1st year

[Myh60]

Hi! What should we be able to do at the end of the 1st year of residency in ophthalmology? At the hospital we don't have many cases and I still have difficulties recognizing large elements at the back of the eye or important pathologies, for example hypertensive/diabetic retinopathy or macular edema. At this moment, I didn't even have retinal detachments... I started to panic and I would need your advice, because I'm already thinking of giving up... It’s normal? I think that at the end of 1st year you need to recognize the important pathologies...

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[PLA2]

what country are you in

 

[RetinaDude]

If you are in an OD training program, I’d say this might not be unusual. But, if you are in the first year of ophtha (PGY2) residency then this is concerning. You should be seeing tons of pathology, and by the end of the first year, be able to identify basic issues like RDs, diabetic retinopathy, CRVO/BRVO, etc…. To me, those are “bread and butter” diseases you should be seeing at least a few times per week (depending on rotation but especially if you are rotating thru retina)

 

[Gonio5]

If you are in an OD training program, I’d say this might not be unusual. But, if you are in the first year of ophtha (PGY2) residency then this is concerning. You should be seeing tons of pathology, and by the end of the first year, be able to identify basic issues like RDs, diabetic retinopathy, CRVO/BRVO, etc…. To me, those are “bread and butter” diseases you should be seeing at least a few times per week (depending on rotation but especially if you are rotating thru retina)

There is not enough information to answer the question. Several possibilities exists including:

1. Two years ago, the ACGME began requiring that ophthalmology residencies have an integrated PGY-1 year. This would eliminate the situation where some residents try to do a cushy internship and also allow for perhaps 3 months of ophthalmology rotations. The original post may be such a PGY-1 resident. I believe this is the most likely.

2. Perhaps an OD training program but the original post says it's ophthalmology residency.

3. Rare case of a resident in a very weak program getting a bad schedule that has few clinics and patients. Even slightly weak programs do train reasonably good ophthalmologists. The variation between the best and worse ophthalmologist is much smaller than many other specialties.

 

[RetinaDude]

Yes, all true. I assumed….which is always bad to assume……since he/she said first year of ophthalmology training that meant he was PGY2.

 

[Myh60]

I am preparing to finish the first year of residency and there are many basic pathologies that I have not seen. For example, in the whole year I saw only one case of anterior uveitis. In the operating room we only have cataract, pterygium, eyelid interventions and ocassionaly intravitreal injections. Also, even in the operating room, it doesn't let me do anything... I just sit, watch and prepare the instruments. I feel like I'm wasting my time and I don't know what to do. Do you have some advice that you could give me from your experience?

 

[Slide]

I am preparing to finish the first year of residency and there are many basic pathologies that I have not seen. For example, in the whole year I saw only one case of anterior uveitis. In the operating room we only have cataract, pterygium, eyelid interventions and ocassionaly intravitreal injections. Also, even in the operating room, it doesn't let me do anything... I just sit, watch and prepare the instruments. I feel like I'm wasting my time and I don't know what to do. Do you have some advice that you could give me from your experience?

First, are you in a US or ACGME-affiliated residency? For a US residency this is fairly unusual.

 

[Gonio5]

Hi! What should we be able to do at the end of the 1st year of residency in ophthalmology? At the hospital we don't have many cases and I still have difficulties recognizing large elements at the back of the eye or important pathologies, for example hypertensive/diabetic retinopathy or macular edema. At this moment, I didn't even have retinal detachments... I started to panic and I would need your advice, because I'm already thinking of giving up... It’s normal? I think that at the end of 1st year you need to recognize the important pathologies...

what country are you in

It is December and the year is almost over? Yet, US residencies start in July. What countries do they end in December? Australia?

First, are you in a US or ACGME-affiliated residency? For a US residency this is fairly unusual.

My guesses is starting to be:
1. Australia
2. U.S. PGY-1 where it is mostly internship with a little ophthalmology exposure. Note that starting 2 years ago, ophthalmology is no longer PGY-2 to PGY-4 but is PGY-1 to PGY-4. The PGY-1 year is 3 months (usually a block but doesn't have to be) of ophthalmology. The ACGME prohibits any research rotation during the 9 months of non-ophthalmology PGY-1 rotations but permits research during part of the PGY-1 opthalmology rotations. Therefore, the original poster could have had as little as one or two months of clinical ophthalmology.

 

[Myh60]

I do my residency in Romania. We start the first year of residency in January and it ends in December.

 

[RetinaDude]

Thank you for the clarification. With this, I stand by my original post. If your year of training (January to December) is purely ophthalmology based (and not combined with rotations through other medical/surgical specialties), then you should definitely be experiencing broader pathology and be able to recognize diabetic retinopathy, detachments, macular degeneration, etc….

 

[PLA2]

There is a Romanian trained doctor who married a department chair in the U.S., who then accepted her into the residency. There, other faculty were afraid to evaluate her for fear of retaliation.

lmfao we all know who this is

 

[Slide]

lmfao we all know who this is

Yeah lol, pretty old news.

 

[Slide]

I do my residency in Romania. We start the first year of residency in January and it ends in December.

I would say in general, yes, this is not good. You should be seeing and doing more.

 

[Myh60]

Thanks for your answers! Because I don't do many things in residency, I keep thinking of giving up the specialty... but I worked so hard to get here... Finally, would you tell me how was your first year of residency in ophtha?

 

[Myh60]

There is a Romanian trained doctor who married a department chair in the U.S., who then accepted her into the residency. There, other faculty were afraid to evaluate her for fear of retaliation.

Oh wow