retina fellowship volume?

[eyegal]

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Can anyone comment on what is considered an above average number of vitrectomies and/or buckles that one should expect to perform as primary surgeon in a 2 year retina fellowship?

Also can anyone comment on fellowship at the National Retina Institute in Maryland?

 

[PDT4CNV]

My guestimate would be that ~250 is the average number of cases most two year fellows do as primary. There are a few 1 year surgical fellows who do about that but other 1 years do much less. There are also some crappy 1 year fellowships where case volume may be <50 as primary.

My fellowship is 2 years and the average is about 600-800 primary cases, but that is more than most typical retina fellows do, particularly those fellowships where the first year is primarily medical retina.

I don't know much about the maryland fellowship you inquired about.

 

[GuP]

My guestimate would be that ~250 is the average number of cases most two year fellows do as primary. There are a few 1 year surgical fellows who do about that but other 1 years do much less. There are also some crappy 1 year fellowships where case volume may be <50 as primary.

My fellowship is 2 years and the average is about 600-800 primary cases, but that is more than most typical retina fellows do, particularly those fellowships where the first year is primarily medical retina.

I don't know much about the maryland fellowship you inquired about.

Where are you doing retina PDT4CNV?

 

[afruff23]

I'm getting way ahead of myself by asking this, but: is the numebr of cases you get in a fellowship a measure of prestige?

 

[orbitsurgMD]

I'm getting way ahead of myself by asking this, but: is the numebr of cases you get in a fellowship a measure of prestige?

Yes and no, but more yes than no.

Busy training programs with multiple academic faculty surgeons will have higher overall case volumes and will also likely offer a more diverse operating experience to a fellow. More faculty means more research, means more attractive to new faculty hires, more attractive to grants-awarding authorities, and so on. So yes, more cases is a feature of bigger departments which is a measure of better-quality training.

 

[RetFellow]

Yes and no, but more yes than no.

Busy training programs with multiple academic faculty surgeons will have higher overall case volumes and will also likely offer a more diverse operating experience to a fellow. More faculty means more research, means more attractive to new faculty hires, more attractive to grants-awarding authorities, and so on. So yes, more cases is a feature of bigger departments which is a measure of better-quality training.

This is true to a point. However, I would point out a certain very well respected eye institute in Baltimore which has a large retina faculty, but relatively low fellow surgical numbers, possibly due to the emphasis on research.

A bigger department doesn't mean better training, just more faculty. Who, though unlikely, could all potentially be poor teachers.

High volume surgery also means less time spent in clinic, where one learns the important when's and why's of performing surgery.

 

[PDT4CNV]

This is true to a point. However, I would point out a certain very well respected eye institute in Baltimore which has a large retina faculty, but relatively low fellow surgical numbers, possibly due to the emphasis on research.

A bigger department doesn't mean better training, just more faculty. Who, though unlikely, could all potentially be poor teachers.

High volume surgery also means less time spent in clinic, where one learns the important when's and why's of performing surgery.

I agree that clinic is important, but equally important is getting good surgical training. In general, you want a fellowship with high surgical volume. 2-3 full days in the OR and 2-2.5 days in clinic each week is what I think is ideal. I think a balanced experience from the get-go is the best.

There are many fellowships out there where the first year is all medical. Some of these are at prestigious places as well. Just think about what you want. I didn't want a year with minimal to no operating. Again, you want balanced training. What you don't want is LOW surgical volume.

 

[orbitsurgMD]

This is true to a point. However, I would point out a certain very well respected eye institute in Baltimore which has a large retina faculty, but relatively low fellow surgical numbers, possibly due to the emphasis on research.

A bigger department doesn't mean better training, just more faculty. Who, though unlikely, could all potentially be poor teachers.

High volume surgery also means less time spent in clinic, where one learns the important when's and why's of performing surgery.

Yeah, I know about them too.

 

[RetFellow]

I agree that clinic is important, but equally important is getting good surgical training. In general, you want a fellowship with high surgical volume. 2-3 full days in the OR and 2-2.5 days in clinic each week is what I think is ideal. I think a balanced experience from the get-go is the best.

There are many fellowships out there where the first year is all medical. Some of these are at prestigious places as well. Just think about what you want. I didn't want a year with minimal to no operating. Again, you want balanced training. What you don't want is LOW surgical volume.

PDT4CNV, I concur with that mix, 2-3 days OR + 2-2.5 clinic, to keep the training balanced. As you point out, programs with LOW surgical volume should be carefully evaluated to see if their training emphasis coincides with an applicant's professional goals. I would say 250-300 should be the minimum # of cases.

@orbitsurgMD - I'd claim I was trying to be subtle, but... no, not really 🙂

 

[Eyesore]

This is true to a point. However, I would point out a certain very well respected eye institute in Baltimore which has a large retina faculty, but relatively low fellow surgical numbers, possibly due to the emphasis on research.

A bigger department doesn't mean better training, just more faculty. Who, though unlikely, could all potentially be poor teachers.

High volume surgery also means less time spent in clinic, where one learns the important when's and why's of performing surgery.

Do you know the numbers first-hand, or is this all speculation? Remember, what applicants say on the trail may not actually be based on fact. Perhaps there is a reason why so many Wilmer residents stay on for retina fellowship. Do you think it is because a Wilmer resident can't get any other fellowships out there? Also, when it is time to get a job, who do you think is going to get the job, the guy who went to a lesser named place with higher volume or the graduate from the place you are bashing? Remember, a big part of getting a good job is by getting the lowdown about the person from the attendings. Which would be more impressive, a stellar rec from an unknown attending, or one (or ten) from a bigwig attending? I know many fellows that came from that goofy place in Baltimore, and I think they are doing fine for themselves. Oh, and their surgical numbers were pretty good, too.

 

[PDT4CNV]

Do you know the numbers first-hand, or is this all speculation? Remember, what applicants say on the trail may not actually be based on fact. Perhaps there is a reason why so many Wilmer residents stay on for retina fellowship. Do you think it is because a Wilmer resident can't get any other fellowships out there? Also, when it is time to get a job, who do you think is going to get the job, the guy who went to a lesser named place with higher volume or the graduate from the place you are bashing? Remember, a big part of getting a good job is by getting the lowdown about the person from the attendings. Which would be more impressive, a stellar rec from an unknown attending, or one (or ten) from a bigwig attending? I know many fellows that came from that goofy place in Baltimore, and I think they are doing fine for themselves. Oh, and their surgical numbers were pretty good, too.

At lot of retina fellowship programs take their own, not just Wilmer. But the Wilmer fellowship is not a high surgical volume fellowship. I wouldn't say it is a crappy fellowship, because the clinical training is still pretty good, but the surgical volume is lower than other fellowships.

My observations have been that potential employers for VRS care more about your training, case volume, and references and who you trained under as opposed to what institution you trained at.

 

[Eyesore]

At lot of retina fellowship programs take their own, not just Wilmer. But the Wilmer fellowship is not a high surgical volume fellowship. I wouldn't say it is a crappy fellowship, because the clinical training is still pretty good, but the surgical volume is lower than other fellowships.

My observations have been that potential employers for VRS care more about your training, case volume, and references and who you trained under as opposed to what institution you trained at.

The point isn't that Wilmer fellowship would take their own. The point is that the Wilmer residents in general have their pick of which fellowships they want to attend. Yet, many of the Wilmer residents stay on for fellowship. And I don't think it is just because of convenience or location. I don't think the Wilmer residents are that dumb that they would stay on for fellowship if the training is subpar.

I agree that the potential employer will care more about your training and references. When these guys are getting references from some of the biggest names in retina, they are going to do well.

Do you think employers are going to hire you thinking that you are completely a finished product after fellowship? Are you going to be as good day 1 post fellowship as you will be in year 5 after fellowship? To me, they are looking for what you can become, rather than what you are now. So as long as you have a rock solid background in both medical and surgical retina training, you are going to do fine.

 

[plasticbuddy]

The point isn't that Wilmer fellowship would take their own. The point is that the Wilmer residents in general have their pick of which fellowships they want to attend. Yet, many of the Wilmer residents stay on for fellowship. And I don't think it is just because of convenience or location. I don't think the Wilmer residents are that dumb that they would stay on for fellowship if the training is subpar.

I agree that the potential employer will care more about your training and references. When these guys are getting references from some of the biggest names in retina, they are going to do well.

Do you think employers are going to hire you thinking that you are completely a finished product after fellowship? Are you going to be as good day 1 post fellowship as you will be in year 5 after fellowship? To me, they are looking for what you can become, rather than what you are now. So as long as you have a rock solid background in both medical and surgical retina training, you are going to do fine.

If you end up going to a mediocre/nonprestigious/or overseas retina fellowship will you still be able to get a job in a more rural area (ie: georgia/carolinas/texas)? is there enough demand for that?

The reason i ask is b/c I am a US M.D. and @ a lower tier US ophtho residency and really want to do retina but don't think I can match in the US... I think the only other option would be to do years of research until I could make enough connections to get in.

 

[plasticbuddy]

If you end up going to a mediocre/nonprestigious/or overseas retina fellowship will you still be able to get a job in a more rural area (ie: georgia/carolinas/texas)? is there enough demand for that?

The reason i ask is b/c I am a US M.D. and @ a lower tier US ophtho residency and really want to do retina but don't think I can match in the US... I think the only other option would be to do years of research until I could make enough connections to get in.

btw the program i am at isn't notoriously bad... it just doesn't have a solid retina fellowship match... any suggestions would be appreciated

 

[RetFellow]

Do you know the numbers first-hand, or is this all speculation? Remember, what applicants say on the trail may not actually be based on fact. Perhaps there is a reason why so many Wilmer residents stay on for retina fellowship. Do you think it is because a Wilmer resident can't get any other fellowships out there? Also, when it is time to get a job, who do you think is going to get the job, the guy who went to a lesser named place with higher volume or the graduate from the place you are bashing? Remember, a big part of getting a good job is by getting the lowdown about the person from the attendings. Which would be more impressive, a stellar rec from an unknown attending, or one (or ten) from a bigwig attending? I know many fellows that came from that goofy place in Baltimore, and I think they are doing fine for themselves. Oh, and their surgical numbers were pretty good, too.

I'm not bashing the institution. I have many friends, co-fellows, and faculty who trained there and who I respect quite highly. The facts are (not speculation), it is not a high volume surgical fellowship, period. It is a well regarded fellowship for many other reasons, but surgical #s is not one of them. They have actively and directly attempted to address this in recent years with changes to the structure of their fellowship program. If you are highly considering an academic career and want to pursue real research during fellowship, this is one place for it. That is one reason why Wilmer residents, many of whom have an academic bent, stay on.

 

[retinaresearch]

Dear All

I would like some input on what matters to get a good retina fellowship

I am a foriegn medical graduate who has done a residency and retina training in a foriegn country

I am presently in a resdiency in the US. It is not a "big name program"

I have fair amount of research, I can get good letters (I think) and I have good OKAP scores. What else can I do or should do to make my application more competitive.

How much is being a FMG and also not coming from a high power program be a negative for me.

How much research matters ?
How important are OKAP scores ?

I really appreciate any input or advice

Thanks
🙂