Manual dexterity and Ophthalmology

[DwyaneWade]

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Hello,

I am currently in my 3rd year and I really looking closely at optho. At this point I am confident that I could match, I enjoy the patient interaction, I love the complexity of the eye, and I think the surgeries are just amazing.

The thing that keeps popping in my mind, however, is whether I am just not cut out for optho given my relatively poor manual dexterity. With practice I became an average knot-tyer/suturer in surgery and I fear that even though I like the field that I just will be useless when it comes to operating in the eye.

How steep is the learning curve? How skilled are people before they match into residency?

Thanks,
DW

 

[Pinkertinkle]

ophtho, miss an H and you won't match.

 

[eyehope]

Hello,

I am currently in my 3rd year and I really looking closely at optho. At this point I am confident that I could match, I enjoy the patient interaction, I love the complexity of the eye, and I think the surgeries are just amazing.

The thing that keeps popping in my mind, however, is whether I am just not cut out for optho given my relatively poor manual dexterity. With practice I became an average knot-tyer/suturer in surgery and I fear that even though I like the field that I just will be useless when it comes to operating in the eye.

How steep is the learning curve? How skilled are people before they match into residency?

Thanks,
DW

Most are not skilled before matching. You will learn surgical techniques during residency. Some conditions such as large tremors or lack of stereopsis may limit your surgical abilities.

In my opinion, some are born with "better" or more "stable" hands, but you can be taught techniques to stabilize your hands and decrease tremors (to some degree). I wouldn't be too concerned with your perceived knot-tying abilities. Ocular knot tying is completely different.

If your optho program has a wet lab with a microscope, I recommend that you practice making wounds and suturing on an animal eye. Most residents can help you out. Then, you can determine whether you have "good" hands. I would focus more on stability than ability. The ability to perform microscopic suturing will become much easier upon repeated attempts.

Proper hand placement on the table and on the instruments (along with a drop of sublingual Timolol) can help tremendously.

That being said, I have met some great surgical ophthalmologists with tremors. They have adapted. And, there are many older ophthalmologist who do not operate.

 

[DwyaneWade]

ophtho, miss an H and you won't match.

I know how to spell it (see the thread title) but the abbreviation I usually seen written without the H

 

[DwyaneWade]

Most are not skilled before matching. You will learn surgical techniques during residency. Some conditions such as large tremors or lack of stereopsis may limit your surgical abilities.

In my opinion, some are born with "better" or more "stable" hands, but you can be taught techniques to stabilize your hands and decrease tremors (to some degree). I wouldn't be too concerned with your perceived knot-tying abilities. Ocular knot tying is completely different.

If your optho program has a wet lab with a microscope, I recommend that you practice making wounds and suturing on an animal eye. Most residents can help you out. Then, you can determine whether you have "good" hands. I would focus more on stability than ability. The ability to perform microscopic suturing will become much easier upon repeated attempts.

Proper hand placement on the table and on the instruments (along with a drop of sublingual Timolol) can help tremendously.

That being said, I have met some great surgical ophthalmologists with tremors. They have adapted. And, there are many older ophthalmologist who do not operate.

Thanks for the comforting post. That is a great idea, I am definitely going to see if I can get access to the wet lab.

 

[Mirror Form]

Hello,

I am currently in my 3rd year and I really looking closely at optho. At this point I am confident that I could match, I enjoy the patient interaction, I love the complexity of the eye, and I think the surgeries are just amazing.

The thing that keeps popping in my mind, however, is whether I am just not cut out for optho given my relatively poor manual dexterity. With practice I became an average knot-tyer/suturer in surgery and I fear that even though I like the field that I just will be useless when it comes to operating in the eye.

How steep is the learning curve? How skilled are people before they match into residency?

Thanks,
DW

If you take your time and operate in a meticulous fashion then you'll be able to compensate for your dexterity. You may never be that hotshot surgeon who does catarct surgeries in 2 minutes, but you'll be able to operate safely. Also, don't forget that fine motor skills can be improved. For example, playing computer games or painting may help. And there's no excuse for practicing suturing under a microscope.

Most of the surgeons out there who would be considered "bad" are that way b/c they are overly aggressive or just don't know what they're doing. For example, there are surgeons out there who have poor dexterity (or technique or skill), but then try and operate just as fast as the hotshots who show their best videos at the academy. They're the dangerous ones. But I've never heard of anyone being called an unsafe surgeon purely due to subpar dexterity.

 

[Toadkiller Dog]

I wholeheartedly agree. Don't let your perceived lack of dexterity as a med student dissuade you. Nearly everyone smart enough to match into ophtho (check my bad-ass spelling!) can be taught to do the fine surgeries.

The one piece of advice I would give you would be to try to match to the program with the highest surgical volume possible. Practice really does make perfect, and there is a difference between 150 and 250 cataracts. Try to get the program that will give you the most experience in terms of surgery.

 

[DwyaneWade]

I wholeheartedly agree. Don't let your perceived lack of dexterity as a med student dissuade you. Nearly everyone smart enough to match into ophtho (check my bad-ass spelling!) can be taught to do the fine surgeries.

The one piece of advice I would give you would be to try to match to the program with the highest surgical volume possible. Practice really does make perfect, and there is a difference between 150 and 250 cataracts. Try to get the program that will give you the most experience in terms of surgery.

That is great to hear! We had a suturing practice the other day and I did not do half-bad, then again I am still much slower than some people.

 

[Friendly]

ophtho, miss an H and you won't match.

Not true. A friend wrote "opthalmology" all the way through his PS, and still matched. You'll be happy to know that he 'got it' by the time he started his cornea fellowship.