can everyone do microsurgery?

[wrangler418]

Hey guys, new to the forum so sorry if this has already been covered. I'm a ms3 and trying to decide between oph and IM. I just finished my oph rotation and really enjoyed it. The only thing I'm worried about is my surgical skills. I don't have a crazy tremor or anything, but I'll admit I'm on the slower side when it comes to picking up new motor skills (I usually get pretty decent after practice practice practice). I got OK at suturing during my surg rotation, but I'm by no means a natural.

I know microsurg is a whole different ballgame though. I didn't get much experience with it on my rotation (tried to suture a pig's eye for like 10 min, but gave up after bending a few needles 😛). How did you all know you were cut out for the type of surgery in oph? is microsurg a skill that you have to be naturally good at or a skill that anyone can master with enough practice? Anyone know fellow residents/trainees who were terrible surgeons starting out but got really good after practicing? The last thing I want is to apply into the field and then realize during pgy2 that I'm physically incapable of doing a cataract.

ty for the help 🙂

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[ophthope]

Anyone know fellow residents/trainees who were terrible surgeons starting out but got really good after practicing?

Just started intern year so I don't have much in the way of personal anecdotes for you, but that sentence is pretty much how everybody in Ophtho I've talked to so far describes learning cataract surgery. We all start out feeling like we're pretty bad at it and only get better with lots of practice. Some people are naturally gifted, but nobody knows before PGY-2 year and it's impossible to predict how good you'll be beyond the things you've already described thinking about. So if you feel like you can 1. Learn a physical skill with practice and 2. Have stereopsis then there is no reason to think you couldn't be an Ophthalmologist. If your program has one of those EyeSi simulators then you could try to put in some time with that thing and see if you could enjoy doing it for real.

 

[MullerCell]

I think just about everyone has the ability to be a good, safe surgeon. Nobody is really a good surgeon at the end of residency. This comes with several years and thousands of cases. You can certainly be serviceable, but every year in practice you should be steadily improving. After several years in practice, the best surgeons are the ones who care the most and expect excellence with every case. There are plenty of sloppy surgeons who can do a cataract really fast, but don't take the time to do difficult cases properly.

 

[RestoreSight]

Just did my first continuous curvilinear capsulorhexis and I must say the best surgeons make this look a lot easier than it really is. No matter how many videos you watch ahead of time doing these techniques on real patients is a totally difference experience. Unless you have a condition that prevents stable hand movements or you can't see through a microscope I think most people become competent with microsurgery, but it takes years of practice to walk, talk and act the part of a professional.

Other than the occasional malignant interviewer that makes you perform a CCC on a grape during your residency interview (yes, this really happens), there is no standard metric to test whether you will be a good microsurgeon or not prior to residency training. It comes down to practice and accepting that it is a learning process that will extend over several thousand surgeries with many bumps along the way. To the OP, my two cents for what its worth is choose ophtho.

 

[MstaKing10]

I think with enough time and practice, anyone can be become a competent mircorsurgeon. The difference between a competent and excellent microsurgeon likely comes down to some innate talent, experience, and smarts.