Dilemma: Plastics vs Ophthalmology

[DocDrakeRamoray]

There's a dilemma I'm going through. Would appreciate any advice.

I have lots of research and activities in Ophthalmology and great relationship with people in the department.

I also like Plastic surgery but don't have any research. Have done some shadowing in plastics and seems like I left good impression there.

I honestly can see myself doing either plastic or ophtalmology+fellowship

Also, I want to stay at my home institution.

Can I apply to both specialties?

I'm afraid Plastics will see opthalmology rotation on my transcipt and numerous activities in opthalmology and would think I'm not commited to Plastics.

If home programs ask, I will have to come clean and say that I applied to both specialties. This will probably kill my chances to match to home program in either specialty.

What can I do in this situation? Please help. Thank you.

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[igap]

Having a back-up to plastic surgery is a smart thing to do. You will have to be prepared to discuss this at any interview where you are asked what your plans are if you do not match plastics. This question has a high likelihood of being asked at your plastics interviews. I think the usual answer is some version of "I will do x, y, and z, and then reapply to plastics", or "I will complete a gs/ent residency and apply for the independent route".

I can only speak from my own point of view here, but if I were interviewing you and I knew that your back-up plan was ophthalmology I would eliminate you from consideration for plastics training. The two fields are incredibly different in their scope of practice, and personality,/work ethic, and so I would conclude that you have not spent enough time/energy deciding on what you really want.

 

[DocDrakeRamoray]

Having a back-up to plastic surgery is a smart thing to do. You will have to be prepared to discuss this at any interview where you are asked what your plans are if you do not match plastics. This question has a high likelihood of being asked at your plastics interviews. I think the usual answer is some version of "I will do x, y, and z, and then reapply to plastics", or "I will complete a gs/ent residency and apply for the independent route".

I can only speak from my own point of view here, but if I were interviewing you and I knew that your back-up plan was ophthalmology I would eliminate you from consideration for plastics training. The two fields are incredibly different in their scope of practice, and personality,/work ethic, and so I would conclude that you have not spent enough time/energy deciding on what you really want.

that's what I'm afraid of. Thanks for your input.

 

[droliver]

I can only speak from my own point of view here, but if I were interviewing you and I knew that your back-up plan was ophthalmology I would eliminate you from consideration for plastics training. The two fields are incredibly different in their scope of practice, and personality,/work ethic, and so I would conclude that you have not spent enough time/energy deciding on what you really want.

I'd agree. The fields are so 100% different it wouldn't really reflect the type of personality most programs would look for.

 

[Winged Scapula]

There's a dilemma I'm going through. Would appreciate any advice.

I have lots of research and activities in Ophthalmology and great relationship with people in the department.

I also like Plastic surgery but don't have any research. Have done some shadowing in plastics and seems like I left good impression there.

I honestly can see myself doing either plastic or ophtalmology+fellowship

Also, I want to stay at my home institution.

Can I apply to both specialties?

I'm afraid Plastics will see opthalmology rotation on my transcipt and numerous activities in opthalmology and would think I'm not commited to Plastics.

As you can see above, that is exactly what they will think. And as noted, the fields, skill set and type of candidate are so different that I think most would find your application less than interesting.

If home programs ask, I will have to come clean and say that I applied to both specialties. This will probably kill my chances to match to home program in either specialty.

Yep probably. You might not even need to "come clean"; they may find out anyway without even asking you. Its a small world out there, especially in these two fields.

What can I do in this situation? Please help. Thank you.

Outside of making up your mind, I think you need to apply to the different specialties (should you decide not to decide) at *different* programs. Since you wish to stay at your home program, and word gets around easily, I suggest you choose which one you will apply to at home. You will need LORs from both specialities from your home program in your file.

 

[DocDrakeRamoray]

What if I switch to plastics and don't apply to optho?

My application still will be heavy in optho and letters won't be as good.

 

[MPMD]

Thread revived! What did you end up picking?

I can see the appeal in both fields, but I agree the actual practice of each is very different. Where did you fall?

 

[tomato basil]

.

 

[OPPforlife]

Ophthalmology is microscopic...plastics is macroscopic. You could always do oculoplastics!


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[TiggidyTooth]

I love these two fields as well. What do you guys mean by "different personalities?" I found both plastic and ophtho surgeons incredibly nice, fun, personable, and well-rounded...

The 2 fields could not be more different. One is pure surgical. Big whacks, long hours. Come in early, round, post-op checks, leave late, long cases, a pager that doesn't stop going off. Remember this is plastic "surgery" with the emphasis on surgery. You are dealing with surgical problems that can be very difficult to treat which require multiple visits to the OR. Ophthalmologists don't even do a surgical internship. Hours are much better. Most of wait they do is in clinic. Floor work is at a minimum. Procedures are microscopic and deal with 1 organ. Did you like your general surgery rotation? If someone told me they like both then my opinion is they haven't fully investigated both. Surgery has to be fueled by a passion to operate because it is so demanding.

Tooth

 

[DermatoFIGHT]

The 2 fields could not be more different. One is pure surgical. Big whacks, long hours. Come in early, round, post-op checks, leave late, long cases, a pager that doesn't stop going off. Remember this is plastic "surgery" with the emphasis on surgery. You are dealing with surgical problems that can be very difficult to treat which require multiple visits to the OR. Ophthalmologists don't even do a surgical internship. Hours are much better. Most of wait they do is in clinic. Floor work is at a minimum. Procedures are microscopic and deal with 1 organ. Did you like your general surgery rotation? If someone told me they like both then my opinion is they haven't fully investigated both. Surgery has to be fueled by a passion to operate because it is so demanding.

Tooth

I disagree with you there. That comment lacks maturity and would be a typical "medical student/medical resident" comment.

Do you like blondes, brunettes, or redheads? Do you like asparagus or spinach? They are all very different but you can enjoy both.

Do you want to have a son or daughter? Both are very different and raising each is different. Will you love one more over the other? I doubt it.

Just because a field is superficially different does not mean one can like both for different aspects. I have seen people switch careers from orthopedic surgery to dermatology and other fields. Interests changes, life changes, injuries happen. When it comes down to it, you cannot objectively evaluate someone's interests because they do not match yours. I enjoyed surgery and internal medicine... how could that be possible? Perhaps the type of patient population and the satisfaction of fast results are what drives the individual.

I don't know anyone that enjoys "big whacks" when they are 50 years old unless they are running away from something in their personal life.

 

[TiggidyTooth]

I disagree with you there. That comment lacks maturity and would be a typical "medical student/medical resident" comment.

I never would have thought that my experience as have endured 4 years of General Surgery training would have lead me to be called "lacking maturity" at this stage of my career. Clearly you missed the point. Surgeons live to operate. We sacrifice immensely for our passion. Countless weddings, birthdays, time with family etc. will be given up to learn the trade. We live for the big cases. The old saying "if you see yourself doing something other than surgery than do that" has been around for a while for a reason and you won't understand until you are in it so when someone says that they like both equally than both options have not been explored properly. Most people that go into surgery that are happy feel that it's surgery or bust. A passion must fuel it. Oh, and studs do big whacks son and it's nothing like choosing between a blond or brunette.

Tooth

 

[DermatoFIGHT]

I never would have thought that my experience as have endured 4 years of General Surgery training would have lead me to be called "lacking maturity" at this stage of my career. Clearly you missed the point. Surgeons live to operate. We sacrifice immensely for our passion. Countless weddings, birthdays, time with family etc. will be given up to learn the trade. We live for the big cases. The old saying "if you see yourself doing something other than surgery than do that" has been around for a while for a reason and you won't understand until you are in it so when someone says that they like both equally than both options have not been explored properly. Most people that go into surgery that are happy feel that it's surgery or bust. A passion must fuel it. Oh, and studs do big whacks son and it's nothing like choosing between a blond or brunette.

Tooth

Nobody is discounting training you have elected to go through; however, you are equating 4 years of general surgery residency with life maturity. Yes, at 30 years old or whatever your age may be, your only experience in life is possibly college, medical school, residency. Your life maturity is severely skewed towards your own experiences and prejudices. At 30 years old, you would still be very young. The people who say "surgery or bust" are also making a life decision at a young age with limited exposure. It is almost like those med students that say "I knew I wanted to be a doctor ever since I was 10 years old". At 10 years old you don't even know what anything is to make those statements versus the idea of being a doctor. Very easy to buy into those ideas and state them.

Everyone misses birthdays and weddings (most aren't even close family anyways). All professionals, it is not unique to being a surgeon. I guess two neurosurgeons I know that just do hair restoration aren't one of the big boys anymore. Life and priorities change as you get older. When you enter practice and get paid ~$300 for appendectomy (if that) you may see your passion change very fast, but I cannot say that as I do not know you. Everyone is motivated differently. The things that draw you to surgery may in fact be different than another person operating right next to you. :-D

 

[rotarman]

Nobody is discounting training you have elected to go through; however, you are equating 4 years of general surgery residency with life maturity. Yes, at 30 years old or whatever your age may be, your only experience in life is possibly college, medical school, residency. Your life maturity is severely skewed towards your own experiences and prejudices. At 30 years old, you would still be very young. The people who say "surgery or bust" are also making a life decision at a young age with limited exposure. It is almost like those med students that say "I knew I wanted to be a doctor ever since I was 10 years old". At 10 years old you don't even know what anything is to make those statements versus the idea of being a doctor. Very easy to buy into those ideas and state them.

Everyone misses birthdays and weddings (most aren't even close family anyways). All professionals, it is not unique to being a surgeon. I guess two neurosurgeons I know that just do hair restoration aren't one of the big boys anymore. Life and priorities change as you get older. When you enter practice and get paid ~$300 for appendectomy (if that) you may see your passion change very fast, but I cannot say that as I do not know you. Everyone is motivated differently. The things that draw you to surgery may in fact be different than another person operating right next to you. :-D

This post is so refreshingly in touch with reality.

 

[TiggidyTooth]

This post is so refreshingly in touch with reality.

Actually it's not. Couldn't be the furthest thing from reality. I didn't reply to the previous post because the poster clearly has no insight into what he/she is talking about. I'm guessing he/she is somewhere early in their career IE med student with minimal exposure to surgery. First off I ain't even close to 30, most people do not work upwords of 100 hours a week ... and neurosurgeons doing hair restoration? No comment. Yes you might get paid $300 for an appy in the middle of the night so you better like what you are doing.

 

[Valadi]

I have to agree with Tiggidy. I'm a current prs resident. The hours can be brutal and cases long. It's enjoyable when you're there at 1am and everyone is very into what's going on. But why would you do that to yourself if you could equally enjoy something else that affords a better lifestyle? After the novelty wears off, I think someone who was seriously considering another specialty would regret the decision and drop out. Or worse, stick it through and have a bad attitude. That is where I assume the attendings' answers are coming from.

And yes, practice patterns change with age. But this is still real surgery, and any attending knows they may be called to come in in the dead of night because of a complication, and accepts this aspect of their life. More to the point of the original discussion, PRS patients can be complicated and sick. The accepted independent model pathways (ortho, GS, ENT, uro, neurosurg) dedicate time to teaching residents how to manage the unstable patient. I know at my program ophtho spends no time in SICU, and is generally a consult service for inpatients. Nevertheless I checked the academic websites at 3 programs (NYU, WUSTL, Hopkins). They also spend no time on trauma, SICU, or other services dealing with sick or unstable patients. Ophtho is a great field, just vastly different in training for the skill set required to be a safe and competent plastic surgeon.

 

[KN.MD]

I'm a PRS resident too. Whoever said plastics is big whacks up there is giving you an incomplete picture. We do tons of microsurgery (at least where I am). The word DIEP makes my sphincter tone increase exponentially.

Someone else above also said: OCULOPLASTICS can be the way to go if you wanna do ophtho first. Botox, ectropions, canthopexies, and blepharoplasties all day, baby.