Surgery vs Research Heavy Programs

[scorp_doc]

What are generally considered or objectively rated the best surgical skills/case load ophthalmology programs?

Surgical skills are my top priority for residency. I am most interested in cornea/refractive but trauma and occuloplastics are at a similar level. I essentially have no interest in being academic staff or being involved in research. I'd like to avoid those programs that groom for that stuff.

I probably do not have a strong enough application for top tier programs but solid mid tier. Not interested in the southeast or southwest. I'm happy with either community or academic, just not looking to have a huge research requirement.

V/r,
SD

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[i-doctor]

I can’t give you specific programs. But, as a general rule:
1) Surgical case volumes will be higher in urban programs with public county hospitals and/or a VA hospital.
2) Case volumes will also be higher in programs without many fellowship programs. Glaucoma/Cornea/Plastics etc fellows will often take away a lot of cases from the residents.

 

[MstaKing10]

I can’t give you specific programs. But, as a general rule:
1) Surgical case volumes will be higher in urban programs with public county hospitals and/or a VA hospital.
2) Case volumes will also be higher in programs without many fellowship programs. Glaucoma/Cornea/Plastics etc fellows will often take away a lot of cases from the residents.

I would disagree with point 1 here. At least on the interview trail, I found that programs in populated urban centers had very low cataract numbers. This was mostly due to competition from multiple programs in the same city or other ophthalmologists in the city. Programs in more rural areas raked in the cataracts since they were the only show in town. Probably something in between would be ideal.

I did find that surgical numbers were the lowest among the more prestigious academic centers. This is partly why most graduates of these programs end up pursuing fellowships.

 

[salami bahama]

Best of luck with the upcoming interview cycle! This may not be helpful from an anonymous person on the internet, but I had two thoughts:

1. I would encourage you to not restrict yourself geographically this early in the cycle, especially since there are very good programs in the southern half of the country that fit the bill of a great clinical program.
2. I would argue the top 10-15 programs interview the most competitive applicants. I may be wrong, but this early in application cycle, I think it would be hard to say you could match at a top 6-10 program, but not a 1-5 program. The ranges of top tier vs middle tier vs lower tier are broader than 5 programs.

It's great to know what you desire in an ophthalmology program, but matching into any ophthalmology program to become an ophthalmologist is an absolute gem. But what you're looking for is a list of great surgical programs, so hey, I'll throw out some. I'm definitely missing some since I'm less knowledgable personably about all of the northeast and midwest programs.

Baylor, UTSW, Emory, Iowa, UCLA, Utah, Oklahoma, UAB, Florida, Colorado, Wills, OHSU, Washington, Michigan, WashU.

 

[scorp_doc]

Thank you all for the input so far!

2. I would argue the top 10-15 programs interview the most competitive applicants. I may be wrong, but this early in application cycle, I think it would be hard to say you could match at a top 6-10 program, but not a 1-5 program. The ranges of top tier vs middle tier vs lower tier are broader than 5 programs.

I appreciate this insight! Actually more reasurring to know that my view on this is wrong. And thank you for the program suggestions.

 

[eyeeye_captain]

Unless there’s a compelling reason, don’t limit your geography if you want “top” stuff. I’ll echo a point from above that the tip top places don’t always have tip top numbers. It’s absolutely true that it’s more of a tier ranking with some gray areas between top/middle/bottom. Interviewees tend to wind up at the same programs - you’ll be shocked how many familiar faces you see on the trail.

The urban area thing cuts both ways. NYC programs have notoriously low numbers. From the prior list (very solid one btw), UTSW and Emory are good examples of programs in big cities with no competition hence good numbers. Florida has maybe the highest anterior segment numbers in the country and nobody would seriously call Gainesville a major city.

Having a county or a VA, or preferably both, is going to get you cases. You’re given significantly more patient responsibilities there than at a university hospital.

Speaking again about the earlier list, Michigan and WashU have good numbers but trend toward research.

These days I know nothing about plastics other than that eyelids block my view to the retina. If you want trauma though, Washington has a borderline crazy reputation for it. Iowa gets a good bit from the farms. I think Colorado covers like 6 states. I’d imagine WashU, UTSW, and Emory get their share. UTMB gets all of south Texas.

I’ll add a few to the list for places I’ve heard have good numbers but are lower down the tier list: Wisconsin, UCSD, Arkansas, Wake Forest, UVA, Nebraska

***most important point: find your fit when you’re done with interviews

 

[i-doctor]

Don’t forget Utah/Moran. Good numbers, wide geographical area, only game in town, and now academics. Has risen quickly to a T10 program.

 

[mjohnsonets]

I interview people from many programs and if you want numbers/surgical diversity, these are great. I have less experience with east coast, OH, and MI residencies though:
DMEI
UAB (in my opinion the most private practice like academic center in the country)
WashU
University of Missouri
University of Louisville
University of Colorado
UTSW
UW-Madison
University of Florida

LSU Shreveport has produced the highest cataract number I've heard of (455) but no multi-focals/femto-experience.

There are others too but these consistently stand out for numbers or diverse training including refractive cataract surgery.

 

[Slide]

I don't have direct confirmation from the faculty but hearing from a few reliable sources that UAB is going through some major transition issues...so applicants beware and do your homework.

 

[AnglesClosed]

I don't have direct confirmation from the faculty but hearing from a few reliable sources that UAB is going through some major transition issues...so applicants beware and do your homework.

every program is going through transition issues. academics is dying a slow death and that’s not exclusive to any program. many departments have lost key faculty and continue to do so.

 

[eyeeye_captain]

There were rumors in last year’s residency spreadsheet that Oklahoma (DMEI) was also having serious turnover issues. Smoke doesn’t always equal fire though.

Agree with doing your homework, people come and go. My retina bingo card for the last couple years didn’t have Yoshi Yonekawa leaving Harvard or Judy Kim leaving MCW.

 

[Slide]

every program is going through transition issues. academics is dying a slow death and that’s not exclusive to any program. many departments have lost key faculty and continue to do so.

Yep agreed. Several of my mentors that I thought would be bedrocks at academic institutions have switched to private practice and like it. I don't know if there is going to be a one size fits all solution for most programs but if something isn't done to address the hemorrhaging of faculty, programs are going to shut down.

 

[Ocularity]

On the flip side of this question, what are some lesser-known or non-top-tier programs that are research-focused or are better fits for residents interested in academic careers? Preferably that aren’t heading towards shutting down or losing a lot of faculty in the next few years.

 

[bergmistro]

duplicate response

 

[bergmistro]

On the flip side of this question, what are some lesser-known or non-top-tier programs that are research-focused or are better fits for residents interested in academic careers? Preferably that aren’t heading towards shutting down or losing a lot of faculty in the next few years.

Challenging question. What do you define as "top tier"?

At the end of the day, most conventional rankings are unfortunately based on research funding, so the "higher tier" programs will naturally tend to have more research support of productive faculty.

The other thing with Ophthalmology, is that it is generally a busy residency, and I am not aware of any program that has dedicated research blocks like some other fields may have. As such, maybe the best bet is a relatively less busy program that has big name faculty. I can't think of many off the top of my head. From speaking with residents at other programs, Scheie and Vanderbilt seem to be relatively chill residences and have big name faculty. This is all hearsay though and may not be accurate, I didn't attend either of those programs.

 

[Ocularity]

Challenging question. What do you define as "top tier"?

At the end of the day, most conventional rankings are unfortunately based on research funding, so the "higher tier" programs will naturally tend to have more research support of productive faculty.

The other thing with Ophthalmology, is that it is generally a busy residency, and I am not aware of any program that has dedicated research blocks like some other fields may have. As such, maybe the best bet is a relatively less busy program that has big name faculty. I can't think of many off the top of my head. From speaking with residents at other programs, Scheie and Vanderbilt seem to be relatively chill residences and have big name faculty. This is all hearsay though and may not be accurate, I didn't attend either of those programs.

I suppose by top tier, I’m referring in part to rankings lists (which, as you’ve said, are heavily influenced by research funding), but more specifically in the context of applying, places that only the most competitive applicants are likely to get into. (Obviously, matching ophthalmology at all is exceedingly difficult these days, regardless of the program. But broadly speaking, I’m assuming that there are places that are more competitive to get into than others.)

I’ve actually seen quite a few program websites mention dedicated research rotations. However, outside of the handful of programs with specific research years (e.g., Stanford SOAR, Wilmer StARR), I’m unclear how involved the research rotations are or how supportive the cultures at different institutions are of research (and where people are genuinely passionate about research vs purely doing it for the sake of getting into fellowship or because the program requires it).

In the new era of signals this cycle, it seems like there’s more pressure than before to get a feel for programs prior to applying and cast a broad net within the signal pool. As someone who does want research to play a significant role in my eventual career, I’m trying to determine a range of programs (with varying levels of competitiveness) that might be relatively more supportive of that goal.

Thanks for the suggestions/impressions of the programs you mentioned. And seems like a reasonable approach of factors to look for.

 

[eyeeye_captain]

I suppose by top tier, I’m referring in part to rankings lists (which, as you’ve said, are heavily influenced by research funding), but more specifically in the context of applying, places that only the most competitive applicants are likely to get into. (Obviously, matching ophthalmology at all is exceedingly difficult these days, regardless of the program. But broadly speaking, I’m assuming that there are places that are more competitive to get into than others.)

I’ve actually seen quite a few program websites mention dedicated research rotations. However, outside of the handful of programs with specific research years (e.g., Stanford SOAR, Wilmer StARR), I’m unclear how involved the research rotations are or how supportive the cultures at different institutions are of research (and where people are genuinely passionate about research vs purely doing it for the sake of getting into fellowship or because the program requires it).

In the new era of signals this cycle, it seems like there’s more pressure than before to get a feel for programs prior to applying and cast a broad net within the signal pool. As someone who does want research to play a significant role in my eventual career, I’m trying to determine a range of programs (with varying levels of competitiveness) that might be relatively more supportive of that goal.

Thanks for the suggestions/impressions of the programs you mentioned. And seems like a reasonable approach of factors to look for.

I lean more toward lists like Doximity since people know the programs. There are fewer research focused programs than clically focused ones, and each type tends to have self-selecting students and programs. A research oriented student won’t rank the clinical programs that highly, and those programs won’t rank the student that highly.

Mayo fits your criteria. Upper middle tier, very academic, not crazy competitive because nobody really wants to live there. Stanford is very much about fitting the program. Their residency and fellowship applications always have questions about innovation and how you plan to change the field/world. From above, Scheie is pretty chill and academic. Vandy must have changed a lot, they were very much a work hard program when I was training. WashU loves MD/PhDs. I think Wisconsin and UAB have high NIH funding for programs you might not suspect.