Rank list guidance

[owleye]

Hi all. I’ve been fortunate to receive some terrific interviews for ophtho residency this season and would appreciate some guidance from this community.

For reference, my career goal is to join or start my own private practice, or work in a privademic setting as I enjoy teaching. I’m likely to pursue subspecialty training and am most interested in medical or surgical retina at this point. I would like to keep traditional academic options open, but leaning against that route at this point.

My questions…

1. Does training at a ‘top’ ophtho residency significantly shift your opportunity set in your career? Ie the bascom palmers, wills, Iowa, Jules steins, Kelloggs of the world. If these programs are indeed more helpful for your career, is that due to quality of training, network, etc?

2. Is training at one of the programs above significantly better than other excellent, but not as prestigiously branded places (eg Colorado, OHSU, Emory, Penn, Columbia, etc)?

3. Some programs I’m considering are significantly higher or lower volume, from both a clinical and surgical perspective. I’d appreciate any comments on the extent to which how ‘busy’ you are dictates how well prepared you are after resident. Ie, will going to a very busy program make me a much better clinician/surgeon?

As I stated above, I’ve been fortunate to get interviews at some of these places, but the ideal locations from a family / long term perspective have not aligned to the traditional prestige markers…I’m wondering what I’d be really giving up, if anything, by choosing one of the less prestigious programs (including some mid-tier state schools not listed above) instead of the traditional big names in ophthalmology. I'm not really clear what makes you a standout candidate for private practice jobs, whether it be the region you trained in, the prestige of your program, the perceived quality of training, or whatever - input on that would be helpful.

Thank you in advance for your help.

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[Baller2016]

I trained at a top 5 place - one of which you mentioned.

I personally think that if you're in a quality program, any of which you mentioned, you're going to get good training. If you're not interested in academia then it especially doesn't matter too much. Some of these top programs are poor surgically and more so for the research/reputation which will help you land a quality fellowship and ultimately some leadership position in academia. I could care less for academia - my goal was private practice so it didn't matter to me.

I do think my program reputation helped me a bit when looking for a job but in the grand scheme of things it's a not a huge factor. The most important things are location/family and the surgical quality of the program. Try to be at a program where you get good surgical numbers.

 

[Ophthalmic Senator]

I had peripheral experience (before residency) in a place sort of between category 1 and 2 in the original post. One resident joked that most programs were either "academic but non-operative" or "high volume but not tops academically but his program was "non-academic, non-operative"!

Wills' Chief Rounds are outstanding, putting many residencies to shame. However, that's just one component of a residency.

One factor almost never discussed is that one outstanding cataract teacher can vastly change one's residency experience. I had the good fortune of this experience. He was so good that it made some other faculty look like crap teachers. One chairman of a program that I interviewed at said that he went to a third world country for a rotation during his residency and, while volume was high, teaching was minimal such that one kept repeating bad technique. I ranked his program higher but didn't get in.

There's one program that gives each resident an office. It's probably because they have more square footage than they can use. They have a YouTube video. It's normal office furniture, like a small desk, small table, bookshelves, and a little cot. If permitted, one could save rent and live there. Just buy a refrigerator, hot plate, and something to hang your clothes and you're all set. You could take showers in the ophthalmology fitness center. The only problem might be if you cooked a steak and made the area smell like grease or cooked something with strong odors, like Vietnamese fish sauce. Anyone want to see the YouTube video?

 

[Ophthalmic Senator]

I interviewed at only one of the programs listed as the original poster's category 1. However, I'd say that there are more factors to consider than category 1 in general versus category 2.

Personality is also important. There was one chair of one of the programs listed in category 1 at one time who was rumored to have an explosive temper. I would not want to go to that program while he was there. This specific chair was not an issue for me because his medical license was revoked in 2017 and he is now history. I heard from someone who was interviewing for residency and sitting in the chair's office while the chair was screaming at the top of his lungs on the phone. Later that applicant was sitting in grand rounds when the chair yelled at a resident because one important test was not done and they couldn't use the case for presentation nationally.

 

[owleye]

I trained at a top 5 place - one of which you mentioned.

I personally think that if you're in a quality program, any of which you mentioned, you're going to get good training. If you're not interested in academia then it especially doesn't matter too much. Some of these top programs are poor surgically and more so for the research/reputation which will help you land a quality fellowship and ultimately some leadership position in academia. I could care less for academia - my goal was private practice so it didn't matter to me.

I do think my program reputation helped me a bit when looking for a job but in the grand scheme of things it's a not a huge factor. The most important things are location/family and the surgical quality of the program. Try to be at a program where you get good surgical numbers.

Thank you for your response.

Is there a threshold you think of for good surgical numbers?