Ophthalmology versus Internal Med

[md2b2012]

I am a third year medical student deciding between ophtho and internal med. Both are good fields and I am torn. I thought I would always do medicine but did not like my rotation. I can easily identify with the medicine residents at my teaching hospitals; I enjoyed my ophtho rotation and found it very refreshing.

Ophtho:
Pros: Great lifestyle, better compensation, clean field with little b***s*** to deal with, ability to do procedures; feel like you made a difference in people's lives
Cons: I might get bored of the eye; you don't get to use all you learned in medical school; limited to private practice unless you do academics

Internal Medicine:
Pros: Intellectually stimulating, more options for fellowship; more options to teach/consulting/hospitalist; ability to interact with other physicians
Cons: Paperwork, lack of procedures, dealing with people's BS more often, more hours and less compensation

A lot of this can be anxiety as I start applying for the ophthalmology match.

I'm sure many people in this forum went through a similar decision process.

What do people think? Thanks.

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[Instatewaiter]

I am a third year medical student deciding between ophtho and internal med. Both are good fields and I am torn. I thought I would always do medicine but did not like my rotation. I can easily identify with the medicine residents at my teaching hospitals; I enjoyed my ophtho rotation and found it very refreshing.

Ophtho:
Pros: Great lifestyle, better compensation, clean field with little b***s*** to deal with, ability to do procedures; feel like you made a difference in people's lives
Cons: I might get bored of the eye; you don't get to use all you learned in medical school; limited to private practice unless you do academics

Internal Medicine:
Pros: Intellectually stimulating, more options for fellowship; more options to teach/consulting/hospitalist; ability to interact with other physicians
Cons: Paperwork, lack of procedures, dealing with people's BS more often, more hours and less compensation

A lot of this can be anxiety as I start applying for the ophthalmology match.

I'm sure many people in this forum went through a similar decision process.

What do people think? Thanks.

Why didn't you like your medicine rotation? I think the answer to that question may answer your question.

In terns of paperwork, I agree it sucks. Same thing goes with dealing with others' BS.

In terms of procedures, depending of what you choose to do, you could do only procedures. Many cardiologists, Gastroenterologists and Pulmonologists do only procedures, all day everyday. It is not for everyone, but some chose it.

Medicine is not for everyone. I wish we could be more helpful but the decision should be your own.

 

[md2b2012]

I did my medicine rotation at a community hospital and saw bread and butter cases. The experience and teaching was good but it did not wow me. However I thought the residents were simply pushing paper, writing notes, and letting the specialists and ancillary staff do most of the work. It's one thing to be the quarterback but another to just pass the ball off every time to the running back and never throwing the ball yourself. Then again, this could be hospital specific.

If I were to do Internal med, I would do something like endo or rheum. I like the subject matter more but it does not compensate well and no procedures. Money is not anything but you have to be realistic. When I think of cardio or GI, all I think of is long hours and rushing back and forth between hospitals and offices to get all your stuff done. I simply don't want that.

My main concern about ophtho is will I miss the rest of medicine. I pride myself on knowing things (like we all do) and I like the idea of working up anemia or ruling out an MI. If a family member asks me twenty years about their newly diagnosed hodgkin's lymphoma, the ophthalmologist me would have little to say. This is not a big deal really, but something one must accept.

 

[dragonfly99]

It sounds like you are still undecided, which is normal at your stage of the game. I would suggest doing more opthalmology rotations and a medicine subinternship in the next few months, along with doing a consult rotation or two in internal medicine. Maybe you could do endocrine or rheum consults, or both.

Internal medicine is a lot of dealing with bs paperwork and you do have to write a lot of notes. That is par for the course in medicine residency. I imagine it would be similar as a hospitalist. Unfortunately the paperwork seems to get worse all the time.

If you are still undecided in a few months, it might be best to apply to optho but be sure to do a medicine prelim year. That way if you change your mind about opthalmology, even during intern year, you can bail and just do internal medicine. It would be harder to make the other switch (IM to opthalmology). It tends to be very hard to interview for other fields while you are an intern in one field, and it's hard to get into competitive specialties once you've already graduated from med school.

 

[Labslave]

It sounds like you are still undecided, which is normal at your stage of the game. I would suggest doing more opthalmology rotations and a medicine subinternship in the next few months, along with doing a consult rotation or two in internal medicine. Maybe you could do endocrine or rheum consults, or both.

Internal medicine is a lot of dealing with bs paperwork and you do have to write a lot of notes. That is par for the course in medicine residency. I imagine it would be similar as a hospitalist. Unfortunately the paperwork seems to get worse all the time.

If you are still undecided in a few months, it might be best to apply to optho but be sure to do a medicine prelim year. That way if you change your mind about opthalmology, even during intern year, you can bail and just do internal medicine. It would be harder to make the other switch (IM to opthalmology). It tends to be very hard to interview for other fields while you are an intern in one field, and it's hard to get into competitive specialties once you've already graduated from med school.

Excellent advice.

 

[staup]

All these things are so variable, especially since specialties in medicine can be so variable.

I would agree in general Optho pays more, although certain medicine specialties can certainly make more than Optho.

In general, there certainly is less social issues in Optho.

As far as the paperwork? I guess Optho has less, but it's not like every time an Optho sees a patient in clinic they don't have to write a note just like IM. Some of the IM notes are more complex, however. Operations may take a while and they only write one note per operation, so that may save some paperwork, but in general it's not as less as you would think. I am an academic hospitalist, and I would say on average, after I round on my patients, I spend about an hour on paperwork everyday. That's not that much. For new admissions, I spend about 30 minutes on the write up. I also believe the process will get more streamlined in the future and become much easier. When you're a student and resident, it takes a lot longer for a write up because you have to think more, but as an attending, things come automatically so the write up becomes less of a struggle.

Finally, the lifestyle factor is so variable as well. I know plenty of Opthos who work much much more than IM docs, both in academic and private practice.

 

[Phloston]

I am a third year medical student deciding between ophtho and internal med. Both are good fields and I am torn. I thought I would always do medicine but did not like my rotation. I can easily identify with the medicine residents at my teaching hospitals; I enjoyed my ophtho rotation and found it very refreshing.

Ophtho:
Pros: Great lifestyle, better compensation, clean field with little b***s*** to deal with, ability to do procedures; feel like you made a difference in people's lives
Cons: I might get bored of the eye; you don't get to use all you learned in medical school; limited to private practice unless you do academics

Internal Medicine:
Pros: Intellectually stimulating, more options for fellowship; more options to teach/consulting/hospitalist; ability to interact with other physicians
Cons: Paperwork, lack of procedures, dealing with people's BS more often, more hours and less compensation

A lot of this can be anxiety as I start applying for the ophthalmology match.

I'm sure many people in this forum went through a similar decision process.

What do people think? Thanks.

Why didn't you like your medicine rotation? I think the answer to that question may answer your question.

In terns of paperwork, I agree it sucks. Same thing goes with dealing with others' BS.

In terms of procedures, depending of what you choose to do, you could do only procedures. Many cardiologists, Gastroenterologists and Pulmonologists do only procedures, all day everyday. It is not for everyone, but some chose it.

Medicine is not for everyone. I wish we could be more helpful but the decision should be your own.

It sounds like you are still undecided, which is normal at your stage of the game. I would suggest doing more opthalmology rotations and a medicine subinternship in the next few months, along with doing a consult rotation or two in internal medicine. Maybe you could do endocrine or rheum consults, or both.

Internal medicine is a lot of dealing with bs paperwork and you do have to write a lot of notes. That is par for the course in medicine residency. I imagine it would be similar as a hospitalist. Unfortunately the paperwork seems to get worse all the time.

If you are still undecided in a few months, it might be best to apply to optho but be sure to do a medicine prelim year. That way if you change your mind about opthalmology, even during intern year, you can bail and just do internal medicine. It would be harder to make the other switch (IM to opthalmology). It tends to be very hard to interview for other fields while you are an intern in one field, and it's hard to get into competitive specialties once you've already graduated from med school.

Excellent advice.

All these things are so variable, especially since specialties in medicine can be so variable.

I would agree in general Optho pays more, although certain medicine specialties can certainly make more than Optho.

In general, there certainly is less social issues in Optho.

As far as the paperwork? I guess Optho has less, but it's not like every time an Optho sees a patient in clinic they don't have to write a note just like IM. Some of the IM notes are more complex, however. Operations may take a while and they only write one note per operation, so that may save some paperwork, but in general it's not as less as you would think. I am an academic hospitalist, and I would say on average, after I round on my patients, I spend about an hour on paperwork everyday. That's not that much. For new admissions, I spend about 30 minutes on the write up. I also believe the process will get more streamlined in the future and become much easier. When you're a student and resident, it takes a lot longer for a write up because you have to think more, but as an attending, things come automatically so the write up becomes less of a struggle.

Finally, the lifestyle factor is so variable as well. I know plenty of Opthos who work much much more than IM docs, both in academic and private practice.

I'm on an ophthal term right now and love it. I've found this thread (despite it being four years old) because I'm in a similar dilemma and love IM but am torn between the two. I've quoted this thread's old posters because perhaps they've now been through the process and can share updated advice.

Ophthal has a huge amount of internal medicine in it. The eyes relate a ton to overall health and autoimmune disease, so the array of differentials is diverse and level of problem solving high. I just want to point that out because I believe that's a really important point and am surprised no one has mentioned that above. I believe if anyone is really keen/passionate on the ophthal profession itself, then he or she should be aware of the depth of the IM, which is a huge plus.

In contrast to what some of the above people have said, I've read that if you apply into ophthal and get in, that's a binding contract (as with every other residency) and you cannot simply switch into IM at the end of an IM prelim year.

From the SF Ophthal Match:
Can I withdraw from the position I accepted through the Match?
No. By submitting a rank list, both the applicants’ choices and the program directors choices make the match result a binding commitment. Withdrawal is possible only in exceptional circumstances and requires written approval from your program director. See the full list of match rules for additional information.

That means if you get into ophthal and take an IM prelim year, you can't just withdraw from ophthal because you liked IM.

Any thoughts on that?

I was thinking of doing an IM residency followed by ophthal, because I'd want the skills/knowledge from IM beforehand. Is that not a feasible pathway? By all means, why in the world would that make someone less competitive.

 

[Instatewaiter]

All of the match is a binding contract. So the same goes for im, neuro, ortho and the rest.

Don't do two unrelated residencies. You're just wasting your time and a ****ton of money from the time you waste making resident money instead of attending money

 

[smartparts]

I did my medicine rotation at a community hospital and saw bread and butter cases. The experience and teaching was good but it did not wow me. However I thought the residents were simply pushing paper, writing notes, and letting the specialists and ancillary staff do most of the work. It's one thing to be the quarterback but another to just pass the ball off every time to the running back and never throwing the ball yourself. Then again, this could be hospital specific.

I would read more about "quaternary" care stuff in IM including ECMO, extracorporeal liver support, destination LVADs, interventional pulmonology, granulocyte transfusion, transplant ID, lung/intenstinal transplants, etc. These are the things you'll probably see and get to manage at a big academic IM program and are FAR more interesting than the stuff that walks into your average community hospital.

 

[Phloston]

All of the match is a binding contract. So the same goes for im, neuro, ortho and the rest.

Don't do two unrelated residencies. You're just wasting your time and a ****ton of money from the time you waste making resident money instead of attending money

How are they completely unrelated? There's a lot of IM in ophtho. And not sure if you're joking about money being important here.

 

[DoctwoB]

How are they completely unrelated? There's a lot of IM in ophtho. And not sure if you're joking about money being important here.

Because they are completely different. Sure in ophtho you see ocular manifestations of systemic diseases and may even be the first the catch a rare case of sarcoidosis, but think of the day to day management. Do you want to manage a patients 10 medical problems while working up a new one or do you want to focus solely on the eye, the eye exam, eye procedures, and more eyes.

Saying ophtho is like IM is like saying Urology is like Neurology because Uro deals with neurogenic bladder

 

[Phloston]

Because they are completely different. Sure in ophtho you see ocular manifestations of systemic diseases and may even be the first the catch a rare case of sarcoidosis, but think of the day to day management. Do you want to manage a patients 10 medical problems while working up a new one or do you want to focus solely on the eye, the eye exam, eye procedures, and more eyes.

Saying ophtho is like IM is like saying Urology is like Neurology because Uro deals with neurogenic bladder

I'm just pointing out the above poster's comment seemed hostile in terms of comparing IM and ophthal. And I didn't say ophtho is like IM. I said there's a lot of IM in ophthal.

 

[DoctwoB]

Not sure how I was hostile. I just disagree with your assertion.

 

[rd31]

I'm just pointing out the above poster's comment seemed hostile in terms of comparing IM and ophthal. And I didn't say ophtho is like IM. I said there's a lot of IM in ophthal.

His/her post isn't hostile. It's just common sense.

Doing 3 years of IM would be a waste of time if you're ultimately doing ophtho as a career. You'll learn all the relevant IM for ophtho in your intern year + ophtho residency. Why would you sacrifice three years of your life for something entirely unnecessary? Would an opthalmologist really benefit from knowing the precise management for HCAP, GI bleed, cellulitis, pyelo, etc.? For all practical purposes, IM and ophtho residencies are completely unrelated.

 

[bashwell]

His/her post isn't hostile. It's just common sense.

Doing 3 years of IM would be a waste of time if you're ultimately doing ophtho as a career. You'll learn all the relevant IM for ophtho in your intern year + ophtho residency. Why would you sacrifice three years of your life for something entirely unnecessary? Would an opthalmologist really benefit from knowing the precise management for HCAP, GI bleed, cellulitis, pyelo, etc.? For all practical purposes, IM and ophtho residencies are completely unrelated.

I believe Phloston is a US-IMG who is doing med school in Australia which might make it more difficult to match into ophtho straight from med school, so doing an IM residency first might help him? Although if any US-IMG can match into ophtho it's Phloston because he's an MD and PhD and has both Step 1 and 2 over 260 if I remember correctly. Personally I'd like to see Phloston make it, he seems like a cool dude.

 

[jdh71]

I'm on an ophthal term right now and love it. I've found this thread (despite it being four years old) because I'm in a similar dilemma and love IM but am torn between the two. I've quoted this thread's old posters because perhaps they've now been through the process and can share updated advice.

Ophthal has a huge amount of internal medicine in it. The eyes relate a ton to overall health and autoimmune disease, so the array of differentials is diverse and level of problem solving high. I just want to point that out because I believe that's a really important point and am surprised no one has mentioned that above. I believe if anyone is really keen/passionate on the ophthal profession itself, then he or she should be aware of the depth of the IM, which is a huge plus.

In contrast to what some of the above people have said, I've read that if you apply into ophthal and get in, that's a binding contract (as with every other residency) and you cannot simply switch into IM at the end of an IM prelim year.

From the SF Ophthal Match:
Can I withdraw from the position I accepted through the Match?
No. By submitting a rank list, both the applicants’ choices and the program directors choices make the match result a binding commitment. Withdrawal is possible only in exceptional circumstances and requires written approval from your program director. See the full list of match rules for additional information.

That means if you get into ophthal and take an IM prelim year, you can't just withdraw from ophthal because you liked IM.

Any thoughts on that?

I was thinking of doing an IM residency followed by ophthal, because I'd want the skills/knowledge from IM beforehand. Is that not a feasible pathway? By all means, why in the world would that make someone less competitive.

You won't want to do an extra residency. Plus there isn't a lot of practical overlap in practice.

 

[Gastrapathy]

Only an eye dentist would think there is a lot of IM in his specialty.

 

[stevesteve123]

I am a third year medical student deciding between ophtho and internal med. Both are good fields and I am torn. I thought I would always do medicine but did not like my rotation. I can easily identify with the medicine residents at my teaching hospitals; I enjoyed my ophtho rotation and found it very refreshing.

.

debatable...

 

[mercaptovizadeh]

I think you should do an AI in IM at a large tertiary care hospital. There, you will be able to appreciate the 1 in 20 patients that we see that have the odd, bizarre, intellectually stimulating disease. The short gut guy whose surgeon prepared his TPN and now he has a weird rash (because there's no zinc in the TPN!), the neuroborreliosis patient with spirochetes practically oozing out of her eyes, the DRESS syndrome patient, the guy with FUO that sounds like TB or cancer whose cause (in the end) is found to be a fish bone stuck in his liver with an abscess around it, etc. A community hospital bread and butter program with essentially no zebras is NOT where you should get your exposure to IM as a med student, no more than your only exposure to ophtho should be corneas but no retinas or lasik but no glaucoma surgery.

 

[mercaptovizadeh]

And, if it's a matter of "importance," I've learned that pretty much EVERYTHING except the most cosmetic of things is important. It's important that your patient not be blind. It's also important that his heart beat fine and that he not have a deadly infection improperly treated. You can help people live longer and live better in whichever specialty you end up practicing.

 

[IMreshopeful]

I'm just pointing out the above poster's comment seemed hostile in terms of comparing IM and ophthal. And I didn't say ophtho is like IM. I said there's a lot of IM in ophthal.

I don't see where you're getting that from. That's like saying diagnosing ocular fungemia is like being exposed to infectious diseases. I heavily disagree that IM and ophtho are that similar; ophtho has an incredibly narrow focus on the eye and any diseases specifically related to the eye. Sure, you'll have ocular manifestations of a lot of systemic diseases - you're still managing a tiny field. Ditto for derm.

 

[Trefoil]

Just to add to this dead thread for future students who are conflicted, I think both can be stimulating intellectually. I have found ophthalmology to have a visceral stimulation to it because you can often directly visualize the pathology and then work backwards to the cause. It is the only field of medicine that I know of that the physical exam is actually important. I think this has taught me to value the physical exam more than laboratory values. There are fields of ophthalmology that are very diagnosis oriented as has been mentioned. Uveitis and Neuro are the two big ones, but retina also has a fair amount of weird Zebras that end up being systemic diseases. You will see weird autoimmune diseases, nutritional deficiencies, weird infections, and strange neurological conditions in ophthalmology. You will not need the same understanding of physiology. If you are someone that values free time, you would likely gravitate to rheum or endo in the future anyway, which we see a lot of in Ophtho. All of our uveitis patients give us pause and force us to consider weird autoimmune etiologies. No, we do not have to manage most of these conditions, but we do make the diagnosis a fair amount of the time, which is really what I find stimulating. Now, I have seen more zebras in medicine, but that is the nature of the beast. If you do something that literally encompasses the entirety of the body, you will see more zebras, but you will often depend on consultants to manage and make these diagnoses. I find both satisfying to be honest (currently a wards intern and enjoying it despite the bs, which there is plenty). I will miss the variety, but I will not miss the ridiculous paperwork that I have to do everyday. Half of what I do as an IM intern could be done by someone with a high school education. The same is not true in ophthalmology. I'm not saying that in a pretentious sort of way. Both my parents only have a high school degree, but I think it is a poor use of your time, and it is not at all enjoyable, which is why you see like minded individuals gravitating to "lifestyle" IM fields which truly are not that different than ophthalmology in terms of scope and variety. Just my two cents though.

 

[cbrons]

It is the only field of medicine that I know of that the physical exam is actually important.

lol

 

[Instatewaiter]

Half of what I do as an IM intern could be done by someone with a high school education. The same is not true in ophthalmology. I'm not saying that in a pretentious sort of way. Both my parents only have a high school degree, but I think it is a poor use of your time, and it is not at all enjoyable, which is why you see like minded individuals gravitating to "lifestyle" IM fields which truly are not that different than ophthalmology in terms of scope and variety. Just my two cents though.

It is so good to see someone with so much experience speaking about things they know so much about. A month a half old intern... I'm guessing this has to be a joke.

 

[jdh71]

Half of what I do as an IM intern could be done by someone with a high school education.

Paper work isn't practicing internal medicine.

I'm cool with eye docs, but let us not pretend you are all something you are not. You guys are also mostly all the same handful or horse**** diagnoses per specialty like everyone else, just confined to one organ. And it's totally cool that it's all about exam and really nothing about history. What does the eye look like?? That might be the only thing that makes me particularly jealous. That and cataract surgery. Nothing much else in medicine is that "curing" - can't see?? Now you can!! But it aint life and death, and even if I grant the occasional systemic disease first found by the eye doc, you aren't going to manage it, at least not for long. In 10 years when you drive by the bad wreck instead of stopping, or won't start CPR in the park, or don't hit the stewdard button on the plane when they call for a doc we'll all know why. I don't hate you for that. I wouldn't either.

 

[Crayola227]

The only thing I can really say about optho is that your medical mission trips, if you chose to do them, would rise very far above medical voluntourism and make a big impact as far as what any one doc can do in a poor locale in a few weeks.

 

[fancymylotus]

Paper work isn't practicing internal medicine.

I'm cool with eye docs, but let us not pretend you are all something you are not. You guys are also mostly all the same handful or horse**** diagnoses per specialty like everyone else, just confined to one organ. And it's totally cool that it's all about exam and really nothing about history. What does the eye look like?? That might be the only thing that makes me particularly jealous. That and cataract surgery. Nothing much else in medicine is that "curing" - can't see?? Now you can!! But it aint life and death, and even if I grant the occasional systemic disease first found by the eye doc, you aren't going to manage it, at least not for long. In 10 years when you drive by the bad wreck instead of stopping, or won't start CPR in the park, or don't hit the stewdard button on the plane when they call for a doc we'll all know why. I don't hate you for that. I wouldn't either.

this is why i you

 

[Trefoil]

It is so good to see someone with so much experience speaking about things they know so much about. A month a half old intern... I'm guessing this has to be a joke.

Not sure why there is so much animosity. I enjoy the diagnostics, just not the crazy bs that comes with it. The social work stuff never goes away. Sometimes the social work side of things can be rewarding, but other times it can be soul crushing. These aren't solely my observations. It's actually pretty well accepted. IM is a great field, and it's what we learn for the majority of medical school. In comparison, no one gets any exposure to ophthalmology anymore. I'm just sharing my observations to help those who are stuck between the two fields. I can actually compare and contrast the two since I have exposure to both. To comments regarding there only being a handful of **** diagnoses, everything is relative. As you go down the rabbit hole, the picture changes and the nuances become clearer. It's just as outrageous to claim that you understand a field that you haven't any exposure to as one that you have 4-5 years exposure to. I would never claim to know much about IM, but as an intern, I am acutely aware of how much paperwork there is.

 

[IMreshopeful]

Not sure why there is so much animosity. I enjoy the diagnostics, just not the crazy bs that comes with it. The social work stuff never goes away. Sometimes the social work side of things can be rewarding, but other times it can be soul crushing. These aren't solely my observations. It's actually pretty well accepted. IM is a great field, and it's what we learn for the majority of medical school. In comparison, no one gets any exposure to ophthalmology anymore. I'm just sharing my observations to help those who are stuck between the two fields. I can actually compare and contrast the two since I have exposure to both. To comments regarding there only being a handful of **** diagnoses, everything is relative. As you go down the rabbit hole, the picture changes and the nuances become clearer. It's just as outrageous to claim that you understand a field that you haven't any exposure to as one that you have 4-5 years exposure to. I would never claim to know much about IM, but as an intern, I am acutely aware of how much paperwork there is.

The animosity is coming from the fact that you described the specialty as something that can be done by someone who is high school trained because you see it as a secretarial sort of of specialty. you made a broad generalization which ticked people off. Yes you were referring to the paperwork specifically, but you're going to find out in your subspecialty that paperwork is everywhere too. You've been protected from a fair amount of it more than likely so far.

 

[drfunktacular]

1) goes to web forum designated for people who practice or want to practice internal medicine

2) says internal medicine is boring and so easy anyone can do it

3) is confused when people do not appreciate this




Sent from my iPhone using Tapatalk

 

[viscera]

 

[jdh71]

Not sure why there is so much animosity. I enjoy the diagnostics, just not the crazy bs that comes with it. The social work stuff never goes away. Sometimes the social work side of things can be rewarding, but other times it can be soul crushing. These aren't solely my observations. It's actually pretty well accepted. IM is a great field, and it's what we learn for the majority of medical school. In comparison, no one gets any exposure to ophthalmology anymore. I'm just sharing my observations to help those who are stuck between the two fields. I can actually compare and contrast the two since I have exposure to both. To comments regarding there only being a handful of **** diagnoses, everything is relative. As you go down the rabbit hole, the picture changes and the nuances become clearer. It's just as outrageous to claim that you understand a field that you haven't any exposure to as one that you have 4-5 years exposure to. I would never claim to know much about IM, but as an intern, I am acutely aware of how much paperwork there is.

Every specialty has bread and butter. Do I occasionally see something weird? Yes. But Im blowing tons of smoke up your ass if I try and pretend it's not all mostly COPD, asthma, cough, unconcerning lung nodule/X-ray finding, or old ladies with the shortness.

Cataract, glaucoma, diabetic/hypertensive retinopathy, MD, and red/dry eye. Sorry mayne. You get to be boring just like the rest of us. That will be the major portion of your day to day existence if you don't specialize. And then you'll still have your handful of few diagnoses.

Don't worry I'll cue the muted trombones . . .

*wha wha whaa whaaaaaaaaaaaa*

 

[Trefoil]

The animosity is coming from the fact that you described the specialty as something that can be done by someone who is high school trained because you see it as a secretarial sort of of specialty. you made a broad generalization which ticked people off. Yes you were referring to the paperwork specifically, but you're going to find out in your subspecialty that paperwork is everywhere too. You've been protected from a fair amount of it more than likely so far.

There wasn't much broad about it. I said half of what I do as an intern could be done by someone who is high school trained. That means that the other half cannot.

For instance, prerounding and reviewing notes in the morning, reviewing labs, physical exam, coming up with a plan. That is all pretty high level stuff and very much stimulating. Love every minute of it (other than presenting).

Copying a medication list from the computer to the SNF transfer form, copying diagnoses to the SNF transfer form, getting yelled at by social work for calling LTCF a SNF, social work realizing that the LTCF was in fact a SNF and correcting me for getting it wrong, taking a urology admission for pain management (when the patient is there for lithotripsy), taking a podiatry admission (for management of blood pressure...place on home medications done), subsequently filling out 2 hours worth of discharge paperwork on the stupid surgical admissions...okay, you should get my point. That type of scut isn't even possible in Ophtho. I have been shielded from some of it, but honestly we don't deal with that stuff at all. Maybe an occasional form to fill out for work, but that isn't the norm.

We have our bread and butter cataracts, dry eye, glaucoma, age related macular degeneration, and diabetic retinopathy, but there are interesting cases too.

You will see a greater number of interesting cases on IM; however, prepare for the bs because you guys take most of it. I don't understand how that isn't a balanced opinion. I am conceding that you guys have more interesting stuff. It is no secret that you all get a bunch of stupid busy work to balance it out. That may be broad, but it has been my experience at 4 different hospitals in 3 different regions of the US. With a complete bs social admin my senior just looked at me and said "We take it. We don't argue. Don't worry. You won't have to deal with this as an ophthalmologist." Literally, a direct quote.

I still concede that IM has the best cases. I'm not saying that your job can be done by someone with a high school graduation. I'm saying that part of your job can be done with almost no thought. Please don't take offense as that is not at all my intention. Just providing information. And for Christ sake stop twisting my words to make me sound like a jack***. We just need to be adults about this.

 

[Trefoil]

Actually, before anyone responds. I can see this is going nowhere and has devolved into some all around idiofest. I am partially to blame for ruining this conversation, but so are all of you. In the future, I will be more mindful with my words in order not to insult y'all. Let's just call it a day and let this dead thread die for good. Nothing good has come of it, and there is no point in arguing. I still stand by my words, but I do think IM is a great specialty. No hard feelings.