Intellectual Stimulation & Neuro v Ophtho

[medstudentmed]

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My question is simple: As a practicing Ophthalmologist, do you find that you have sufficient intellectual stimulation at your day-to-day job?

One of the aspects I like about Ophtho is the melding of medicine and surgery. For me, general surgery or orthopedic surgery would be boring because most of what you do involves surgery and there is not much intellectual stimulation in that (gross over-generalization, I know). I enjoy surgery; however, I want there to be of an intellectual aspect to my day to day job. Did you also want this out of a career, and if so, did you find it in ophthalmology?

Also - I'm sure a lot of you had considered Neurology at some point due to the intrinsic similarities in the science/area of focus/etc. Neurology is pretty well known for being very 'intellectual' in the sense that it is heavy on the diagnosis and the 'thinking' aspects of medicine. Ideally, I would like a field that has the ability to make a significant impact and affords me the opportunity to do procedures and surgeries (like ophtho) combined with the intellectual stimulation of neurology. Did I describe ophthalmology?

Thanks

 

[JMK2005]

Also - I'm sure a lot of you had considered Neurology at some point due to the intrinsic similarities in the science/area of focus/etc.

Haha.. don't repeat that statement again.

You should do ophthalmology and then do a fellowship in neuro-ophthalmology.

If you really like neurology, you can do a residency in that then do a fellowship in neuro-ophthalmology but you can't do any procedures.

 

[cme2c]

Neurology is pretty well known for being very 'intellectual' in the sense that it is heavy on the diagnosis and the 'thinking' aspects of medicine.

The neurologists I have come across are "pretty well-known" for ordering tests and don't think whatsoever.

 

[FutureCTDoc]

Vitreo-retinal surgery is definitely mentally stimulating. However like most things in medicine it's mainly horses. The disease are complicated, management is both medical and surgical, the field is procedural and you need to use your brain as most patients give poor/vague complaints. If you want to see zebras go into academic medicine.

 

[MR1]

I wouldn't say general ophtho is on the level of neurology as far as sitting around thinking about things. Neuro-op, yes most definitely and that is why most neuro-op only survive in academics, you can't only see 10-15 patients a day outside of the ivory towers.

Ophtho for me is a visual speciality, 80% of the time I don't even need a history and I can "see" what is going on and for me I like that.

Yes there a times, we have to stop and really dig into a history and think about things, but again this mostly happens with neuro-op stuff

 

[orbitsurgMD]

My question is simple: As a practicing Ophthalmologist, do you find that you have sufficient intellectual stimulation at your day-to-day job?

One of the aspects I like about Ophtho is the melding of medicine and surgery. For me, general surgery or orthopedic surgery would be boring because most of what you do involves surgery and there is not much intellectual stimulation in that (gross over-generalization, I know). I enjoy surgery; however, I want there to be of an intellectual aspect to my day to day job. Did you also want this out of a career, and if so, did you find it in ophthalmology?

Also - I'm sure a lot of you had considered Neurology at some point due to the intrinsic similarities in the science/area of focus/etc. Neurology is pretty well known for being very 'intellectual' in the sense that it is heavy on the diagnosis and the 'thinking' aspects of medicine. Ideally, I would like a field that has the ability to make a significant impact and affords me the opportunity to do procedures and surgeries (like ophtho) combined with the intellectual stimulation of neurology. Did I describe ophthalmology?

Thanks

Neuro-ophthalmology fits your description. It can very easily be combined with orbit and oculoplastics to make a viable private practice.

 

[MstaKing10]

I din't think neuro-ophth had a place outside of academics or an exclusively neuro-ophth clinic. Curious to know how you would incorporate this into a busy private practice obritsurg? Most of the neuro patients I saw in clinic were optic neurits, other optic neuropathies, MS, MG, CN palsies and malingerers. Seems that they would take up a lot of time in a busy private practice. If an optic nerve sheeth fenestration was indicated, it would be referred out to the orbital surgeon who would essentially do the surgery then bounce it back to neuro for management. Also, if you advertise yourself as the neuro-ophthalmology guy in town, I imagine you would be overwhelmed with tons of neuro patients and this may limit your plastics load. Also, does this mean you would do two fellowships as well?

Just curious.

 

[MR1]

I know there are some combined neuro-plastics fellowships, from what I have heard though they are typically "light" on plastics whereas you get trained in simple stuff, not the big orbital things. Honestly I don't understand this blend, really the only fellowship blend I understand is neuro-peds.

As far as someone doing both a neuro AND plastics fellowship, that just sounds nuts.

 

[orbitsurgMD]

I din't think neuro-ophth had a place outside of academics or an exclusively neuro-ophth clinic. Curious to know how you would incorporate this into a busy private practice obritsurg? Most of the neuro patients I saw in clinic were optic neurits, other optic neuropathies, MS, MG, CN palsies and malingerers. Seems that they would take up a lot of time in a busy private practice. If an optic nerve sheeth fenestration was indicated, it would be referred out to the orbital surgeon who would essentially do the surgery then bounce it back to neuro for management. Also, if you advertise yourself as the neuro-ophthalmology guy in town, I imagine you would be overwhelmed with tons of neuro patients and this may limit your plastics load. Also, does this mean you would do two fellowships as well?

Just curious.

You can typically tailor your practice to your preferences. Doing both does not mean sacrificing complicated oculoplastics cases to accommodate neuro patients. (Really, optic neuritis usually does not take up huge amounts of office time, and neither does MG or cranial nerve palsy presentations.) You can smoke out malingerers pretty quickly. I never have to waste much time on them.

I know some who have done two separate fellowships and others that have done only one. It works both ways. An intensive surgically-oriented neuro/plastics fellowship is not orbit-shy or "plastics-light" as you put it.

You probably wouldn't want to do neuro if you were planning to develop your plastics practice to include lots of non-facial cosmetic procedures or lengthy facial cosmetic procedures like face and neck lifting. There are only so many hours in the week. But those practices are not all that common anyway.

 

[Mirror Form]

My question is simple: As a practicing Ophthalmologist, do you find that you have sufficient intellectual stimulation at your day-to-day job?

Almost all fields of medicine are intellectually stimulating. If you're busy, you'll see plenty of interesting cases mixed in with the routine ones.