilson II, MD

http://www.amazon.com/exec/obidos/A...5654?creative=327641&camp=14573&link_code=as1

"Basic Ophthalmology for Medical Students and Primary Care Residents"

by Cynthia A. Bradford

http://www.amazon.com/exec/obidos/A...5654?creative=327641&camp=14573&link_code=as1

You can also browse for other ophthalmology texts here:
http://www.eyerounds.org/books.htm

and on MedRounds.

A free video on how to do complete a Two Minute Eye Exam for Students and Primary Care Physicians can be found here:
http://www.medrounds.org/bookstore/ProductDetail.php?product_id=32


Learn to to refract - Refraction Tutorial: The Fundamentals for the Beginner and Expert by Todd Zarwell, OD

http://www.medrounds.org/refract/menu.htm

What is the Central Application Service (CAS)?

This is a centralized application service for ophthalmology and a few other medical specialties. You submit all your letters and application materials to this service. The service will then send copies of your applications to the programs you are applying to. The Dean?s letter is sent after November when CAS receives it. The website is www.sfmatch.org.

Ophthalmology is an early match and results are known in January. This allows time for students to arrange for an internship program which is organized by the NRMP (http://www.nrmp.org).

How competitive is ophthalmology?
All applicants must be graduates from a medical school with the M.D. or D.O. degree.

Applicants are very strong candidates with good grades in medical school, excellent board scores, demonstrated interest in ophthalmology, and outstanding letters of recommendation. Here are some statistics from the 2001 match:

CAS Participants: 798 (662 rank lists submitted)
Matched Participants: 435 (379 were new US Seniors, 83% of new US Seniors matched)
Matched Avg. USMLE I: 224
Unmatched Avg. USMLE I: 206
Avg. applications: 36
Avg. interviews: 7.5
Number of IMGs matched: 23

For the 2004 Match:
CAS Participants: 786 (639 rank lists submitted)
Matched Participants: 438 (369 were new US Seniors, 82% of new US Seniors matched)
Matched Avg. USMLE I: 228
Unmatched Avg. USMLE I: 218
Avg. applications: 41
Avg. interviews: 7.9 (Average offers 4)
Number of IMGs matched: 35
Percent Matched AOA - 20%

For the 2005 Match:
CAS Participants: 761 (596 rank lists submitted)
Matched Participants: 443 (374 were new US Seniors, 86% of new US Seniors matched)
Matched Avg. USMLE I: 229
Unmatched Avg. USMLE I: 213
Avg. applications: 43
Avg. interviews: 8.4 (Average offers 4.4)
Number of IMGs matched: 34

For the 2006 Match:
CAS Participants: 743 (620 rank lists submitted)
Matched Participants: 446 (382 were new US Seniors, 88% of new US Seniors matched)
Matched Avg. USMLE I: 230
Unmatched Avg. USMLE I: 215
Avg. applications: 45
Avg. interviews: 8.1 (Average offers 4.4)
Number of IMGs matched: 26

For the 2007 Match:
CAS Participants: 792 (648 rank lists submitted)
Matched Participants: 449 (399 were new US Seniors, 89% of new US Seniors matched)
Matched Avg. USMLE I: 231
Unmatched Avg. USMLE I: 215
Avg. applications: 47
Average offers 4.0
Number of IMGs matched: 25

SDN 2004 Match Stats:
http://forums.studentdoctor.net/showthread.php?s=&threadid=100344

SDN 2005 Match Stats:
http://forums.studentdoctor.net/showthread.php?t=169692

SDN 2006 Match Stats:
http://forums.studentdoctor.net/showthread.php?t=253556

SDN 2007 Match Stats:
http://forums.studentdoctor.net/showthread.php?t=353655

SDN 2008 Match Stats:
http://forums.studentdoctor.net/showthread.php?t=483563

SDN 2009 Match Stats:
http://forums.studentdoctor.net/showthread.php?t=593386

How many interviews do I need to ensure matching at a program?

Historically, applicants who have at least 7-8 interviews have the most likelihood of matching. However, with recent competition rising, most people will encourage the completion of 10 or more interviews, depending on your competitiveness.

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[Andrew_Doan]

Is basic science or clinical research needed before applying?

While ophthalmological research is helpful, it is not required. The most competitive programs do require prior research. For instance, this is what the Wilmer Institute says about their successful residents:

1. Outstanding college and medical school academic records.
2. Board scores above the 90th percentile.
3. Evidence of academic potential as indicated by authorship (especially first-authored) of at least one scientific article (ideally, concerning an ophthalmologic subject) in a peer-reviewed journal.
4. Evidence of commitment to ophthalmology as indicated by involvement (research, electives, etc.) in the ophthalmology department at their medical school.
5. For foreign medical graduates, at least the 90th percentile on the ECFMG examinations

What is the timeline for applying to an ophthalmology residency?

The best time to do ophtho electives is in June/July/August. This way you can ask for and receive letters of rec in a timely manner.

June: register with SF match.

By June/July - have your CV and personal statement done. Both should be given to everyone that is going to write you a letter of rec. Try to give your letter writers a month to write the letter. My advisor recommended one letter of rec from ophtho, one from medicine, one from G-surg. I am sure others on this forum might have done that part differently or have other suggestions.

June/July - register with ERAS (central application service for prelim/transitional programs and all other things that don't go through SF match). Your school will issue you a "token."

August - I would try to have my ophtho application (including all letters of rec) in by the end of August/beginning of September. SF match will post a "target date" on their website.

September - By the beginning of Septemeber, you can start submitting your application to ERAS. I would try to get it completely submitted no later than the middle of September.

If you are asking the same letter writer who wrote you a letter for ophtho to write you one for internship, i would ask them to write you 2 versions of the same letter. One that states, "this candidate will make an awesome ophthalmologist" and one that states "this candidate will make an excellent intern."

October - register with NRMP. This is the matching service for your internship year or for all other things that don't go through SF match. Note: NRMP is different from ERAS!

November/December - Try to leave your schedule during the months of November and December open for interviews. For example, this is not the time to be doing your 4th year medicine sub-I because you will be traveling a lot. Rather, this is a great time to do a research block or at my school, radiology. Count on the bulk of your interviews lasting through the 1st 2 weeks of december. Try to knock off your prelim interviews during this time, if you can. If not, prelim programs generally offer interview dates in January.

Beginning of January - Ophtho rank lists do to SF match.

End of January: ophtho match

February: rank lists do for NRMP

End of March: regular match.

How is ophthalmology residency structured?

Most programs are three years following a one year internship in either: internal medicine, general surgery, or transitional medicine. Residency programs may vary in how they set-up the rotations, but most adhere to the following outline.

As a first year resident, you mainly focus on learning about the various ocular diseases. Time is spent in both general ophthalmology clinic and sub-specialty clinics, such as: retina, pediatrics, neuro-ophthalmology, ocular pathology, glaucoma, cornea, and oculoplastics.

During the second year, residents are introduced to intra-ocular surgery and laser surgery. Second year residents spend most of their time in sub-specialty clinics such as: retina, neuro-ophthalmology, glaucoma, pediatrics, and general ophthalmology.

The third year resident devotes most of their time learning advanced surgical procedures and refining their surgical skills. They spend a lot of time with anterior segment/cataract surgery, cornea, oculoplastics, and backup call at night and weekends for traumas.

During the residency, most programs have the first year residents take primary call. The first year deals with the initial evaluation and treatment of patients. If surgery is needed or a second opinion is required, then the senior residents are available.

What are the competencies in ophthalmology?

http://webeye.ophth.uiowa.edu/eyeforum/compindex.htm

What are the required number of surgeries each resident should complete? Class 1 surgeries are done as the primary surgeon and Class 3 surgeries are done as the assistant.

http://www.acgme.org/RRC/Oph_OpStats.asp

Which residency programs are good? Where do I find rankings for programs?

Start by asking people in the field about good residency programs. You can also read feedback from other applicants and residents in: http://forums.studentdoctor.net/showthread.php?t=470595

There are two main ranking sources for residency programs and ophthalmology departments. One is offered by US News and the other from Ophthalmology Times. Click below for the rankings:

http://www.usnews.com/usnews/nycu/health/hosptl/rankings/specrepopht.htm

http://www.ophthalmologytimes.com/ophthalmologytimes/article/articleDetail.jsp?id=76764&pageID=1

http://www.ophthalmologytimes.com/o...rticleDetail.jsp?id=128492&pageID=1&sk=&date=

What should I look for in a residency training program?

Things I looked for when i applied/interviewed:

1. Residents - were they happy or not, would you fit in with them.

2. Surgical numbers - find out how many you will get as the primary surgeon [i.e., Class 1] (some places say you get 150 cataracts but they count standing in the corner and watching as a case) and what types of cases (i.e., - make sure it's not 150 cataracts with no exposure to retina/ plastics/ glaucoma/ etc). Ask the residents about this. Personally, I was very suspicious about programs that made you go to (or had an "optional rotation" in) another country or state for a month to do surgery.

3. Fellowship/ job placement - do residents get good ones or do they struggle with this.

4. Faculty - will they teach you or are you just there to do their scutwork.

5. Location - speaks for itself, although you should consider going to a less desired location if the program is great - it will probably get you back to where you want to be.

6. Academics - lectures/ wet labs/ etc - some places require saturday morning lectures - decide whether or not you are willing to have only one day off per week for your entire residency.

7. Call - are you willing to take in house call or not?

8. Research - most programs require it, but to a different extent. Decide how much research you want to do, and if academic medicine is important to you.

9. Hospitals - programs with multiple hospitals will get you more surgery and a wider range of pathology. What i mean by this is that the VA and county hospitals get you alot of rare/ end stage pathology and surgical experience. "Nicer" hospitals show you what most of us will probably be doing out of residency. it is good to have both experiences.

There is a lot more, and no program is perfect. No matter what happens, be happy if you match somewhere. Good luck to all the applicants this year.

Also look at residency reviews on: Scutwork.com


What is the lifestyle of a practicing ophthalmologist?

Because most surgeries are now outpatient procedures, most ophthalmologists can adhere to regular clinic hours, e.g. 8 AM - 5 PM. Practices vary, but most will devote 2-3 days per week in clinic and 1-2 days per week for operating time. Call is usually shared among physicians within the practice, and any major traumas or problems usually get referred to a teaching hospital if available.

How much do ophthalmologists make?

This greatly varies depending on the setting you practice in. Academic and military physicians usually make half to two-thirds of what private practicing ophthalmologist can make. If one is in a practice that owns an ambulatory surgical center, then the earning potential is higher because these physicians bill for both the surgery and the use of the surgical center. The answer to this question can be answered here:

http://www.allied-physicians.com/salary_surveys/physician-salaries.htm

http://www.cga.state.ct.us/2003/olrdata/jud/rpt/2003-R-0297.htm

http://www.ophmanagement.com/archive_results.asp?article=85973

Where can I find available ophthalmology positions?
Here:
https://secure3.aao.org/professionalchoices/search.cfm?cfid=1849251&cftoken=8814392

Where can I find ophthalmology programs or references for the Palm or Pocket PC?

www.EyeRounds.org/downloads.htm

http://forums.studentdoctor.net/showthread.php?t=168549


Can I contribute to this FAQ?

If you would like to add to this FAQ, then please drop me an e-mail or private message. You will be acknowledged for your contributions. I will also need updated statistics from the Central Application Service for newly matched residents each year; so, if you receive the summary sheet from CAS after match day, then please forward me a copy.

 

[Andrew_Doan]

The links provided do not work or are outdated.

Please send me a message, and I will update the links.

Websites related to ophthalmology:

http://www.medrounds.org/ophthalmology-pearls/2006/06/free-online-educational-resources.html

If corrections are needed or you want to contribute to this FAQ, then please send me a message. Thank you!

 

[Andrew_Doan]

Please contact me if you want to add an abbreviation to the list below. I remember the great difficulty as a medical student and first year resident trying to learn the "lingo". I hope this list will help.

http://forums.studentdoctor.net/showthread.php?t=120338