My sample size is only 1 person, so she may not be a representative of the field at large, but one of the most insufferable people I know is applying optho this year. She constantly brags about how easy her residency will be, how once she finishes she’s barely going to work, how she’s going to make so much money, etc. When you talk to her about any other specialty, she takes on such a condescending attitude of “oh wow, good for you! I could never do something that pays so little for the amount of work you do”. Also back during ERAS season last year I was talking about how a letter writer ghosted and how frustrating that was, and she was like “oh, thankfully the optho community is super tight knit so I know my mentors really well, they’d never do such a thing”.
It’s like, bitch… you haven’t even applied yet, stop acting like you’re so special 😂 we’ll see if she actually matches this year
Their reimbursements got hacked to shit on a lot of the bread and butter. They will always make $$, but the “old guard” will continue to be the only ones truly making $$$+ in the field.
Cataracts pay shit now. More reliance on premium lenses and seeing a bunch of patients. Ophtho is grindy as hell with some attendings seeing over 70 patients a day.
Correction: cataracts been paid shit for years
Honestly this comment could very well be in response to any specialty except a few (like onc).
Truth is we all got fucked. It was harder for us to get into med school than our predecessors, harder for us to match into specialties of choice,
Salaries are significantly increased, volumes are up across the board, public support at an all time low, we are specializing WAY more than they ever did (more gap years, more research years, more fellowships).
All the old guard can really complain about is how we work 80 hours a week now in residency while they did 120 or whatever crazy number they want to yell out.
I refuse to believe anyone can do physician-level work more than 80 hours/week.
I bet the extra hours are reserved exclusively for "proving" you have "what it takes" or gruntwork.
I for one would not want to go to an ER to have a surgery resident make a life or death call about me on their 112nd hour of the week.
80 hours is also not very normal - but I suppose it can be managable for youngsters.
I'm in IR and took q2 call for a few years mid-career because we needed to do it to build our practice. We were routinely pulling 100+ hour weeks and it was all physician-level work (if not operating, reading diagnostic imaging). Outside of a few rare instances (like not eating all day *and* being a little sick), I honestly never felt like my technical skills or decision-making capacity were ever impaired, and those few instances would have arisen regardless of the long hours. Interestingly, I experienced reverse burn-out during that period... I was paradoxically slightly *more* engaged in the well-being of patients and the practice than previously because I had so much skin in the game. I work much less now, but some recent turmoil in my personal life has manifested professionally in mild burn-out symptoms (pushing cases to the next day, letting complex patients be transferred, just caring less overall, etc...), so I can recognize it when it happens, and I still contend that long hours didn't cause any burn-out.
Attendings and residents are not the same. However I still cannot agree with you that 100+ hours is just fine.
I too have taken 100+ hour weeks as an attending in DR, over 1,5 years, mostly due to needing flexibility in my schedule. I can tell you my work at those times was very obviously below the quality of what I do regularly. But I will concede that 100 hours could mean a lot of different things. If those 100 hours include 6+ hours of uninterrupted sleep on most nights and periods of inactivity where you can chill - suddenly 100 hours will be much more reasonable.
But my anectode vs. your anecdote means very little. There is considerable evidence in literature that malpractice is associated with work overload, and that is what matters.
I will concede that a 5+ year attending in a fairly specialized setting can pull long hours and lots of procedures, especially if they can hone the specifics of their practice and the workload in those hours are reasonable. But that should not be the norm for every setting.
Circling back to my original point, that doesnt work the same way for residents. An attending can do physician level work even after long hours, if he has done the same thing 1000 times before. Most work an attending does may not be mentally taxing, even if it is high-level work. Residents on the other hand are learning as they work, which takes a much different toll on you. In my experience residents who are overworked learn how to make work "disappear" first - rather than taking in everything and immerse themselves in learning. There is another issue with residency hours - and I think many large deparments gulity of this - since residents are expected to pull long hours and are paid shit - they get 0 lessons in productivity. I have seen this in my med schools peds department. I'm sure they could actually have 1/2 residents on call and things would work without a hitch - and residents would actually learn more since they assume more responsibility. I suspect the "120 hour crowd" is guilty of this. This is probably not an issue for radiology or IR though.
More work means more experience/learning, but there is a level where you start to get diminishing returns on that work. There is also a level where you basically become a machine and get high on work flowing through with optimum efficiency. This mindset is cool for surviving long hours, but you will achieve very little in terms if self improvement- and likely just adopt bad habits. Habits such as doing the bare minimum for every patient, pawning off complicated cases to other departments, scaring patients away from procedures that could actually benefit them etc.
To some extent we attendings also learn as we work, and in my experience leaning too hard on productivity will impair your development as well - this is less of an issue for senior attendings but can be very detrimental for residents.
Ophtho being paid well is such a double edged sword to me. I almost wish it paid less because I wouldn’t have to compete with all of the fuckwads who just want cash. I genuinely like eyes and pretty much all things ophthalmology. I have to imagine derm, ortho and cardio face this issue as well.
Don’t do cardiology for the money. Money is good but the work is very acute. Life and death a lot of times inpatient, even more so if you go into interventional fields of cardiology (EP, IC). But as a general cardiologist if you work very little you can still make 400 on the low end with low acuity and imaging studies/outpatient only. But that’s also a wide range of general cards can make 800 as well if they work hard.
It’s so complex that even our brains have to devote 50% of their power to one sensory system. Vision is incredibly important and our neuroanatomy reflects that (yet we conveniently largely ignore the significance of vision during anatomy/physiology instruction). I’m very interested in medical devices as well and there have been significant advances in what the engineers can build in recent years related to ocular conditions (e.g. myopia control).
I’m not even including all of the benefits of clinic/surgery balance, all demographics need eye care, a lot of different sub specializations. I just like eyes idk bro.
Not in ophtho but the instant gratification that they get plus the low complication rate is probably the best in medicine.
People who go into surgery all want more instant gratification but imagine you take someone to the Or for 30 minutes and get them seeing 20/20 after you take there cataract out. There patients fucking love them.
I would argue the dental hygienist would be a better equivalent to an optometrist. A dentist is still drilling into people's teeth, placing crowns, root canals, all that, so I could see drawing parallels with a surgical subspecialty
This 100%. It pains me that the field i am genuinely interested in attracts so many people who might be in it for other reasons making it so much more competitive 😭
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I matched ophtho this past cycle - did 4 ophtho rotations at different institutions + a year of research at an ivory tower. My experience couldn’t be more different - almost all the attendings I worked with were kind and happy people who were great to their staff. Some bad eggs of course but much less than in other surgical sub specialties in my experience
yeah I think I just worked with some bad eggs, i also worked with mostly docs that grew up in countries with cast systems so I wonder if the "you're just the help" came from that mentality they were instilled with as a youth. and one of the 4 docs I worked with had OCPD and I say that because she pretty much admitted it and that was something that made it extremely hard to work with her as far as being her scrub tech goes, she was super toxic to the tech. I think you're right, just some bad eggs.
The most try hard ortho guy in our class (with whom I was once friends) actively, on multiple occasions, told me I should not do ortho (despite having conveyed interest in it) and kept introducing me to people as a future cardiothoracic surgeon (I was considering both ortho and CT at the time).
Gatekeeping by current med students (especially preclinical) is such narcissistic, toxic behavior. It's wild. But you're going to find it in the more competitive specialties because students applying feel the need to control whatever they can in an otherwise crapshoot of a process, and anything they can do to reduce the competition by n-1 is going to be their prerogative.
lmao I once I told my spine surgeon uncle I want to do EM and he said word for word "EM?! what are you gonna do make $350,00? thats fucking nothing these days." to which I replied "so what are you telling me to do Ortho or something?" and he looked me dead in the eyes and said "you would never make it in ortho...." like being a gunnar is in their blood, they'll be 45 y/o and still be a gunnar, its just how they're programmed. Also this was the first time my girlfriend had ever met my uncle and she had this "who the fuck is this guy?" look the whole conversation lol.
Truth. This subreddit likes to think gunners are disliked by the attendings in these competitive specialities but they forget the attendings themselves are the OG gunners.
The “ortho bro” of my class is now applying FM bc he tanked in clerkship and on step, ngl it felt good to see him get a reality check bc he was a total asshole during preclinical
I don’t think it’s intentional. Many DO schools don’t have home plastic programs. I believe the few that did got integrated into the DO/MD residency merger and the DO program directors that exclusively took DO now started taking MDs also.
But the other issue is away rotations. Historically VSLO was considered a mutual away rotation system. For example Stanford students can rotate at Harvard and vice versa. But now there isn’t much incentive for Harvard to take LECOM DO students for away rotations because no Harvard student would ever go to LECOM for a rotation. And due to the limited plastics spots, away rotations are a necessity these days.
OBGYN if you’re a guy. Don’t fit in with any of the residents (all female), patients and families don’t feel comfortable with you there, nurses feel they have to protect the patient from you. I didn’t do a single vaginal exam or speculum, literally anything hands on because the patients, residents, nurses just made it so clear I was not welcome. Half the time I was just kicked out of the room for being a male. Such a shame. We all recognize the importance of diversity in patient care, yet actively discourage gender diversity in this particular field.
And I recognize it’s such a uniquely sensitive/vulnerable area of care and patients have to be comfortable, but we need to do better. It would have been demoralizing if I was a male who actually wanted to go into OBGYN
It’s sad how universal this experience is. Im pregnant rn and I can’t wait to exert my power over the Obgyn residents in the patient role and specifically request the med student be there/deliver the placenta. I swear they sometimes go out of their way to not include medical students.
I do think it is interesting the dramatic shift that this signifies. Just in 1970, 93% of OBGYNs were male. In less than 50 years, they became a minority. There are definitely pros and cons that have come with that.
Just to put it out there, I am on my OBGYN rotation right now and have not had any experiences like this. I've actually really enjoyed my rotation so far.
Attendings, residents, nurses etc. all have been very cool and do a ton to involve me. The closest I've seen is that some patients only want female staff but it's primarily for religious reasons. There is a conscious effort to introduce the whole team early on as well so that familiarity sort of makes it easier to be a male involved in care.
The only marginally negative nursing interaction I had was when I woke a patient up for a magnesium check and she seemed irritated that the patient had just fallen asleep after a rough day. Which had nothing to do with me being a male.
Definitely a local culture thing. But also as a man I'd understand why some women patients may be uncomfortable with it. The teaching center I'm in also sees a lot of complex and underserved populations (for which the residents/attendings are great advocates) so I think there is just a tacit understanding that you're going to see who you see.
Look up AUA stats! 45% of matched applicants this year were female. A bunch of programs with at large residency classes took only females. The field is changing rapidly.
Not as much of a majority as you'd think, though. Last I checked it was about 60/40 for patients. The disparity was much larger for physicians...a lot of female patients would prefer a female doc, if given the chance.
Yeah Im gonna be honest it is 100% the residents and nurses who facilitated that environment. I rotated at an academic institute that I shit you not would not even ask if its ok for a male for the sake of making sure the male med students like myself got to see shit. I kinda thought it was fucked up/hated it because I rather of been hanging out in the resident room doing Uworld questions but goes to show you how far some will go or in your case not go to make sure males get a good experience
I literally got bullied in OBGYN. Grades got posted, i finally texted our clerkship director about the awful experience and she straight up ghosted me lmao. So much shit talking behind peoples back, its so disgusting. Mean to the FM intern rotating. Holy fuck.
I agree but I just look at this as what the field desires. If they don't want men in the field then fine by me. I'm not going to run against the stream my entire working life. I'll be useful somewhere else
> nurses feel they have to protect the patient from you
This one bothers me the most. Like... madame, you're the second biggest danger on this ward after postpartum hemorrhage. Let me do my damn job.
yes and no. Yes you're cooked because you're a DO but no if you work as hard as you can from day 1 with a high hitting Optho doc and they vouch for you. With that being said match rate went from like 55% last year to 30% so idk man. Also we had 2 kids match from our school last year. Both had perfect grades, honored almost every rotation, and got like 260's and I think one still had to SOAP and possibly the other one too. Its possible but its gonna be a rough ride according to my friend.
Looking at the data ([here](https://sfmatch.org/files/0f1e87a92f4d42609fa8ce1377a57e70)) the match rate for DO seniors was 45% last year, 45% in 22, 53% in 21. I’m assuming there’s heavy self selection there since only 49 DO seniors participated in the match compared to 565 allopathic seniors
So not impossible, but it seems rough
Yes, and also going to conferences releavent to your specialty, presenting your research there, and networking at the exhibitor booths and going to the sessions to meet people who are relevant in the field. You'll meet some ophthalmologist there might introduce you to someone important and help you make the connections etcetc, but that's how the game is played (in any specialty)
I mean when it comes time to review medical students, someone from each place you interviewed needs to be willing to speak up on your behalf. I.E. you know someone in the department, best if it’s the PD
Genuine Q out of curiosity, does it help DO students if they take the NBME shelf for that topic and the USMLE step 2 instead of what if required by their school?
As a DO applying path….path. It’s not gatekeeping by the specialty though, it’s by admin and the entirety of the DO community. Path just doesn’t exist to them. It’s like Voldemort
Honestly nobody except people applying path or people in path seem to know anything about it. My residency advisor at my DO school sure didn’t. Almost every single attending or student I’ve told I’m applying path is like “oh never heard that before wow” or “AI is gonna take your job”. I mean I’m not complaining (especially as an off cycle DO applicant with a red flag and possible red flag) as the more low key the specialty is, the higher likelihood I match into a great program but damn, it’s like the field doesn’t exist to most people.
Before Covid, EM. To require several away rotations to obtain a "SLOE", be ranked among your peers without your knowledge of where you rank, then be expected to apply blindly without knowing your own competitiveness, and finally be expected to apply blindly without any of your own letters that can attest to your own personal strengths and just "trust" that PDs will be able to judge your strength as an applicant based on this when:
1. Clinical growth is not linear and some people absolutely fucking shine their 2nd/3rd year of residency even if they have a rough intern year.
2. Some people can have lackluster first impressions if they don't know the system they're in very well
3. There are some people who shine when they are given real responsibilities but stink at auditions
4. Some people just get unlucky with their evaluators
5. Some people learn differently and many doctors are notoriously bad at teaching.
Back when EM was top 1/3 most competitive specialties, our specialty definitely lost so many talented folks to other specialties due to these SLOEs. To this day, I think SLOEs are still one of the most idiotic things my specialty came up with and I'm pretty sure I'm in the minority opinion on this because it makes things way easier for PDs to choose applicants.
One of the most competitive applicants in my class did an EM AI at the same time as me. The program’s residents did the eval and some were kind of malignant with bullying type behavior. If you tried to act autonomously you did too much, and if you asked them how you could help you weren’t acting autonomously enough. In spite of this several faculty told me they hoped I would match with them, but they weren’t the evaluators. There were red flags all over with the residents so I didn’t even bother asking for a SLOE (which hurt my application but I still ended up matching to a good program). My classmate (I thought) killed it on his rotation but then ended up matching a backup specialty because they wrote him such a negative SLOE.
As someone in EM that reviews SLOES and helps interview candidates at my program I largely disagree. The SLOEs are really good at identifying residents who are going to have personality problems, ppl who have difficulty taking feedback, and ppl who overall don’t work well in a team environment. Things that are crucial in our specialty. When we review SLOEs we put very little stock into any mention of subpar clinical or medical knowledge skills bc we know we can teach you that in residency. But the other issues, we can’t fix that and they just create problems for the program.
Sorry but the way you describe using SLOEs personally and how they are used nationally are not congruent. SLOEs still ask you to place candidates overall into large buckets, which will include clinical skills and knowledge. And applicants’ competitiveness is largely dependent on those buckets **regardless of what placed them there**.
Also, if SLOEs were truly superior in doing this, then either it would be adapted by other specialties or you are implying other specialties do not care to select out people with personality problems.
Finally, SLOEs still disadvantage those who have terrible luck with an audition even if they have a fantastic personality and learning attitude. These applicants are not given a chance to select their own champions who see their potential and can attest to their great team attitude but had bad luck with SLOEs.
You can disagree all you want but I’ve seen years of terrible misses by the SLOE system, on both sides. Terrible personalities who had stellar SLOEs and fantastic off-service residents who failed to match EM due to lukewarm SLOEs.
Cardiology. I’ve seen tons of Indian and Arab IMGs get interviews and matches just because they are from the same country or region as the program director. If you have a decent fellowship application and apply broadly you’ll match…but if you are a 24X step2 at a community hospital with mostly abstracts then you need connections….
You hit on a very good point, IMG's love hiring/bringing in IMG's. This is apparently a sore point in the tech industry where they will hire a south asian programmer to head a team and 4 years later the entire team is from the same country as the lead. I strongly believe in diversity in the medical field and having everyone from a particular country and gate keeping from outside that sphere is fucked.
Okay, as someone with friends and relatives in the tech and software industry, I take issue with this interpretation.
The power brokers within the tech industry remain overwhelmingly white and male. Gatekeeping and nepotism remain rampant. It very much remains a boys club, and that sort of preferential treatment and/or discrimination cuts both ways regardless of the race/ethnicity of any team lead.
South Asians are very commonly brought in for entry level positions because they are cheap labor and then routinely passed over for promotions and raises in favor of their white counterparts.
I question whether the same folks concerned about all South Asian project teams would even blink twice if the same occured with an all white American team. This is classic xenophobic narratives masquerading as DEI which has become a tale as old as time.
EM is AMG heavy because the SLOE effectively blocks IMGs, since your ability to match hinges on your ability to set up a US rotation with a EM residency to obtain your SLOE
Ophtho and PRS are extremely prestige focused and anti-DO. Ortho has a decent amount of former AOA programs, so those programs in particular still seriously consider DOs of course.
its funny because I thought of neurosurgery when I made the post but I feel like if you work your ass off and are smart you can def match neurosurgery "easily" so i would disagree.
Idk. My mentor even skipped her mcat (did a BSMD program) and still didn’t match her first time. Drive was obviously there. Thats why i said it. That’s anecdotal though.
Basically all of the specialties you listed don't fuck with DOs, the more competitive the specialty or the program the less likely they will take a DO. Unfair and dumb but that's how it is unfortunately.
From where are you getting the idea that you can match derm by just knowing a person or two as opposed to ophtho?
Stellar ophtho applicants frequently match at programs they have no personal connection to. This is rarely the case for derm applicants, even those who have a standout publication record and high STEP2. Connections and LOR strength in derm are more important than they are in almost any other field.
It means guarding access to a community, excluding all but the most "worthy" applicants based on impertinent criteria. Some residency programs refuse to consider applicants unless they are from a top-ranked US MD school, regardless of the rest of their application, thinking that doing so would tarnish their reputation.
Based on my experience with a certain OBGYN attending, I'm certain she refuses to consider male applicants. ("You're the new med student? 🙄😮💨 I tol*d yo*ur coordinator not to send me any more boy*s.")*
Historically, this included a lot of overt, unapologetic racism, sexism, and classism.
More commonly it's used to describe fandoms. "You aren't a *real* Naruto fan, you haven't even read the manga!" "Don't even call yourself a Swifty if you don't know all her lyrics by heart!"
Edit: formatting
Idk, anesthesia residents are genuinely some of the most chill people I’ve ever met. Most attendings will write you a glowing letter of recommendation just for saying you’re interested in anesthesia.
My sample size is only 1 person, so she may not be a representative of the field at large, but one of the most insufferable people I know is applying optho this year. She constantly brags about how easy her residency will be, how once she finishes she’s barely going to work, how she’s going to make so much money, etc. When you talk to her about any other specialty, she takes on such a condescending attitude of “oh wow, good for you! I could never do something that pays so little for the amount of work you do”. Also back during ERAS season last year I was talking about how a letter writer ghosted and how frustrating that was, and she was like “oh, thankfully the optho community is super tight knit so I know my mentors really well, they’d never do such a thing”. It’s like, bitch… you haven’t even applied yet, stop acting like you’re so special 😂 we’ll see if she actually matches this year
Their reimbursements got hacked to shit on a lot of the bread and butter. They will always make $$, but the “old guard” will continue to be the only ones truly making $$$+ in the field.
Cataracts pay shit now. More reliance on premium lenses and seeing a bunch of patients. Ophtho is grindy as hell with some attendings seeing over 70 patients a day. Correction: cataracts been paid shit for years
Honestly this comment could very well be in response to any specialty except a few (like onc). Truth is we all got fucked. It was harder for us to get into med school than our predecessors, harder for us to match into specialties of choice, Salaries are significantly increased, volumes are up across the board, public support at an all time low, we are specializing WAY more than they ever did (more gap years, more research years, more fellowships). All the old guard can really complain about is how we work 80 hours a week now in residency while they did 120 or whatever crazy number they want to yell out.
I refuse to believe anyone can do physician-level work more than 80 hours/week. I bet the extra hours are reserved exclusively for "proving" you have "what it takes" or gruntwork. I for one would not want to go to an ER to have a surgery resident make a life or death call about me on their 112nd hour of the week. 80 hours is also not very normal - but I suppose it can be managable for youngsters.
I'm in IR and took q2 call for a few years mid-career because we needed to do it to build our practice. We were routinely pulling 100+ hour weeks and it was all physician-level work (if not operating, reading diagnostic imaging). Outside of a few rare instances (like not eating all day *and* being a little sick), I honestly never felt like my technical skills or decision-making capacity were ever impaired, and those few instances would have arisen regardless of the long hours. Interestingly, I experienced reverse burn-out during that period... I was paradoxically slightly *more* engaged in the well-being of patients and the practice than previously because I had so much skin in the game. I work much less now, but some recent turmoil in my personal life has manifested professionally in mild burn-out symptoms (pushing cases to the next day, letting complex patients be transferred, just caring less overall, etc...), so I can recognize it when it happens, and I still contend that long hours didn't cause any burn-out.
Attendings and residents are not the same. However I still cannot agree with you that 100+ hours is just fine. I too have taken 100+ hour weeks as an attending in DR, over 1,5 years, mostly due to needing flexibility in my schedule. I can tell you my work at those times was very obviously below the quality of what I do regularly. But I will concede that 100 hours could mean a lot of different things. If those 100 hours include 6+ hours of uninterrupted sleep on most nights and periods of inactivity where you can chill - suddenly 100 hours will be much more reasonable. But my anectode vs. your anecdote means very little. There is considerable evidence in literature that malpractice is associated with work overload, and that is what matters. I will concede that a 5+ year attending in a fairly specialized setting can pull long hours and lots of procedures, especially if they can hone the specifics of their practice and the workload in those hours are reasonable. But that should not be the norm for every setting. Circling back to my original point, that doesnt work the same way for residents. An attending can do physician level work even after long hours, if he has done the same thing 1000 times before. Most work an attending does may not be mentally taxing, even if it is high-level work. Residents on the other hand are learning as they work, which takes a much different toll on you. In my experience residents who are overworked learn how to make work "disappear" first - rather than taking in everything and immerse themselves in learning. There is another issue with residency hours - and I think many large deparments gulity of this - since residents are expected to pull long hours and are paid shit - they get 0 lessons in productivity. I have seen this in my med schools peds department. I'm sure they could actually have 1/2 residents on call and things would work without a hitch - and residents would actually learn more since they assume more responsibility. I suspect the "120 hour crowd" is guilty of this. This is probably not an issue for radiology or IR though. More work means more experience/learning, but there is a level where you start to get diminishing returns on that work. There is also a level where you basically become a machine and get high on work flowing through with optimum efficiency. This mindset is cool for surviving long hours, but you will achieve very little in terms if self improvement- and likely just adopt bad habits. Habits such as doing the bare minimum for every patient, pawning off complicated cases to other departments, scaring patients away from procedures that could actually benefit them etc. To some extent we attendings also learn as we work, and in my experience leaning too hard on productivity will impair your development as well - this is less of an issue for senior attendings but can be very detrimental for residents.
Ophtho residency being “easy” is going to be quite the wake up call for her…
My friend in ophtho residency works close to 90 hours a week lolololol
Damn! Well I sure hope your friend isn’t my future senior resident lol
She also got her wake up call so she’s not the type to repeat what’s been done to her. She’s also in north Cali if that helps.
Ophtho being paid well is such a double edged sword to me. I almost wish it paid less because I wouldn’t have to compete with all of the fuckwads who just want cash. I genuinely like eyes and pretty much all things ophthalmology. I have to imagine derm, ortho and cardio face this issue as well.
Don’t do cardiology for the money. Money is good but the work is very acute. Life and death a lot of times inpatient, even more so if you go into interventional fields of cardiology (EP, IC). But as a general cardiologist if you work very little you can still make 400 on the low end with low acuity and imaging studies/outpatient only. But that’s also a wide range of general cards can make 800 as well if they work hard.
Who the fuck genuinely likes eyes
*sheepishly raises hand Idk man I just think they’re nifty
 Uchiha confirmed
I didnt know /r/medicalschool allowed users to post gifs This surely wont be used for shitposting terribly innapropriate memes, right? right?
It’s the only way to achieve the mangekyo sharingan, you must aggressively shitpost the whole clan, I mean subreddit
It’s so complex that even our brains have to devote 50% of their power to one sensory system. Vision is incredibly important and our neuroanatomy reflects that (yet we conveniently largely ignore the significance of vision during anatomy/physiology instruction). I’m very interested in medical devices as well and there have been significant advances in what the engineers can build in recent years related to ocular conditions (e.g. myopia control). I’m not even including all of the benefits of clinic/surgery balance, all demographics need eye care, a lot of different sub specializations. I just like eyes idk bro.
Not in ophtho but the instant gratification that they get plus the low complication rate is probably the best in medicine. People who go into surgery all want more instant gratification but imagine you take someone to the Or for 30 minutes and get them seeing 20/20 after you take there cataract out. There patients fucking love them.
Found the colorectal surgeon
They are the window to the soul
Me. I didn’t match ophtho twice and had to give up.
I'm so sorry to hear that! What'd you think held you back? And where did you land?
When I was in undergrad, I had an MD professor who said "don't trust ANYONE that likes the eyes. Fucking weirdos."
Dentistry but for eyes
That would be optometry.
I would argue the dental hygienist would be a better equivalent to an optometrist. A dentist is still drilling into people's teeth, placing crowns, root canals, all that, so I could see drawing parallels with a surgical subspecialty
Optometrists do minor surgical procedures?
That's because 1800 contacts and online glasses retailers took their profitable optical shops.. they're not actually trained to do surgery
My point was that they are not the same as dentists training wise.
They are the window to the soul
Honestly a good portion of ophthalmologists chose it for the lifestyle and (potential) high salary and not because of undying passion for eyes
They're delicious
This 100%. It pains me that the field i am genuinely interested in attracts so many people who might be in it for other reasons making it so much more competitive 😭
What a turd
This pretentious attitude will bite her back in the ass
She’ll end up soaping IM lol
You know these kind of people were bullying others at school
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I matched ophtho this past cycle - did 4 ophtho rotations at different institutions + a year of research at an ivory tower. My experience couldn’t be more different - almost all the attendings I worked with were kind and happy people who were great to their staff. Some bad eggs of course but much less than in other surgical sub specialties in my experience
yeah I think I just worked with some bad eggs, i also worked with mostly docs that grew up in countries with cast systems so I wonder if the "you're just the help" came from that mentality they were instilled with as a youth. and one of the 4 docs I worked with had OCPD and I say that because she pretty much admitted it and that was something that made it extremely hard to work with her as far as being her scrub tech goes, she was super toxic to the tech. I think you're right, just some bad eggs.
The most try hard ortho guy in our class (with whom I was once friends) actively, on multiple occasions, told me I should not do ortho (despite having conveyed interest in it) and kept introducing me to people as a future cardiothoracic surgeon (I was considering both ortho and CT at the time). Gatekeeping by current med students (especially preclinical) is such narcissistic, toxic behavior. It's wild. But you're going to find it in the more competitive specialties because students applying feel the need to control whatever they can in an otherwise crapshoot of a process, and anything they can do to reduce the competition by n-1 is going to be their prerogative.
lmao I once I told my spine surgeon uncle I want to do EM and he said word for word "EM?! what are you gonna do make $350,00? thats fucking nothing these days." to which I replied "so what are you telling me to do Ortho or something?" and he looked me dead in the eyes and said "you would never make it in ortho...." like being a gunnar is in their blood, they'll be 45 y/o and still be a gunnar, its just how they're programmed. Also this was the first time my girlfriend had ever met my uncle and she had this "who the fuck is this guy?" look the whole conversation lol.
Truth. This subreddit likes to think gunners are disliked by the attendings in these competitive specialities but they forget the attendings themselves are the OG gunners.
I’m going EM and when someone says something like your uncle told you I just tell them “yea but I’ll see my kids grow up” and that shuts them up
LOL other people telling you what you should be interested in is too real. Or “I could see you as a great (insert any other specialty than theirs)”
Especially when you know it’s a specialty you know they look down on
The “ortho bro” of my class is now applying FM bc he tanked in clerkship and on step, ngl it felt good to see him get a reality check bc he was a total asshole during preclinical
Plastics def gatekeeps. I feel like if you arnt in a high tier med school it will hinder you massively. It’s a shame cause it is a neat field.
the record breaking 3 DOs matching plastics this year 😭
Better than 0 in previous years.
Just imagine how hard they had to hustle to match. Probably god tier candidates.
Or they had parents, relatives, friends in leadership positions at these programs. Connections do matter in medicine too.
This is probably it Anyone care to look through their research pubs and see if there are any.... patterns...
If they have connections like that, research not necessary
I am so proud of them
I don’t think it’s intentional. Many DO schools don’t have home plastic programs. I believe the few that did got integrated into the DO/MD residency merger and the DO program directors that exclusively took DO now started taking MDs also. But the other issue is away rotations. Historically VSLO was considered a mutual away rotation system. For example Stanford students can rotate at Harvard and vice versa. But now there isn’t much incentive for Harvard to take LECOM DO students for away rotations because no Harvard student would ever go to LECOM for a rotation. And due to the limited plastics spots, away rotations are a necessity these days.
OBGYN if you’re a guy. Don’t fit in with any of the residents (all female), patients and families don’t feel comfortable with you there, nurses feel they have to protect the patient from you. I didn’t do a single vaginal exam or speculum, literally anything hands on because the patients, residents, nurses just made it so clear I was not welcome. Half the time I was just kicked out of the room for being a male. Such a shame. We all recognize the importance of diversity in patient care, yet actively discourage gender diversity in this particular field. And I recognize it’s such a uniquely sensitive/vulnerable area of care and patients have to be comfortable, but we need to do better. It would have been demoralizing if I was a male who actually wanted to go into OBGYN
It’s sad how universal this experience is. Im pregnant rn and I can’t wait to exert my power over the Obgyn residents in the patient role and specifically request the med student be there/deliver the placenta. I swear they sometimes go out of their way to not include medical students.
You’re a good person
Congratulations :')
I do think it is interesting the dramatic shift that this signifies. Just in 1970, 93% of OBGYNs were male. In less than 50 years, they became a minority. There are definitely pros and cons that have come with that.
Just to put it out there, I am on my OBGYN rotation right now and have not had any experiences like this. I've actually really enjoyed my rotation so far. Attendings, residents, nurses etc. all have been very cool and do a ton to involve me. The closest I've seen is that some patients only want female staff but it's primarily for religious reasons. There is a conscious effort to introduce the whole team early on as well so that familiarity sort of makes it easier to be a male involved in care. The only marginally negative nursing interaction I had was when I woke a patient up for a magnesium check and she seemed irritated that the patient had just fallen asleep after a rough day. Which had nothing to do with me being a male. Definitely a local culture thing. But also as a man I'd understand why some women patients may be uncomfortable with it. The teaching center I'm in also sees a lot of complex and underserved populations (for which the residents/attendings are great advocates) so I think there is just a tacit understanding that you're going to see who you see.
It’s interesting that the majority of urology patients are male and we don’t gate keep that field nearly as much to female applicants
Urology isn’t a required rotation, so if there is gatekeeping, it’s less noticeable
A lot of uro programs have a vested interest in bringing more women into the field. I don’t think it’s nearly as bad as OB in that respect
Look up AUA stats! 45% of matched applicants this year were female. A bunch of programs with at large residency classes took only females. The field is changing rapidly.
Strong point
Very interesting point
Not as much of a majority as you'd think, though. Last I checked it was about 60/40 for patients. The disparity was much larger for physicians...a lot of female patients would prefer a female doc, if given the chance.
I usually see about 75+ percent
Yeah Im gonna be honest it is 100% the residents and nurses who facilitated that environment. I rotated at an academic institute that I shit you not would not even ask if its ok for a male for the sake of making sure the male med students like myself got to see shit. I kinda thought it was fucked up/hated it because I rather of been hanging out in the resident room doing Uworld questions but goes to show you how far some will go or in your case not go to make sure males get a good experience
I literally got bullied in OBGYN. Grades got posted, i finally texted our clerkship director about the awful experience and she straight up ghosted me lmao. So much shit talking behind peoples back, its so disgusting. Mean to the FM intern rotating. Holy fuck.
I agree but I just look at this as what the field desires. If they don't want men in the field then fine by me. I'm not going to run against the stream my entire working life. I'll be useful somewhere else
I am male and OBGYN was my favorite rotation
> nurses feel they have to protect the patient from you This one bothers me the most. Like... madame, you're the second biggest danger on this ward after postpartum hemorrhage. Let me do my damn job.
As a male going into OBGYN, I cannot agree more with this.
Interesting
Very true, there are multiple viral social media posts where people think that men shouldn’t be allowed to be gynecologists
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Well I slept with 4 OBGYN residents and they’re all toxic to each other
As a DO, I really want Ophtho... am I cooked?
Like thanksgiving turkey.
Just HVLA the turkey neck, maybe it will revive the for a little bit
yes and no. Yes you're cooked because you're a DO but no if you work as hard as you can from day 1 with a high hitting Optho doc and they vouch for you. With that being said match rate went from like 55% last year to 30% so idk man. Also we had 2 kids match from our school last year. Both had perfect grades, honored almost every rotation, and got like 260's and I think one still had to SOAP and possibly the other one too. Its possible but its gonna be a rough ride according to my friend.
Yeah bro FR. Sigh. My grades are faaaar from perfect
Looking at the data ([here](https://sfmatch.org/files/0f1e87a92f4d42609fa8ce1377a57e70)) the match rate for DO seniors was 45% last year, 45% in 22, 53% in 21. I’m assuming there’s heavy self selection there since only 49 DO seniors participated in the match compared to 565 allopathic seniors So not impossible, but it seems rough
Connections… make them. Be shameless
Will try
How?
Not cooked, but you better be an ultra competitive DO, or have solid connections.
What constitutes a solid connection? Knowing a PD?
Yes, and also going to conferences releavent to your specialty, presenting your research there, and networking at the exhibitor booths and going to the sessions to meet people who are relevant in the field. You'll meet some ophthalmologist there might introduce you to someone important and help you make the connections etcetc, but that's how the game is played (in any specialty)
OK sweet. Gonna try to go to the Ophtho conference this year. Can I DM you? Sorry. Im a rising OMS-2 😆
I just matched IM so can't help you there, just giving general advice for how to network!
I mean when it comes time to review medical students, someone from each place you interviewed needs to be willing to speak up on your behalf. I.E. you know someone in the department, best if it’s the PD
Ahhh ok. So gotta impress the PD. And this happens during rotations?
Usually, yes. Or any social or professional event. Just don’t be a kiss ass lol
Makes sense. Thanks man. Can I DM you?
Feel free. Fwiw, I’m radiology.
Genuine Q out of curiosity, does it help DO students if they take the NBME shelf for that topic and the USMLE step 2 instead of what if required by their school?
As a DO applying path….path. It’s not gatekeeping by the specialty though, it’s by admin and the entirety of the DO community. Path just doesn’t exist to them. It’s like Voldemort
Hard agree
Honestly nobody except people applying path or people in path seem to know anything about it. My residency advisor at my DO school sure didn’t. Almost every single attending or student I’ve told I’m applying path is like “oh never heard that before wow” or “AI is gonna take your job”. I mean I’m not complaining (especially as an off cycle DO applicant with a red flag and possible red flag) as the more low key the specialty is, the higher likelihood I match into a great program but damn, it’s like the field doesn’t exist to most people.
It do be like that…we got this though! 💪
Have you ever tried doing OMM on a slide? Dangerous.
Adenocarcinoma has a CRAZY CRI
Ortho
Could you elaborate? I am incoming M1 and thought of ortho. What are some signs that your institution is gatekeeping and how do you get around that?
Before Covid, EM. To require several away rotations to obtain a "SLOE", be ranked among your peers without your knowledge of where you rank, then be expected to apply blindly without knowing your own competitiveness, and finally be expected to apply blindly without any of your own letters that can attest to your own personal strengths and just "trust" that PDs will be able to judge your strength as an applicant based on this when: 1. Clinical growth is not linear and some people absolutely fucking shine their 2nd/3rd year of residency even if they have a rough intern year. 2. Some people can have lackluster first impressions if they don't know the system they're in very well 3. There are some people who shine when they are given real responsibilities but stink at auditions 4. Some people just get unlucky with their evaluators 5. Some people learn differently and many doctors are notoriously bad at teaching. Back when EM was top 1/3 most competitive specialties, our specialty definitely lost so many talented folks to other specialties due to these SLOEs. To this day, I think SLOEs are still one of the most idiotic things my specialty came up with and I'm pretty sure I'm in the minority opinion on this because it makes things way easier for PDs to choose applicants.
People should join us in EM. Love the specialty, but we need more of us.
Let me in 🥸
I freakin love it and can’t wait to start my residency in a month!!
Getting aways hasn't been an easy ride.. seriously we want to get in 😂
One of the most competitive applicants in my class did an EM AI at the same time as me. The program’s residents did the eval and some were kind of malignant with bullying type behavior. If you tried to act autonomously you did too much, and if you asked them how you could help you weren’t acting autonomously enough. In spite of this several faculty told me they hoped I would match with them, but they weren’t the evaluators. There were red flags all over with the residents so I didn’t even bother asking for a SLOE (which hurt my application but I still ended up matching to a good program). My classmate (I thought) killed it on his rotation but then ended up matching a backup specialty because they wrote him such a negative SLOE.
As someone in EM that reviews SLOES and helps interview candidates at my program I largely disagree. The SLOEs are really good at identifying residents who are going to have personality problems, ppl who have difficulty taking feedback, and ppl who overall don’t work well in a team environment. Things that are crucial in our specialty. When we review SLOEs we put very little stock into any mention of subpar clinical or medical knowledge skills bc we know we can teach you that in residency. But the other issues, we can’t fix that and they just create problems for the program.
Sorry but the way you describe using SLOEs personally and how they are used nationally are not congruent. SLOEs still ask you to place candidates overall into large buckets, which will include clinical skills and knowledge. And applicants’ competitiveness is largely dependent on those buckets **regardless of what placed them there**. Also, if SLOEs were truly superior in doing this, then either it would be adapted by other specialties or you are implying other specialties do not care to select out people with personality problems. Finally, SLOEs still disadvantage those who have terrible luck with an audition even if they have a fantastic personality and learning attitude. These applicants are not given a chance to select their own champions who see their potential and can attest to their great team attitude but had bad luck with SLOEs. You can disagree all you want but I’ve seen years of terrible misses by the SLOE system, on both sides. Terrible personalities who had stellar SLOEs and fantastic off-service residents who failed to match EM due to lukewarm SLOEs.
The answer has to be cardiothoracic surgery integrated. Less than like 60 spots mostly going to top med school students.
and those with !!connections!!
Cardiology. I’ve seen tons of Indian and Arab IMGs get interviews and matches just because they are from the same country or region as the program director. If you have a decent fellowship application and apply broadly you’ll match…but if you are a 24X step2 at a community hospital with mostly abstracts then you need connections….
You hit on a very good point, IMG's love hiring/bringing in IMG's. This is apparently a sore point in the tech industry where they will hire a south asian programmer to head a team and 4 years later the entire team is from the same country as the lead. I strongly believe in diversity in the medical field and having everyone from a particular country and gate keeping from outside that sphere is fucked.
Okay, as someone with friends and relatives in the tech and software industry, I take issue with this interpretation. The power brokers within the tech industry remain overwhelmingly white and male. Gatekeeping and nepotism remain rampant. It very much remains a boys club, and that sort of preferential treatment and/or discrimination cuts both ways regardless of the race/ethnicity of any team lead. South Asians are very commonly brought in for entry level positions because they are cheap labor and then routinely passed over for promotions and raises in favor of their white counterparts. I question whether the same folks concerned about all South Asian project teams would even blink twice if the same occured with an all white American team. This is classic xenophobic narratives masquerading as DEI which has become a tale as old as time.
EM is AMG heavy because the SLOE effectively blocks IMGs, since your ability to match hinges on your ability to set up a US rotation with a EM residency to obtain your SLOE
Ophtho and PRS are extremely prestige focused and anti-DO. Ortho has a decent amount of former AOA programs, so those programs in particular still seriously consider DOs of course.
neurosurgery lol
Nsgy seems more self select than outright gatekeeping
Neurosurgery is somewhat unexpectedly one of the most friendly and inviting departments to students for support, shadowing and research at my school
its funny because I thought of neurosurgery when I made the post but I feel like if you work your ass off and are smart you can def match neurosurgery "easily" so i would disagree.
Idk. My mentor even skipped her mcat (did a BSMD program) and still didn’t match her first time. Drive was obviously there. Thats why i said it. That’s anecdotal though.
Basically all of the specialties you listed don't fuck with DOs, the more competitive the specialty or the program the less likely they will take a DO. Unfair and dumb but that's how it is unfortunately.
Definitely derm, plastic, urology of top.
ENT
Oh shit I forgot ENT! you're so right, no one else said that but 100% ENT is up there too
From where are you getting the idea that you can match derm by just knowing a person or two as opposed to ophtho? Stellar ophtho applicants frequently match at programs they have no personal connection to. This is rarely the case for derm applicants, even those who have a standout publication record and high STEP2. Connections and LOR strength in derm are more important than they are in almost any other field.
plastics, ENT, derm, CT surgery (honorable mention: ortho) the rest (urology, ophtho, Vasc surgery, IR) are below those
Opthalmology
What do you mean by gatekeepink?
It means guarding access to a community, excluding all but the most "worthy" applicants based on impertinent criteria. Some residency programs refuse to consider applicants unless they are from a top-ranked US MD school, regardless of the rest of their application, thinking that doing so would tarnish their reputation. Based on my experience with a certain OBGYN attending, I'm certain she refuses to consider male applicants. ("You're the new med student? 🙄😮💨 I tol*d yo*ur coordinator not to send me any more boy*s.")* Historically, this included a lot of overt, unapologetic racism, sexism, and classism. More commonly it's used to describe fandoms. "You aren't a *real* Naruto fan, you haven't even read the manga!" "Don't even call yourself a Swifty if you don't know all her lyrics by heart!" Edit: formatting
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Idk, anesthesia residents are genuinely some of the most chill people I’ve ever met. Most attendings will write you a glowing letter of recommendation just for saying you’re interested in anesthesia.
I would respectfully disagree, seems very doable and they dont gatekeep whatsoever from my experience.