Ophtho to IM back to Ophtho? Career advice please

[Deckard]

I have completed an Ophtho residency. Job market has been tough for where I want to be.

I know this may sound unusual or crazy to some but for other very personal reasons I am thinking of pursuing a Internal medicine residency. IM would be a means for me to provide for my family and the job market is much better for where I want to be.

I certainly enjoy IM and I think I can do well in it but at the same time I can't deny that my passion is Ophtho. My question is, if I accept the IM residency, will I shut the door forever on Ophtho ?

Ideally, I want to succeed in IM in the near term but have the option to resume Ophtho when it's the right time for me.

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[odwire usa]

choose what you like

 

[Eyefixer]

Wow, what a testament of times! You are probably in LA, SF, NY, etc. I do feel your pain. I had to make some tough choices after residency and ended up slightly away from the place where I wanted to be. I don't think people in other fields fully understand how bad the job market is in competitive areas. (I hear $90K in NY for general...). There is no right or wrong answer in your situation. I don't think you are shutting the doors forever, but it will definitely be hard to come back (hek, I don't operate for 2 weeks and I feel rusty). I am hoping for a better job market for us in the future, but I don't think anyone really knows with Obamacare.

I have completed an Ophtho residency. Job market has been tough for where I want to be.

I know this may sound unusual or crazy to some but for other very personal reasons I am thinking of pursuing a Internal medicine residency. IM would be a means for me to provide for my family and the job market is much better for where I want to be.

I certainly enjoy IM and I think I can do well in it but at the same time I can't deny that my passion is Ophtho. My question is, if I accept the IM residency, will I shut the door forever on Ophtho ?

Ideally, I want to succeed in IM in the near term but have the option to resume Ophtho when it's the right time for me.

 

[Mirror Form]

I have completed an Ophtho residency. Job market has been tough for where I want to be.

I know this may sound unusual or crazy to some but for other very personal reasons I am thinking of pursuing a Internal medicine residency. IM would be a means for me to provide for my family and the job market is much better for where I want to be.

I certainly enjoy IM and I think I can do well in it but at the same time I can't deny that my passion is Ophtho. My question is, if I accept the IM residency, will I shut the door forever on Ophtho ?

Ideally, I want to succeed in IM in the near term but have the option to resume Ophtho when it's the right time for me.

You're right, it does sound crazy! Did you complete an ophtho residency in the US? Have you passed your boards? There must be more to this story.

I just cannot believe that someone would consider going back to an IM residency if you planned to ever go back to ophtho. Residency is a huge commitment, and then you have to get board certified afterward. Furthermore, the starting salary a hospitalist isn't exactly that high these days either.

If you need to make yourself more marketable, why not do a peds ophtho, neuro-opth, or glaucoma fellowship? Heck, you could do two of them in the same time that you would complete a IM residency.

 

[Deckard]

You're right, it does sound crazy! Did you complete an ophtho residency in the US? Have you passed your boards? There must be more to this story.

I just cannot believe that someone would consider going back to an IM residency if you planned to ever go back to ophtho. Residency is a huge commitment, and then you have to get board certified afterward. Furthermore, the starting salary a hospitalist isn't exactly that high these days either.

If you need to make yourself more marketable, why not do a peds ophtho, neuro-opth, or glaucoma fellowship? Heck, you could do two of them in the same time that you would complete a IM residency.

Yes, I completed ophtho residency in the US. Board eligible and not certified yet. As I said in my original post, I have personal reasons why I need to stay where I am.

So far the response from Eyefixer is that it would be difficult to get back to Ophtho. I am hoping more people can chime in to say that it won't be impossible

 

[guttata]

Yes, I completed ophtho residency in the US. Board eligible and not certified yet. As I said in my original post, I have personal reasons why I need to stay where I am.

So far the response from Eyefixer is that it would be difficult to get back to Ophtho. I am hoping more people can chime in to say that it won't be impossible

No offense, but your plan doesn't make sense.

1. Are you trying to buy more time by doing a three year IM residency, hoping that an ophtho job will open up in the near future? If you live in a desirable locale, ophtho grads will continue to flock to the area. But, the good news is that the population growth in these areas will eventually support the need for more specialists.

2. If this is a financial consideration, you would be better off moonlighting at a lenscrafter, doing non-medical consulting, or working part-time for an EYEMD group. If you really have your heart set on staying in the area, go talk to the practices in the area. I am sure most would not mind if you work part-time/weekend hours for production - you can generate $$$ for them when no one is in clinic and everyone wins. It may also give you an inside track for any future openings.

3. Let's say a position does open up after you finish IM residency. How is an EYEMD group going to look upon someone who has left the field for 3+ years? Do you really think they are going to hire you? You may be the most passionate person about ophtho, but your behavior (if you completed an IM residency) would suggest otherwise.

4. Consider doing exams for a local VA. This can help pay the bills.

5. Consider starting your own practice. It won't be easy, but I think if you devoted as much time to your new practice as you would in IM residency (80hrs/week), your chance of success is high.

6. How far are you willing to commute? Often times there are underserved areas close to very desirable cities.

7. I also agree with the previous poster who mentioned fellowship. Peds and glaucoma tend to be in greatest demand right now. If practices are really desperate, they will sign you to a contract before you begin fellowship.

 

[LUBDUBB]

I have completed an Ophtho residency. Job market has been tough for where I want to be.

I know this may sound unusual or crazy to some but for other very personal reasons I am thinking of pursuing a Internal medicine residency. IM would be a means for me to provide for my family and the job market is much better for where I want to be.

I certainly enjoy IM and I think I can do well in it but at the same time I can't deny that my passion is Ophtho. My question is, if I accept the IM residency, will I shut the door forever on Ophtho ?

Ideally, I want to succeed in IM in the near term but have the option to resume Ophtho when it's the right time for me.

I am sorry to hear that you are going through a tough time. I am just curious as to what you are exactly asking. Are you saying that ophtho jobs do not pay well in your area (e.g 90k) so you would like to instead spend three years in an IM residency making (50k)?

IMHO, if your passion is ophtho, be the best darn ophthalmologist in your area, do not settle for an average salary! Be the Neiman Marcus in your area not the Macys! [Pardon my idealism, match day is one day away]

Best of luck in your endeavors, I do hope you find a solution that makes you and all those involved happy.

 

[Deckard]

I just wanted to update that I decided not to pursue the IM position. I actually scrambled for an ophtho fellowship and got the spot! I am also doing some locum tenems in my area.

Thanks everyone for influencing me to stay the course.

 

[DKofLV]

I just wanted to update that I decided not to pursue the IM position. I actually scrambled for an ophtho fellowship and got the spot! I am also doing some locum tenems in my area.

Thanks everyone for influencing me to stay the course.

I thought you said you already completed an Ophtho residency?

 

[Deckard]

I thought you said you already completed an Ophtho residency?

I did complete an Ophtho residency. That is why I am going into fellowship.

If you meant how I could get into an IM position, I did one year of IM before starting Ophtho.

 

[DKofLV]

I did complete an Ophtho residency. That is why I am going into fellowship.

If you meant how I could get into an IM position, I did one year of IM before starting Ophtho.

Excellent. Congrats on the match

 

[anzq]

Im glad everything worked out for you well in the end Deckard. Apologies as I just joined SDN a few days ago and so am just now catching up on all the posts. I think you'll probably enjoy your fellowship, and have renewed vigor for the field!

Mirror and Guttata bring up some intriguing points, that weren't apparent to me at least in the beginning. Now I'd actually venture out there and say that while they all comments made so far make sense, and it may 'appear' after an IM residency that you're not committed to ophth, I personally know 2 folks who've done just such a thing. You can go into neuro or uveitis or such overlapping fields with medicine. One actually moonlights in IM for extra moolah, and has a day job as an academic ophth at a major teaching institution (one of the following powerhouses - I wont say which - USC, Iowa, Harvard, UCLA, NYEE, Wills).

Comments anyone?!

 

[Meibomian SxN]

Im glad everything worked out for you well in the end Deckard. Apologies as I just joined SDN a few days ago and so am just now catching up on all the posts. I think you'll probably enjoy your fellowship, and have renewed vigor for the field!

Mirror and Guttata bring up some intriguing points, that weren't apparent to me at least in the beginning. Now I'd actually venture out there and say that while they all comments made so far make sense, and it may 'appear' after an IM residency that you're not committed to ophth, I personally know 2 folks who've done just such a thing. You can go into neuro or uveitis or such overlapping fields with medicine. One actually moonlights in IM for extra moolah, and has a day job as an academic ophth at a major teaching institution (one of the following powerhouses - I wont say which - USC, Iowa, Harvard, UCLA, NYEE, Wills).

Comments anyone?!

Is there really such a high need for neruo and especially uveitis?

It may make the surgeon more "marketable" but the cases that need those sub-specialists are so rare that location selection would be even more limited.

 

[Mirror Form]

Now I'd actually venture out there and say that while they all comments made so far make sense, and it may 'appear' after an IM residency that you're not committed to ophth, I personally know 2 folks who've done just such a thing. You can go into neuro or uveitis or such overlapping fields with medicine. One actually moonlights in IM for extra moolah, and has a day job as an academic ophth at a major teaching institution (one of the following powerhouses - I wont say which - USC, Iowa, Harvard, UCLA, NYEE, Wills).

Comments anyone?!

I know a few dual boarded ophthalmologists too, but most did ophtho after their first residency. Also, they were all apparently highly motivated to do research and teach at an academic center.

If you goal is just to practice ophtho, then doing an IM residency won't help you very much in finding an ophthalmology job. Whereas, doing ophtho fellowships will certainly help. Internal medicine residencies are no cake walk either. And then you have to get board certified in two specialties . . . it's just not a good plan for someone who primarily desires to practice ophthalmology.

 

[Mirror Form]

Is there really such a high need for neruo and especially uveitis?

It may make the surgeon more "marketable" but the cases that need those sub-specialists are so rare that location selection would be even more limited.

Neuro and Peds are in very high demand across the country. I'm not sure about uveitis, but I would imagine that a uveitis fellowship would still be helpful when applying for comprehensive ophthalmology positions (as would most any fellowship).

 

[abu barney]

I have completed an Ophtho residency. Job market has been tough for where I want to be.

I know this may sound unusual or crazy to some but for other very personal reasons I am thinking of pursuing a Internal medicine residency. IM would be a means for me to provide for my family and the job market is much better for where I want to be.

I certainly enjoy IM and I think I can do well in it but at the same time I can't deny that my passion is Ophtho. My question is, if I accept the IM residency, will I shut the door forever on Ophtho ?

Ideally, I want to succeed in IM in the near term but have the option to resume Ophtho when it's the right time for me.

Yes, it sounds hellla crazy to me. IM, aside from the intellectual stimulation (that happens in reality like once every two weeks), is a 3 year residency in pain. Your life is shot for the first year, and the rest of the two years you're covering inpatient and consult services on the weekends while all your friends are having fun. I know because I did one myself and ran to ophthalmology afterwards. There's no comparison--the incessant beeping, smells, hustling for chairs or computers, chasing around doing nonsense discharge planning work. Yes it's important work, but why do it when there are plenty of internists and you're an ophthalmologist? Yes the job market is better for IM but man that is a short-sighted decision to do a another residency--a very painful residency, mind you--so you can check off DVT or diet orders on a checklist for another COPD exacerbation.

My advice to you is the same advice I give to MS4 students confused between ophthalmology and IM. All things aside, do you want a career (and residency, mind you) in which you will probably have to work on some weekends for the rest of your life, or one that you don't.

Hope this helps. I wouldn't touch it with a ten foot pole.