Any advice?

[BTR1208]

I am a 2nd year undergrad at Indiana University. I have always wanted to be an Ophthalmologist. I have had 3 eye surgeries myself so I was fascinated from a young age. After graduating high school I decided on Optometry just because I did not know if I had what it took to get through medical school. I am starting on my science prerequisites this Fall and know I will really be in the thick of things as it has been a fairly easy ride thus far. I have a 3.8 and do not plan on letting that go down. I am the kind of person that really likes to have a plan and once I have it I execute. I have been really struggling to decide if I should stick with Optometry or go for exactly what I want and take the Ophthalmology path. Is there anyone that has been in my situation and what did you decide? Also any other advice would be great appreciated.

Thanks guys!

B

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[EyeFun]

You have a 3.8 so far and that's great. Science classes tend to be harder, but if you are motivated to keep your GPA up that's fantastic. If you can keep your GPA up near a 3.7, you should be fine going to an American medical school. If you're dream is to be an ophthalmologist, I wouldn't let it go so early. You should try to keep that dream alive and help motivate you to do your best in the rest of your undergraduate coursework and on the MCAT. My fiance's dream was to go to a top14 law school. She ended up doing a masters and taking the LSAT 3 times before she got there, but she finally made it. Life is a long road and if you want to be an ophthalmologist that bad, then go on and do it! I wish you the best of luck in your endeavors.

 

[The Doctor]

I think that most people who are relatively high functioning could make it through medical school given enough effort and dedication. If you truly wish to make it through med school, I bet you could do it. A large part of the difficulty stems from maintaining your composure and performance as you are forced to memorize large amounts of information and work for longer hours. Many people who start med school will ultimately change their mind on specialty choice once they have exposure to various fields, so keep that in mind.

The one other thing that I hesitate to mention to you is that your past eye surgeries may put you at a disadvantage during the application and training process. Did you have surgeries for strabismus, and have you been tested for stereoscopic vision? I do not agree with discriminating on the basis of a disability that can be accomodated, but there are several ophthalmology programs that will test your visual acuity, color vision, and stereoscopic vision as part of the application process. Additionally, you may have difficulty learning to perform cataract surgery if you had strabismus surgeries which have left you under a certain level of stereopsis. I have not trained yet, so I cannot say for certain - I'm only repeating what I heard out on the interview trail this past year. You may also want to think twice about mentioning those surgeries in your personal statement or when you apply. I had friends this year who had congenital cataracts or sceral buckle surgeries for retinal detachments who became interested in ophthalmology because of their experience as a patient. I think this type of experience is valuable, but they were counseled not to mention the surgeries during the application process. Others with more experience or knowledge on the matter can probably advise you better here than I can.

 

[xanthomondo]

I think that most people who are relatively high functioning could make it through medical school given enough effort and dedication. If you truly wish to make it through med school, I bet you could do it. A large part of the difficulty stems from maintaining your composure and performance as you are forced to memorize large amounts of information and work for longer hours. Many people who start med school will ultimately change their mind on specialty choice once they have exposure to various fields, so keep that in mind.

The one other thing that I hesitate to mention to you is that your past eye surgeries may put you at a disadvantage during the application and training process. Did you have surgeries for strabismus, and have you been tested for stereoscopic vision? I do not agree with discriminating on the basis of a disability that can be accomodated, but there are several ophthalmology programs that will test your visual acuity, color vision, and stereoscopic vision as part of the application process. Additionally, you may have difficulty learning to perform cataract surgery if you had strabismus surgeries which have left you under a certain level of stereopsis. I have not trained yet, so I cannot say for certain - I'm only repeating what I heard out on the interview trail this past year. You may also want to think twice about mentioning those surgeries in your personal statement or when you apply. I had friends this year who had congenital cataracts or sceral buckle surgeries for retinal detachments who became interested in ophthalmology because of their experience as a patient. I think this type of experience is valuable, but they were counseled not to mention the surgeries during the application process. Others with more experience or knowledge on the matter can probably advise you better here than I can.

Yeah, I missed this one and I think it really hurt me. Alternatively, though, you can mention at the end of your personal statement that you have 20/20 vision and 40 arcsec of stereopsis. You might want to get an eye exam sooner rather than later checking for stereovision because if you don't have any you won't be able to do surgery and that could save you a lot of frustration down the road.

If your vision isn't holding you back I would go for ophtho...don't sell yourself short just because you have some doubts.

 

[BTR1208]

I think that most people who are relatively high functioning could make it through medical school given enough effort and dedication. If you truly wish to make it through med school, I bet you could do it. A large part of the difficulty stems from maintaining your composure and performance as you are forced to memorize large amounts of information and work for longer hours. Many people who start med school will ultimately change their mind on specialty choice once they have exposure to various fields, so keep that in mind.

The one other thing that I hesitate to mention to you is that your past eye surgeries may put you at a disadvantage during the application and training process. Did you have surgeries for strabismus, and have you been tested for stereoscopic vision? I do not agree with discriminating on the basis of a disability that can be accomodated, but there are several ophthalmology programs that will test your visual acuity, color vision, and stereoscopic vision as part of the application process. Additionally, you may have difficulty learning to perform cataract surgery if you had strabismus surgeries which have left you under a certain level of stereopsis. I have not trained yet, so I cannot say for certain - I'm only repeating what I heard out on the interview trail this past year. You may also want to think twice about mentioning those surgeries in your personal statement or when you apply. I had friends this year who had congenital cataracts or sceral buckle surgeries for retinal detachments who became interested in ophthalmology because of their experience as a patient. I think this type of experience is valuable, but they were counseled not to mention the surgeries during the application process. Others with more experience or knowledge on the matter can probably advise you better here than I can.

Yes I did have surgery for strabismus. That is a let down. I figure I will just stick with Optometry then, I really could not see myself going to med school for any other reason than Ophthalmology.

Thanks for the info!

 

[RestoreSight]

...I really could not see myself going to med school for any other reason than Ophthalmology.

That sounds a bit narrow minded to me. Ophthalmology is one of many awesome fields in medicine. Ever see a total knee replacement up close? Ever watch a skilled invasive cardiologist thread a catheter into someone's right coronary? Ever see the satisfaction on a patient's face when they have been in the hospital for a month and are finally discharged home with a clean bill of health? Its hard to see the big picture of medicine when you are a pre-med, but the vast majority of physicians first want to heal, then decide what field they want to specialize in later. I would ask yourself what your real goals are before you write off medicine entirely just because you may or may not be able to enter ophthalmology.

 

[Visionary]

That sounds a bit narrow minded to me. Ophthalmology is one of many awesome fields in medicine. Ever see a total knee replacement up close? Ever watch a skilled invasive cardiologist thread a catheter into someone's right coronary? Ever see the satisfaction on a patient's face when they have been in the hospital for a month and are finally discharged home with a clean bill of health? Its hard to see the big picture of medicine when you are a pre-med, but the vast majority of physicians first want to heal, then decide what field they want to specialize in later. I would ask yourself what your real goals are before you write off medicine entirely just because you may or may not be able to enter ophthalmology.

You also might want to visit the optometry forum. Not a very happy place recently.

 

[BTR1208]

I understand where you are coming from and it really is good advice. So can anyone confirm that I will not be able to enter ophthalmology? Is it surgery in general or just eye that I will not be able to do? I am just extremely interested in Ophthalmology and feel I would have loved the environment. What other fields would be suggested for me? I was originally going to do Chiropractic (don't laugh) then switched to Optometry and have been hearing awful things about that field so I just want to find something I will be happy doing and can be successful.

 

[BTR1208]

You also might want to visit the optometry forum. Not a very happy place recently.

So i have heard and it is really disappointing. Seems the field is just hard to do well in.

 

[Visionary]

I understand where you are coming from and it really is good advice. So can anyone confirm that I will not be able to enter ophthalmology? Is it surgery in general or just eye that I will not be able to do? I am just extremely interested in Ophthalmology and feel I would have loved the environment. What other fields would be suggested for me? I was originally going to do Chiropractic (don't laugh) then switched to Optometry and have been hearing awful things about that field so I just want to find something I will be happy doing and can be successful.

As The Doctor asked, do you have stereopsis? If your strabismus surgery was early enough, you may have enough stereopsis for it to not be an issue. You pretty much have to have at least a fair amount of stereopsis to perform microsurgery. Too small and delicate an area to be relying on other depth cues.

 

[BTR1208]

As The Doctor asked, do you have stereopsis? If your strabismus surgery was early enough, you may have enough stereopsis for it to not be an issue. You pretty much have to have at least a fair amount of stereopsis to perform microsurgery. Too small and delicate an area to be relying on other depth cues.

It was done at a very young age. 3 surgeries before I was 3 years old. They could never get my eyes lined up perfect. I do not have a lazy eye anymore at all. When I go to the Optometrist for example, I can not see the fly's wings. The doctor says I only primarily see out of my right eye. Is this going to be a deal breaker? I am also considering dermatology, but my real passion is in Ophthalmology.

Thanks for your responses guys!

 

[Visionary]

It was done at a very young age. 3 surgeries before I was 3 years old. They could never get my eyes lined up perfect. I do not have a lazy eye anymore at all. When I go to the Optometrist for example, I can not see the fly's wings. The doctor says I only primarily see out of my right eye. Is this going to be a deal breaker? I am also considering dermatology, but my real passion is in Ophthalmology.

Thanks for your responses guys!

No fly means you essentially have no stereopsis. I don't think ophthalmology is an option for you, unfortunately. There may be some ophthalmologists out there without stereopsis, but I doubt it. Stereopsis is really a must have for microsurgery. Of course, better you find this out now than when you're a 4th year med student applying to ophthalmology residencies. Optometry is still an option, but I'd seriously consider medicine, as there are so many more opportunities for specialization. You never know what may peak your interest. I was set on ophthalmology going in, but flirted with other specialties and could have seen myself being happy in them.

 

[BTR1208]

If you dont mind me asking what else peaked your interest? Derm seems very intriguing.

 

[Visionary]

If you dont mind me asking what else peaked your interest? Derm seems very intriguing.

Honestly, Derm didn't do it for me. I found the Derm clinic rather boring, and the procedures weren't as interesting or numerous as I was expecting. Mostly just punching or shaving off lumps and bumps and looking at them under the microscope. The thing I remember about Derm is that the residents were mostly female and were the only ones I ever saw wearing open-toed heels in the hospital! I actually liked ENT quite a bit. Nice variety of procedures/surgeries. Also enjoyed my trauma surgery rotations, though the lifestyle was a deal-breaker. GI was pretty nice, if you can deal with sticking scopes up people's corn holes. Good mix of clinic and procedures with a nice lifestyle.

 

[RestoreSight]

Honestly, Derm didn't do it for me. I found the Derm clinic rather boring, and the procedures weren't as interesting or numerous as I was expecting. Mostly just punching or shaving off lumps and bumps and looking at them under the microscope. The thing I remember about Derm is that the residents were mostly female and were the only ones I ever saw wearing open-toed heels in the hospital! I actually liked ENT quite a bit. Nice variety of procedures/surgeries. Also enjoyed my trauma surgery rotations, though the lifestyle was a deal-breaker. GI was pretty nice, if you can deal with sticking scopes up people's corn holes. Good mix of clinic and procedures with a nice lifestyle.

I have a hard time hating on derm (my wife is a PGY-4 derm resident), but then again its so easy... as an attending its pretty cush, but as a resident they work you pretty hard and the level of minutia you are required to learn is extraordinary. The skin is the largest organ in the body and its shocking how many funky things can happen to it. That said, derm seems to attract an odd set of personalities. They are like gunners on another level. Ophtho is pretty darn competitive, but derm is really in a league of its own.

It always seems like the differential for med students who like ophtho is ENT, radiology, anesthesia derm, cards, and GI, with gen surg sort of lagging behind. If I hadn't matched in ophtho I probably would have done ENT, radiology, or anesthesia in that order. With that said, its hard to imagine you couldn't find happiness in another medical field. Each of the above specialties have sub-specialties with increasingly complex and cool procedures. Keep an open mind.

 

[hello07]

My 2 cents of advice. As a practicing OD for almost 20 yrs, Optometry is a wonderful profession. You help people see better and practice the way you want to practice-private, corporate(retail optical) clinic, hospital based or with ophthalmology. Choice is yours,
Our profession -the American Optometric Association curently is in disarray. We have never been this divide as a profession before. The topic of board certification for us is ridiculous. More OD schools have opened up and more are opening- further saturation.

Keep up your gpa and take mcats and go to med school. You'll have more opportunities as a physician and you'll be more marketable. Trust me, no matter how great of a cliician you turn out to be as an OD, you will always be considered second class citizen among the health care profession. OMD will always be ahead of us in terms of respect and monetary.

If you believe you'll find your nitch as a happy OD- go for it! If I could turn the clock back 25 yrs I' do certain things differently now.


Aim higher- go to med school w 3.8

Best regards

 

[The Doctor]

This is coming from someone who hasn't graduated med school yet, but when I think of derm, I think of acne, rash, acne, acne, eczema, psoriasis, acne, mole check, eczema, acne, melanoma, acne... I know there are many minutiae they have to learn and that dermatologic skin diseases are very important for quality of life, but I just could not get myself interested in the bread and butter complaints that dermatologists address. Not to mention that manual instantaneous fermentation of liquids and low-speed unpowered water-skiing during storms are pretty much pre-requisites to matching in derm these days.

I tried radiology since my parents kept hounding me to do so as they heard it was the big bucks, but while I found the technology pretty cool, the monotony on a minute to minute basis, the lack of patient contact, and the fact that you no longer handle medical decision making axed that specialty for me. I found radiation oncology to be especially cool given the technology and because dealing with social issues such as death and dying have always been an interest of mine but ultimately decided that I did not want to work with dying patients nor give them complications such as pneumonitis, erectile dysfunction, and colitis. Urology is similar to ophtho in several ways and I enjoyed that rotation, but I also felt uneasy about the complications and questionable utility of routine surgical intervention in prostate cancer. ENT has a few similarities to ophtho but with much more involved, longer and inpatient surgical cases. Internal medicine is pretty cool as well because there is a lot of variety and social issues to manage, and there is a wide range of subspecialties or general practice patterns to pursue.

I remember reading somewhere that there are over 110 different ways to subspecialize in medical care -- probably best to make your decision about medical school first and then go from there, though I agree that it is a good idea to think ahead about what your ultimate goal and endpoint might be along the way.

 

[BTR1208]

I spoke with a professor at IU and he said :

"Some controversy about it- no universally agreed upon answer. We have trained residents and fellows here without stereopsis so it can be done."

"Bottom line is that you can be what you want to be. You will constrained only by your desire and demonstrated abilities, not by whether or not you can pass a stereo test."

Very good news!

 

[Shnurek]

Where do you want to practice? I want to practice in a small town outdoorsy setting so I chose optometry. If you want to be in a big city then ophthalmology is the way to go as the higher patient populations can support diverse pathology and surgical cases. With optometry people bitch about it because they don't have the balls to leave the big cities and saturate themselves. In small towns you get a lot more interesting cases like foreign body removal, bread and butter eye pathology etc. I will get on medical panels and advertise myself as an Eye Doctor and not just as a simple refractionist that also sells glasses.

 

[TheLesPaul]

"Bottom line is that you can be what you want to be. You will constrained only by your desire and demonstrated abilities, not by whether or not you can pass a stereo test."

Not to be overly discouraging, but I was always told by the ophtho faculty in my department that without stereopsis, one can be at best a mediocre surgeon. While there are routes you can take which don't involve surgery under a microscope (medical retina, uveitis?), it seems to me that one's demonstrated abilities under a microscope would be significantly impacted by lack of stereopsis?

And there are a *million* specialties in medical school that you'll like -- eye surgery is not the be-all and end-all of medicine! I would ask myself, before choosing optometry vs ophthalmology -- do I want to be the end-point of care, i.e., do I want the training and certification to completely treat and cure a patient's disease, or am I okay with referring patients?

 

[tm12]

While I was interviewing, many programs required documented stereopsis of at least 40 seconds. Other programs did not require documented eye exams but said please please do not rank this program because we will not let you graduate if you do not have stereopsis and cannot do cataract surgery. Optometry is a field that also requires stereopsis. Being an optometry and losing vision in one eye is different from having one eye and applying to optometry.

If you can see primarily out of only one eye, please consider a different career.

It was done at a very young age. 3 surgeries before I was 3 years old. They could never get my eyes lined up perfect. I do not have a lazy eye anymore at all. When I go to the Optometrist for example, I can not see the fly's wings. The doctor says I only primarily see out of my right eye. Is this going to be a deal breaker? I am also considering dermatology, but my real passion is in Ophthalmology.

Thanks for your responses guys!

 

[Visionary]

I spoke with a professor at IU and he said :

"Some controversy about it- no universally agreed upon answer. We have trained residents and fellows here without stereopsis so it can be done."

"Bottom line is that you can be what you want to be. You will constrained only by your desire and demonstrated abilities, not by whether or not you can pass a stereo test."

Very good news!

That's a great line for a movie of the week, but I'm afraid it's not very good real world advice. Look, I'm not saying you can't become an ophthalmologist. It's just that I think it will be incredibly difficult and potentially dangerous to do so without stereopsis. Just this morning, for instance, I tried to perform an intravitreal injection with one eye closed. It was very difficult for me to tell how close the needle was to the globe. Would my other depth cues be more fine-tuned if I didn't have stereopsis? I don't know. Maybe.

Let me give you a scenario, though. You get into med school, then ophthalmology residency. Everything is going great. You try and perform your first YAG capsulotomy and hit the cornea instead of the lens capsule. This continues to be an issue for several other procedures. Faculty become concerned. They inquire and find out you have no stereopsis and you're kicked out of the program. Believe it or not, that's a true story. What do you do then?

Here's another, hypothetical, one. Say you manage to actually make it through residency and are in practice. You have a bad surgical outcome and are sued. It comes out during trial that you have no stereopsis....

Listen, all I can do is give you my opinion. It's up to you what you want to do with it. In my opinion, you should not pursue ophthalmology or any other microsurgical subspecialty. That said, there are many other medical specialties that I'm sure you would find rewarding. Best of luck to you.

 

[RestoreSight]

Just this morning, for instance, I tried to perform an intravitreal injection with one eye closed.

Just curious, why did you try this with one eye closed?

 

[Visionary]

Just curious, why did you try this with one eye closed?

Based on the above conversation, I just wondered if I could do it comfortably with only monocular depth cues. Answer is no. Had to open the other eye.

 

[RestoreSight]

Based on the above conversation, I just wondered if I could do it comfortably with only monocular depth cues. Answer is no. Had to open the other eye.

If you had succeeded it would have made an excellent case report: "Stereopsis an unnecessary requirement for successful monocular intravitreal injection"

 

[eyehope]

I spoke with a professor at IU and he said :

"Some controversy about it- no universally agreed upon answer. We have trained residents and fellows here without stereopsis so it can be done."

"Bottom line is that you can be what you want to be. You will constrained only by your desire and demonstrated abilities, not by whether or not you can pass a stereo test."

Very good news!

This, unfortunately, is very bad advice. I will second Visionary statements.
Although I have not trained any residents who do not possess stereopsis
(as far as I can tell), I have heard from other attendings. It would be very
difficult to complete the surgical requirements during residency. Moreover,
the attendings would likely not want to supervise you (they are liable).

If you really like eyes, consider a neurology residency, followed by
a fellowship in neuro-ophthalmology

 

[fourchambered]

If you're not generally interested in medicine, do not pursue ophthalmology. At your stage it's hard to imagine the amount of time and sacrifice needed to strike a path into and through medical school. Keeping up your 3.8 is the least of it. It's countless hours trying to string together research opportunities, finding mentors that will take you seriously, holding yourself to the highest standard on exam after exam, endless exhausting hours working on the MCAT, Step 1, and Step 2. Not to mention the numerous rotations on which you will be working long hours that have nothing to do with ophthalmology (i.e. swimming in amniotic fluid, changing people's wound vacs, praying that your patients have farted or pooped every morning). It's not worth it to go through all of that on the off chance that you could struggle your way into becoming a mediocore ophthalmologist. Without stereopsis, that is essentially what you are doing.