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Words of Wisdom for New Graduates

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After the confetti has fallen and the congratulations have been extended comes the realization that you just graduated and are now embarking on a life in ophthalmology. It is usually about this time that the panic sets in. What are you supposed to do now?

Never fear. Every ophthalmologist has been in the same situation. So, to help guide you through this exciting time, four of the YO Committee members have shared their collective wisdom and experience as you transition from student to physician.

From Parag D. Parekh, MD, MPA:

  • Increase your disability insurance amount. Also, if you have children, consider getting term life insurance. If you already have it, increase the value.
  • Rent, don't buy a house when you first start out. If you're not happy at your new job, you want to be able to leave. If you buy a house straight out of fellowship and then decide the new job or the new city isn't working out, you'll probably take a big loss if you need to turn around and sell the house.

From Aaron M. Miller, MD:

  • After a grueling three-year ophthalmology residency, there will be temptations to celebrate your new job with a new vehicle, house or other luxury item. Try to maintain your same cost of living for your first three years in practice. The extra savings could come in handy if you need to change jobs or invest further in your new practice.
  • It takes time to build a practice. Be patient and take advantage of down time in your clinic schedule to market yourself to referring physicians. A face-to-face encounter with these individuals and their office staff can make an enormous impact on your practice growth rate.
  • Always send a letter to a patient's primary care physician, regardless of whether this physician referred the patient to you or not. Try to avoid lengthy and technical letters to non-ophthalmologists — their main interest is in your diagnosis and management plan.

From Sanjay R. Kedhar, MD:

  • Whether you are in private practice or academia, find a mentor in your local community whom you can talk to about issues like practice building or academic promotion. Despite how well you were prepared in residency, there are many questions you probably don't know you should ask. A mentor can often make suggestions or offer help in areas you didn't know would be issues.
  • Join your local/state ophthalmic society. In addition to providing good opportunities to stay involved with ophthalmology, the local societies offer good networking opportunities. If you have a particular subspecialty that isn't well represented in your area, you might offer to give a lecture or talk before one of the meetings.
  • Attend Grand Rounds or conferences at your local academic institution. Again, good networking opportunities are available here.
  • If you are hiring your own staff or have input into hiring, consider personal attributes first. Many people can be trained to do particular tasks; however, personalities don't change all that much.
  • Discuss any issues or problems with your partners/colleagues in practice as they arise rather than letting problems fester.
  • On the financial front, purchase disability insurance before you graduate. 
  • If you haven't done so already, start putting money into a tax-deferred retirement account such as a 401(k) or 403(b) savings plan.

From Robert F. Melendez, MD:

  • Patients are most concerned about how much we care. They will value your concern from simply listening to them in the exam room to a phone call the evening of their surgery.
  • After board certification, continue to stay up to date with all areas of ophthalmology. Read often and subscribe to a variety of journals. Attend the Academy Annual Meeting and your specialty meetings each year.
  • Volunteer to speak at a Grand Rounds presentation at your local hospital. This will help build your portion of the practice and bring notoriety to the practice at large.
  • When a patient brings in a newspaper article, take time in front of them to review it. Even if you are running behind in your schedule, still look at it and tell them you will review it later. Send an email to them or make a phone call with your comments.
  • Ask senior partners to observe you and provide pearls that will help in those difficult cases and even in the straightforward ones. For instance, one of my senior partners alerted me to identifying a loose capsular bag during cataract surgery. He taught me that if the capsule is difficult to puncture and has a lot of folds during the capsulorrhexis, this is suggestive of a loose bag and requires modification of the phacoemulsification settings. Additionally, another partner added a pearl of positioning the intraocular lens. He recommended the edge of the IOL should have better coverage by the edge of the iris inferiorly because the upper lid can cover the edge of the IOL superiorly in well-dilated pupils.
  • If/when you become a partner in a practice (or start your own), you will have the opportunity to reap financial benefits, as well as expose yourself to risks. Take time to understand the financials (income statement, balance sheet, and cash-flow statements). Increase your efficiency in the clinic and in the operating room without compromising quality. Strive to improve others in your practice.

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About the authors: Parag D. Parekh, MD, MPA, is a cataract, refractive and glaucoma specialist with Ophthalmic Consultants of Boston. He is a clinical assistant professor at Harvard/Massachusetts Eye and Ear Infirmary and Tufts/New England Eye Center. Aaron M. Miller, MD, practices in Houston, where he specializes in pediatric ophthalmology and strabismus. >> Read Aaron's clinical pearls on pediatric ophthalmology. Sanjay R. Kedhar, MD, practices in Brooklyn and New York, where he specializes in uveitis/immunology and cornea/external disease. He is also an assistant professor of ophthalmology at The New York Eye & Ear Infirmary and clinical instructor of ophthalmology at the Wilmer Eye Institute at Johns Hopkins University School of Medicine in Baltimore. Robert F. Melendez, MD, is a partner at Eye Associates of New Mexico in Albuquerque. He is also an assistant clinical professor in the department of surgery/division of ophthalmology at the University of New Mexico in Albuquerque. >> Read Rob and Sanjay's tips on using the O.N.E. search.