Publication Exclusive: A question for residents — Comprehensive ophthalmology or subspecialty fellowship?

Phelan Piehota, DO, and Andrew T. Strand, DO, examine the pros and cons of going directly into practice or continuing in education.

CEDARS Debates is a monthly feature in Ocular Surgery News. CEDARS — Cornea, External Disease, and Refractive Surgery Society — is a group of cornea, cataract and refractive surgery specialists, here to discuss some of the latest hot topics in ophthalmology.

One of our missions is to promote resident education, including introducing residents to the process of speaking from the podium and contributing as authors in medical journals. This month, Dr. Phelan Piehota and Dr. Andrew Strand, residents at the Ohio University Heritage College of Osteopathic Medicine Doctors Hospital in Columbus, discuss a dilemma that all residents may face: the choice of whether to go directly into practice as a comprehensive ophthalmologist or to complete a subspecialty fellowship. We hope you enjoy the discussion.

Kenneth A. Beckman, MD, FACS, OSN CEDARS Debates Editor

A case for comprehensive ophthalmology

As one nears the end of residency, he or she comes to a crossroads that all past, present and future residents must consider. Do I subspecialize with a fellowship or enter the workforce? During my residency specialty rotations, I would find myself wondering, “Could I see myself practicing this specialty for the rest of my career?” Inevitably, the answer would be yes. So, it was easy to conclude, if all the specialties in ophthalmology appealed to me, a career in comprehensive ophthalmology is without a doubt the best fit.

Phelan Piehota

The most appealing aspect of comprehensive ophthalmology is the variety of pathology that can be seen on a daily basis. I enjoy the excitement of not knowing what will walk through the door. Pathologies ranging from macular degeneration to ptosis, from strabismus to cataract, could all be seen in one morning in a comprehensive ophthalmology practice. I will have the opportunity to diagnose and treat the whole family unit, ranging from little Timmy’s strabismus to mom’s presbyopia to grandpa’s glaucoma and cataracts. I chose medicine for the variety and mystery surrounding every diagnosis. Comprehensive ophthalmology offers variety with each new patient.

Andrew T. Strand

Comprehensive ophthalmology is inherently flexible. You could choose to practice in either a rural or urban setting. Your referral base consists of both primary care professionals as well as optometrists in the community, as opposed to specialists who rely mainly on other ophthalmologists for their patient base, which usually necessitates a more urban practice. Due to the projected shortage of comprehensive ophthalmologists by 2020, we will be in high demand in towns and cities of all sizes across the country. As reported by the American Academy of Ophthalmology, the demand will only continue to grow with baby boomers entering their twilight years and the rates of age-related eye diseases increasing with every birthday candle blown out.

Click here to read the full publication exclusive, CEDARS Debates, published in Ocular Surgery News U.S. Edition, April 25, 2015.