Ophthalmology Business

MAR 2014

Ophthalmology Business is focused on business topics relevant to the entrepreneurial ophthalmologist. It offers editorial, opinion, and practical tips for physicians running an ophthalmic practice. It is a companion publication of EyeWorld.

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18 Ophthalmology Business • March 2014 "The advantage of fellowships is that the surgeon acquires skills and an intense knowledge of the subspe- cialty," Dr. Koch said. For a general ophthalmologist, fellowships may not be necessary, but Dr. Koch said for an ophthalmologist interested in corneal transplant surgery, for instance, "a fellowship is essential. Someone who's interested in cataract s urgery may be able to head right out after residency, but something more intricate like transplant surgery and complex IOL procedures" mandates more training and specialization than a brief time during residency allows. Academic settings provide more opportunities to interact with other specialties than private settings might, Dr. Galor said. At larger teaching hospitals, cornea fellows and glaucoma fellows are exposed to grand rounds-type of analyses and discussions that may not occur in the private sector, she said. There are great surgeons and teachers in all settings, but academic settings will have a greater number of potential mentors. "There's also the possibility to have more primary responsibility for patient care," Dr. Koch said, as fel- lows in an academic setting are more likely to have "their own" patients, following them from presentation through the entire follow-up period earlier in their fellowship than their private center colleagues. Fellow considerations Perhaps the biggest difference between academic and private settings is the type of research opportunities available. "If your goal is to get bench e xperience, there are numerous academic ancillary personnel who are helpful and can assist with study design," Dr. Koch said. Baylor has been involved in sev- eral clinical studies as an investigator site, but Dr. Koch noted that is not typical of most academic settings. "The barrier for pharmaceutical and device companies is that the Institutional Review Boards at academic settings are usually more onerous than those affiliated with private clinics," Dr. Koch said. "Certainly, some private fellowships offer wonderful clinical research opportunities with outstanding mentors." Dr. Galor said the clinical volume of an academic center is greater than even some of the high- est volume private practices. "Some academic centers (like some private practices) have higher volumes than others, and those will have fellows participating in a lot of the hands-on patient care," she said. Residents considering either private or academ- ic fellowships should also consider how difficult (or easy) it would be to get surgical time—and how quickly they'll become fully responsible for each aspect of the surgery. Fellows are provided extensive time at Veterans Affairs or county hospital settings, Dr. Koch said, and there will be a greater diversity of patients at the larger public hospi- tals. "Fellows see them, operate on them, follow up with them with supervision, but have primary responsibility fairly early on," he s aid. "It's one of the aspects of our fellowships that is well received as a great element of our training." Dr. Koch was quick to add that superb surgical experiences with high surgical volumes can be had in some private settings as well. "Fellows have one year to be specially trained," Dr. Galor said. "If research is something the ophthal- mologist has a great interest in and he or she enjoys collaboration on various projects, an academic center may be a better fit." It all boils down to the individ- ual, Dr. Galor said. "Those consider- ing a fellowship need to ask where they see themselves in five to 10 years. It's not a 'private vs. public' thing. It's a matter of which institu- tion is right for you and which one 'gels' with your personality." OB Editors' note: Both physicians are employed by academic institutions. Contact information Galor: agalor@med.miami.edu Koch: dkoch@bcm.edu continued from page 16 02-19_OB March 2104_Layout 1 2/19/14 11:07 AM Page 18

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