I just started optho. rotation as an elective and I am not getting any feedback on what to do or what is expected. Can someone ( attendings or residents) give me a heads up on what I should be working on at home to prepare for this rotation...books, procedures I can practice at home, anything. The faculty seems a little cold , nobody introduced themselves or gave me any direction, sucks but thats ok. I just want to be as prepared and helpful as I can. Thanks for any advice.
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lost in optho. rotation
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Hehe. Sounds like most medical student ophtho rotations that I have ever witnessed!
Unlike your other rotations in medical school, most residents/attendings in ophtho:
1) Do not need your help to do scut work. In fact, you are probably just slowing them down in a very busy clinic. This is in contrast to inpatient rotations (eg. general surgery) where the residents rely on (and thus appreciate more) medical students.
2) Probably don't even realize you're supposed to be there. Since they don't need your help, it's doubtful they have received a 'list' of students rotating through.
My advice to you is just to be friendly, try not to get in the way, try to express some interest in the field, and maybe read about interesting things that you have seen in clinic. Also, don't try to 'impress' others with your Ophthalmology knowledge --as a medical student, you likely won't know much and will come across as arrogant.
-J
Unlike your other rotations in medical school, most residents/attendings in ophtho:
1) Do not need your help to do scut work. In fact, you are probably just slowing them down in a very busy clinic. This is in contrast to inpatient rotations (eg. general surgery) where the residents rely on (and thus appreciate more) medical students.
2) Probably don't even realize you're supposed to be there. Since they don't need your help, it's doubtful they have received a 'list' of students rotating through.
My advice to you is just to be friendly, try not to get in the way, try to express some interest in the field, and maybe read about interesting things that you have seen in clinic. Also, don't try to 'impress' others with your Ophthalmology knowledge --as a medical student, you likely won't know much and will come across as arrogant.
-J
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I just started optho. rotation as an elective and I am not getting any feedback on what to do or what is expected. Can someone ( attendings or residents) give me a heads up on what I should be working on at home to prepare for this rotation...books, procedures I can practice at home, anything. The faculty seems a little cold , nobody introduced themselves or gave me any direction, sucks but thats ok. I just want to be as prepared and helpful as I can. Thanks for any advice.
Busy clinics sometimes leave little time for medical student teaching.
Some suggestions;
Certainly you want to get an understanding of the basic eye examination. Appreciate the order in which the exam is done. Get an understanding of acuity, of what corrective lenses do, of general physiological change with aging, like presbyopia and cataract development. Learn how to do a pupil exam. Learn how and why to evaluate for an relative afferent pupillary defect. Learn how to do tonometry with the Goldmann tonometer and the tonopen (leave the Schiotz, IMO). Learn the order of the slit lamp exam. Try your hand at manifest refracting with a phoropter and a retinoscope. Learn what you can about a retinal exam with a binocular indirect and 20 D (or similar) indirect lens. Try to learn how to look at the retina with slit lamp binocular indirect lens.
Learn some facts about the different types of glaucoma and how the diagnosis is made, features of the glaucomatous optic nerve, glaucoma-related field loss and diagnostic modalities using scanning laser ophthalmosopy (GDx, HRT, OCT).
Learn some facts about age-related macular degeneration, the differences between non-exudative and exudative forms, the treatments available for each and the relevant major studies that support those treatments.
Learn some facts about diabetic retinopathy, features of the disease, relevant therapies.
Learn the signs and symptoms of retinal tear and detachment.
Learn the treatment of acute angle-closure glaucoma.
Learn some facts about pediatric strabismus, ages of onset, importance of early diagnosis and treatment to prevent amblyopia. Learn what amblyopia is and why prevention is important (try to recall the work of the Harvard researchers, Drs. Hubel and Weisel.)
Be familiar with the treatment of acute conjunctivitis, differences between bacterial, viral and other infectious and non infectious causes. Learn the treatment for infectious keratitis, the risks of contact-lens misuse and keratitis from specific pathogens (I will leave that for you) and the best methods for the prevention of those infections.
Develop a useful method for approaching the following: the red eye, the painful eye, sudden vision loss, double vision, flashes and floaters.
Go see some surgery.
Go see an ophthalmic ultrasound exam and appreciate what it can and cannot do, both B-mode and A-mode.
Oh and try to see a cataract extraction and IOL implant or two, or at least see a video of the same. You might also try to see a plastic case or two to get an appreciation of the diversity of the field.
When I took a third-year ophthalmology mini-elective, I thought that it was interesting but I didn't see myself going into the field. A year later, I was certain that I wanted ophthalmology more than any other specialty.
As a resident, here are my suggestions:
1. Read as much as you can about ophtho. Stick to the basics and know them well before moving on to more complicated topics. Ophtho can be intimidating because we write in a language and use abbreviations no one else can understand. Take the time to learn the vocabulary first.
Here is a great book for starters. It is the single best resource I have found for beginners and I recommend it to all my students.
http://www.ophthobook.com/
2. Be as proactive as you can be without getting in the way. Believe it or not people notice whether or not you are a motivated student, especially residents.
3. Get the residents to show you the basics of the eye exam, especially how to use the slit lamp and various lens to look at the fundus. Ophtho is a very visual field and it's a lot more fun when you're actively engaged and actually doing things rather than standing by shadowing.
4. If you're interested in ophtho, find ways to show you're interested to the faculty and residents. If you're not, then read, have fun and try to learn a few things about the eye before your rotation ends.
1. Read as much as you can about ophtho. Stick to the basics and know them well before moving on to more complicated topics. Ophtho can be intimidating because we write in a language and use abbreviations no one else can understand. Take the time to learn the vocabulary first.
Here is a great book for starters. It is the single best resource I have found for beginners and I recommend it to all my students.
http://www.ophthobook.com/
2. Be as proactive as you can be without getting in the way. Believe it or not people notice whether or not you are a motivated student, especially residents.
3. Get the residents to show you the basics of the eye exam, especially how to use the slit lamp and various lens to look at the fundus. Ophtho is a very visual field and it's a lot more fun when you're actively engaged and actually doing things rather than standing by shadowing.
4. If you're interested in ophtho, find ways to show you're interested to the faculty and residents. If you're not, then read, have fun and try to learn a few things about the eye before your rotation ends.
Last edited:
Hehe. Sounds like most medical student ophtho rotations that I have ever witnessed!
Unlike your other rotations in medical school, most residents/attendings in ophtho:
1) Do not need your help to do scut work. In fact, you are probably just slowing them down in a very busy clinic. This is in contrast to inpatient rotations (eg. general surgery) where the residents rely on (and thus appreciate more) medical students.
2) Probably don't even realize you're supposed to be there. Since they don't need your help, it's doubtful they have received a 'list' of students rotating through.
My advice to you is just to be friendly, try not to get in the way, try to express some interest in the field, and maybe read about interesting things that you have seen in clinic. Also, don't try to 'impress' others with your Ophthalmology knowledge --as a medical student, you likely won't know much and will come across as arrogant.
-J
As a resident, here are my suggestions:
1. Read as much as you can about ophtho. Stick to the basics and know them well before moving on to more complicated topics. Ophtho can be intimidating because we write in a language and use abbreviations no one else can understand. Take the time to learn the vocabulary first.
Here is a great book for starters. It is the single best resource I have found fro beginners and I recommend it to all my students.
http://www.ophthobook.com/
2. Be as proactive as you can be without getting in the way. Believe it or not people notice whether or not you are a motivated student, especially residents.
3. Get the residents to show you the basics of the eye exam, especially how to use the slit lamp and various lens to look at the fundus. Ophtho is a very visual field and it's a lot more fun when you're actively engaged and actually doing things rather than standing by shadowing.
4. If you're interested in ophtho, find ways to show you're interested to the faculty and residents. If you're not, then read, have fun and try to learn a few things about the eye before your rotation ends.
Busy clinics sometimes leave little time for medical student teaching.
Some suggestions;
Certainly you want to get an understanding of the basic eye examination. Appreciate the order in which the exam is done. Get an understanding of acuity, of what corrective lenses do, of general physiological change with aging, like presbyopia and cataract development. Learn how to do a pupil exam. Learn how and why to evaluate for an relative afferent pupillary defect. Learn how to do tonometry with the Goldmann tonometer and the tonopen (leave the Schiotz, IMO). Learn the order of the slit lamp exam. Try your hand at manifest refracting with a phoropter and a retinoscope. Learn what you can about a retinal exam with a binocular indirect and 20 D (or similar) indirect lens. Try to learn how to look at the retina with slit lamp binocular indirect lens.
Learn some facts about the different types of glaucoma and how the diagnosis is made, features of the glaucomatous optic nerve, glaucoma-related field loss and diagnostic modalities using scanning laser ophthalmosopy (GDx, HRT, OCT).
Learn some facts about age-related macular degeneration, the differences between non-exudative and exudative forms, the treatments available for each and the relevant major studies that support those treatments.
Learn some facts about diabetic retinopathy, features of the disease, relevant therapies.
Learn the signs and symptoms of retinal tear and detachment.
Learn the treatment of acute angle-closure glaucoma.
Learn some facts about pediatric strabismus, ages of onset, importance of early diagnosis and treatment to prevent amblyopia. Learn what amblyopia is and why prevention is important (try to recall the work of the Harvard researchers, Drs. Hubel and Weisel.)
Be familiar with the treatment of acute conjunctivitis, differences between bacterial, viral and other infectious and non infectious causes. Learn the treatment for infectious keratitis, the risks of contact-lens misuse and keratitis from specific pathogens (I will leave that for you) and the best methods for the prevention of those infections.
Develop a useful method for approaching the following: the red eye, the painful eye, sudden vision loss, double vision, flashes and floaters.
Go see some surgery.
Go see an ophthalmic ultrasound exam and appreciate what it can and cannot do, both B-mode and A-mode.
Oh and try to see a cataract extraction and IOL implant or two, or at least see a video of the same. You might also try to see a plastic case or two to get an appreciation of the diversity of the field.
When I took a third-year ophthalmology mini-elective, I thought that it was interesting but I didn't see myself going into the field. A year later, I was certain that I wanted ophthalmology more than any other specialty.
Thanks for the helpful advises!
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You also may consider requesting to be in an exam room that has a teaching scope so that you can see what the examiner sees in the slip lamp and so you'll know what to look for when you are using the slip lamp.
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