Ophthalmology

[racccjlm]

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I'm curious if anyone on here knows much about ophthalmology. I've been reading a lot of stuff on VIN, and am really getting interested in it! What does the average ophthalmologist's day look like? How much surgery are you involved in?

 

[sunshinevet]

I work in a practice with an opthalmologist in it. She consults M pm, Tue am pm, Wed am pm, Thursday shes at a teaching hospital, Fri am. She does surgery Tuesdays, Wednesdays, Fridays. She does surgery most of those days and consults are generally full.

She seems to have to deal with lots of crap patients though

She doesn't work weekends, but she will come in if another vet has an ocular emergency, and needs her to see it. But this happens very rarely.

She also does call outs to see horses eyes, generally on mondays.

 

[racccjlm]

Hey thanks for the reply sunshinevet 🙂 Good to know!

 

[Bill59]

A lot of ophtho is outpatient. Most eye diseases can be diagnosed in the exam room and many can be treated on an outpatient basis. It's mostly seeing the same things over and over. This is good if you like a specialty that deals with straight-forward cases. If you prefer chasing esoteric diagnoses, you would probably be happier with something like medicine or neuro.

Common surgeries are cataracts, eyelids, and corneas. These generally have a good prognosis so the surgeries are pretty rewarding. Patients rarely die from eye diseases so there's not a lot of death and destruction. You will see a lot of diabetics.

The job outlook is excellent. General practitioners are very good about referring eye cases. There are still relatively few residencies so unlike surgery and medicine, there are not a lot of new specialists coming into the market each year. With the ability to see a lot of patients and some high-fee surgeries (cataracts) ophthalmologists have a lot of earing potential.

The lifestyle is very good. You won't have a lot of sick inpatients and emergencies are uncommon, with perforating corneas being the main things. 4-day weeks and no call are common for private practice.

Because of these factors, ophtho residencies are some of the most competitive residencies out there these days.

 

[racccjlm]

A lot of ophtho is outpatient. Most eye diseases can be diagnosed in the exam room and many can be treated on an outpatient basis. It's mostly seeing the same things over and over. This is good if you like a specialty that deals with straight-forward cases. If you prefer chasing esoteric diagnoses, you would probably be happier with something like medicine or neuro.

Common surgeries are cataracts, eyelids, and corneas. These generally have a good prognosis so the surgeries are pretty rewarding. Patients rarely die from eye diseases so there's not a lot of death and destruction. You will see a lot of diabetics.

The job outlook is excellent. General practitioners are very good about referring eye cases. There are still relatively few residencies so unlike surgery and medicine, there are not a lot of new specialists coming into the market each year. With the ability to see a lot of patients and some high-fee surgeries (cataracts) ophthalmologists have a lot of earing potential.

The lifestyle is very good. You won't have a lot of sick inpatients and emergencies are uncommon, with perforating corneas being the main things. 4-day weeks and no call are common for private practice.

Because of these factors, ophtho residencies are some of the most competitive residencies out there these days.

Thanks Bill - this is exactly what I'm looking for. We had an emergency/anesthesia resident speak with us today about what he's going through to get double boarded. While I would absolutely love being involved in that kind of fast paced world, I think I'd burn out fast. I get emotionally involved too easily and the odd hours are not something that I want to deal with on a regular basis. Thanks for the overview - it confirms what I've been hearing/reading.

 

[Bill59]

Yeah, all those things are important. But the MOST important thing is what you're interested in. The ophtho speciality has a lot of good features but if you don't love -- just really LOVE -- eyeballs, you probably won't be happy. Or good.

 

[random23]

Bill, do you have any similar insight on specializing in anesthesia? I love anesthesia more than anything else so far- but I don't really know where anesthesia specialists fit into the working world...is it more common to be involved in emergency/critical care if you are interested in anesthesia? The only anesthesia specialists I know of are the ones working at vet schools teaching us...is there a place for anesthetists outside university hospitals?

 

[alliecat44]

random23, I know your question is directed at Bill, but thought I'd chime in as I considered anesthesiology myself.

The short answer is yes, there is a place for anesthesiologists in private practice. However, there are very few who work in that sort of environment. Places like the Animal Medical Center in NYC, Ruffian Equine Medical in NY, and Animal Scan (a private MRI company) employ anesthesiologists. I've also heard of a couple who have established pain clinics, and when I was considering the possibility myself I thought of having an independent consultation service. i.e., folks like veterinary dentists with difficult patients would provide me with patient records, PE findings, ECG etc and I could consult with them on protocols...not sure of the liability of that given that I wouldn't actually be seeing the patient. I also thought of an ambulatory anesthesia service--having scheduled days with various specialty practices who could operate on their high-risk patients on the days that I'd be there. Unfortunately, though, you can't always schedule a surgery for a high-risk patient--they're often emergent scenarios.

I spent some time working with one of the aforementioned private practice anesthesiologists and decided it wasn't for me because of limited/absent client contact, very limited to absent patient follow-up, and no relationship with the patient once it's extubated and out the door. For me, that relationship was a bit too brief to be wholly satisfying. However, I was interested in it because of my fascination with pathophysiology, pulmonary physiology and pharmacology--I still think it's a really cool specialty and I had a fabulous time with the anesthesiologist.

One of my specialist friends pointed out to me that as an anesthesiologist, all of your job opportunities are necessarily dependent on other services/practices/doctors--which is true in the case of any specialist, but more so for this particular specialty. Something to keep in mind.

Hope this helps. 🙂

 

[Bill59]

I'm thinking the same as alliecat. Anesthesiologists have little if any client contact (which is a huge advantage for some people). Like other ancillary services (pathology, radiology) you are instead interacting with the attending vets. You need to know a lot of physiology, pharmacology and pathophysiology for a broad range of systems.

You have to deal with surgeons wanting you to get their cases on the table or schedule one more case at the end of a long day. You have to multi-task and delegate because you often have multiple techs sitting cases you're responsible for. So you need good people and management skills.

20 years ago anesthesia was the default critical care experts but ACVECC dips have taken over that role, although anesthesiologists are still the go-to folks for ventilator cases and advanced life support since they deal with that all the time.

Unlike the explosion of many private practice specialists, there are relatively few anesthesiologists in private practice. Most are in academics, which means the job market is not as good as many specialties. You can have quite a bit of call for emergency surgeries -- bloats, backs, c sections.

Anesthesia is starting to get into the chronic pain management area although that's yet to be a major part of most practices.

Competition for residency slots is probably average or a little below average.

 

[racccjlm]

Yeah, all those things are important. But the MOST important thing is what you're interested in. The ophtho speciality has a lot of good features but if you don't love -- just really LOVE -- eyeballs, you probably won't be happy. Or good.

Also a good point - I assure you I do. Been fascinated with eyes from an early age

I've had some awesome classes that delved into eyes, so I know that I'm definitely interested.

 

[random23]

I'm thinking the same as alliecat. Anesthesiologists have little if any client contact (which is a huge advantage for some people). Like other ancillary services (pathology, radiology) you are instead interacting with the attending vets. You need to know a lot of physiology, pharmacology and pathophysiology for a broad range of systems.

You have to deal with surgeons wanting you to get their cases on the table or schedule one more case at the end of a long day. You have to multi-task and delegate because you often have multiple techs sitting cases you're responsible for. So you need good people and management skills.

20 years ago anesthesia was the default critical care experts but ACVECC dips have taken over that role, although anesthesiologists are still the go-to folks for ventilator cases and advanced life support since they deal with that all the time.

Unlike the explosion of many private practice specialists, there are relatively few anesthesiologists in private practice. Most are in academics, which means the job market is not as good as many specialties. You can have quite a bit of call for emergency surgeries -- bloats, backs, c sections.

Anesthesia is starting to get into the chronic pain management area although that's yet to be a major part of most practices.

Competition for residency slots is probably average or a little below average.

thanks for the info Bill and Alliecat, was very helpful!