VIVIANA BARQUET, MD
Glaucoma fellowship is an exciting and challenging time that goes by faster than some may realize. As I embark on the second half of my fellowship, I am armed with several useful takeaways from my experience so far.
Ask Questions
During fellowship, you work very closely with your attendings, whether in clinic or the OR. Knowing the reasoning behind their preferences, treatment paradigms, and interpretation of glaucomatous disease will influence your own reasoning. Do not be afraid to ask questions or discuss challenging cases.
Mix It Up
Each attending has their own surgical approach, and, as a fellow, it is important to learn their different techniques. Not only will this allow you to curate your own preferences, but it will also be beneficial if you are faced with a case in which you must deviate from your standard approach. Additionally, familiarizing yourself with various surgical instruments and materials is important, as you may have different equipment available to you in practice. Developing a toolbox with a variety of skills and techniques will help you manage unexpected situations.
Hit the Books
Study and prepare for a case by reading operative reports or pearls you have jotted down, watching videos, or practicing in the wet lab as if you were going to do the case on your own. This will help you feel more confident and start conditioning you for real-world surgical challenges.
Record and Review
It is important to not only record your cases but also watch your surgical videos, learn from your successes and mistakes, and consider whether you could have managed each scenario differently. It is also beneficial to have videos of your cases for presentations and conferences.
Track Outcomes
Keep track of your patient outcomes, especially as you try different approaches and work to establish your preferred technique.
Connect
The people you meet in residency and fellowship will be your lifelong colleagues and mentors. Make sure to create lasting relationships with people you can rely on to discuss cases and exchange opinions with into the future.
GIO CAMPAGNA, MD
Be prepared to experience a regression in your surgical skills at the beginning of fellowship. It is natural to develop confidence toward the end of residency, but, if you are starting your fellowship at a new institution, then the OR may feel a bit foreign at first. Even subtle differences in the operating microscope, operating chair, patient headrest, microkeratomes, instruments, phaco machines, lens platforms, etc., can make the surgical experience unfamiliar and contribute to a sense of uneasiness. In some ways, it feels like being part of the away team, playing on someone else’s turf.
When I started fellowship, it took me a couple of weeks to adapt, and the adjustment period was fraught with frustration and even self-doubt at times. My attendings demonstrated a great deal of patience and grace while I worked though the kinks. Rely on your mentors to guide you through these challenges and take solace in the fact that you are not alone in feeling this way. Learning to tackle these struggles at the beginning of fellowship training will make the transition to practice so much easier.
TERESA HORAN, MD
Fellowship is short, and there is so much to learn during this period. It is an exciting and busy time and an opportunity to expose yourself to as many interesting cases as possible. When you are in the trenches, remember that it is good to be busy this year. Lean on your mentors and cofellows for advice on any challenging cases. Be thoughtful about each movement or decision throughout the year, as this is the time to shape your future practice patterns. Ask “Why?” often (either in your head or to your mentors). There should be a reason behind each suture pass or change in management. Be open to different ideas. Try everything once and then decide whether to incorporate it into your practice. Keep a running list of your preferences to ease the transition to practice. Enjoy the year! It will go by in the blink of an eye.
TIMOTHY TRUONG, MD
The journey through medical training is an interesting one. We spend much of our schooling chasing after an almost prescriptive “right” answer to, “What do I have to do next?” So, we study hard, get the best exam scores we can, get involved with research, and explore the massive field of medicine. Residency brings about new challenges; you are now Dr. (insert surname) and are responsible for caring for patients in their most vulnerable moments. Yet, as in medical school, there is still a predetermined set of rotations, skills, and challenges (and for good reason). Within this framework, you hope to scratch the surface on the most common, most vision- and life-threatening, and most practical conditions to be able to become an excellent comprehensive physician.
In my opinion, fellowship is the first time that we start to move away from asking, “How do I become an ophthalmologist?” and toward asking, “Who do I want to be as an ophthalmologist?” After the initial challenges of adapting to a new health system, building a new cohort of colleagues and friends, and adjusting to a new city (all things we have done time and time again), I found myself in the perfect position to learn how I want to build my own future practice. Discussions of blebology with Norm A. Zabriskie, MD; quandaries on how to best address resident surgical teaching with Rachel G. Simpson, MD; inquiries into research and glaucoma testing methodologies with Brian Stagg, MD, MS; complex cases with Iqbal Ike K. Ahmed, MD, FRCSC; and yet another urgent add-on glaucoma surgery with Craig J. Chaya, MD, or Austin Nakatsuka, MD, fill my day with joy and wonder. Complications and difficult social circumstances for patients remain incredible challenges to deal with, but with such amazing faculty, a motivated and excited medical team, and the absolute best cofellow, I am finally able to see myself growing into the physician I’ve always hoped to become.
To those who have just matched: Congratulations! Get ready to start one of the best and most challenging year(s) of your life. To those who continue to struggle and trudge through medical training: It absolutely gets better, and there is so much to look forward to.
