Need advice: Ok to do Oculoplastics "Fellowship" with private attending?

[baconandeggs]

Hello,

My spouse has been offered an Oculoplastics "Fellowship" training with a private attending. From what I know, the attending has a strong academic background, board certified, and is a member of ASOPRS. However, I've never heard of a fellowship training with a private practice as most if not all fellowships are completed at accredited teaching hospitals?

I'm looking for some feedback from anyone who has experience with this. Is going this route even a viable option/ opportunity? If yes, are there pros & cons? Or is it not a wise career path?

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[orbitsurgMD]

Hello,

My spouse has been offered an Oculoplastics "Fellowship" training with a private attending. From what I know, the attending has a strong academic background, board certified, and is a member of ASOPRS. However, I've never heard of a fellowship training with a private practice as most if not all fellowships are completed at accredited teaching hospitals?

I'm looking for some feedback from anyone who has experience with this. Is going this route even a viable option/ opportunity? If yes, are there pros & cons? Or is it not a wise career path?

Most plastics fellowships are preceptored by a single attending. Some have more, but one is not unusual.

I think it is helpful to be affiliated with an academic center, if for no better reason than it provides more cases and possibly the opportunity to work independently, which is nice when you also have a preceptor around. I would be reluctant to do a fellowship that didn't have at least one large tertiary center; it makes for a better opportunity to see other associated specialists, neurosurgery, radiology, radiation oncology and general plastics. In fact I would much prefer a university hospital fellowship that wasn't ASOPRS "approved" to a fellowship that was "approved" that didn't have that kind of affiliation.

ASOPRS approval is nice, but its significance outside gaining membership to ASOPRS more easily is negligible. In the community, no one knows or cares what it is (but they do know and do care about ACS membership.)

 

[Wolverine98]

Oftentimes these happen when someone was running a fellowship at an academic center, and then left for private practice (for whatever reason). They just take the fellowship with them. I agree with above that you want to at least have access to a major center for the big trauma cases.
The other thing that you lose out on, IMO, is teaching residents, which can help you learn a lot more than actually doing your own cases.

Dave

 

[Wolverine98]

I should also mention, unless it's changed in the last couple of years, I know of a few of these private fellowships that are ASOPRS, so you won't even necessarily be losing out on that by going this route.

 

[baconandeggs]

orbitsurgMD, Dave, thank you for the perspectives. Very helpful!

 

[DOCTORSAIB]

I keep hearing that ASOPRS fellowship are extremely competitive.

My question is what difference does it make once you're in PP? Land a fellowship where you'll be well-trained, ASOPRS or not. Then get bogus accreditions like the American Aesthetics Society and take a few weekend courses (for only $2,000 each) and get "certified" to give Restylane/Botox injections, do dermabrasions, laser hair removal, etc.

I'd think that would make me much more marketable to the ignorant public than being a member of ASOPRS.

What do you guys think?

 

[orbitsurgMD]

I keep hearing that ASOPRS fellowship are extremely competitive.

My question is what difference does it make once you're in PP? Land a fellowship where you'll be well-trained, ASOPRS or not. Then get bogus accreditions like the American Aesthetics Society and take a few weekend courses (for only $2,000 each) and get "certified" to give Restylane/Botox injections, do dermabrasions, laser hair removal, etc.

I'd think that would make me much more marketable to the ignorant public than being a member of ASOPRS.

What do you guys think?

Some ASOPRS programs are more competitive than others. All have an unrealistically early application deadline, which requires choosing a subspecialty at the beginning of second year--way too early, IMO. "Approved" programs have more to do with compliance with initiatives to reduce the numbers of plastics fellowship graduates without having to compel longtime ASOPRS members and fellowship sponsors to shut down their fellowships. Up until that time, there was no such thing as an "approved" fellowship, if your sponsor was a member, you could sit for the exam for membership yourself. And most ASOPRS members at that time had done one-year-long fellowships with no concerns for the adequacy of training.

To date, the only accreditation authority ASOPRS has is for admission to its own membership rolls, and since that is not a specialty board recognized by the ABMS, the organization's importance in that respect is limited. That isn't to say ASOPRS is not valuable or beneficial or important; I think it is, because it has a very active role as a communications and teaching facility within the Academy and to members and non-members who look to them as a source of vetted information about oculoplastics. As a subspecialty academy, I think it is great, sort of the same as the Vitreous Society (forget the new name, now) has been vis-a-vis retina practice.

The fact is that there are outstanding places where you can train in oculoplastics all over the globe that are not ASOPRS "approved", but that says nothing about the excellence of the training.

 

[shredhog65]

I agree with about orbitsurgMD the relevence of ASOPRS to patients. They generally do not know what it is (a few self motivated patients might, but this is rare). Once you are in an established practice, I don't think it makes much of a difference (that is, assuming ASOPRS never becomes certified - if it does, it could affect hospital/OR privaleges).

That being said, there are some benefits of an ASOPRS fellowship. First and foremost, they are supposed to be regulated by the ASOPRS education committee. This is to ensure the fellow is trained in a variety of areas as well as has sufficient surgical volume. There are, however, several outstanding non-ASOPRS fellowships. The programs I know of are all at major medical centers where there is high surgical volume and a wide spectrum of pathology. I think these are excellent programs. Second, many ASOPRS members will not consider hiring a non-ASOPRS oculoplastic surgeon. Third, if you are interested in academic medicine, ASOPRS may be important.

I do know some people who have taken a position under a private oculoplastic surgeon. Just like the others have said, you need to be sure that you will see enough pathology and that there will be enough surgical volume. Also, make sure that they are not just using the fellow to cover call and see general patients. On the other hand, there are some oculoplastic surgeons that have been in practice for years (and are doing very well) that have trained in this type of fellowship.

Just my 2 cents...