Elective at Wilmer - some questions

[sjkpark]

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I'm a medical student from New Zealand doing 7-week elective in ophthalmology at Wilmer from September. I just have a few questions:

1. They wanted me to spend 7 weeks in 2 subspecialties, rather than 4 weeks in general and 3 weeks in subspecialty. Although I prefer doing 2 subspecialties, it's been a long time since I've done clinical ophthalmology - would they expect me to be proficient in ocular examinations? Our curriculum is different and we are expected to spend a lot of time in core subjects so I've only been doing gen med, gen surg, psych, O&G, and paeds this year.

2. I asked to do 2 of neuro-ophthalmology, glaucoma or retina. I am still quite keen to do neuro-ophth (because I have no experience with it but I think it's an exciting field). But I wouldn't mind doing any other sub-specialties for the other half. Can anybody familiar with Wilmer recommend a sub-specialty that's student-friendly and educational? I would like an LOR at the end of both electives, so it would be good if it is a sub-specialty where I can be under 1-2 attendings, rather than to have different attendings every day.

3. Any general advice on what to read and do before I go? Though I have Step 2CK scheduled on 5th of September so I have very little time for anything but to prepare for the exam.

Thanks

 

[JR]

Hello and welcome to the forum! I am a resident at Wilmer and I'll try to answer your questions.

1. Although no one would expect you to be proficient in clinical examinations as a medical student, some basic examination skills are desirable. This will make your elective time more productive and will also allow attendings to involve you more in patient encounters. Without any clinical skills you run a risk of just standing around and watching.

2.

Can anybody familiar with Wilmer recommend a sub-specialty that's student-friendly and educational?

I'd say Uveitis, Medical Retina, and Peds are really good. However, can't vouch for their availability during your elective time.

I would like an LOR at the end of both electives, so it would be good if it is a sub-specialty where I can be under 1-2 attendings, rather than to have different attendings every day.

I don't think it's a problem. You will usually work with just a few attendings on an elective. Getting to know someone well enough in just a few weeks to get a personal solid LOR maybe much more difficult.

3.

Any general advice on what to read and do before I go? Though I have Step 2CK scheduled on 5th of September so I have very little time for anything but to prepare for the exam.

.

See this thread for info:

http://forums.studentdoctor.net/showthread.php?t=66427.

Good luck!

 

[sjkpark]

Thanks for your reply!

1. Although no one would expect you to be proficient in clinical examinations as a medical student, some basic examination skills are desirable.

What are the basic clinical skills that you think I should be familiar with?

2. I'd say Uveitis, Medical Retina, and Peds are really good. However, can't vouch for their availability during your elective time.

Funny, because I asked the student administrator for neuro-ophthalmology AND either one of glaucoma or retina. (She hasn't gotten back to me yet but never indicated that it would be a problem.) But I just looked at JHU elective catalogue and realised that they don't have pure clinical elective in glaucoma, retina, uveitis or paeds. The only pure clinical sub-specialty electives that are listed are: neuro-ophth and oculoplastics (and ocular pathology, not too sure whether it counts but anyhow). Have you seen any elective students floating around in these other sub-specialties not listed on catalogue?

I don't think it's a problem. You will usually work with just a few attendings on an elective. Getting to know someone well enough in just a few weeks to get a personal solid LOR maybe much more difficult.

Do you think it would be a better idea to do 7 weeks at neuro-ophthalmology? I do agree that 4 weeks and 3 weeks might be too short, but 7 weeks in one subspecialty sounds too long.

Thanks!

 

[JR]

1. I'd recommend knowing at least how to do a basic ophthalmology H&P, know how to use a slit lamp, and be able to perform a dialted funduscopic examination. Neuro work ups are much more complex and detailed as compared to basic ophthalmologic exams, so some knowledge of neurology and current imaging techniques is also helpful.

2. I don't think I can be helpful to you in terms of elective scheduling; I did not do a Wilmer elective as a medical student and I did not go to JHU for medical school, so I don't know anything specific in those areas. Being a foreign medical student, you may have different elective rules apply to you as well. Sorry.

3. If getting a good LOR is your primary goal, I'd say go for 7 weeks. Besides, Neil Miller is awesome!

 

[rubensan]

whew, that's a lot of neuro-op 😉

1. I'd recommend knowing at least how to do a basic ophthalmology H&P, know how to use a slit lamp, and be able to perform a dialted funduscopic examination. Neuro work ups are much more complex and detailed as compared to basic ophthalmologic exams, so some knowledge of neurology and current imaging techniques is also helpful.

2. I don't think I can be helpful to you in terms of elective scheduling; I did not do a Wilmer elective as a medical student and I did not go to JHU for medical school, so I don't know anything specific in those areas. Being a foreign medical student, you may have different elective rules apply to you as well. Sorry.

3. If getting a good LOR is your primary goal, I'd say go for 7 weeks. Besides, Neil Miller is awesome!

 

[sjkpark]

3. If getting a good LOR is your primary goal, I'd say go for 7 weeks. Besides, Neil Miller is awesome!

Thanks for your reply.
I'd say learning lots of ophthalmology is my primary goal, then good LOR.
I'll email Lindsay Spurlin and find out what's easier for her to organise.

 

[sjkpark]

3. If getting a good LOR is your primary goal, I'd say go for 7 weeks. Besides, Neil Miller is awesome!

Another question about doing neuro-ophth for 7 weeks:
During neuro-ophth rotation, would Neil Miller be the only attending that I work with?
Or would I also have the opportunity to work with other attendings who potentially could write me LORs?

 

[JR]

You should be able to work with other people in the department if you ask. However, Dr. Miller's letter will go A MUCH LONGER way. His letter is what you want.

 

[sjkpark]

Looks like they decided it for me! It's kind of a relief in a way. I am very excited nevertheless.

Hi,
It looks like you will be spending the majority of your time here with the glaucoma division. It is being determined how those doctors will divide your time.
You should have a couple days a week free from that, and during that time I will schedule individual assginments for you. I will try to have you spend some time with neuro-opth faculty, depending on who is available on your open days. I'll try to get some retina in there for you to.

Are there any glaucoma doctors whose letters will go a long way? I heard of Harry Quigley, I know that his name is almost synonymous with glaucoma, but are there any others who are good teachers and nice to students?

 

[JR]

Dr. Quigley is the most senior faculty member in the glaucoma department. He is a great teacher and you will enjoy your time with him.