Editor’s note: My predecessor, M. Bruce Shields, MD, launched a wonderful series titled “What We are Doing Today.” I’m very happy to extend that series of descriptions of senior ophthalmologists (SOs) who have interesting hobbies and vocations that may serve as their destination so that they can retire to instead of from something.
But I’d also like to start a new series. I thought of calling it “What We Were Once Doing” but went with the catchier “The Way We Were” instead. Each issue will have an interview with a distinguished SO with a story of how different things once were.
I wish I had started this decades ago. I’ve been privileged to have been included in a circle of very colorful as well as famous figures who sometimes, under the influence of intellectual lubricants, told fantastic stories of crazy things that used to happen in academic departments. I used to think of this as the wild west of ophthalmology in the sense that it was a time before law and order arrived. I wish I had a tape recorder in the days when Drs. Steve Ryan, Ron Smith and Ed Maumenee would tell these riveting stories around the dinner table.
Well, I have a recorder now. And in this series, I’ll try and capture some of the narratives of “The Way We Were.” This time, I interview Bart Mondino, MD, chairman of ophthalmology at the Stein and Doheny Eye institutes at UCLA.
Dr. Sadun: Let’s start with a short foundation of where you grew up and went to school. And how you got interested in medicine or ophthalmology.
Dr. Mondino: I was born and raised in Sacramento, Calif. I received my bachelor’s degree, went to medical school and did my internship at Stanford University. I was used to the Bay Area. In fact, I wasn’t familiar with winter clothes. I had taken some electives in ophthalmology at Stanford and decided, in the fall of my senior year of medical school to apply to ophthalmology. This was late in 1970 and the war in Vietnam dominated all of our plans. I thought I was a reasonably strong applicant on paper.
My United States Medical Licensing Examination scores were high, and I had earned honors grades, etc. Yet, I was very disappointed that I didn’t receive any response for an interview from any of the 10 or 20 residency programs to which I applied. In fact, I got one rejection. It was a letter from Wilmer that [Dr.] Ed Maumenee signed personally and explained why they wouldn’t interview me. [Dr.] Maumenee had been at Stanford and knew my references who had written my support letters, so I guess he might have wanted the chance to explain. He gave two reasons: I had not served in the military and had not gotten a Berry Plan [deferment of military service until after residency] which I wasn’t yet eligible for until the end of my senior year, so they didn’t want to invest in me when I couldn’t control what would happen. House staff were being pulled out of programs at the time to serve in Vietnam.
Time was going by, and I wasn’t getting any interviews. It wasn’t going well as I didn’t have a single offer for an interview. Then, one day, I got a phone call from [New York University] where they offered me an interview in New York. I asked why because I hadn’t served in the military and did not have the Berry Plan. She wasn’t so worried about the draft and even suggested they could get a congressman to help. So, I said sure. But since I was going to New York, I called Manhattan Eye and Ear and also Cornell to see if I couldn’t get more interviews on the same trip, and they gladly agreed. I arranged to have two interviews one day, and one the next. I asked why they didn’t offer me interviews on their own. They replied you have to call for one which I didn’t know.
Dr. Sadun: So, you flew to New York?
Dr. Mondino: I took a red-eye and arrived at Kennedy Airport with little sleep and in casual clothes. I changed into a suit in the airport lavatory.
Dr. Sadun: That’s funny. I had a similar situation when I was a resident applicant. I flew to Boston and arrived at Mass Eye and Ear in wrinkled clothes and no sleep. And in a sour mood. I’m still amazed that they took me. It was hard for us before the match. Resident interviews could be wildly disorganized on both sides.
Dr. Mondino: From the airport I took a cab and went straight to my first interview at Manhattan Eye and Ear. But when I got there, a woman apologized to me and said that the slot had already been taken. She stopped me at the front desk, and I couldn’t even get into the department offices. But she also told me that Cornell was looking seriously at my application. Cornell was related to Manhattan Eye and Ear for resident applications because they had the same chair. I was disappointed, having flown across the country.
So, I walked outside and trudged, by foot, to my next interview about five blocks away at Cornell. It had snowed, and I didn’t have boots. But the sun pierced through the clouds highlighting the white tower of Cornell and I took that as a positive sign or omen. I got to interview a few of their faculty, including Stuart Brown, Donald Shafer and Harvey Lincoff.
Stuart Brown would play a major role in my career development and life. At the end of the afternoon, as I was getting ready to leave, I was approached by an administrative secretary who offered me the residency slot on the spot! There were only two resident positions (per year), and I was offered one. But there was a catch. I had to tell them yes or no immediately. I couldn’t even sleep on it. I ended up saying yes, of course, since I had nothing else. I was very favorable in thinking about Cornell because a previous college roommate was a medical student there and spoke highly of Cornell.
New York City and especially the Upper East Side was a great place for a single young man and seemed like a fun adventure. Manhattan Eye and Ear had filled its spot on a few hours’ notice so I couldn’t take any chances. But I didn’t like that I had to make such a big decision and only five minutes to make it. The rest of my career would be the consequence.
Then I found a phone and called NYU to tell them that I wouldn’t be interviewing with them the following day. To my surprise, she was very upset with me and gave me a hard time. But what could I do? I had just given Cornell my word.
Dr. Sadun: But you didn’t have the Berry Plan. Wasn’t Cornell worried? Weren’t you?
Dr. Mondino: Cornell didn’t seem concerned, and ultimately, I got the Berry Plan and was secure in knowing I wasn’t going to be drafted to Vietnam during my residency.
I was on the Upper East Side, and it’s nice. And I walked around until I found a local diner on First Avenue. I remember eating shrimp there. I felt very good about things and how the situation had worked out. I even found an earlier flight back to California, and I took a cab back to the airport that evening. And Cornell was generous with its house staff. They took good care of you. They gave me a salary about four times what I would get from Stanford for an internship. And they provided a great furnished apartment with subsidized deductible rent across the street from the hospital. And living in Manhattan on the Upper East Side was a lot of fun.
Dr. Sadun: So, serendipity decided where you went for residency.
Dr. Mondino: Serendipity. Just so. I was very influenced by Stuart Brown at Cornell. Then I followed him to do my fellowship at Pittsburgh and stayed there awhile. So much of my influences, my career and my choices were dictated by how things transpired that one winter day at Cornell.
Dr. Sadun: So, things are better now that we have the residency match?
Dr. Mondino: Absolutely. It wasn’t good back then. Not at all. The programs had all the power. The randomness of it was crazy. And I enjoyed having a lot to do with changing that. At the [Association of University Professors of Ophthalmology (AUPO)*], I was in a position to help organize and run the San Francisco residency match for ophthalmology. Later, through the Fellowship Compliance Committee (FCC) and the Central Application System (CAS), again organized through the AUPO, we were able to help fellows avoid the crazy process of applying to each program individually and helped eliminate “sweatshops.”
Look at what I went through. When people apply at different times, and institutions accept you at different times, and you have to make decisions one at a time, it’s just so disorganized and unfair. The new match systems are at least fair and sane. I don’t think that current residents and fellows can imagine the pressure of applying to and accepting an offer before the match came into existence. Now, having these matches for residents and fellows, the situation has improved immeasurably.
*Dr. Mondino served for 10 years as executive vice president of the AUPO after being on its board of trustees for six years.