Did I choose the wrong specialty?

[nima123]

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So I started my ophtho residency with very high hopes. I got extremely interested in the field as a med student, did a whole bunch of electives, research, etc. Went through internal medicine year just counting down the days till I could start ophtho, and here I am now...two weeks in into ophtho, and every day I feel more disappointed that the day before 🙁

The part of med school that I absolutely hated was my first 6 months as a clerk, when I was lost, felt useless and dumb and was considering dropping out. That's when I discovered ophtho, and it became my motivation to keep going and do well.

Now in ophtho, and after a comfortable year in internal medicine, I am feeling like a clerk again. I feel overwhelmed in the clinic, don't know how to manage calls, want to study but don't know where and how to start. My assessments are often incomplete, I get the Dx wrong, and don't know how to manage even the simple stuff.

My senior and attending seem to ignore me except for when there's scut work to be done. I'm afraid to ask questions to further expose my lack of knowledge.

To make matters worse, I'm starting in peds, and I suck at retinoscopy and the indirect. I feel terrible...

I really wonder if I should just go back to internal medicine, save lives and feel great about it. Is this all worth it? Please help!

 

[LightBox]

Don't worry. EVERYONE feels lost at the beginning of Ophthalmology residency. The amount of knowledge that you have to learn can be overwhelming at times. I would start with memorizing everything in the Wills Manual, so that you can survive your hospital calls and routine office stuff. Also, create a strict reading schedule (e.g. 20 pages a night or 1-2 chapters a night). Peds is tough for anyone because the patients are not cooperative and also the concepts are probably the most intellectually-involved (like Neuro).

Trust me...the fun begins when you start operating and have to deal less with hospital call. As an attending, the REAL fun begins! (aka: very minimal/no call and great lifestyle).

 

[MR1]

I can't count the number of times I have heard this. Many people HATE ophtho the first few months. For the reasons you have said. Give it 3-6 months and I'd say there is a 99% chance you will do a 180 and be loving ophtho.

Also you are crazy to think you should know anything about ophtho at this point but if your seniors expect you to they are nuts too.

 

[guttata]

Calm down.

The first few months will be the toughest and there is a steep learning curve.

Reading
1. The best way to learn is to read about the disease after you see a patient in clinic.
2. Read about the differential for red eye, painful eye, acute vision loss (most of your
after-hour calls will fall into one of those categories).
3. Read about trauma management.
4. Read about anything that can acutely blind or kill a patient.
5. Wills Eye Manual is a great resource (pair it up with an Atlas)

Exam
1. Learn to obtain a good history with pertinent positives/negatives (as you learn
more about diseases, you will become more focused)
2. Physical exam. Do it systematically - start with an external exam, then eyelids, cornea, a/c, etc.
If you can figure out the cause of red eye or vision loss, then you can narrow down
your differential. Proficiency will come with time.

It is tough starting on peds because it is an entirely different world. Keep with it.
You should not be afraid to ask your senior residents questions. They are suppose
to be there for you. They should remember what you are going through and be
more empathetic to your concerns.

 

[JMK2005]

So I started my ophtho residency with very high hopes. I got extremely interested in the field as a med student, did a whole bunch of electives, research, etc. Went through internal medicine year just counting down the days till I could start ophtho, and here I am now...two weeks in into ophtho, and every day I feel more disappointed that the day before 🙁

The part of med school that I absolutely hated was my first 6 months as a clerk, when I was lost, felt useless and dumb and was considering dropping out. That's when I discovered ophtho, and it became my motivation to keep going and do well.

Now in ophtho, and after a comfortable year in internal medicine, I am feeling like a clerk again. I feel overwhelmed in the clinic, don't know how to manage calls, want to study but don't know where and how to start. My assessments are often incomplete, I get the Dx wrong, and don't know how to manage even the simple stuff.

My senior and attending seem to ignore me except for when there's scut work to be done. I'm afraid to ask questions to further expose my lack of knowledge.

To make matters worse, I'm starting in peds, and I suck at retinoscopy and the indirect. I feel terrible...

I really wonder if I should just go back to internal medicine, save lives and feel great about it. Is this all worth it? Please help!

First few months of ophth residency suck. It gets much better. We've all been through it and felt the same way.

 

[cubsrule4e]

Not much else to add except another agreement from a resident perspective. I wouldnt say I hated it the first few months but I was definitely doubting myself. By October or so when I had gotten most of the basics down, felt more comfortable with call, etc, it was a lot better. Then 2nd year I got into the OR and it got fun. Now that im starting 3rd year, operating like a fiend, and primary call is over, its freakin awesome!👍

 

[Tiburon]

Wow. All of a sudden I'm super excited for the 1st few months of my Ophtho residency.....

 

[Visionary]

What they said. Keep at it. It gets better.

 

[odieoh]

Starting on a peds rotation just adds to the pain. Learning to use the slitlamp and indirect can be challenging on a cooperative adult patient. Having to do it on a squirming screaming lump would make for a very frustrating first rotation. Hang in there.

 

[Nystagmeetya]

Thank you so much for starting this thread!

I started my residency 3 weeks ago and have been overwhelmed... The clinics are sooo busy, and I'm still struggling with the slit lamp lenses and indirect. I have come home every day feeling like a complete idiot and failure.

I feel so much better after reading all of these replies. I thank all of you for posting your experiences and encouraging words.