Ophthalmology from another field?

[res1]

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Hi, I am new to posting on this forum, but have been following it for quite some time. I'm currently a second year internal medicine resident at a good program. I did my ophthalmology rotation very late in medical school (second to last rotation - after match); i went into it thinking that i would hate it, but i ended up loving the rotation, enjoyed watching the wide variety of intricate surgeries, and was impressed by the number of extremely grateful patients. I also was impressed by the balance of medicine and surgery that the speciatly has to offer.
In any case, ever since i started residency, i have considered applying for an ophthalmology position after i finish my current residency. I have decent board scores (240s Step I, 260s Step II) and I know that my current attendings would write solid letters of recommendation and support me in my decision.
I was wondering if this is a common practice, and would it help or hurt when applying to have a board certification in another area of medicine? Also, has anyone gone through this process?
Any advice would be greatly apprecicated. Thank you very much.

 

[victorkomd]

I am a third year medical resident who matched in ophthalmology last year. This is very involved discussion. Email me: [email protected]

 

[victorkomd]

It is much more difficult as a resident applying for another residency as competitive as ophthalmology than as a medical student. Medicare subsidizes the majority of resident's salaries. Medicare does not like physicians changing fields. Once you graduate from medical school and you decide to do internal medicine, you receive 3 years of subsidized residency. If you decide to change your mind during residency, you have to find programs willing to pay your salary out of their own budget. Some programs would not even consider my application because of this issue. Ophthalmology residency programs are generally well funded and don't have a program finding the extra $100k to pay a resident they really would like to have.

 

[Visioncam]

Ophthalmology residency programs are generally well funded and don't have a program finding the extra $100k to pay a resident they really would like to have.

This is false information sometimes used by programs as an excuse not to take such a resident. The federal government has what they call indirect and direct GME funding. One source (need to look up which one, direct or indirect) is not affected at all by having previous residency experience. The other one is partially affected. One faculty told me that the difference is that the hospital, not the department, loses about $10,000 per resident if such a resident is chosen and then only for the extra years. The fact is the department does not lose $100,000 per resident taken who has had previous training as the above post suggests.

For example, a medicine resident who has done 3 years at first gets 3 years of funding. Afterwards, all of the ophthalmology residency training is funded at a reduced rate. If a general surgery resident did 3 years (5 year program), the first 2 years of ophthalmology residency is fully funded and the last year is not quite fully funded.

Many ophthalmology residencies are funded at a profit. They get a lot more money (approx. double) compared to the resident's salary. If a department is managed well, they can easily make a big profit by having residents. If not magaged well, they can at least break even.

 

[victorkomd]

Here are some articles that explain the Medicare subsidy for residency training and what happens when physicians switch specialties.

 

[victorkomd]

Here are some more articles. I have the second part to the JAMA article but it is too large to upload. Email me if you want it: [email protected]