surgical numbers

[wolverine32]

Hey everyone
I've read many times on this forum about how important it is for a program to have good surgical (i.e. cataract) numbers. Just how important is this factor if the resident is going into a subspecialty that doesn't involve cataract surgery, such as surgical retina or occuloplastics? I don't see how doing 150 cataracts vs. 90 cataracts during residency makes a difference if someone's going to not be doing any cataracts for the next two years during fellowship. Does doing more cataracts during residency help you in terms of either skill or resume when you look for a job in vitreoretinal surgery or occuloplastics?

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[PDT4CNV]

Hey everyone
I've read many times on this forum about how important it is for a program to have good surgical (i.e. cataract) numbers. Just how important is this factor if the resident is going into a subspecialty that doesn't involve cataract surgery, such as surgical retina or occuloplastics? I don't see how doing 150 cataracts vs. 90 cataracts during residency makes a difference if someone's going to not be doing any cataracts for the next two years during fellowship. Does doing more cataracts during residency help you in terms of either skill or resume when you look for a job in vitreoretinal surgery or occuloplastics?

"Good surgical numbers" includes all types of ophthalmic surgery, not just cataracts...but people use cataracts as a gauge for judging programs. It should be obvious that more surgery=better in most cases. Be aware that in practice, retina often ends up with some ant. segment cases. Anyway, it is not uncommon for second or third year ophtho residents who have matched in plastics or retina to give up cataract cases to other residents, similarly, those doing cornea or peds may give up retina cases to other residents.

At some point, maybe after 75 cataract cases, the routine cases offer little extra, but its that occasional challenging case that is of additional benefit...but you know, you can't always eat a gourmet meal, so for every 5 or 10 routine cases, that 1 challenging case you will still learn something.
Once again, you would rather be at a program where you at least have the option of doing 150-200 cases rather than struggling to graduate with 75-80.

 

[Retinamark]

It is still extremely important for surgical retina, because complicated anterior segment cases often end up at retina. Also, the more anterior segment cases you've done, the better your microsurgical skills will be and this translates into better surgical skills for retina cases.

 

[IEye]

The quality of teacher is also important. I may have done 15 cataract cases with one attending and 15 with another. However, one of the attending was clearly a better teacher than the other. It is conceivable that a program has no really good teachers. Resident applicants have no way to know because it's all smiles during the interview, even at (particularly at) lousy programs....or, as one thread is entitled, even at programs that suck.

 

[LASIKguy]

I agree with above.

Beware, at a lot of programs (esp famous ones where attendings are mostly doing research or seeing private patients) you operate BY YOURSELF after 15-20 cases (i have witnessed that) or your teacher is a Senior or cheif resident or a fellow. Make sure you ask on your interview trail about who staffs the cases - having a anterior segment or good general guy who has done several thousand cataract is always better.

Also, make sure you ask if cases are class I or III, many programs will fool you into believing that they do 150 cataracts but that includes 50 class III, where you are watching.


From what I have heard, every cataract is diff and there is always a challenging one every 10-15 cases as mentioned correctly above, so the more cataracts you do, the better you get.

But again, if you are coming out of a well-known program but you didn't do enough cases, you can get a good fellowship and do more cases.

My program is small but we get > 200 cataracts, > 50 class I vitrectomies etc.

Goodluck on the interview trail.

 

[GuP]

I agree with above.

Beware, at a lot of programs (esp famous ones where attendings are mostly doing research or seeing private patients) you operate BY YOURSELF after 15-20 cases (i have witnessed that) or your teacher is a Senior or cheif resident or a fellow. Make sure you ask on your interview trail about who staffs the cases - having a anterior segment or good general guy who has done several thousand cataract is always better.

Also, make sure you ask if cases are class I or III, many programs will fool you into believing that they do 150 cataracts but that includes 50 class III, where you are watching.


From what I have heard, every cataract is diff and there is always a challenging one every 10-15 cases as mentioned correctly above, so the more cataracts you do, the better you get.

But again, if you are coming out of a well-known program but you didn't do enough cases, you can get a good fellowship and do more cases.

My program is small but we get > 200 cataracts, > 50 class I vitrectomies etc.

Goodluck on the interview trail.

do you mind sharing what program you are in?

 

[LASIKguy]

Texas Tech program in Lubbock (middle of no where ), Texas
ttuhsc.edu/eye