General ophthalmologist without surgery?

[GoodmanBrown]

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I'm an MS3, and deciding my 4th year schedule and to a certain extent, my career.

I really enjoy eyes and the eye exam, but I could take or leave surgery. I did an elective in cornea and found cataracts tolerable because it's such a short procedure, but found cornea replacements a bore. I kinda dread the hours-long retina and oculoplastics surgeries. Is this a red flag for me for ophtho?

Ideally, I think I'd like to be a general ophthalmologist who doesn't do surgery. I'd like to see things like HSV keratitis, glaucoma, uveitis, and retinal issues, but not be an active surgeon. Injections and in-office procedures (e.g. YAG) would be fine. Is there any space in the private world for this? In academics?

Also, as a side note, are MD and diabetic retinopathy the main reasons people are seen by medical retina? Thanks!

PS: Sorry to the folks who did reply to my post in the other thread. I appreciate the responses.

 

[guttata]

If you can tolerate the residency, there is a small place for nonsurgical ophthalmologists. But, you would likely need to do a fellowship in medical retina or uveitis. You could be a general non-surgical ophthalmologist, but those jobs are generally undesirable (ie, scutmonkey for a cataract cowboy). There are more opportunities for super sub-specialists at academic centers.

Yes, AMD and diabetic retinopathy make up the majority of medical retina patients. They probably also get referrals for chronic uveitis, retinal tears, vein occlusions.

 

[GoodmanBrown]

If you can tolerate the residency, there is a small place for nonsurgical ophthalmologists. But, you would likely need to do a fellowship in medical retina or uveitis. You could be a general non-surgical ophthalmologist, but those jobs are generally undesirable (ie, scutmonkey for a cataract cowboy). There are more opportunities for super sub-specialists at academic centers.

Yes, AMD and diabetic retinopathy make up the majority of medical retina patients. They probably also get referrals for chronic uveitis, retinal tears, vein occlusions.

Thanks for the thoughts. How many days per week does a general, private practice ophthalmologist spend in the OR? What kind of cases does he/she do? All cataracts, or mixing it up with cornea replacements or others?

 

[guttata]

Very few general ophthalmologists perform corneal transplants - the exception being older docs who used to do a little bit of everything (from glaucoma filtering procedures to retinal detachment repairs). Now, with increase specialization and knowledge, this is less commonplace.

Cataracts constitute the great majority of cases for generalists. Pterygia removal, blepharoplasty, eyelid tightening procedures, refractive surgery are within the scope of some generalists. Most of these surgeries are short (less than 30-60 mins, depending on proficiency).

Most generalists spend 0.5 to 1.5 days in the OR per week. I would estimate the average is one day a week, or 20% of your time. Many will take off the afternoon of surgery day. However, you must understand that you will be in the OR more often during your residency. You will be in the OR multiple times a week, depending on the service. You will mainly be assisting in the first year, and become the primary surgeon in your latter years.

Once you are out of residency, you can limit your practice to your desires. It is a matter of whether you will be successful attracting patients with these limitations (that's why I suggested medical retina). Most nonsurgical generalists are older docs who have retired their surgical practice.