A good mentor can make all the difference in the course of your career — just ask Academy President Keith Carter, MD. He was set on entering private practice until a mentor suggested he reconsider an offer in academic medicine.
That advice changed not only Dr. Carter’s life, but also the lives of the many students who’ve experienced his leadership as residency program director and later chairman of one of the country’s top ophthalmology programs.
At the time, Dr. Carter planned to return home to Indianapolis and practice near the hospital that his mentor ran (a lifelong Indy 500 fan, Dr. Carter has only missed three races since 1969). But his mentor pushed back when Dr. Carter mentioned his two academic job offers. “He says, ‘Try that first,’” Dr. Carter said. “‘You don’t always get the opportunity to pass along knowledge to people that way. You don’t always get the same stimulating environment to work.’”
Thirty years later, Dr. Carter continues to enjoy the variety and challenge of running the University of Iowa ophthalmology department and his work with patients as an oculoplastics specialist.
Academy CEO David W. Parke II, MD, said Iowa’s program has “absolutely flourished under [Dr. Carter’s] leadership.”
Dr. Carter acknowledged the challenge of attracting students to a rural campus, but said, “We actually use the cornfield thing to our advantage.” Given the location, he said, ophthalmologists don’t have the same competition they might in other places, which allows them to do more career-satisfying activities.
But students come for more reasons than that. “We work very hard to keep the environment in our halls good,” he said. “Once you come visit, we have a shot at you.” He also credited the program’s long history of excellence.
Advice for trainees
Because of its quality, the University of Iowa has long been a competitive match. For those who don’t get to experience Dr. Carter as chairman, he offered some advice on finding and learning from a mentor, no matter where you train.
- Prioritize fit over prestige. “Find someone who actually has an interest in you,” he said. If it’s hard to schedule time or the person doesn’t offer much useful information, find someone else. “The relationship is beyond just advice. A lot of times it becomes personal.”
- Be proactive. Though ophthalmology programs continue to diversify, available mentors may be a more homogenous group. “Underrepresented minorities need to reach out to the majority to get help also,” said Dr. Carter, an African American physician. “Be aggressive. Make an appointment. Go visit somebody and be surprised.”
- Don’t reject hard feedback. “The most important thing I stress to trainees is to listen to your mentor,” he said. “Even though the feedback you get is not necessarily what you want to hear sometimes, I think everybody should take the opportunity to assess and evaluate it. Not at that moment, per se, but after you get away, say, ‘Is that valid? Is that something that can improve me?’”
Advice for responding to medicine’s changing demographics
As Dr. Parke noted in the Academy’s EyeNet Magazine, ophthalmology is undergoing significant demographic changes. Dr. Carter has a front-row view of that change — and, as he recently wrote in EyeNet, he wants to help ensure ophthalmologists better represent the patients they serve.
According to the Association of American Medical Colleges, African American and Hispanic medical students are particularly underrepresented — a gap that affects patient care and trainees. Dr. Carter said ophthalmologists shouldn’t shy away from that reality. “Pay attention to the environment [mentees are] in,” he said. “Sometimes it’s difficult for mentees to seek people that don’t look like them.”
Ophthalmologists must also confront medicine’s history. Though the Academy never restricted membership due to race, institutions like the American Medical Association did.1 As Richard Koplin, MD, reported for the Academy’s Scope, 19th-century eye specialist David McDonagh was denied a diploma by his medical college president.
While medicine works to narrow the representation gap, ophthalmologists who trained and practiced amid one demographic reality may find themselves advising trainees who face different circumstances.
Regardless of your position, Dr. Carter encouraged potential mentors to be proactive, too. “Reach back and find students that need mentoring,” he said. “Mentor students based on potential and career goals that match with what your strengths are. That can come in a variety of students.”
Dr. Carter also offered advice for those who’ve completed training.
- On giving constructive feedback: “Feedback should be based on honesty,” he said. Whether a student is competitive, average or below average, give appropriate feedback. “Honesty, students can deal with. Misinformation hurts. Setting one’s sights too high is disappointing also. As a mentor, you just have to keep it based on honesty.”
- On embracing limits: “We have to realize that we can’t get it all done in one day, and it’ll be waiting for us tomorrow. I think that’s a challenge for us because we’re so goal-oriented that we feel like we need to finish it. Sometimes you just can’t finish everything in a day or a week or a month. You have to realize that and live with it.”
- Why he values diversity: “Being an oculoplastic surgeon allows you to work with different subspecialties,” each of which brings its own expertise. “That’s very important, because in ophthalmology, we’re pretty much isolated in what we do. We do an excellent job, but our interface with the house of medicine is limited. I think now you’re going to see more interaction with primary care providers in caring for diabetics, for example. … In my field, [work with diverse experts] was a natural interface because of the collaborative surgical treatment of patients.”
Dr. Carter met with young ophthalmologists participating in the Academy’s Leadership Development Program XX, class of 2018, during their January session in San Francisco. Those who participate in the Academy’s Advocacy Ambassador Program will get to meet Dr. Carter at Mid-Year Forum 2018, April 18 to 21 in Washington, D.C. He will also speak at the YO Program, Oct. 28, during AAO 2018 in Chicago.
1 Ward, Thomas J. Black Physicians in the Jim Crow South. 2003: University of Arkansas.
Images courtesy of the University of Iowa.