Ophthalmology vs General Surgery

[kandyps]

I am a third year med student and I am having conflict choosing between General Surgery and Ophthalmology. I have centered my research and attended to Ophtha Grand rounds, etc since the beginning of third year because is more competitive, but I did also a good job in my GS clerkship and I am in good standing with surgery

I think I have the numbers to go either way, although with my qualification i would probably get in to a better GS residency than an ophtha residency.

I really like being in the OR, using the scalpel and just really cutting and putting back together parts of the human body. I am an anato freak and used to be Anato TA to fellow MS. What I dont like of surgery is the lifestyle, the waking up @ 4am and arriving @ 430 am to the hospital. I know overall surgery has a sacrificed lifestyle that I am not really sure I want.

I dont have a lot of exposure to Ophtha, but when I did get to go to the clinics I loved the gadgets, the peds emergencies, etc. My research is in ROP and i really liked the clinics, get to help those kids with their future visual acuity, etc. and saw some interesting cases of metastatic cancer in retina,etc. I do like their lifestyle.

Something that is very important to me right now is that the SFmatch is very expensive, and you have to do a transitional application too in ERAs. I need to know what to do if I am gonna invest in Ophtha (i dont really have money, all i have are loans...)

I have a enrolled in Ophtha in August to exposed myself and try and decide, but by then I should have the SFM application ready to go and payed.

WHAT to DO?? ANY feedback will be welcomed!!! Thanks

---

Members don't see this ad.

 

[MPMD]

My advice is to continue to gun for ophtho, but to do a gen surg prelim year -- you will likely be able to get one at a strong program. Not all are completely miserable, and at some you get decent operating experience as an intern (VMMC and OHSU come to mind). You will always be able to switch form ophthalmology to general surgery, though the other way around will be more difficult.

It sounds like you are torn between the excitement and scope of general surgery vs the technology, lifestyle and research of ophtho. I think it is important to keep in mind that if you do gen surg, your anatomical scope will almost certainly narrow (esp if you do a fellowship), and the excitement will wane. My understanding is that the deal breaker for most surgically-minded individuals in ophtho is the amount of clinic. If you actually enjoy ophtho clinic (not saying its weird, ophtho clinic can be pretty cool), then ophtho might be a better fit for you. If you miss the surgical volume and variety during residency, you can try for a plastics or peds fellowship later on.

Bottom line, try to match ophtho, and if you stil feel drawn to gen surg after a surgical internship you can always switch.

 

[kandyps]

My advice is to continue to gun for ophtho, but to do a gen surg prelim year -- you will likely be able to get one at a strong program. Not all are completely miserable, and at some you get decent operating experience as an intern (VMMC and OHSU come to mind). You will always be able to switch form ophthalmology to general surgery, though the other way around will be more difficult.

It sounds like you are torn between the excitement and scope of general surgery vs the technology, lifestyle and research of ophtho. I think it is important to keep in mind that if you do gen surg, your anatomical scope will almost certainly narrow (esp if you do a fellowship), and the excitement will wane. My understanding is that the deal breaker for most surgically-minded individuals in ophtho is the amount of clinic. If you actually enjoy ophtho clinic (not saying its weird, ophtho clinic can be pretty cool), then ophtho might be a better fit for you. If you miss the surgical volume and variety during residency, you can try for a plastics or peds fellowship later on.

Bottom line, try to match ophtho, and if you stil feel drawn to gen surg after a surgical internship you can always switch.

Sounds like an awesome alternative! You can still enter 1st yr ophtho with a prelim in surgery?
Thanks again;
🙂

 

[MstaKing10]

I am a third year med student and I am having conflict choosing between General Surgery and Ophthalmology. I have centered my research and attended to Ophtha Grand rounds, etc since the beginning of third year because is more competitive, but I did also a good job in my GS clerkship and I am in good standing with surgery attendings.

My qualifications are:
Step 1 241
GPA acc- 3.73 (without the ObGYN, IM, and Psych grades)
AOA nominee
Research in Summer MS1, and on semester Ophtha - 1 poster pres, no publications
Anato TA 2years


I think I have the numbers to go either way, although with my qualification i would probably get in to a better GS residency than an ophtha residency.

I really like being in the OR, using the scalpel and just really cutting and putting back together parts of the human body. I am an anato freak and used to be Anato TA to fellow MS. What I dont like of surgery is the lifestyle, the waking up @ 4am and arriving @ 430 am to the hospital. I know overall surgery has a sacrificed lifestyle that I am not really sure I want.

I dont have a lot of exposure to Ophtha, but when I did get to go to the clinics I loved the gadgets, the peds emergencies, etc. My research is in ROP and i really liked the clinics, get to help those kids with their future visual acuity, etc. and saw some interesting cases of metastatic cancer in retina,etc. I do like their lifestyle.

Something that is very important to me right now is that the SFmatch is very expensive, and you have to do a transitional application too in ERAs. I need to know what to do if I am gonna invest in Ophtha (i dont really have money, all i have are loans...)

I have a enrolled in Ophtha in August to exposed myself and try and decide, but by then I should have the SFM application ready to go and payed.

WHAT to DO?? ANY feedback will be welcomed!!! Thanks

Honestly ophtho and gen surg are pretty different fields. You should definitely get more exposure to ophtho and decide what you really want to do. If you do a gen surg prelim without applying to ophtho and then decide to apply to ophthlo then you will have to scramble into a vacancy spot during your prelim year which is really hard to do and no guarantee that you will get into an ophtho program. Alternatively, you will have to find an opening in gen surg and continue with general surgery. Either way, not ideal.

Most of us were in the same boat in terms of student loans and debt during med school, but don't worry about the money. You will regret not applying because you didn't want to spend and extra thousand bucks or whatever. You're right, it aint cheap, but you are talking about the rest of your life here. And after all the money you have spent for undergrad and med school, this is a drop in the bucket really.

 

[orbitsurgMD]

Sounds like an awesome alternative! You can still enter 1st yr ophtho with a prelim in surgery?
Thanks again;
🙂

Sure. GS is a great background for ophthalmology.😉

 

[maxheadroom]

My advice is to continue to gun for ophtho, but to do a gen surg prelim year -- you will likely be able to get one at a strong program. Not all are completely miserable, and at some you get decent operating experience as an intern (VMMC and OHSU come to mind). You will always be able to switch form ophthalmology to general surgery, though the other way around will be more difficult.


Bottom line, try to match ophtho, and if you stil feel drawn to gen surg after a surgical internship you can always switch.

This qualifies as "terrible advice" from a medical student who has no basis for giving it. If you match Eyes and try to switch after your intern year, the General Surgery programs are going to be very suspicious of you. Their view will mostly be that you either didn't know what you wanted -- so why should they believe that you know now? Or they will be suspicious that you can't hack it in the much more strenuous atmosphere of a General Surgery training program.

The best options for you, in order of best to worst:
1. Try to get your Dean's Office to let you do your Eyes rotation earlier so you can figure out what you want. I did something similar to choose between Plastics and Ortho.
2. Apply to both, spend a lot of money, run up a bit more debt.
3. Intentionally delay 4th year -- do research or something. Use the time to get more experience with both so you can make a better informed decision.

Applying to Eyes with the intention of bailing to General Surgery if things don't work out is a terrible idea. You (possibly) rob a "real" Eyes applicant of a spot if you don't keep it. You put yourself at a huge disadvantage if you end up wanting General Surgery. If you're a Star Trek fan, you'll be familiar with the concept of the "no-win scenario" -- this is it.

 

[guttata]

It sounds like your heart is saying yes but your mind is saying no to general surgery.

I am not sure you will be completely happy with ophtho even if you work less and sleep more.
Have you considered other surgical subspecialties (ENT or plastics) which may fulfill your anatomically-geared mind while being more lifestyle friendly?

 

[kandyps]

The best options for you, in order of best to worst:
1. Try to get your Dean's Office to let you do your Eyes rotation earlier so you can figure out what you want. I did something similar to choose between Plastics and Ortho.
2. Apply to both, spend a lot of money, run up a bit more debt.
3. Intentionally delay 4th year -- do research or something. Use the time to get more experience with both so you can make a better informed decision.

I really dont have the money, max out the loans. I think I should apply to ophtha and do my august rotation and If i dont like it, retrieve my application in SF match, can that be done?
Can I apply to both? What if I match in both?

It sounds like your heart is saying yes but your mind is saying no to general surgery.

I am not sure you will be completely happy with ophtho even if you work less and sleep more.
Have you considered other surgical subspecialties (ENT or plastics) which may fulfill your anatomically-geared mind while being more lifestyle friendly?

Exactly what i've been saying.
I've never considered plastics.
When i went trough ENT i like it, but never thought of doing it. The step 1 mean was 243 last year, i dont have any research in ENT, i dont know the attendings nor the residents. And here there is only one position yearly for ENT (i would apply everywhere obviously, but i would really like to stay). Do u think I have a chance?

😕

 

[kandyps]

Sure. GS is a great background for ophthalmology.😉

Great! I did not know! 👍
Thanks!

 

[maxheadroom]

SF Match is before the NRMP, so you would have time to withdraw from the match for General Surgery, but you would spend a whole lot of money interviewing for GenSurg. I think the bigger question is "What do you want to be when you grow up?" Can you find a way to get in some Ophtho time without a "real" rotation? It's a tough situation, but dual-applying to those two specialties seems like a big stretch. The other problem is that we're pretty good at figuring out people whose interests don't "make sense." In Plastics we get people who have Derm all over their CVs. They don't get an interview. Someone with GenSurg/ENT/Ortho stuff on their application makes a lot more sense for us.

I'm not saying that Ophthalmologists are not surgeons, but their practice of surgery is completely different from General Surgery/Ortho/Plastics/ENT/NeuroSurg/Urology. The bigger question for you is which side of that divide is right for you.

 

[maxheadroom]

Great! I did not know! 👍
Thanks!

Um, I think the 😉 was sarcastic. I don't think orbitsurgMD was actually endorsing General Surgery as a good route to Ophtho.

 

[orbitsurgMD]

Um, I think the 😉 was sarcastic. I don't think orbitsurgMD was actually endorsing General Surgery as a good route to Ophtho.

No, I was sincere. GS is a good route to go, although not commonly taken. There are a lot of valuable things I learned as a general surgery intern that I would not have learned as a TY or in IM. I can't say I relished the 130 hour workweeks (oh, the good old days) but I have to say I liked surgery.

Whether it is the best choice for someone who is undecided is less clear. I was in the military and at that time, anyone wanting any surgery training above PGY1 had to go to the fleet first as a general medical officer. As it happens, I left the service at the end of my repayment obligation and did an ophtho residency followed by an oculoplastics fellowship. Looking back, I think surgery was a great way to prepare for ophtho, even if the usual pathway is different. I believe the field would be better served if it took the same internship path as does ENT.

 

[ophthodude]

No, I was sincere. GS is a good route to go, although not commonly taken. There are a lot of valuable things I learned as a general surgery intern that I would not have learned as a TY or in IM. I can't say I relished the 130 hour workweeks (oh, the good old days) but I have to say I liked surgery.

Whether it is the best choice for someone who is undecided is less clear. I was in the military and at that time, anyone wanting any surgery training above PGY1 had to go to the fleet first as a general medical officer. As it happens, I left the service at the end of my repayment obligation and did an ophtho residency followed by an oculoplastics fellowship. Looking back, I think surgery was a great way to prepare for ophtho, even if the usual pathway is different. I believe the field would be better served if it took the same internship path as does ENT.

Oculoplastics is a lot different than the rest of ophtho. One ophtho attending told me his oculoplastics partner chose that fellowship because he wanted to be a more invasive surgeon without having to do a general surgery 5-year residency. He said he took the easier route to get there through ophtho residency haha.

 

[ophthotwenty13]

i decided late last year, like yourself. more important than anything, what you need to do is spend all of your free time in ophtho clinics/ER/OR and figure out gen surg or ophtho; none of this wishy-washy do a prelim year and then transition from one specialty to another. that's nonsense.

you need to spend all of your free time, even if means possibly missing some of your current clinical activities in ophtho related experiences to figure this out. i spent about 2-3 weeks every afternoon until night in the OR/ophtho ER/clinics to make sure this is what i really wanted. i did this while i was on my pediatrics rotation. i suggest you do the same.

also, from what i recall sfmatch was due late august or early sept. if you dont have letter writers lined up, now is the time to start working with attendings because in ophtho letters can be instrumental and everybody knows everybody. you can use your time spent now to gain contacts and talk to residents and ask who would be good to work with to get a letter.

you should go ahead and prepare for sfmatch, regardless of financial issues, if you are seriously considering ophtho.

 

[MPMD]

This qualifies as "terrible advice" from a medical student who has no basis for giving it. If you match Eyes and try to switch after your intern year, the General Surgery programs are going to be very suspicious of you.

Fair enough. My basis was that I know people that switched from ophtho -> EM and ophtho -> ENT, figured going to GS wouldn't be an issue either. Good to know directors would be suspicious. I agree that rotating ophtho earlier than Aug followed by GS is the best way to figure this out and that this should be easily accomplished before you apply (due to how different the fields are). I was NOT suggesting that the prelim year is the mechanism by which you should decide, just that it would be a good fit if you want a more surgical experience (and thought that if you happen to discover you'd made a huge mistake you could easily switch, though I now retract that).

 

[ophthope]

My basis was that I know people that switched from ophtho -> EM and ophtho -> ENT, figured going to GS wouldn't be an issue either.

I've never met anyone who even seemed to know anyone that switched out of ophtho voluntarily. You might be bad luck! Seriously though I just wanted to say that it's a different story if there is some other reason you are switching out like you just ended up being a bad microsurgeon or you developed a tremor or your stereo vision is impaired somehow and you didn't know it. In those cases I don't think any residency directors would be dubious of you switching into their field.

 

[maxheadroom]

I've never met anyone who even seemed to know anyone that switched out of ophtho voluntarily. You might be bad luck! Seriously though I just wanted to say that it's a different story if there is some other reason you are switching out like you just ended up being a bad microsurgeon or you developed a tremor or your stereo vision is impaired somehow and you didn't know it. In those cases I don't think any residency directors would be dubious of you switching into their field.

Or MPMD is at a place with a really crappy residency program. I know of a Derm program that has had multiple people leave for non-Derm programs because they hated their residency so much.

My main point is that most surgical specialties want decisive applicants. And if you were wishy-washy about Ophtho, why would we expect you to not eventually be wishy-washy about us?? It's best to do what you have to do to figure out where you belong, even if it means delaying graduation by a year. That's a much better, easier to explain move than trying to change programs after a year.

 

[ophthope]

My main point is that most surgical specialties want decisive applicants. And if you were wishy-washy about Ophtho, why would we expect you to not eventually be wishy-washy about us?? It's best to do what you have to do to figure out where you belong, even if it means delaying graduation by a year. That's a much better, easier to explain move than trying to change programs after a year.

Oh yes, I 100% agree with you. If OP is this indecisive and can't figure it out early in fourth year then delaying a year may be the best option. It really sounds like OP should spend some time with ENT and other surgical specialties as well, which another year would allow. Or just bite the bullet and apply to Ophtho while spending a ton of time in Ophtho clinic/OR early in M4 year, then withdraw if it isn't for you and apply to more Gen Surg programs in NRMP. Choosing that course would mean you had a more limited time to fix your indecision, however.

 

[orbitsurgMD]

I knew of a couple of cases. One went to peds with an ophtho acceptance in hand. Another finished his PGY2 year in ophtho at a large midwestern eye institute program and transferred to become a PGY2 at a prestigious diagnostic radiology program in St. Louis. It is not common, but still happens. With ophthalmology incomes in decline, some ambivalent candidates go elsewhere.

 

[Eyefixer]

This happens more then you think. I remember a few years ago a PGY2 from UCLA dropped out and went to general surgery I think. I know the guy who took his spot having transferred from much leas prestigious program. Around the same time, UCI PGY2 transferred to a different speciality as well. In my upper level class a guy dropped medicine completely and went into business industry ( he was MD/MBA ).

 

[kandyps]

i decided late last year, like yourself. more important than anything, what you need to do is spend all of your free time in ophtho clinics/ER/OR and figure out gen surg or ophtho; none of this wishy-washy do a prelim year and then transition from one specialty to another. that's nonsense.

you need to spend all of your free time, even if means possibly missing some of your current clinical activities in ophtho related experiences to figure this out. i spent about 2-3 weeks every afternoon until night in the OR/ophtho ER/clinics to make sure this is what i really wanted. i did this while i was on my pediatrics rotation. i suggest you do the same.

also, from what i recall sfmatch was due late august or early sept. if you dont have letter writers lined up, now is the time to start working with attendings because in ophtho letters can be instrumental and everybody knows everybody. you can use your time spent now to gain contacts and talk to residents and ask who would be good to work with to get a letter.

you should go ahead and prepare for sfmatch, regardless of financial issues, if you are seriously considering ophtho.

I am gonna try and spent my time now that i finished IM (today) and i am starting psych rotation. So i can be sure, because it is very difficult to decide after spending that whole lot of $$ ! Also try and land in prelim surgery for my internship and then completly decide which way to go....

Thanks for all the advices, they re all appreciated 😉

 

[Winged Scapula]

I am gonna try and spent my time now that i finished IM (today) and i am starting psych rotation. So i can be sure, because it is very difficult to decide after spending that whole lot of $$ ! Also try and land in prelim surgery for my internship and then completly decide which way to go....

Thanks for all the advices, they re all appreciated 😉

I'm afraid you have misunderstood the above option as being reasonable. It should be a last resort (and only then if you absolutely cannot delay graduation while you decide which path to follow).

I cannot speak for Ophtho but I can confidently tell you that if you end up in Prelim GS and decide to pursue a Categorical GS position, it will be a difficult route. Fair or not, Preliminary GS residents are seen are seen as "damaged goods", you will not be as desirable a candidate as the 4th year medical student to GS programs. Obviously there are exceptions but you will be a stronger candidate as a final year student. Some students have found delaying graduation for a year, while doing research or additional electives, helpful in making a career decision.

 

[hurdlepup]

I'm afraid you have misunderstood the above option as being reasonable. It should be a last resort (and only then if you absolutely cannot delay graduation while you decide which path to follow).

I cannot speak for Ophtho but I can confidently tell you that if you end up in Prelim GS and decide to pursue a Categorical GS position, it will be a difficult route. Fair or not, Preliminary GS residents are seen are seen as "damaged goods", you will not be as desirable a candidate as the 4th year medical student to GS programs. Obviously there are exceptions but you will be a stronger candidate as a final year student. Some students have found delaying graduation for a year, while doing research or additional electives, helpful in making a career decision.

Looking at the stats for US seniors versus independent applicants from the SF match website, I would not recommend waiting a year to apply for Ophtho either...

 

[kandyps]

I'm afraid you have misunderstood the above option as being reasonable. It should be a last resort (and only then if you absolutely cannot delay graduation while you decide which path to follow).

I cannot speak for Ophtho but I can confidently tell you that if you end up in Prelim GS and decide to pursue a Categorical GS position, it will be a difficult route. Fair or not, Preliminary GS residents are seen are seen as "damaged goods", you will not be as desirable a candidate as the 4th year medical student to GS programs. Obviously there are exceptions but you will be a stronger candidate as a final year student. Some students have found delaying graduation for a year, while doing research or additional electives, helpful in making a career decision.

I cannot delay graduation nor go into research, i do not have the $ for it. I have max out my loans yearly and still end up needing more $. It is not an option for me right now.
I can expose my self for the entire month of may and make my decision.

Looking at the stats for US seniors versus independent applicants from the SF match website, I would not recommend waiting a year to apply for Ophtho either...

Yo can do ophtho will any transitional/ preliminar you still start in 2015.

 

[ophthope]

Looking at the stats for US seniors versus independent applicants from the SF match website, I would not recommend waiting a year to apply for Ophtho either...

Yes, I think the consensus is that if you wait a year the best thing to do is to delay graduation so that you can apply as a US senior. So do the "research" or "off" year between M3 and M4.

 

[Slide]

I cannot delay graduation nor go into research, i do not have the $ for it. I have max out my loans yearly and still end up needing more $. It is not an option for me right now.
I can expose my self for the entire month of may and make my decision.



Yo can do ophtho will any transitional/ preliminar you still start in 2015.

There are paid "pre-residency fellowship" positions that let you do research and take ocular-related courses. However, I believe these are pretty competitive.

 

[azzarah]

I was deciding between ophtho and general surgery in med school too. I'm really glad that I did in terms of the lifestyle and length of training. Someone told me if you love ophtho as much as Gen Surg, do ophtho. If you go through med school and you don't find anything more exciting that general surgery, then do that....

 

[RestoreSight]

Gen surg is pretty cool. Its a rough and tumble field, but there are a lot of options once you are finished with training (vascular, trauma, plastics, etc). I know a guy who just completed a two year plastic surg fellowship and is doing very well. He also moonlighted during his residency at a community hospital nearby and made an extra 150k/yr doing 3 overnights a week. I don't think that option is really open to ophtho residents. Lifestyle is better in ophtho and there are few life-threatening bad outcomes, but I would understand some personality types would hate what we do everyday.

 

[orbitsurgMD]

The people who like both general surgery and ophthalmology and who choose ophthalmology often end up, and not surprisingly, in retina or plastics.

 

[kandyps]

The people who like both general surgery and ophthalmology and who choose ophthalmology often end up, and not surprisingly, in retina or plastics.

I love retina! I am working on ROP and I would like and make a contribution to the field!