prestige

[gnin]

The issue of medical prestige has coem up frequently on this board. Which specific "top ten" opthalmology programs look unfavorably upon students who do not come from big name schools, and which are more open minded about accepting students from lower ranked (ie non "top 20") schools?

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[Andrew_Doan]

Originally posted by gnin
The issue of medical prestige has coem up frequently on this board. Which specific "top ten" opthalmology programs look unfavorably upon students who do not come from big name schools, and which are more open minded about accepting students from lower ranked (ie non "top 20") schools?

I wouldn't worry too much. The average applicant applies to 40+ programs. You might as well throw in the top 10 programs.

 

[yagmd]

For any of the residents, fellows, practicing ophthalmologists...

Has anyone found that it makes a difference to patients where you did your residency and/or fellowship training?

I would think that in some cases patients might be more impressed with ophthalmologists who had trained at well known institutions (i.e. Yale, Stanford, Cornell, etc) even though their residency training programs may not be nearly as good as lower profile institutions with world-class ophthalmology residencies (Iowa, U Miami, Thomas Jefferson, USC, etc). Does any of this seem to matter to patients or to referring physicians in the community?

 

[JR]

In my experience it makes a whole lot of difference; especially for ophthalmologists in private practice. Patients are geting more and more eduacated before seeing a doctor, and in the overwhelming majority of cases inquire where the physician did his/her training before selecting that particular physician. Obviously, this mostly applys to patients with health insurance who do have the luxury of selelcting their physicians.

 

[yagmd]

JR,

Do you think that private practice patients care more about the reputation of the institution overall or the reputation of the institution for eye care specifically (i.e. US News best eye hospitals)? In other words, do patients prefer an ophthalmologist who trained at a big name institution with an average ophtho program (i.e. Yale, Stanford, Cornell, etc) or a lesser known institution with a highly rated ophthalmology program (Iowa, U Miami, Thomas Jefferson, USC, Baylor, NY Eye & Ear, etc).?

 

[Visionary]

I think the importance of residency program name recognition depends upon your goals as an ophthalmologist. If you want to be on faculty somewhere, it is clearly more important--look at the faculty bios at most institutions. If you want to be in private practice, it is likely less important. Yes, patients are more frequently utilizing resources, such as the internet, to educate themselves about medicine; however, ask most people how they arrived at their choice of ophthalmologist (or any specialist, for that matter) and they will, more often than not, cite word of mouth. "My GP recommended her." "The same guy did my aunt's LASIK." I doubt many patients can even tell you where their physicians trained. That is not to say that name recognition is never a factor in establishing your community reputation amongst other physicians--i.e., your professional referral base. Of course, if you plan on going back to your hometown to practice, name recognition may be less of a factor in becoming established. Just my opinion. 😀

 

[JR]

In my experience it is the name of the institution. I think that generally only a few people outside of the ophthalmologic field know the specific rankings/strength of individual programs. So, graduates from programs that are generally considered weaker, but have well-known names overall, will benefit from this misconception. In my personal opinion, however, clinical strength of most US graduates probably does not vary too much ( but there are defenately exceptions).

 

[mjl34]

I've spoken with a few people in private practice about this issue and I don't know that it matters at all - as long as you're not going into academics. Even if you want to stay in academics, your personal motivation will be the ultimate deciding factor - not where you train.

The biggest issue I've heard raised from future employers is surgical skill - and that only comes with experience. One local ophthalmologist said he'd never hire anybody from a "top ten" program again after he had to spend significant time training a recent graduate on some of the more commonly performed procedures. Therefore I would look for a place that will give you adequate time in the OR - regardless of prestige.

If you really think that somebody from Wilmer is going to be a better surgeon just because they went to wilmer, you're wrong. Like most things in life - you get out what you put in. Does anybody on this board think that Andrew wouldn't be as great of an ophthalmologist if he wasn't at Iowa? He's great because of his desire to be so.

Once you get out into the world and are a competent surgeon, your success will likely depend on your atttitude, business skill, and the way you treat your patients. If you have decent "people skills", then your patients will like you and recommend you to others. The vast majority of your patients will never know where you trained (unless you advertise it), but they will ALWAYS remember their surgical outcome and how you treated them.

my two cents.

 

[JR]

Wow... slow down, buddy. Did you read my post? Let me refresh your memory; I actually stated: "In my personal opinion, however, clinical strength of most US graduates probably does not vary too much..." Hence, I am actually agreeing with you.

"If you really think that somebody from Wilmer is going to be a better surgeon just because they went to wilmer, you're wrong." What? Where did I imply that? In my post I simply meant that in my PERSONAL experience, after working at ONE eye institute for 5 years, I have noticed that many patients inquired about their physician's credentials (granted it was not a VA or a county hospital).

What you said above makes a lot of sense. I also think that your competence as a surgeon, your social and business skills will play a major role in your future career, much more so than where you trained.

And, btw, University of Utah is an excellent program and I'd consider myself very lucky if I had matched there.

 

[Andrew_Doan]

Originally posted by mjl34

The biggest issue I've heard raised from future employers is surgical skill - and that only comes with experience. One local ophthalmologist said he'd never hire anybody from a "top ten" program again after he had to spend significant time training a recent graduate on some of the more commonly performed procedures.

I agree with this. Many of the top ten programs lack in surgical volume for their residents. Iowa is fairly good, but still falls behind in the surgical volume for some procedures seen at a place like UT Southwestern or Utah. However, USC is now a top 10 program, and their residents receive tons of surgical experience.

At Iowa, we receive about 140-170 cataracts, over 100 plastic procedures, 20-30 muscle surgeries, over 100 retina lasers, 5-10 refractive surgeries, and dozens of corneal procedures including PKP. We also assist as the second surgeon in twice to three times as many cases, which I feel is also a good learning experience.

 

[mjl34]

JR -
I know you and think you're great - I wasn't knocking you at all. I should have said Jules Stein, or Doheny, or Wills because my comment was to address the notion that the most important aspect of training is prestige.

I also think Wilmer and the University of Utah are great places, but I thought Casey was a better place for me and ranked it higher.😀

 

[yagmd]

I agree that the surgical training/volume is sub-optimal at many of the top programs. Most of the top northeastern programs and low to moderate surgical volumes -- Wilmer, Mass Eye & Ear, Wills, Scheie, etc.

However, many top programs in other parts of the country have outstanding surgical volumes -- Bascom Palmer, Emory, Duke, UT Southwestern, Doheny, etc

There is no mystery to this... academic centers that dominate a large metro area and/or geographic region and programs that have a close affiliation with a VA and/or county hospital will inevitably have superior surgical volumes to otherwise outstanding programs (i.e. Wilmer) which have none of the above.