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[insearchofwisdom]

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[AQ888]

Hi, I personally know a couple of people that have switched from IM after spending several years in private practice. It is definitely doable, the only question is if you will be willing to spend the time, energy and $ by going through residency training again.

If you really are willing to make this sacrifice, then you need to think about what you are going to do to prove your commitment to Ophthalmology. One way would be to get involved in some kind of research project (Maybe get involved in some projects involving diabetic retinopathy and use your endo connections?), present at a few conferences, make connections etc.

It all comes down to what your 'end goal' is, and what you are willing to sacrifice for it.

 

[Cornfed101]

I think I prefer a specialty where you sort of do something for the patient rather than rely on them to take medications/counsel them, etc. Also, the burnout seems lower. So the questions I have: is the grass just greener to me because I'm not in ophtho?

Ophtho has plenty of chronic conditions that are influenced by patient compliance: glaucoma, diabetic retinopathy, macular degeneration (somewhat), dry eye.

 

[Dusn]

GI seems to offer all the advantages Ophtho does and probably pays better. I think GI is what I would have tried to do if I had gone into internal medicine.

 

[Slide]

I've known a few physicians that have gone into ophthalmology after doing family medicine or another field. Very doable but at the same time, the competition for ophthalmology spots is much more fierce, especially when those said physicians applied for ophthalmology.

There are some downsides to ophthalmology as well, compared to more "cognitive" fields. Our reimbursement for procedures is constantly under the microscope for cuts, and not often there's pressure to run clinic like a mill, though I'm sure this isn't unique to ophthalmology.

There's still counseling regarding chronic conditions like diabetic retinopathy, glaucoma, etc. There are procedures and surgeries we can perform to stall and temporarily reverse things, but there's still an aspect of counseling not unlike your field. At least for me, compliance plays a huge part in whether my patient is going to do well long term or not - can't fix a retinal detachment/macular hole if the patient doesn't position, or doing a complex diabetic TRD repair doesn't do any good in the end if the patient's A1c is still > 15 for years and the patient refuses to take any responsibility.

Ophthalmology has always drawn exceptional candidates into the field that are contributing towards great things - I know I am biased, but some of the smartest physicians in general I know are ophthalmologists. I'm not exactly sure what you mean by ambition, but if you're thinking in terms of contributing to the field, while your drive would be welcome, you'll find out there are a ton of exceptional ophthalmologists doing great things for the field.

To me it really sounds like you're burned out. I would say perhaps maybe see if that is truly the case for you, and if so, perhaps addressing it may help reinvigorate your passion in endocrine. Even in our field, it's easy to get burned out in medicine.

 

[insearchofwisdom]

Thank you for your responses! This was helpful.