ophtho vs gen surg

[xoxom]

Hi, so i would like some perspective because his has been on my mind and it would be nice to hear other people out.
I went to med school for ophhto, no doctors in my family, but have had major life changes due to a sibling with eye disease, hence ophtho. I engaged in some research projects in the first and second year but my med school does not have a home department so it was very sparse. Come step 1 -> 233. Honored fam med pass for everything else (currently in IM and Psych). In year 3 I had a three week ophtho elective and while i liked it it was mostly clinic and I was looking forward to finishing the day, the clock was on my mind. Then come gen surg, I did not realize how much I liked it until I finished because once you cover cases all day and even scut work, i did not mind that because it felt like I was helping out. I loved the hustle of it, getting things done, how everything layers down in the OR (since the patient is asleep) and the people become more themselves (for better or worst). But then gen surg is 5 years and not an easy life. Now i was thinking gen surg + colorectal = 6 years -> also allows some opportunity at being able to have a more elective practice (correct me if am wrong).

If i want ophtho-> finish 3rd year, possibly take a research year either between 3rd and fourth year or after graduation if that does not pan out. gen ophtho -> oculoplastics or retinal surgery fellowship.

Do you know anyone who finished a research year during med school? did it help them?

---

Members don't see this ad.

 

[Dr. Death]

Hi, so i would like some perspective because his has been on my mind and it would be nice to hear other people out.
I went to med school for ophhto, no doctors in my family, but have had major life changes due to a sibling with eye disease, hence ophtho. I engaged in some research projects in the first and second year but my med school does not have a home department so it was very sparse. Come step 1 -> 233. Honored fam med pass for everything else (currently in IM and Psych). In year 3 I had a three week ophtho elective and while i liked it it was mostly clinic and I was looking forward to finishing the day, the clock was on my mind. Then come gen surg, I did not realize how much I liked it until I finished because once you cover cases all day and even scut work, i did not mind that because it felt like I was helping out. I loved the hustle of it, getting things done, how everything layers down in the OR (since the patient is asleep) and the people become more themselves (for better or worst). But then gen surg is 5 years and not an easy life. Now i was thinking gen surg + colorectal = 6 years -> also allows some opportunity at being able to have a more elective practice (correct me if am wrong).

If i want ophtho-> finish 3rd year, possibly take a research year either between 3rd and fourth year or after graduation if that does not pan out. gen ophtho -> oculoplastics or retinal surgery fellowship.

Do you know anyone who finished a research year during med school? did it help them?

Are colorectal surgeons doing a lot of elective surgeries? I think you ought to do gen surg. You probably don't have a great shot to match ophtho in the first place and it sounds like you would be choosing it for lifestyle more than what you actually like.

 

[Oedipa Maas]

I did an optho elective for my surgical subspecialty requirement. The group of docs I worked with seemed to dislike the actual work of the field and they seemed annoyed at having to do "extra work" like refracting patients that didn't want to be seen by an optometrist. Obviously this is not true of all ophthalmologists but it was interesting to see a group of people really dislike their jobs despite their field on the whole tending to score highly on those "job satisfaction" surveys. If you're watching the clock now after just three weeks of it, imagine how much you are going to be watching it when you are an attending. I had the same feeling you did, and I think it's partially because the field is so sub-specialized that you are seeing the same thing all day every day. The day I was with the glaucoma doc, I saw 20+ glaucoma cases a day and saw the same medications prescribed and the same laser procedures performed. The most fun I had on that rotation was the ER follow-up day with the residents because it wasn't the same pathology for 8 hours. Now, unlike you, I did NOT love gen surg and I think there is something to be said for it that you even loved the scutwork of it and the hustle of the all. That was how I landed on psych, when I thought about "the worst parts" and "scutwork" of the fields I was considering, I still liked those things in psych or at least felt like I could deal with them.

 

[OnePunchBiopsy]

You are correct, colorectal surgeons have more opportunity to establish a more elective practice. Hemorrhoid bandings, colonoscopies, lap Sigmoidectomies. This only happens if the hospital you work for has a dedicated colorectal call pool.

Having to take general surgery call is going to kill the cushiness of an elective practice.

Old teachings dictate that if you are torn between general surgery and something else, pick the other thing. Colorectal is becoming more competitive due to the idea of a more elective practice. Also, some practices deal A LOT with inflammatory bowel diseases like Crohn’s and Ulcerative colitis, the latter of which are often sad cases requiring multiple trips to the OR. An elective practice is never guaranteed.

Pick the thing that you are ok doing the worst of.

 

[efle]

233 step from a med school with no home department and during COVID?

I'd probably look at that situation and apply something else >> ophtho, but that something may not be gensurg if lifestyle is on your mind.

 

[Cawolf]

Your chances at ophthalmology don't look great, I agree. Plenty of people take a research year and are super productive and then match into fields like ophthalmology, ENT, PRS, etc. You would need to do much better on Step 2 CK, have some research in the field, likely an away (challenging if not impossible before this application year) and excellent letters. These challenges apply to all students so there will definitely be more leeway, but without a home department you are at a disadvantage.

I think it sounds like you want to go into general surgery. Best of luck.

 

[noflag]

I did an optho elective for my surgical subspecialty requirement. The group of docs I worked with seemed to dislike the actual work of the field and they seemed annoyed at having to do "extra work" like refracting patients that didn't want to be seen by an optometrist. Obviously this is not true of all ophthalmologists but it was interesting to see a group of people really dislike their jobs despite their field on the whole tending to score highly on those "job satisfaction" surveys. If you're watching the clock now after just three weeks of it, imagine how much you are going to be watching it when you are an attending. I had the same feeling you did, and I think it's partially because the field is so sub-specialized that you are seeing the same thing all day every day. The day I was with the glaucoma doc, I saw 20+ glaucoma cases a day and saw the same medications prescribed and the same laser procedures performed. The most fun I had on that rotation was the ER follow-up day with the residents because it wasn't the same pathology for 8 hours. Now, unlike you, I did NOT love gen surg and I think there is something to be said for it that you even loved the scutwork of it and the hustle of the all. That was how I landed on psych, when I thought about "the worst parts" and "scutwork" of the fields I was considering, I still liked those things in psych or at least felt like I could deal with them.

I do just want to say that my experience with Optho rotations has been far different, especially in terms of physician satisfaction in what they do and variety. Most Ophthos I worked with whole heartedly recommend the field without being prompted, which was not an experience I had with most other specialties outside of maybe Derm and ENT. Yes, I definitely agree that compared to a Gen Surg clinic you might be seeing more similar cases, however I think what people love about Optho is the hands-on, visual, and immediate gratification nature of clinic and the variety of tools at your disposable in clinic and the OR.

For example in a general optho clinic day you could end up doing intravitreal injections, pan retinal photocoagulation laser treatment of the retina for diabetic retinopathy, YAG laser capsulotomies, peripheral iridotomies all in the same day. Not many surgical fields have that kind of procedure variety in their clinic. As for the OR, as an attending you can still have variety. Yes, there are definetly surgeons who do 30+ cataracts in a day and they love it. There are also others who will do cataracts alongside many other refractive, corneal transplant, etc. surgeries. With Retina you might get some more variety, and usually more surgery days in your week. With plastics you probably get the most variety, however you generally stay away from intraocular surgeries. Surgical glaucoma is an exploding field with new innovations like minimally invasive glaucoma surgery being widely adopted and generally you get more variety with surgeons doing cataracts along with glaucoma tubes, shunts, other surgeries.


As for OP:
I think its tough as a student to truly experience Optho and not feel bored in clinic if you are not the one sitting at the slit lamp evaluating patients. Often times you end up staring at the back of the resident or attending head all day. But I encourage you to find opportunities to learn how to do basic work ups of patients with the slit lamp and you'll see the beauty of visual diagnosis. Seeing the retina in stereoscopic (3D) using indirect lenses was one of the most incredible things I witnessed as a rotator, and something quite unique about the field. Not many others were you can DIRECTLY see the pathology, make an accurate diagnosis, and do something to treat it, all as the same provider.

 

[Baller2016]

I agree with noflag. I was pretty bored as a med student in ophtho clinic. There is not a whole lot you can do and you have no idea what you are seeing. As a resident, it's truly the best field in my humble opinion. There are surgeons who operate 2-3 days a week and others who do half-day to one day per week. It's all how you want to structure your practice. I wouldn't let you being bored as a med student dictate your speciality. My ENT friend was incredibly bored in ENT clinic as a med student because he had no idea what he was doing and basically shadowing. My derm friend was also super bored in derm clinic as a med student. Again no idea what you are seeing. Once you gain knowledge, it becomes fun! I think this is particularly true for these super sub-specialized fields. It's easy to know if you like gen surg, peds, IM as a med student and you actually feel like you can contribute.

Now if you are interested in ophtho - it will be hard with your step score. Super competitive field. You'll likely need a gap year but if you can build connections and get research/pubs under your belt, it can be done! If you have any more questions, feel free to PM me.

Sorry for all the typos - using my iPhone