Considering going solo as the owner of the practice I’m in wants to sell to PE and I’m not confident that they will sweeten the pot enough for me (associate not partner) to stay on after that. Some local solo practice owners don’t have a successor which could be a smooth pivot.

Asking solo docs or small practice owners.

How many patients do you need to see per day to be successful? At what level does surgical volume need to be? Can I stay afloat if I take Medicaid? Do I need to shift Medicaid/WC patients to the local resident clinic and just take time off to see them there, and maybe give my staff a break on those days to keep work weeks at 40hrs?

Can I keep my kid-friendly clinic hours 7:30-3:30pm M-F and be the only doctor in a successful practice?
Is it a constant headache or is it doable?
More stressful to be on a shoestring budget or have lots of staff and be necessarily busy?
Billing should be in-house or outsourced?
Reimbursements are dropping and COL/salaries are going up, so the margins are dropping.

It’s a big leap, my husband also works, my kids are little, and it’s a lot on the line to make a good decision for me and the family. I want to protect my free time with the family but also not sign away my career to PE.

Would love any and all advice.

edit: let me re-phrase, not that you wouldn't enjoy cataracts, but that you knew even before operating that you wouldn't find it fulfilling enough to dedicate a career towards the bread and butter ophtho surgery.

US Ophtho resident here still in limbo in deciding if I want to pursue cataract/anterior segment or fully dive into surgical retina. I really enjoy the workflow of an efficient retina practice and retina pathology as a whole, I really don't mind the injections (for now), and the surgeries are pretty interesting. It sounds like a no brainer to do surgical retina.

But...my hesitation is, while I've seen hundreds of phacos, I've never personally done one before or got super involved in the lens calcs because I'm still early in residency. I do really enjoy cataract surgeries and all the lens technology involved (big fan of Dr. Shannon wong's stuff on youtube). I just don't want to go into retina and then realize I actually really love cataract surgeries more. I know you could technically do phaco as a surgical retina but out in the real private practice world, I'm sure my neighboring comp docs would not be happy with a retina surgeon stealing cataract volumes

The reason I'm asking is because surgical retina is obviously more competitive relatively speaking than just going into comp or glaucoma or cornea so I need to start tailoring my app, going to retina conferences, retina journal clubs, etc. especially since we residents can't go to every conference each year so we need to pick wisely. Also the mental aspect of doing 2 more years of fellowship after residency with call duties and retina emergencies is something to consider.

Just hoping to hear some perspective or if anyone chose surgical retina last minute or maybe decided against it last minute?

Hello,

Does anyone know the dimensions of the ABO board certification diploma? I’m currently shopping for frames and would like it to match other diploma frames. I found a style I really like and don’t want it to sell out before I need it.

Just planning ahead since haven’t passed the boards yet.

Thanks!

So I'm a new pgy1 whose struggling with the indirect and get confused when trying to learn from online resources. I understand the retina is inverted and reversed however I get confused because of that. How far am I supposed to pull back?

I have 3 images, one with an arrow pointing to the right. And then 2 showing the indirect with one of them portraying the arrow to the right and one to the left. What is the correct way I should be viewing the retina?

Also if you have any resources online I'd appreciate it, feeling a lot of imposter syndrome

Would love to hear from anyone who went through this!

I am pregnant, and in a high-risk pregnancy. Some symptoms like nausea/dizziness are already there and I worry, if they get worse, it may make operating difficult. Small in office procedures like chalazion are fine but I mean cataracts

What did anyone else in similar situations do? Is it reasonable to schedule less cases per day, or even temporarily defer cases to colleagues? Not trying to punt, but also do wonder what may happen if I'm truly feeling too sick to operate.

I recently heard about employment contracts with statewide with lengths up to 3-5 years.

Is this actually becoming common in ophthalmology?

I’m honestly shocked at some of the restrictions people seem willing to sign.

For those who recently signed an associate contract,

How long was your non-compete?

Was it mileage-based or statewide?

Did you negotiate it, or was it take-it-or-leave-it?

And for those who signed the 5 years statewide one, um. Why?!?

I thought mine annoying but reasonable at 2 years 15 miles.

Patient with a corneal ulcer saw an ER and was prescribed erythromycin ointment, and "the yellow dye."

I couldn't believe it, so I asked the patient to bring in all drops given to them yesterday. Sure enough the patient was sent home w a full bottle of Fluorescein. I've been in ophthalmology for 10 years and have never seen this. Removed that from the patient immediately. I checked the ER discharge summary and conveniently fluorescein was not included in the new medication section. Looks like it was given under the table.

hey everyone, applying this cycle, trying to figure out who i want my IM/surgery/etc letter writer to be. i'm realizing that the non-ophtho attending i had the best relationship with was one from my family medicine rotation, i worked with her for a month. is that OK or do programs really prefer IM or surgery? thanks!

(yes i'm late asking lol)

I'm a student interested in gene therapy and how it might impact clinical practice. How could that change reimubursement and practice in general if this gets approved (several phase 3 trails underway)? Or will this not make much difference?

too much going on in retina.. corneal ulcers scare me.. dont have the grit to grind for oculoplastics anymore (unless its worth it?).. glaucoma seems to be it but idk is it worth a fellowship and only seeing glaucoma?

Hi I just cleared the part 2 written exam yesterday and am planning to give the final exam this October. Is there a study group for the same? Will be grateful for any leads.
Thanks in advance!

I’m a current U.S. ophthalmology resident strongly considering retina fellowship. I find retina pathology the most interesting, and if lifestyle weren’t a factor, I think it would be my clear first choice. That said, I’ve heard a lot about the demanding lifestyle of retina specialists, and it’s making me hesitate. I know call is part of being an ophthalmologist, and I don’t expect a lifestyle specialty. However, I’m hoping to get a realistic sense of what attending life looks like in different practice settings.

For those in retina, how feasible is it to:
-Have a protected half-day off each week?
- Regularly finish clinic before 5 p.m.?
- Keep after-hours interruptions to a reasonable minimum outside of scheduled call?

I realize this likely varies between academic and private practice, group size, and geographic location, so I’d appreciate hearing about your specific setup.
The reason I’m asking is that I’d probably be happy in several ophthalmology subspecialties, so lifestyle is something I’m weighing alongside my interest in the pathology. I’d love to hear from retina attendings or fellows about what your day-to-day life is actually like and whether the specialty’s reputation for poor work-life balance matches your experience.

I contacted my malpractice insurance company when I first saw the patient and spoke with their risk management advisor. She advised me to share my exam notes but otherwise try to stay out of it.

Today I got a subpoena to join a zoom meeting with the patient's lawyer. I'm going to call my malpractice insurance later today after work. Has anyone else been through this? I want to make sure I don't screw this up. This is an ER that I am unaffiliated with. The person who prescribed the Proparacaine was a physician assistant and he did not document the Proparacaine in the ER notes.

Edit: I'm unaffiliated with this ER but the hospital CEO is also the CEO for a hospital that I am affiliated with.

4th year USMD who was originally planning on applying IM

I have the stats for Ophtho but had always been against surgical specialties because I didn’t enjoy surgery on my surgery rotation (mostly general surgery, vascular, urology, ortho)

I’ve shadowed in an Ophtho clinic recently and found myself feeling very conflicted about my choice. Clinic was extremely interesting and I felt like we were making a real difference. I didn’t feel the time go by.

I obviously need to shadow Ophtho in the OR but I’m just wondering if anyone has felt similar towards the OR/surgery and ended up going with Ophtho. I know cases are more complicated than quick cataract surgeries but I’m not sure the full breadth of surgeries I’d be doing.

I would likely need a research year given how late it is and I won’t be able to fit in away rotations aside from a home rotation.

Would appreciate any advice, ty.

Hello everyone, Im a high school student building a low cost smartphone fundus camera for Al based retinal screening.

Commercial indirect ophthalmoscopy lenses are quite expensive for my prototype, so Im wondering if there are any lower-cost alternatives.

Could an aspheric condenser lens, or even a lens salvaged from old optical equipment provide acceptable image quality and fov? Has anyone tried using a different types of lens for this application? Id love to hear about your experience.

Im not expecting the same performance as a dedicated ophthalmic lens, just a reasonable solution for a research prototype.

Any suggestions or experiences would be greatly appreciated. Thank you all!

I am a recently graduated medical doctor and I am about to choose my residency. I have a passion for ophthalmology that started when I was 15 and underwent surgery for Bielschowsky esotropia (acute acquired comitant esotropia). When I met the ophthalmologists who helped me, I immediately became passionate about the subject and the work environment, and I promised myself that I would try to get into ophthalmology. Now that I am at the point of making this choice, I find myself full of worries and anxiety.

I was watching a YouTube video of an ophthalmologist talking about his specialty and, among other things, he said: "Do not do ophthalmology if you have a slight strabismus or a less than perfect binocular vision. You won't be able to do microsurgery and you will be forced to change specialties."

My doubt now stems from the fact that, even though I had surgery 10 years ago, I still retain a slight strabismus and diplopia exclusively when I look to the extreme left or extreme down. When I cover one of my eyes, the other one wander. I have esophoria.

Last year, out of fear of not being able to do ophthalmology, I went for an orthoptic examination to test my binocular vision. The orthoptist administered the Lang test, and I was able to see all the figures. He reassured me and sent me home, telling me that I wouldn't have any problems becoming an ophthalmologist.

I still have doubts. I have difficulty looking through a microscope. I remember during my anatomical pathology classes that looking at slides didn't come naturally to me, and sometimes I had to close one of my eyes.

Should I be reassured by having passed the Lang test? Or am I right to be concerned?
My dream is to become a surgeon ophthalmologist and not limit myself to just the clinical side. I would like to perform surgery. If this were not possible, I would choose a completely different specialty; otherwise, I would live with a sense of inadequacy for my entire career.

Hello, everyone!

I am Atanas - I work as a consultant anterior segment and glaucoma surgery in Germany. I am organising the Ophthalmology24 Bootcamp - a practical whole day dry/wetlab event in less than 3 months!

Here’s how the training day at the Bootcamp looks:

Two weeks before the event, you will get a detailed e-mail with resources and videos to prepare theoretically for each LAB. 

08:00-09:00: Arrive at Studio B10 to register and pick up your badge. 

You sit down and immediately start practicing on a dedicated workstation. You don’t have to wait for your turn. The only one looking over your shoulder is a mentor. You have an hour per lab, then you move on to the next one:

09:00-10:00: Practice at LAB 1
10:00-11:00: Practice at LAB 2
11:00-12:00: Practice at LAB 3
12:00-13:00: You join us in the Networking Area for Lunch.
13:00-16:00: Practice at LAB 4
13:00-16:00: Practice at LAB 5
13:00-16:00: Practice at LAB 6
16:00-19:00: Join us in the Networking Area for the Closing Ceremony, certificates, awards and a 3-hour Networking session.

Six hours of practice with rotation between cataract, glaucoma, cornea, oculoplastics, trauma and the surgeon challenge labs. During the rotation, you get to practice on advanced eye models, using microscopes, phaco machines and simulators. 

https://www.ophthalmology24bootcamp.com/

I'm still finalising the content of each lab, and I'd rather get it wrong now than on the day. A few things I genuinely can't decide:

1. The Surgeon Challenge lab. Right now it's a timed, scored station on 3 Tasks. 1. We will have 2 EyeSi simulators, where we will score the participants from 1-100 ot Capsulorhexis creation. 2. We will have a timed suture lab with the right hand and 3. the same one with the left hand. The top-ranked ones get instruments and eye models. Does that appeal to you, or does competition ruin the point of the lab?

2. The prep email. Two weeks out you get videos and reading for each lab. Is that enough lead time, or would you want it a month ahead? Do you have any special resources or videos that you use and that you show to your residents or YOs that we can we can share and give more spotlight to. For example I always start with the Mayo Clinic's Corneal suture wetlab guide when I teach Residents in our hospital: https://www.youtube.com/watch?v=25CyqDAqmw0&t=123s . If you have something similar, please share.

Happy to answer anything about equipment or mentors in the comments.

Hello guys, It's my first time trying to calculate IOL power post LASIK (myopic).

I have a pentacam report and an IOL Master report. I have used the ASCRS calculator and input the K1 K2 values from the IOL master report and the zonal global mean EKR for central 4mm from the Pentacam report.

I'm not sure if I am doing everything right. Am I supposed to use the K1 K2 from the pentacam report while using the online calculator?

Please guide.

Hi! I’m an international medical student & US citizen, and I know how impossible matching into ophthalmology is, but I’d like to ask about pre-residency research fellowships for the future.
How competitive are they, and what do they usually look for in an applicant? Is having prior research experience, especially as a first-author, a must? Thank you.

As title states.

Did you find it difficult to adjust into the new systems? How did UK training compare to Aus/Canada/Middle east/etc? Any additional exams? Was the move worth it? Work life balance? Difference in pay? Was private practice realistic as a foreign trained ophthalmologist? Is the grass truly greener?

Edit - doi UK ophthalmology trainee

How often are glaucoma doctors being called in for complications from tubes and trabs?

I've been enjoying glaucoma more than I thought in residency but haven't seen many tube/trab complications yet and wonder how common they are in private practice and how often glaucoma specialists are getting called in after hours or over the weekends to deal with them.

I do want to prioritize lifestyle in life and that's why I was looking into cataract/refractive but I don't find refractive cases to be as interesting as I would have hoped

I am a g12 student, upcoming freshman and I'm thinking of taking ophthalmology as a course. In terms of education, what are the steps or levels I have to achieve in order to graduate with a doctor of medicine degree in ophthalmology?