awesome surgical residencies

[freeWillieB]

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Okay, I'm completely fired up to have finally decided that ophthalmology is "the one". Now, can anyone suggest the best residencies to become the baddest a$$ eye surgeon on the planet without having to pretend that I'm interested in research, primary care ophtho, or anything else for that matter?

 

[PDT4CNV]

Okay, I'm completely fired up to have finally decided that ophthalmology is "the one". Now, can anyone suggest the best residencies to become the baddest a$$ eye surgeon on the planet without having to pretend that I'm interested in research, primary care ophtho, or anything else for that matter?

There are some good programs in africa and antarctica that might suit a candidate with your interests. Try going there.

We do a lot of surgery at my program, but ya know, we have to do research and learn ophthalmology, so you probably wouldnt be interested.

 

[Olddog1]

You sound like you would be a stellar resident at any program. In leiu of a personal statement I would send this post to all programs. Seriously. It would save the programs time because they wouldn't interview someone who may not fit in, it would save you $$ in travel, and you would be sure to get accepted to a program of your particular interest.
You may want to re-think your now chosen vocation because you don't have the slightest clue what is involved in an Ophthalmology residency or what it is like to be a practicing Ophthalmologist. Frankly, I am not sure if medicine is the right career path for you. Hopefully, the residency interviewers will be smarter than the committee that let you into medical school.

 

[freeWillieB]

dang that's harsh. is it taboo to be interested primarily in being a good surgeon?

 

[Free Radicle]

OldDog has a point that residency is heavy on lots of things other than surgery, and it will take learning the nitty gritty details of ocular path, micro etc to get through residency. That being said I do not think its too terribly wrong to love ocular surgery, BUT that will not land you a spot in any residency program. Be a diplomat on interviews with a positive response to every question and you will do fine. When you get into private practice then you can concentrate on surgery more. Just my 2 cents. Good Luck

 

[freeWillieB]

Thanks free radicle. Maybe my 1st post was too testosterone-charged (had just worked out at the time). Of course I love the learning part, otherwise I'd be doing something far different than medicine. But ultimately what excites me is surgerating on folks to help them see. Truce pdt4 and olddog 😍 ?

And if anyone wants to throw in some suggestions of great surgical residencies, I'd appreciate that too. thanks

 

[rubensan]

i admire your enthusiasm. i remember when i was a medical student and watching phaco for the first time and thinking "this is awesome, i want to do this!" in addition (and i think this is what other people on this forum are alluding to) ophthalmology is also very closely related to internal medicine. in fact, aspects of ophthalmology like retina and uveitis are probaly more closely related to internal medicine than any other surgical subspecialty. you also can not possibly become a good cataract surgeon without learning how to diagnose and stage a cataract and learning the basic concepts behind refraction. you will not be proficient in laser photocoagulation until you understand what diabetic retinopathy is and how it progresses. this is all bread and butter "primary care ophthalmology" my friend. so don't expect to walk into your ophthalmology residency and be handed the phaco and say "here operate like crazy." it's not just knowing the surgical skills, it's also knowing when to operate and how to manage the complications. as you learn more about ophthalmology, i hope you begin to understand that these are some of the fundamental differences that separate us from the optometrists, a group of whom are really pushing and lobbying hard for the right to "become the big bad a#! surgeons."

now, to answer your question re: programs with great surgical experience and volume:
UC Davis
USC
UCLA
UC Irvine
Utah
Cal Pacific (San Francisco)

essentially any program with a VA and county hospital affiliate will generate good surgical volume.

one last thing, there is more to ophthalmic surgery than cataract surgery. for all of you that will be interviewing this year, get a flavor for the variety of surgery that the residents do. plastics, peds, trabs, and extracaps are important components of your training. don't just be lured by progams that advertise "our residents do 200 + phacos" and then you learn that they have never done strabismus or glaucoma surgery.

 

[jjmcentee@hotma]

On the same topic. I am currently a 2nd year at a DO school, but I was an Optician for 22 years prior to entering medical school.

I am obviously interested in opthalmology.

I am interested in landing a residency in the North East. Is there a source that may list some rankings or evaluations of residencies in Opthalmology.

I am at the point of trying to get rotations to survey and court potential sites, any advise would be appreciated.

Seems most programs shy away from 3rd years, but if I could get my resume in their hands, I think they would reconsider.

 

[Wolverine98]

I would add Oklahoma to the list of high numbers, they've been just a little bit behind Utah for the last several years.

There are a few other things to consider:
1) Will the program numbers change? Utah's numbers are based on 2 residents per year, but they've expanded now. They project that they'll still get 250+ cataracts during their time, but you never know.

2) Hospital affiliations can change. The program that worked with the Chicago VA when I interviewed had lost that affiliation by the time I started residency, and a different Chicago program was taking care of the VA. This is obviously more important somewhere like Chicago where you have a lot of programs fighting for the VA.

3) What do the numbers mean? As mentioned above, you can throw out some fantastic numbers, especially if you don't differentiate class I and class III. Even beyond that, you have to look at what is considered class I in a given department. If you ask 10 different program directors what counts as class I vs class III, you'll get 11 different answers. At some programs, if the resident does anything beyond wet the cornea, it's a class I; at others, if the staff assists a third year resident at all, it's bumped to a class III.

4) On the subject of VA's and county hospitals, while they will get you good numbers, they are not necessary for good numbers. I trained at a residency that had neither. However, it is in the heart of the inner city. There is another program near by with both a county hospital and a VA affiliation. The top resident in their class (by numbers) would have been in the middle of my class. It all depends on how the program is structured. I just mention this because I believe it's a myth that one should only consider programs with a VA or county hospital (and a very popular myth at that).

Dave

 

[fatman41]

I was told UTSW had ~160 cataracts, but was also a standard deviation above the mean in all other surgical categories. Plus you apparently get incredible autonomy there.

 

[Olddog1]

I was told UTSW had ~160 cataracts, but was also a standard deviation above the mean in all other surgical categories. Plus you apparently get incredible autonomy there.

Autonomy is good to an extent, but if there is nobody to tell you what is wrong you will keep making the same mistake. I know of one program where they rarely had an attending staff cataracts (I am not sure how they still have their accrediation). Attendings are helpful to get you out of trouble, but also help critique things to make the cases go more smoothly. I do echo one of the earlier postings in that Class one in not squirting the cornea or making the paracentesis, make sure you ask the residents at the interviews exactly what their number mean.

 

[IOP]

Both Baylor and Bascom Palmer residents get great surgical
experiences. In both places, residents easily get over 150
cataracts. In addition, they get a good number of retina
(vitrectomy) and glaucoma surgeries (trabeculectomy and
tube shunts). All those surgeries are with residents as primary
surgeons. Also, all the surgeries are staffed and most times
they are staffed by renowned surgeons with prominent
reputations.

The number of refractive surgeries is dependent
upon each resident's motivation to look for and sign up patients.

 

[rubensan]

Autonomy is good to an extent.

Very well said! The best programs will combine autonomy and direct attending clinical and surgical supervision.

 

[ckyuen]

you have a lot of autonomy from utsw. All cataracts were staffed. We had a lot of attendings staffing our cataracts. two rotations were mainly with town physicians who volunteered their time to staff you. The great thing was you got a lot of different advice and learned a lot of different techniques. Also they were more than willing to give you very unbiased and honest feedback about your surgical skills. Most of the attendings you work with normally, may favor you or another resident and that influences their judgement of your surgical skills which may give you a false sense of security that you are a better surgeon than you really are, or vice versa. But we had town physicians who volunteered to be there for one half day a month every month or four weeks something like that, and fellows and our attendings also thrown in there. Any way worked out to be about 20 different town doctors who did observation, you worked with maybe 2/3 of them, and some a couple of times. They would watch you and give you recommendations, but they would not take over your case, unless you were going to do harm. This means as a resident you had someone to offer you guidance when you needed it, but it also put the pressure on you to become an excellent surgeon. I remember a town doc telling me, you're too good to be doing cases under local after seeing my first cataract. Next case I recommend you do topical. I was apprehensive, but he said don't worry I'll help guide you through it, and he offered me the most important advice which was let go of the rhexis if you need to and things will be okay. The patient was spanish speaking with a dense cataract who could really see that great when I asked the intepreter to tell him look straight. I'm sure my heart was beating much faster than normal, but after getting through that case I was much more comfortable with doing cases under topical anesthesia. A lot of attendings in academic settings may not do topical for whatever reason, but in private practice it's very common. So you may miss out on that. This applies for any technique. stop and chop, flip, prechop, etc. Bottom line, many people tell you to have at least one great cataract surgeon at you program. With the town docs coming and our faculty at utsw you had more like 10 excellent cataract surgeons teaching you.

 

[ckyuen]

Also with our town docs they would give you feedback that many of your academic attendings would not, so as not to violate the hierchy of resident and attending. I remember one town doc giving me feedback like, "I wish I could have operated like you three years into practice", which I took with a grain of salt, and felt he meant I was ready to practice. Most academic attendings would never admit a resident could do something better than they could have. Many of them compared me to my peers. Many gave flattering comments, some not, but you had so many instructors that you got a lot of good feedback. And a lot of them would tell you they felt it was time to graduate when they would say "you're ready for private practice".