Optometric Ophthalmology residency

[Eyesontheprizedoc]

Hello fellow SDN members! I’ve been extremely curious about this topic for some time. It’s a well known fact that to be an eye surgeon (ophthalmologist) you must go to medical school and then do a minimum 3-4 year residency after. This is where ophthalmologists mainly learn about the eye and how to treat/surgically treat different conditions. It has always seemed to me, that ophthalmology training could be improved exponentially by implementing an ophthalmology residency after optometry school. Even though this isn’t likely to go over politically, wouldn’t this be the most effective way for ophthalmologists to know the most about the eye? Medical student know far less about the eye than optometry students do upon graduation. The learning curve would be much less if they entered a 4 year ophthalmology residency upon completing optometry school, and would seem to make a more competent clinician. Please give me your thoughts as to if this would or would not be the most efficient model to train eye surgeons! I have not heard much about this idea.

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[UnicornOpt]

My goal is to spend less than 30 seconds on writing my post so I won't flesh out my reasoning, but no, that would not be a good model. Your claims aren't sound, and as a practicing optometrist, I think this is a horrible idea.

 

[Eyesontheprizedoc]

My goal is to spend less than 30 seconds on writing my post so I won't flesh out my reasoning, but no, that would not be a good model. Your claims aren't sound, and as a practicing optometrist, I think this is a horrible idea.

Thank you for your reply. I know you didn’t want to state your reasonings but I would really like to hear them. I realize that this isn’t likely to happen due to political reasons but why do you think this would be a horrible idea from an academic standpoint? It just seems like you would have a more sound understanding of the eye going into said residency if this was the format.

 

[deleted480308]

Thank you for your reply. I know you didn’t want to state your reasonings but I would really like to hear them. I realize that this isn’t likely to happen due to political reasons but why do you think this would be a horrible idea from an academic standpoint? It just seems like you would have a more sound understanding of the eye going into said residency if this was the format.

Because there is far far more to surgery than just the anatomy of the thing you cut

 

[Eyesontheprizedoc]

Because there is far far more to surgery than just the anatomy of the thing you cut

That is obvious. Essentially everything ophthalmologists learn about the eye or surgery is learned IN RESIDENCY, so would it not be beneficial to learn a bunch of stuff about the eye before residency and then do that same Ophthalmology residency? I am not cutting the same residency out of the equation at all!

 

[deleted480308]

That is obvious. Essentially everything ophthalmologists learn about the eye or surgery is learned IN RESIDENCY, so would it not be beneficial to learn a bunch of stuff about the eye before residency and then do that same Ophthalmology residency? I am not cutting the same residency out of the equation at all!

My point was you also need to know the med school stuff. You don’t know what you don’t know.

 

[Eyesontheprizedoc]

My point was you also need to know the med school stuff. You don’t know what you don’t know.

I see your point, and I appreciate your responses. I’m just wondering how much of that stuff do you really use as a practicing ophthalmologist? Isn’t the information a little overkill? In optometry school you do also go through the entire human body (obviously not as much in depth as med school, but it is still extensive). How much med school knowledge do ophthalmologists really remember and use on a daily basis?

 

[percyeye]

Practicing Optometrist here. If you want to be an Ophthalmologist we all know go to Med school. I shadowed in medicine and the eyes were pretty much the only organ system I enjoyed. I would almost fall asleep shadowing the family medicine doc. The reason I went with Optometry is just because you get into Medical school doesn't guarantee which specialty you'll go into.

At the same time I don't like Ophthalmologists screaming at the top of the mountain that we are killing patients for every single scope expansion.

 

[Eyesontheprizedoc]

I’m extremely disappointed in the professionalism of the people on this forum. I am simply searching for insight to this theoretical situation (which again I realize would never happen in real life). I appreciate the genuine responses, but for the most part I am disgusted by the “troll land” that Student Doctor Network has become.

A few things I would like to state:

-I am currently finishing my 2nd year of optometry school. At my school, during the first year we go through a whole entire body course and it is quite extensive (obviously not to the degree that med school does, but still). We spend just as much time learning about the entire body during the first year as we do the eye itself. In the second year we also have a general pharmacology course where we learn about systemic drugs. We take these courses with dental students.

-This being said, in the dental world, after graduating dental school one can embark on a 6 year residency to become a maxillofacial surgeon and receive an MD. Why does it make sense for this to be a plausible path to become a surgeon, but it doesn’t make sense for Ophthalmology to have a similar route? At least in my experience, we are learning the same amount of systemic information as the dental students.

-There would be no short-cut in the proposed hypothetical scenario in terms of time. Optometry school is 4 years, Medical school is 4 years, and the Residency would be identical to a traditional Ophthalmology residency. Only the top students in Optometry school would be eligible for this residency. Not just anybody would match with this residency.

-This being said, I just want some honest soul searching as to the efficiency of this proposed model? My basis for asking this question is based on my discussions with Ophthalmologists and Optometrists. I may just be an in-experienced student, but I am quite aware of the level of expertise of both of these professionals (both of which I respect immensely). I have an Optometrist in my family and I’ve worked as a technician at an Ophthalmology practice, so please spare me the details of the current process of becoming an Ophthalmologist/Optometrist.

I only reposted on the medical forum because nobody was addressing my real/true question. If you have some sound reasoning for one side or the other, please comment! Otherwise keep your comments to yourself please

 

[Eyesontheprizedoc]

I’m mostly referring to the comments of this repost on the medical forum btw

 

[percyeye]

Things have settled down now somewhat between Optometry and Ophthalmology but for many years there was a serious scope battle going on. Optometrists still are not allowed to attend the national Ophthalmology meeting. So don't be surprised when you get nothing but back handed from the MD community. They will fight Optometry on every inch of scope expansion. Not blaming them because it is essentially a turf/money fight. Luckily every time scope has been expanded Optometry has proven again and again that we are a competent bunch that can provide great care to patients.

Right now Optometry and Ophthalmology work well together. But if you start working in a state you'll see your true allies and friends whenever new legislation is put forward.

 

[deleted480308]

I’m extremely disappointed in the professionalism of the people on this forum. I am simply searching for insight to this theoretical situation (which again I realize would never happen in real life). I appreciate the genuine responses, but for the most part I am disgusted by the “troll land” that Student Doctor Network has become.

A few things I would like to state:

-I am currently finishing my 2nd year of optometry school. At my school, during the first year we go through a whole entire body course and it is quite extensive (obviously not to the degree that med school does, but still). We spend just as much time learning about the entire body during the first year as we do the eye itself. In the second year we also have a general pharmacology course where we learn about systemic drugs. We take these courses with dental students.

-This being said, in the dental world, after graduating dental school one can embark on a 6 year residency to become a maxillofacial surgeon and receive an MD. Why does it make sense for this to be a plausible path to become a surgeon, but it doesn’t make sense for Ophthalmology to have a similar route? At least in my experience, we are learning the same amount of systemic information as the dental students.

-There would be no short-cut in the proposed hypothetical scenario in terms of time. Optometry school is 4 years, Medical school is 4 years, and the Residency would be identical to a traditional Ophthalmology residency. Only the top students in Optometry school would be eligible for this residency. Not just anybody would match with this residency.

-This being said, I just want some honest soul searching as to the efficiency of this proposed model? My basis for asking this question is based on my discussions with Ophthalmologists and Optometrists. I may just be an in-experienced student, but I am quite aware of the level of expertise of both of these professionals (both of which I respect immensely). I have an Optometrist in my family and I’ve worked as a technician at an Ophthalmology practice, so please spare me the details of the current process of becoming an Ophthalmologist/Optometrist.

I only reposted on the medical forum because nobody was addressing my real/true question. If you have some sound reasoning for one side or the other, please comment! Otherwise keep your comments to yourself please

Because you won’t know what a medical school graduate does. You are useful and valuable but not interchangeable

So no, you cannot be an ophthalmologist that way

 

[Eyesontheprizedoc]

Because you won’t know what a medical school graduate does. You are useful and valuable but not interchangeable So no, you cannot be an ophthalmologist that way

What is the basis of this point of view? If you are a medical school graduate, what insight would you have on this? Do you ever wish that you had focused less time on a certain area of med school? What certain things did you learn in med school that served you well in your Ophthalmology residency? Your views seem definite. I just want to discuss the pros and cons of each scenario. It seems to work for dental students who become maxillofacial surgeons just fine, so why not for ophthalmologists as well?

 

[enalli]

What certain things did you learn in med school that served you well in your Ophthalmology residency?

What kind of nonsense is this? What do you think we do in medical school, just sit around twiddling our thumbs?

You know what? We should have high schoolers go straight into ophthalmology residency since apparently you have decided medical school is useless and learning starts in residency.

 

[Eyesontheprizedoc]

What kind of nonsense is this? What do you think we do in medical school, just sit around twiddling our thumbs?

You know what? We should have high schoolers go straight into ophthalmology residency since apparently you have decided medical school is useless and learning starts in residency.

You are putting words in my mouth. I never said that medical school wasn’t a good thing. I’m strictly comparing training methods of ophthalmology and I only mentioned maxillofacial surgery as an example! And I’m not even saying that the current way of training ophthalmologists is a bad way of doing it. They are very skilled professionals. But could this training be improved even more? I realize that I could be completely wrong about this but I want specific facts as to why people think it should or should not stay the same. Please, I’m begging for a genuine comparison of opinions...... I really do respect doctors (most of them at least).

 

[deleted480308]

You are putting words in my mouth. I never said that medical school wasn’t a good thing. I’m strictly comparing training methods of ophthalmology and I only mentioned maxillofacial surgery as an example! And I’m not even saying that the current way of training ophthalmologists is a bad way of doing it. They are very skilled professionals. But could this training be improved even more? I realize that I could be completely wrong about this but I want specific facts as to why people think it should or should not stay the same. Please, I’m begging for a genuine comparison of opinions...... I really do respect doctors (most of them at least).

The best option is to leave th requirements intact. Go to med school if you want to be an ophthalmologist

 

[HarmonicConvergence]

Just saying this isn't a crazy idea. Podiatry does it we're not MD's and are able to do surgery, very complex surgery including vascular and ortho. Uphill battle tho, you'd have to restructure your whole education to be comparable to MD/DO and even then you'll have to really sit for USMLE for them to believe you know enough. I suspect you'd have resistance because is there a need for more eye surgeons? For dentist I suspect their was a need for surgeons that specialized in that area and who better than someone with dental education. For podiatry there is a need for podiatric services, not so much surgery tbh but we kinda took that with us. But for eye surgeries seem like optho's are good enough and there isn't really a need for more eye surgeons. I'm sure optho has seen what happened to anesthesia and crna's or ortho and podiatrist and have learned what happens if you let other professions expand scope unchecked. They'll fight you every step of the way I'm sure. Just my 2 cents.

 

[Eyesontheprizedoc]

Just saying this isn't a crazy idea. Podiatry does it we're not MD's and are able to do surgery, very complex surgery including vascular and ortho. Uphill battle tho, you'd have to restructure your whole education to be comparable to MD/DO and even then you'll have to really sit for USMLE for them to believe you know enough. I suspect you'd have resistance because is there a need for more eye surgeons? For dentist I suspect their was a need for surgeons that specialized in that area and who better than someone with dental education. For podiatry there is a need for podiatric services, not so much surgery tbh but we kinda took that with us. But for eye surgeries seem like optho's are good enough and there isn't really a need for more eye surgeons. I'm sure optho has seen what happened to anesthesia and crna's or ortho and podiatrist and have learned what happens if you let other professions expand scope unchecked. They'll fight you every step of the way I'm sure. Just my 2 cents.

Thank you for your response! And I see what your saying. It definitely is a turf battle, but you reiterated my point perfectly in saying that there are plenty of other non-MD/DO specialties that perform surgery (podiatry,dentistry,etc.). Interestingly enough, I’m not even interested in doing surgery personally as an optometrist (after I graduate in the up coming years), but it shouldn’t be too far-fetched to believe that we are highly trained professionals who could potentially someday have this expanded scope available with further training. Thanks for the genuine input!

 

[Weirdy]

Thank you for your response! And I see what your saying. It definitely is a turf battle, but you reiterated my point perfectly in saying that there are plenty of other non-MD/DO specialties that perform surgery (podiatry,dentistry,etc.). Interestingly enough, I’m not even interested in doing surgery personally as an optometrist (after I graduate in the up coming years), but it shouldn’t be too far-fetched to believe that we are highly trained professionals who could potentially someday have this expanded scope available with further training. Thanks for the genuine input!

Optometry school prepares you to practice upon graduation. It does not prepare you for residency or an intern year.

For you to go toe to toe with MD/DO, your course curriculum and board objectives would have to change to meet the minimum requirements that prove your training is equal to those received from MD/DO students.

Your clinical education would also have to involve more than just optometry clinics in different geographical regions.

With all due respect, 1 pharmacology course and 1 systemic pathology course will not be sufficient to say you can medically manage patients.

I have met absolutely brilliant OD students who had sGPAs rivaling those of MD/DO students when they were applying.
I have met a ton of students who applied to OD programs because they could ace the OAT did not want to take the gap year to apply MD/DO.

GPA wise there is no problem but take a look at standardized testing alone. There is a massive difference between the OAT and MCAT.

The point I am getting at- it is a different flavor of training.
Length of training does not mean equal training.

If it did, then take it to the USMLE and see if they'll let OD students sit for it.

 

[Eyesontheprizedoc]

Optometry school prepares you to practice upon graduation. It does not prepare you for residency or an intern year.

For you to go toe to toe with MD/DO, your course curriculum and board objectives would have to change to meet the minimum requirements that prove your training is equal to those received from MD/DO students.

Your clinical education would also have to involve more than just optometry clinics in different geographical regions.

With all due respect, 1 pharmacology course and 1 systemic pathology course will not be sufficient to say you can medically manage patients.

I have met absolutely brilliant OD students who had sGPAs rivaling those of MD/DO students when they were applying.
I have met a ton of students who applied to OD programs because they could ace the OAT did not want to take the gap year to apply MD/DO.

GPA wise there is no problem but take a look at standardized testing alone. There is a massive difference between the OAT and MCAT.

The point I am getting at- it is a different flavor of training.
Length of training does not mean equal training.

If it did, then take it to the USMLE and see if they'll let OD students sit for it.

I like where you’re going with this comparison. I feel that you’re putting a lot of emphasis on the application process of optometry vs med school. I do not deny that medical school does attract a higher caliber of students than optometry does in general, but this is does not mean there are not extremely bright students in optometry. There definitely are, just like you stated. There are some MD/DOs that are not the brightest as well. It is all a spectrum. Theoretically only the best of the best optometry students would be competitive for this residency.
As far as taking the USMLE, this is a process for passing national boards as a medical student. Optometry students obviously wouldn’t pass it, but medical students would also most definitely fail the Optometry boards. This whole scenario (aside from being unlikely due to political/monetary factors) is based on the idea that medical students who will become ophthalmologists could definitely use some more knowledge about the eye while in med school at the cost of sacrificing some of the extensive coverage of the entire human body. Btw optometry students study the whole human body for a year, and pharmacology for a year as well. We are capable of managing a wide variety of patients as far as treating the eye medically goes. No MD can properly treat every system of the body independently. To think they could would be nothing less than pure ignorance.

 

[VA Hopeful Dr]

What is the basis of this point of view? If you are a medical school graduate, what insight would you have on this? Do you ever wish that you had focused less time on a certain area of med school? What certain things did you learn in med school that served you well in your Ophthalmology residency? Your views seem definite. I just want to discuss the pros and cons of each scenario. It seems to work for dental students who become maxillofacial surgeons just fine, so why not for ophthalmologists as well?

There's been a handful of OD/MDs on this board over the years. Go search for their posts as this does get discussed every few years.

Also, have you ever looked at the OMFS curriculum?

 

[Eyesontheprizedoc]

There's been a handful of OD/MDs on this board over the years. Go search for their posts as this does get discussed every few years.

Also, have you ever looked at the OMFS curriculum?

No, I haven’t looked too much into the OMFS curriculum. That would be the residency curriculum thought, correct? Where can I find these posts? I can’t find any in the search bar..... Do you have a link to one?

 

[GypsyHummus]

If OD schools want any chance of doing surgery, they will have to restructure their entire curriculum like the DPMs did, and maybe do a residency.

Idk how the dental students get away with not having to do a residency.

Most ODs I know don’t want to do surgery and are happy to just be ODs. Yeah, it’s not as prestigious as a brain surgeon, but so what?

Just saying this isn't a crazy idea. Podiatry does it we're not MD's and are able to do surgery, very complex surgery including vascular and ortho. Uphill battle tho, you'd have to restructure your whole education to be comparable to MD/DO and even then you'll have to really sit for USMLE for them to believe you know enough. I suspect you'd have resistance because is there a need for more eye surgeons? For dentist I suspect their was a need for surgeons that specialized in that area and who better than someone with dental education. For podiatry there is a need for podiatric services, not so much surgery tbh but we kinda took that with us. But for eye surgeries seem like optho's are good enough and there isn't really a need for more eye surgeons. I'm sure optho has seen what happened to anesthesia and crna's or ortho and podiatrist and have learned what happens if you let other professions expand scope unchecked. They'll fight you every step of the way I'm sure. Just my 2 cents.

 

[HarmonicConvergence]

If OD schools want any chance of doing surgery, they will have to restructure their entire curriculum like the DPMs did, and maybe do a residency.

Idk how the dental students get away with not having to do a residency.

Most ODs I know don’t want to do surgery and are happy to just be ODs. Yeah, it’s not as prestigious as a brain surgeon, but so what?

I think the difference between optometry and OMFS is OMFS is unique. Sure there are other medical specialties that overlap and do those type of surgeries but OMFS will theoretically be the best at. Their training is super intense and only the best of the best get in. I'd assume their is nothing unique about optometrist doing surgery that an ophthalmologist isn't already the best at.

If podiatry didn't always have surgery I'm sure the ortho's would not be about us having surgical residencies. So really its your optometry ancestors fault for not securing surgery in your scope of practice from the jump.

 

[VA Hopeful Dr]

No, I haven’t looked too much into the OMFS curriculum. That would be the residency curriculum thought, correct? Where can I find these posts? I can’t find any in the search bar..... Do you have a link to one?

Top right corner.

Yes, residency curriculum.

 

[Eyesontheprizedoc]

Optometry scope is in fact exapanding. Some states allow you to do some surgeries. Arkansas for example just did Arkansas secures expanded scope of practice

 

[GoSpursGo]

No, I haven’t looked too much into the OMFS curriculum. That would be the residency curriculum thought, correct? Where can I find these posts? I can’t find any in the search bar..... Do you have a link to one?

TBH, I don't know all of the specifics, but I believe a large part of the OMFS curriculum, in addition obviously to learning the surgery, is a lot of filling in the med school gaps that they didn't get in dental school. For example I recall having OMFS students on my clinical rotations that were totally unrelated, ie OB/Gyn and pediatrics. But that's necessary to get the MD degree, which is a degree for general medicine.

The OMFS pathway exists because they are the only ones who can do that kind of surgery, and really need the DDS and MD. I struggle to imagine why one would get an OD/MD when you can already obtain an opthalmology residency with just an MD.

 

[Eyesontheprizedoc]

This is solid insight. Thank you! It’s good to know that they still require multi-specialty rotations in the OMFS residency. Do you know how long those rotations go for? Is it 2 years just like med school? I bet a lot of DDS/MDs hate that

 

[lagbydesign]

TBH, I don't know all of the specifics, but I believe a large part of the OMFS curriculum, in addition obviously to learning the surgery, is a lot of filling in the med school gaps that they didn't get in dental school. For example I recall having OMFS students on my clinical rotations that were totally unrelated, ie OB/Gyn and pediatrics. But that's necessary to get the MD degree, which is a degree for general medicine.

The OMFS pathway exists because they are the only ones who can do that kind of surgery, and really need the DDS and MD. I struggle to imagine why one would get an OD/MD when you can already obtain an opthalmology residency with just an MD.

You saw DDS/MD or DMD/MD OMFS residents in the 6 year pathway. You really don't need an MD to be a practicing OMFS. 4 year OMFS residents don't do any med school rotations, and they only have the DDS or DMD from dental school. Either pathway is acceptable to become an OMFS. The 6 year pathway with the MD is newer than the 4 year pathway btw.

 

[lagbydesign]

This is solid insight. Thank you! It’s good to know that they still require multi-specialty rotations in the OMFS residency. Do you know how long those rotations go for? Is it 2 years just like med school? I bet a lot of DDS/MDs hate that

Most OMFS residencies have off service rotations in gen surg and anesthesiology (allows them to run IV sedations by themselves depending on the case). The amount of time spent off service really depends on the program. Some of them still spend two full years on gen surg, and others spend the bare minimum.

Like I told GoSpursGo, these are not med school rotations (even though the 6 year OMFS residents have to do med school rotations as well), these are residency rotations.

 

[Pink Eye]

I would suggest finding an ophthalmologist who was an optometrist prior to Med school. They exist, I’ve met them. He or she will be able to accurately tell you the differences and what their views are. They are the least biased and have the best perspective. You can also google them and try calling them. I’m sure they would speak to students.