Uveitis/Retina Lifestyle

[BumpityBump]

---

Members don't see this ad.

Hey guys,

I'm interested in doing fellowships in uveitis AND surgical retina as I'd ideally like to practice both in the future. My question is, what would the lifestyle be like doing this? As I am very dedicated to my family, I do not want to commit to this path if its going to just bring me future misery... Also, would I be taking a huge pay cut by also doing uveitis? Thanks all in advance.

 

[mtwop]

Hey guys,

I'm interested in doing fellowships in uveitis AND surgical retina as I'd ideally like to practice both in the future. My question is, what would the lifestyle be like doing this? As I am very dedicated to my family, I do not want to commit to this path if its going to just bring me future misery... Also, would I be taking a huge pay cut by also doing uveitis? Thanks all in advance.

Also interested in the responses here. Not to hijack the thread, but similarly I would also like to hear comments on lifestyle of comprehensive ophthalmology vs surgical retina in the private practice world (definitely worse in the academic side from what I've been exposed to at my home institution). Thanks again

 

[onthefence1]

Anyone in practice have any input for these?

 

[dunnoaboutthat]

Also interested in uveitis and surgical retina. Anyone?


Sent from my iPhone using SDN mobile

 

[Trichromatic]

Definitely interested in surgical retina, and also like uveitis and peds. I've seen the former combination, but I've never seen retina+peds (meaning peds retina, uveitis, etc.). I suppose you wouldn't need to do either additional fellowship if your retina fellowship gave you enough exposure. As far as mtwop's question, my medical school eye institute was private, and the retina surgeons over there had pretty good lifestyle. Still put in more hours than the comprehensive docs, but they mostly did non-emergent stuff and worked 8am-5pm. We had a large academic eye center nearby, however, so I assume those mac-on RD's at 3a.m. were getting done over there lol.

 

[DrZeke]

Most people still do Mac on RD next morning.


Sent from my iPhone using SDN mobile app

 

[Trichromatic]

Most people still do Mac on RD next morning.


Sent from my iPhone using SDN mobile app

OK.

 

[Slide]

Most people still do Mac on RD next morning.


Sent from my iPhone using SDN mobile app

To add to this, you can sometimes pull off a pneumatic retinopexy and avoid the OR altogether. Nowadays there's really no need to go to the OR immediately for a Mac on RD, it can be added on at the end of the day or put on the next day (doesn't even have to be first case). I would imagine this hte case especially for academic centers where surgical time is hard to come by on short notice.

 

[100D]

To the OP: It depends what kind of practice you join, what you make of your clinic, and what the call structures are.

Uveitis won't "bring misery" if you love the work. But each uveitis visit will take longer than a retina visit, so you'll get paid less, and there is more behind-the-scenes work like coordinating care with rheum etc. So you if want/need to see many uveitis patients, your clinics will be longer. Usually the uveitis person doesn't see as many patients as a pure retina person. You should shadow some retina surgeons who do substantial uveitis and see for yourself. I think it's a very cool field.

Like anything, do what you love, and you'll usually gravitate towards types of practices that permit compatibility with your priorities. It all depends on what you mean by "misery." I don't think any subspecialty of ophthalmology has a "miserable" lifestyle.

 

[DrZeke]

To the OP: It depends what kind of practice you join, what you make of your clinic, and what the call structures are.

Uveitis won't "bring misery" if you love the work. But each uveitis visit will take longer than a retina visit, so you'll get paid less, and there is more behind-the-scenes work like coordinating care with rheum etc. So you if want/need to see many uveitis patients, your clinics will be longer. Usually the uveitis person doesn't see as many patients as a pure retina person. You should shadow some retina surgeons who do substantial uveitis and see for yourself. I think it's a very cool field.

Like anything, do what you love, and you'll usually gravitate towards types of practices that permit compatibility with your priorities. It all depends on what you mean by "misery." I don't think any subspecialty of ophthalmology has a "miserable" lifestyle.

This is a great post. Residents talk like this a lot. Refer to how "miserable" you will be if you're not a refractive or cataract surgeon seeing routine and simple things. In my program there is often talk of getting done as soon as possible and raking in the dough. Yesterday at a conference I met two people who had their first jobs later than most due to extra training and interests. They seemed incredibly happy and I was relieved, because I will be in the same boat.

We all have different interests. Some of us like to think through problems and love disease and pathophysiology even though we left internal medicine with a big smile on our face. Some people love glaucoma and don't mind operating on monocular patients, while others thinks that is awful. Obviously if you are interested in uveitis+ retina you like disease and pathophysiology and all that. In my program when I mention uveitis most people look at me like I've lost my mind.

As you move through residency you will start to understand what kind of person and Doctor you are and what you like. I realized I really wanna help sick people with sick eyes even if I'm an ophthalmologist. I also know that cataract reimbursements keep going down and so money is not everything and I'm not sure that some residents' understanding of how money is made in private practice is very accurate. So take everyone's opinion in residency with a grain of salt, and try and weigh what they say against who you know you are and what your expectations are. By talking with many different people and reading forums like this you eventually get a sense of reality and can shape expectations a bit better. Even though we all went into Ophtho, many of us want different things. I've also found it's important to find like-minded individuals to have as role models. They have helped me with many of my decisions academically and professionally.

Oh and uveitis patients initial visits take a while, but once work up is complete the rest can be quick. Especially with electronic medical records and large outpatient networks of physicians... Coordinating care isn't that hard, you just need to develop a good relationship with a rheumatologist. And often all it takes is an online message through EMR or your staff faxing a letter. If you do retina with uveitis there is a lot of local therapy, injection, implant to be done as well on these patients...


Sent from my iPhone using SDN mobile app

 

[gregoryhouse]

This is a great post. Residents talk like this a lot. Refer to how "miserable" you will be if you're not a refractive or cataract surgeon seeing routine and simple things. In my program there is often talk of getting done as soon as possible and raking in the dough. Yesterday at a conference I met two people who had their first jobs later than most due to extra training and interests. They seemed incredibly happy and I was relieved, because I will be in the same boat.

We all have different interests. Some of us like to think through problems and love disease and pathophysiology even though we left internal medicine with a big smile on our face. Some people love glaucoma and don't mind operating on monocular patients, while others thinks that is awful. Obviously if you are interested in uveitis+ retina you like disease and pathophysiology and all that. In my program when I mention uveitis most people look at me like I've lost my mind.

As you move through residency you will start to understand what kind of person and Doctor you are and what you like. I realized I really wanna help sick people with sick eyes even if I'm an ophthalmologist. I also know that cataract reimbursements keep going down and so money is not everything and I'm not sure that some residents' understanding of how money is made in private practice is very accurate. So take everyone's opinion in residency with a grain of salt, and try and weigh what they say against who you know you are and what your expectations are. By talking with many different people and reading forums like this you eventually get a sense of reality and can shape expectations a bit better. Even though we all went into Ophtho, many of us want different things. I've also found it's important to find like-minded individuals to have as role models. They have helped me with many of my decisions academically and professionally.

Oh and uveitis patients initial visits take a while, but once work up is complete the rest can be quick. Especially with electronic medical records and large outpatient networks of physicians... Coordinating care isn't that hard, you just need to develop a good relationship with a rheumatologist. And often all it takes is an online message through EMR or your staff faxing a letter. If you do retina with uveitis there is a lot of local therapy, injection, implant to be done as well on these patients...


Sent from my iPhone using SDN mobile app

Do you mind going more into what a typical uveitis clinic would look like and what the management for them would be? Are you actually taking care of their autoimmune meds or do you just let the rheum people take over and follow the patient for eye care?

 

[DrZeke]

Do you mind going more into what a typical uveitis clinic would look like and what the management for them would be? Are you actually taking care of their autoimmune meds or do you just let the rheum people take over and follow the patient for eye care?

Most people do not prescribe the autoimmune meds themselves, though they may guide the rheumatologist especially if it's just a uveitis and not a systemic condition. Most ophthalmologists I know initiate the work up to find the cause and look for inflammatory markers. I know many people are ok prescribing oral steroids depending on lab results, but if they think the person needs immune modulating medicines they will get with rheumatology. The ophthalmologist does local therapy- injections, lasers, inserts.

However there are certain people who are comfortable prescribing and Dr Foster in Boston even has his own infusion Center if I'm not mistaken.

Go on away rotations first before deciding on subspecialty 🙂.

Sent from my iPhone using SDN mobile app