• 10 Things I Wish I Knew as a First-Year Resident

    The past 10 years of YO Info Resident Edition have provided new residents with a treasure trove of information. Here are the top 10 things I have learned from these past editions that I wish I had known starting out as an ophthalmology resident.

    1. Call is tough and stressful but establishing a routine will help you standardize your approach to every patient and prevent you from missing any steps. Keep a Wills Eye Manual in your call bag or pocket and refer to it often — the Academy has made the Wills Eye Manual available to all members through the AAO Ophthalmic Education App.

    2. Part of your examination routine is the 8-point eye examination. Write it down, print it out and follow it for every patient every time. The results are your eye vitals — and are truly vital for every patient. At the slit lamp, follow your routine on every patient.

    3. Learn from every patient encounter in clinic and every experience in the operating room (OR). In the OR, find a goal for each case. When you’re a PGY-2 in the cataract OR, learn to set up and troubleshoot the phacoemulsification machine, learn the name and purpose of every instrument and learn the names and purposes of each viscoelastic device. These tips and more will help you become a master learner in the OR.

    4. Always keep your differential diagnosis broad when encountering patients in the clinic, emergency room and hospital. What are the most common diagnoses for this constellation of findings and history? What are the worst things this could be? Check out this list of Top 9 Mistaken Diagnoses and Top 12 Vision-Threatening Diagnoses.

    5. We are not only ophthalmologists, but also radiologists. Look at every MRI and CT scan you order. Learn to read and interpret optical coherence tomography (OCT) scans — a frequently ordered test in our clinic. Learn how OCTs work and when to use them and explore the OCT course.

    6. Be an advocate for your patients and your profession. Advocacy starts in the clinic and continues into the legislative bodies of your state and country. As a new resident, you bring a fresh and new perspective to our profession — don’t accept the status quo. How can we better serve our patients, protect sight and empower lives? Be engaged within your state ophthalmology society as well as the Academy.

    7. Use your time wisely. As a resident, you have many responsibilities: call, clinic, grand rounds, didactics, self-directed learning. Be efficient with your time. We practice evidence-based medicine. We should also practice evidence-based learning! Read Make It Stick and Ultralearning. As Laura Green, MD writes, “The most important techniques demonstrated in these books are effortful practice, drilling and varied practice.” Use these techniques every time you sit down to study.

    8. Take care of yourself. If you don’t take care of yourself, you can’t take care of others. This means something different for every person. Take a moment and think, “What do I need to be my best self?” Schedule “me” time and find people you can talk with about stressors in your life.

    9. Adhere to deadlines. There are a lot of things going on behind the scenes of your residency program, and many require you to respond to emails in a timely manner. Turn in your goals/objectives early, do your required online training modules and respond to your program coordinator. These little things are noticed and will make everyone’s lives better.

    10. Follow Dr. Mike Siatkowski’s 8 keys to a successful ophthalmology residency. My personal favorites: embrace/own your cluelessness and don’t take constructive criticism personally. You are new to ophthalmology! You know it and your attendings know it. But listen carefully to feedback. Learn, incorporate the feedback into your own practice and move forward!

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    Evan Silverstein, MDEvan Silverstein, MD, is chair of the YO Info editorial board. He is a pediatric ophthalmologist and an assistant professor of ophthalmology and associate resident program director at Virginia Commonwealth University in Richmond, VA.