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Found: Answers to a Third-Year Resident's Most Pressing Question
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As I was getting my daily cardio workout walking from one end of the colossal New Orleans convention center to the other, the words of Academy President Paul Sternberg, MD, remained in my mind: “Most strategic plans fail because there is inadequate follow-through.”

I Had Questions
Earlier that day, I heard him speak along with numerous other experienced physicians willing to bestow valuable knowledge on those fortunate enough to be in attendance. Their goal: to take a group of financially, politically and legally perplexed young ophthalmologists and give them the keys to a successful career.

YO Committee Chair Rob Melendez, MD, introduces Academy President Paul Sternberg Jr., MD
YO Committee Chair Rob Melendez, MD (left), introduces Academy President Paul Sternberg Jr., MD, during the 2013 YO Program.

As a first time Annual Meeting attendee, I had a broad range of expectations. Each ophthalmologist with whom I discussed the meeting liked and disliked it for different reasons. I was pleased to discover that the subspecialty events took place on Saturday, giving me a set schedule around which I could begin to explore this grand experience and come to my own conclusions.

Obviously, education was at the top of my list of things to do. I had high expectations of numerous renowned speakers. On my first break, I ventured into the monstrous exhibition hall. After taking about five steps, my wish list had already drained my bank account. However, my most pressing questions were not related to education or fancy equipment at all.

What I really wanted to know was, How are people handling their personal and professional lives after residency? How are fellow young ophthalmologists dealing with all of the topics we don’t learn about in our training programs?

Somehow, the YO organization managed to cram the answers to nearly all of my questions into one lecture series. Get ready to take some notes.

They Had Answers
Coding. One of the first speakers covered the basics of coding, the topic that gives me the most anxiety of any that I will have to deal with when I am on my own. I barely have a grasp on ICD-9. How am I going to handle ICD-10? Grant Morshedi, MD, gave a good overview of the topic using many familiar and unfamiliar acronyms (ICD, CPT, CMS, RVU). Later, Academy coding executive Sue Vicchrilli, COT, OSC, elaborated on specific issues, including how to use a modifier to unbundle and how to get paid for bilateral surgery. According to her, many experienced surgeons are performing these tasks incorrectly. Ultimately, our knowledge of these items is directly tied to our financial compensation. Great sources include the CODEquest: Conquering ICD-10-CM course, EyeNet’s Savvy Coder, and

Employment. If you are a third year as I am, you may be discussing employment options as we speak. The majority of us have absolutely no idea what we are doing when it comes to contract negotiation. Why would we? Thankfully, the YO Program covered this, too. Here's a summary. 

Step one, get a lawyer. It is worth the money in the long run. Use them as the “bad guy” to present your requests regarding salary, bonus, time off, partnership buy-in and any other issues. That way you maintain a good relationship with the practice. Beware of anyone who tells you that everyone signs the same contract. With some discussion, you will find that this is generally not true. If it is, you may not want to be a part of that practice.

Marketing. If you are awesome at what you do, people will just magically find you, right? To some extent, yes. Satisfied-patient and physician referrals represent a large portion of a physician’s patient base. However, nearly everyone researches physicians online these days. If you have one out of five stars next to your name, you are going to lose a significant percentage of patients. 

In their lectures, Andrew Doan, MD, PhD, and Randall V. Wong, MD, showed us the necessary steps to obtain a positive Internet presence. Create a website now. It takes time for Google to recognize you and direct Web surfers to your site. Include interactive content such as a blog. Create a professional Facebook page. Give satisfied patients your card and ask them to rate their experience online. These tips will help you tremendously.

OKAPs and the boards. No member-in-training lecture is complete without a discussion of OKAPs and the boards. Janice Law, MD, gave some really great tips. First of all, you need to read the Basic & Clinical Science Course series cover to cover. This may seem obvious, but I know people who don’t do this. Review books are definitely not enough. 

Second, you need to practice, practice, practice. If you are preparing for the oral boards, get a partner to talk out the topics. This gets you used to responding quickly and completely and lessens your chances of freezing. 

Finally, do questions. Do thousands of them. By now, we should all know about However, the Academy website has great resources as well. Check out the Ophthalmic News and Education (ONE®) Network, Resident Hub™ and ProVision.

Be an Advocate. The most important message I took away from this program was the importance of getting involved. This is a volatile time politically and financially. Politicians only know about our issues and concerns if we tell them. Advocate at national, state and local levels. Our societies are always looking for able-bodied participants and leaders.

Whatever the next step in your ophthalmology career, make sure that you always follow-through. I know that’s my plan. And thanks to the meeting, I have a more concrete idea how to do it.

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About the author: Carlton Fenzl, MD, is a PGY-4 ophthalmology resident at Jamaica Hospital Medical Center/NYMC program in Jamaica, Queens. Contact Dr. Fenzl at Carlton Fenzl, MD
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