Why Ophthalmology Residents Should Consider a Retina Fellowship

by Nikolas J.S. London, MD, FACS, Daniel L. Chao, MD, PhD, and Matt Geller, OD
Jan 22, 2020
7 min read
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Watch our interview with vitreoretinal surgeons Nikolas J. London, MD, FACS and Daniel Chao, MD, PhD about what drew them to the retina specialty and why they think this career path is a great option for MDs.

At a certain point in your ophthalmology residency, it becomes time to decide whether or not you’ll pursue a subspecialty—and if so, which one. Are you one of the many ophthalmology residents considering the vitreoretinal surgery specialty? If you choose retina fellowship, you’ll join the most popular ophthalmology specialty, and find a variety of modalities and opportunities open to you.

We sat down with vitreoretinal surgeons Nikolas J. London, MD, FACS and Daniel Chao, MD, PhD to discuss what drew them to the retina specialty and what keeps them excited about the field. The retina field offers good work-life balance, an atmosphere of camaraderie, and the opportunity to work with and on cutting-edge technologies.

Clearly, there are plenty of perks to this field; let’s dive in!

Why retina fellowship?

Retina is a rewarding specialty as the pathologies you deal with have the potential to cause blindness, and vitreoretinal surgeons help to save their patients’ eyesight. As a surgeon, you’re called upon to fix things, and being able to see the tangible results of your work is incredibly gratifying. When it comes to career satisfaction, the energy and intensity of retinal surgery can’t be beat.

In addition, the retina subspecialty is at the forefront of technological development in the field. For example, the first FDA-approved gene therapy was for retinal disease, and artificial retina implants are helping blind people see again. Further advancements like placing telescopes in the eye, implanting electrode arrays on the retina, and placing implants in the brain make for an exciting, dynamic field.

Vitreoretinal surgeons play a critical role in developing these technologies and advising the companies that create them. There are opportunities to serve as a consultant to companies developing cutting-edge technologies, and other opportunities to perform clinical trials of new treatments.

Clinical trials are another great way to have a direct impact on the field. The new developments that you’ll see come about through these trials really exemplify the pace of innovation in ophthalmology; retina in particular. It’s great to be able to offer patients new treatments that might benefit them and ultimately help the community at large.

What does each modality offer?

There are a variety of settings that you can choose from as a vitreoretinal surgeon. As with all subspecialties, the best one for you really depends on your specific personality and goals. You might find yourself in an academic setting, a private practice, or a multispecialty group.

Academic setting

The academic setting offers unique options as compared to other modalities. If you like to see patients but want to spend a significant amount of time doing clinical or lab research, academia might be the setting for you.

You will have a variety of opportunities available to you—teaching, conducting research, or collaborating with other departments at your university. The academic setting offers a relatively flexible schedule, and you’ll find your days split between patient care and research.

Private practice

In a private practice, you’ll have a bit more control over your career. There’s plenty of risk and reward here, so it’s not for everyone. However, if you’re looking to explore the business side of things, this is a great option for you.

You won’t always know what’s going to happen in the future, but you’ll have a bit more control over your work and schedule than in other settings.

Multispecialty group

These are large multispecialty groups, such as Kaiser Permanente, where you’re part of a whole system, or multispecialty ophthalmology groups, where you might have a smaller retina group. Perks include a built-in referral base and the ability to interact with ophthalmologists within the group. This setting is ideal for ophthalmologists who want to focus on patient care, but aren’t looking for clinical or bench research.

If you’re a recent grad or resident who’s thinking about which modality you’d like to practice in, it’s important to first decide what you want out of your career.

Work-life balance and the retina specialty

As an ophthalmologist in private practice, your patient load will be light at first—you’ll need to build a patient base. Once you get further in your career, you’ll be able to choose how busy you are.

Your location also matters. In more saturated markets (e.g., Los Angeles, New York City), your days may be a bit slower than they would be in smaller cities where there are few ophthalmologists.

If you’re working at a practice that offers emergency and after-hours care, you can expect to be called in at off hours to “save the day.” However, most surgeries last only one to two hours. You’ll need to roll with the punches, but shouldn’t need to pull regular all-nighters.

Additionally, even emergency cases often have a 12 to 24-hour window, so you can take care of them the next morning.

As a vitreoretinal surgeon, you won’t be sacrificing your family life as much as you would be in other fields of medicine.

How long is retina fellowship?

Retina fellowship is typically two years, although some programs are only one year long. After completing medical school (four years), an ophthalmology residency (a one-year general medicine internship plus three years of ophthalmology residency training), and fellowship (two years), you’ll be an official member of the retina “club”—a practicing vitreoretinal surgeon.

But first, there’s getting from residency to fellowship. During your residency, you’ll have plenty of time to contemplate the specialty and modality in which you’d like to practice. Ask around, shadow someone—take advantage of your network to discover what you like.

How to be competitive for retina fellowship

Once you’ve picked the vitreoretinal specialty, there are a few boxes to check to make yourself a competitive applicant for retina fellowship:

  • Publish clinical research
  • Get to know your faculty
  • Demonstrate excellence in patient care

But most importantly, build those relationships! You’ll not only be able to get letters of recommendation from vitreoretinal specialists at your university, but you’ll immediately see the importance of these mentors once you begin practicing. Your personality, passion for the field, and drive will make or break your career. Demonstrating that you work well on a team will set you up for success years into the future.

There’s a reason retina is the most popular subspecialty

In the retina field, many of us value a good work-life balance. Overall, ophthalmologists are a fun group to be around—we like to work hard, but we also know how to let off steam.

Being able to form great relationships with your colleagues and patients alike sets the retina field apart. Macular degeneration and other surgical patients come in for routine follow-ups, and you can get to know patients very well over the years. The satisfaction you get from saving someone’s eyesight and being able to see the results of your work is another great motivator.

There’s always room for excellent people in the field, especially if you’re passionate about what you do. If you’re excited about the prospect of changing people’s lives, saving their vision, and building great relationships with both colleagues and patients, then vitreoretinal surgery is the field for you!

“If you want to do anything in life, just persevere and show that you can do it and you will succeed.”

—Nik London, MD, FACS

After all, with the increasing incidence of macular degeneration, diabetic retinopathy, and more, the need for retina specialists is growing. Joining this rapidly advancing field will provide you with plenty of opportunity to grow in your career and help a variety of patients!

Looking to grow your network? Have questions? Reach out to Nik and Dan here!

  • Nik London, MD, FACS: nik.london@gmail.com
  • Dan Chao, MD, PhD: DLchao@ucsd.edu
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About Nikolas J. S. London, MD, FACS

Nik London, MD is the Chief of Ophthalmology at Scripps Memorial in La Jolla. He graduated from Case Western Reserve University School of Medicine in 2005 and eventually completed an ophthalmology residency. He specializes in retinal and vitreous disease.

About Daniel L. Chao, MD, PhD

Daniel L. Chao M.D., Ph.D., is an Assistant Professor of Ophthalmology at the Shiley Eye Institute. He is a retina surgeon, clinician-scientist, and entrepreneur.

About Matt Geller, OD

Dr. Matt Geller is an entrepreneur with a track record of developing successful online platforms to solve problems in the healthcare space. Matt is the co-founder and CEO of CovalentCareers and NewGradOptometry.


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