Ophthalmology

[palma]

Hey guys,

 

Just wanted your thoughts on what life is like once you complete an ophtho residency. I am neither a resident nor have applied yet. So once you complete your residency I guess you have the choice of setting up your own practice, working for a hospital or getting more specialized training. My questions are as follows:

How difficult is it to land a job at a hospital?

Are opthalmologists able to set up a practice almost right out of residency (given that they have financial backing, is the residency enough to give you enough experience)?

Are there caps on how much you can do, say you want to work longer than the average 40 hour work week?

What are your options if you don't match on your first try (I am also not very familiar with the CaRMS process)?

 

I will definitely be looking into these questions on my own by speaking to other resident and ophthalmologists, but was wondering if other members have looked into them.

 

Thanks,

Palma

[monkey799]

I presume you are early in med school.

 

You'll find out soon enough, that ophtho is one of the most difficult pathway in medicine, in terms of getting into residency, building your practice, and finding OR time.

 

Those are political and sensitive questions to ask of attendings and residents, so don't be surprised if you don't get sincere answers.

 

Search this forum cuz there is lots of posts about it.

 

If you do succeed - really succeed - in ophtho, there is a strong reward, at least financially. Just check their billings.

[palma]

Alright monkey thanks a lot for the information. One question I would like to have answered is what are one's options if they don't match into ophtho or any other residency that was their top choice?

[palma]

I forgot to mention earlier that I have searched all the terms associated with ophthalmology and gone through all of those threads. If you know of any in particular do let me know. I was also wondering if the odds are really that bad for ophtho. I mean 41% match rate is pretty good given the odds of getting into meds were a lot worse. Is it just because the process of matching is so much less formulaic than the med school process?

 

Thanks,

Palma

[bluekazoo]

Does anyone know what an ophthalmologist fresh out of residency can expect in terms of being able to secure OR time/set up a practice? From what I have heard, it can be quite difficult to do both of these, at least in a major urban centre like Toronto. What do you end up doing if you're not able to get significant OR time?

[sarakj]

Does anyone know what an ophthalmologist fresh out of residency can expect in terms of being able to secure OR time/set up a practice? From what I have heard, it can be quite difficult to do both of these, at least in a major urban centre like Toronto. What do you end up doing if you're not able to get significant OR time?

 

I know a relatively new grad ( 7 yrs) who has his own clinic in Toronto. He makes his money through check ups and laser tx mainly. He has secured only twice a month OR time. Though, he has a very comfortable life. So I assume he makes enough money to be able to work 4 days a week woth very good hours!!!!

[neuropathy123]

here is how it goes

 

new grads - no OR time, so you run clinics and check ups, and refer pts to guys with OR time, these old farts are holding OR time tight cuz it's money maker

 

in the mean time, start fighting for OR time

 

if things work out and luck is on your side, then after a few years (and certainly fellowships) - you'll start with 1 day OR time per month

 

then keep fighting for a few more years - then it's 2 days per month

 

and keep going and going...

 

when you become an old fart with loads of OR time, you'll be holding onto them tight cuz it took you decades to acquire them and they are money maker

 

a few factors to keep in mind

 

(1) new grads are coming out every year on this pathway

 

(2) there is increasing number of residency grads due to program expansion, while the amount OR time is still essentially the same

 

(3) old farts aren't retiring any time soon d/t variety of factors like losing value of stock and retirement portfolio etc - so they get fellows to operate while they bill...

 

essentially, the competition will simply get worse in the future

 

to succeed there are things you need to have that may be beyond your control, liked getting liked by the group and having connection; I've heard of well-established ophtho guy from Dalhousie who's been unable to break into Vancouver's ophtho group after trying again and again for >10 years.

 

or,

 

you can be happy and just do office and laser tx, and watch your peers with the same training (but more motivation and will to fight) make 5x your salary

 

not to mention the rise of optometrists, who can now already legally perform laser treatment and some surgeries in Oklahoma state - and this trend is expected to spread across US and eventually Canada

[mdfever]

Interesting information. Don't know it is the same case for other specialties as well like OB/Gyn, nephorlogy, ENT etc.

[palma]

So, I guess if you can't get over time you are not able to do things you want whether for personal gratification or financial reward. One option I guess would be to start in a small town and then consider moving to bigger town? I remember meeting a fairly young ophthalmologist at a hospital in Kingston, ON who seemed to have regualar OR time. So, other than LASIK, there are not any other procedures that opthos do in their own practice? Sorry I am such a newbie!

[bj89]

So, I guess if you can't get over time you are not able to do things you want whether for personal gratification or financial reward. One option I guess would be to start in a small town and then consider moving to bigger town? I remember meeting a fairly young ophthalmologist at a hospital in Kingston, ON who seemed to have regualar OR time. So, other than LASIK, there are not any other procedures that opthos do in their own practice? Sorry I am such a newbie!

 

They do cataracts too I believe.

[crockett]

here is how it goes

 

new grads - no OR time, so you run clinics and check ups, and refer pts to guys with OR time, these old farts are holding OR time tight cuz it's money maker

 

in the mean time, start fighting for OR time

 

if things work out and luck is on your side, then after a few years (and certainly fellowships) - you'll start with 1 day OR time per month

 

then keep fighting for a few more years - then it's 2 days per month

 

and keep going and going...

 

 

There are a lot of established ortho and gen surg guys who don't operate 2 days a week, i would be quite surprised if there were many optho's operating this much (or more). That being said, a lot of surgeons will get OR time in smaller hospitals in return for running a clinic once a month or taking call every so often etc., so this is always an option.

[bnface]

There are a lot of established ortho and gen surg guys who don't operate 2 days a week

 

i wouldn't say a lot......

 

my experience in both community and academia says otherwise.

[crockett]

Sorry made a couple mistakes there- should have said don't know many people operating > 2 days per week, although after re-reading the post it said 2/month not 2/week, so my point is irrelevant anyways haha.

[bluekazoo]

I got the chance to speak with a senior ophthalmologist in Toronto who encouraged me to pursue ophtho but to realize that, in Toronto at least, "there are no OR positions at this time" and that there won't be many in the future. He estimated that there is a backlog of about five years worth of newly-graduated people already who are working purely office positions and said that they would get priority over younger people like me when it came time to hand out OR time. I have to admit it made me think twice a bit as it would be disappointing to spend 5+ years learning skills that I would never get to use.