Hey, no worries. My ego is completely secure. Honestly, I'm not trying to convince you of anything. As DOCTORSAIB said, you seem to have it all figured out. You must have matched to an incredible residency, too. Good for you! The concept of resistant AMD subtypes and targeted therapy has only been more broadly discussed in the retina community over the last year or so, and that's mainly been at meetings--little actual peer-reviewed literature on the subject. Many are still just injecting away or giving up on resistant cases.
I'm actually posting for the other medical students and residents who are open-minded enough to appreciate my perspective and experience. I'm one of a few attendings who regularly post to this forum. I try and answer questions, offer advice, and (in the case of your post) correct misinformation. The readers of this forum can decide for themselves whether they want to take the word of a medical student or a board-certified, fellowship-trained medical retina specialist.
Here's my main issue with your post. You basically denigrated an entire subspecialty, stating that it's only beneficial for those who didn't have enough exposure in residency. Following your logic, why do we have glaucoma fellowships? I did quite a few trabs and tubes in residency. They weren't that hard (tubes, especially), and I know some comprehensive docs who do them. Why do we have peds fellowships? I did plenty of muscles in residency, and you pretty much aspirate pediatric cataracts. I also know some comprehensive docs who do muscles. I guess the only reason to even do a 2 year surgical retina fellowship is to learn vits and buckles, because most residencies don't give you enough volume. Should be able to do that in a year, though, don't you think? Heck, the actual surgeries aren't that difficult. Why are most surgical fellowships 2 years? Maybe because 85-90% of retina is medical and most of the 1st year of fellowship is medical? You should call around to some of the surgical retina fellowship directors, though, and tell them you would like to just set up a 1 year, purely surgical fellowship, because you will get enough medical retina training in residency. While you're at it, you should really go give a talk at this year's ASRS meeting in Boston to warn the retina community about the coming surplus of retina specialists, because the darn comprehensive docs are scooping up all the medical retina, which is the bulk of their livelihood.
Enough silliness, though. The real point of any fellowship is to obtain advanced training in a subspecialty. It's kind of like learning a foreign language, say Spanish. Residency is like the Spanish classes you take in high school or college. They teach you the core vocabulary and grammar. If you stop there, you can probably get along okay in a Spanish-speaking country. Fellowship is like an immersion course, where you live in a Spanish-speaking country with a host family for a period of time and speak only Spanish. That's how you pick up the intricacies of the language and approach fluency. The final step is practicing on your own, like moving permanently to a Spanish-speaking country. That's when you achieve true fluency. You'll be amazed at how much more you learn, when you're out on your own--no faculty backup, following your own patients on a regular basis. Love this job!
