Rank list confusion

[Freedom]

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I have reached "ranker's block" for the following schools and would love some input. I think I would get a great education at all of them and would feel comfortable in all these cities, and consequently they are pretty much equal in my mind. So since I have a family, it's come down to issues of stress-reduction for me, and what will be easiest for my family--i.e. what program has nicest hours, allows me most time at home during days and weekends, and has a positive atmosphere and great people so I don't come home at night pre-occupied with what happened at work. This is the tentative order I've come up with, but still unsure:

1) U. Minnesota: 8 AM-5:30; call for one week q 2-3 weeks, but don't get called in all time. Does anyone know what fellowships they get and if it's one or two years of primary call?

2) U. Wisconsin-Madison: 7 AM, q3 call for one year, get called in 1-2x/week, but atmosphere seemed really laid back and resident-friendly)

3) Vanderbilt: 7 AM start time end 5:30/6:30; q10 call x1 year, q5 x6 months)

4) (UIC) University of Illinois--Chicago: 7:30-6, I've heard it's not very family friendly now, and they have some Saturday classes and late evening meetings, q 6 call x 1 year but get to go home if up all night)

5) NYEE (7:30-6/6:30, some Saturday clinics, call q7 all three years)

I would definitely appreciate any help or insight!

 

[rubensan]

freedom,

i think you are correct is stating that you will probably get great ophthalmic training at any of these institutions. since family is obvoiusly important to you, perhaps you also need to ask yourself which one of the these locations is the best place to raise a family? is the lower east side of manhattan or downtown chicago the best place to raise a family? for some yes, for some no. only you and your family can answer that.

i guess i am responding to your e-mail mainly to say don't choose a program based on perceived ease or frequency of call. of course the culture and lifestyle that a program affords (+/- saturday or evening lectures, etc) are very important but come july 1, 2008 you and your ER colleagues will know very little about the eye and you will be seeing and coming in for a lot no matter where you are taking home call. frankly, the threshold for an ER doc or pediatrician calling an ophthalmologist at a major teaching institution/ trauma center is very low. the vision will always "be down." the eye will always "be red and painful." the extraocular movements "are never full" and the IOP is always "30" because many ER docs do not know how to do a basic eye exam, use a tonopen or simply want to dispo the pt out of the ER ASAP. although many of these cases end up being more fiction than fact, when you receive this information from an ER doc via telephone, you WILL be preoccupied whether you are at home or on the 7th hole of your golf game.

bottom line: ophthalmology call can be painful no matter its shape or form. go to where you and your family will be the most happy.

other things to consider: NYEE has saturday clinics, no? UIC has an eye ER; anything from the scalp to the chin and sometimes more caudal than that with eyes can come your way, no? i'll let JR give you the pros/cons of the an Eye ER. i'm not saying these things are good or bad, but you should consider them.

gotta go... the consult pager is going off!

 

[JR]

It is so funny, Ruben sounds just like me this time last year .

I completely agree with Ruben, family support is very important. Call schedule is a secondary consideration partly because you never know what that call is really like until you actually do it. Since my program has both in-house and home call, my opinion is that home call is definitely more painful. I'd rather work a 24 hr shift in the eye ER with good equipment, ophthalmic nurses, ophthalmic ward, where I can get an MRI and/or CT in 20 min, etc.,etc. and go home the next am vs. driving all over town to different (or the same) hospitals and then having to go to clinic the next day. But that's just me.

I don't know much about the specific programs you mentioned, but definitely consider where YOU think you are going to the happiest ( the infamous "gut feeling" ).

Good luck! Only 10 days left

P.S. Ruben, lemme guess, you consult pager says: "Hi, I am a PA from nuerosurgery; we have 4 pts post-pituitary adenoma resection who need baseline vision exams before they go home. And, no, this can not be done as an outpatient". 😀

 

[rubensan]

close...it was the classic "k lac/ruptured globe + seidel." My exam: s/p altercation VA 20/30, minor K abrasion, diffuse PEK. no peaked pupil, no hemorrhagic chemois, no hyphema, seidel negative, IOP 17. Dx: misuse of flourescein and cobalt blue filter by ER MD.😉 yet another illustration of how the story can take a 180 degree turn (for better or worse) once you see the patient. we are in-house and it takes me all of 30 seconds to walk to the ER and see whatever it is they want me to see and explain when seidel it and IS NOT positive. but if i were at home and got this call, i would still be obligated to come in.

yeah, it is funny JR! i remember reading your posts last year and thinking. "i think JR is overreacting, ophthalmology residency will be a cinch!" 😀 then you get handed the consult pager!

along the lines of neurosurgery, i actually had a neurosurgeon yell at me last week wondering why i wouldn't walk to the outpt clinic on a friday night and "bring the [explitative] visual field machine" to the patient's bedside to do HFVs before they take the pt to the OR the following AM for a pituatary adenoma. 👎

 

[JR]

Dang, not even close. Oh well 🙂 .

You are definitely over the hump now Ruben, only 5 months to go. Do you know what you wanna do yet?

 

[drusen007]

i just know that 3rd years do take primary call at minnesota. apparently it's not bad because you're now pretty adept at handling calls, but it's still primary