rubensan...curious about your thoughts on below (from the "Program Compendium" thread).
Positives: beautiful location, great autonomy at LA county 1 and 3rd years. Good volume (~125-50 phacos). Big name faculty (esp retina), residents seem to get great fellowships. I think you will be well trained and extremely efficient as a graduate from there. The Chair seems to be very supportive, approachable, and down to earth.
this sums up every reason why i ranked doheny/lac-usc as my #1 choice. just to clarify, LA is great location but LAC-USC is not in a "beautiful" location. i feel that our chair is emblematic of all of our faculty; they are all supportive, well known, down-to-earth and approachable.
Negatives: the 1st, 3rd years are worked to the bone at County. Many looked dog-tired. Not in of itself, bad, but there is very little ancillary support (techs) at County, and I'm not sure how much you are taught by the bigwig Doheny faculty except for the second year. At county, it looks like you have huge volume immediately, like the first month of 1st year, and there is not that much teaching. Guidance is available from seniors , but they are also busy as 3rd years. I think the County attendings are volunteers.
gosh, i hope i am not looking exhausted. i thought my co-residents and i were laughing pretty hard with the applicants yesterday.
i receive a lot of these questions and i always preface this answer by stating that i went to medical school at usc. i knew what i was getting into from the beginning. if you are looking for a program where you are going to work from 9AM - 3PM with all of your weekends off, then doheny (nor wilmer, BPEI, jules stein, uc davis for that matter) should not be your top pick. your first year is hard, i will not deny that as i am writing this on a saturday while on call. but "hard" is relative. i still waltz in at 700 AM, grab my coffee and say hello to my gsurg and IM friends who have allready been there 1-2 hours. we average call q7 (sometimes it's q4, sometimes it's q12) and have 2-3 goldne weekends per month. we do see a lot of patients, if you look at our residency website, the first line reads:
"The general philosophy of the Department of Ophthalmology is that resident education is best provided in the evaluation and management of a wide variety of ocular conditions."
i learn by doing and by seeing and having people show me stuff. you can read all you want about CSME, fuch's endothelial dystropthy, optic nerve head drusen, intermediate uveitis, angle recession glaucoma, accomodative ET and lower lid margin lacs but until you see this stuff and manage it, i don't think you know it.
In general, I always wonder what a good balance is on: great autonomy but little supervision (county, va, etc) vs. less autonomy but good teaching (univ hospital etc.)
the best programs will combine both.
could our county ancillary staff be better? perhaps. are visual accuities checked on all new patients for you? yes. if the ancillary staff like you, do they go the extra mile and check vision and pressures on everyone when you are really busy? yes. is there always an attending (ACS, outside staff, fellow, doheny staff) if you need one. yes, 95% of the time. did i want to go to a program where i saw all private patients and ran all management decsions by an attending? NO!!!! so if that is what you are expecting from your first year, then doheny will let you down. rather if you are looking for a program that balances autonomy (la county) with one-on-one teaching (doheny, childrens hospital LA) then doheny is an excellent place. during our first year, we spend one day a week working with an attending at doheny or childrens hospital LA. at these 2 places, your goal is to learn and not just "get through patients."
look, ophthalmology is clinic-based. it isn't like internal medicine where the team rounds on all the patients and everyone puts the stethoscope on the patient to listen to the murmur. you can't run every patient by someone. the goal of first year should be to master the ophthalmic exam (it is by far the toughest of any field) i.e., indirect ophthalmoscopy, the neuro-oph exam, gonio, peds (motility, retinoscopy it's all a blur until you do it on A LOT of patients). by mastering this, you get to know what normal is pretty qucikly and run the abnormal stuff by someone senior. when you are on call, you realize there are only a few ophthalmic emergencies. we see all of them pretty early on and if you have questions on the other stuff, you arrange close f/u. there is always the senior resident, fellow and ACS to call if you have questions. our seniors are great and they will come in for mac-on RDs and ruptured globes. and don't worry in 2 years, so WILL WE! another goal of 1st year should be getting comfortable in the OR by doing pterygia, minor plastics, ruptured globes, enucleations, muscle surgery and a few extra-caps. doheny meets ALL of these goals and FAR surpasses them.
re: the ACS. i get along fine with our ACS.
