At a meeting of ophthalmologists several years ago, a prominent oculoplastic surgeon confided to us that he felt unfulfilled in his career and wished he had gone into retina instead. This interest dated back to residency, but even at this late stage in his career, the faculty member was considering a retina fellowship. As a young ophthalmologist, how can you make sure you are on the right track?
Poll: What would the most satisfying improvement in your current job be?
Factors in Choosing a Subspecialty
Deciding on a subspecialty and practice type plays a crucial role in your future professional satisfaction. A 2018 Medscape survey of 24,000 doctors found only 77 percent would choose medicine again and only 62 percent would choose the sample specialty.1 Several external factors drive this decision-making process, including the complex health care delivery environment, market forces and population demographics (to name just a few).2,3
Within ophthalmology, Steven J. Gedde, MD, and his colleagues at the Bascom Palmer Eye Institute found that the perception of prestige often drove residents’ decisions to pursue fellowship.4
But what about passion and excitement? My oculoplastics colleague always knew that both subspecialties could be fulfilling, but it took the course of his career to see just how much oculoplastics and retina differed in disease presentation, diagnostics and patient care.
The Secret to Choosing Well
Three keys can help you identify the most satisfying career path early on.
1. Find your career “flow.” Hungarian psychologist Mihaly Csikszentmihalyi says people are happiest when they achieve career “flow.” He defines this as “a state in which people are so involved in an activity that nothing else seems to matter follows … a state of concentration or complete absorption with the activity at hand and the situation.”5
Flow can provide the sustenance required to counter the numerous personal and financial sacrifices necessary for training and practice. In turn, the good emotions trump negative feelings, anxiety and helplessness, all of which can intrude on the practice of medicine and contribute to burnout.
Ophthalmology provides a number of career opportunities and ways to find your own flow. Your choice might involve retina vs. cornea; comprehensive vs. surgical environments; anterior vs. posterior segments; private vs. academic practice; or research vs. patient care settings.
2. Find a good mentor … early. A good role model can help you pare down your choices and cultivate what’s right for you. This mentor can also help you develop and maintain your flow as your career progresses.
3. Establish your niche. Another key factor for professional success in ophthalmology is identifying an area in which you can excel and establishing your own niche. If this focus matches well with your passion and skill set, you are on the right path to becoming an expert.
Our professional lives provide two good examples. One of us (Dr. Jampol) gravitated to less common research areas in ophthalmology, such as systemic diseases in the eye, prostaglandins, sickle cell retinopathy, cystoid macular edema, white spots and infections of the retina. Later in his career, he became intrigued by clinical trials for AMD and diabetic retinopathy.
I (NJV), on the other hand, was inspired by role models and a desire to care for patients with complex systemic conditions. Gravitating to neuro-ophthalmology, I evolved as an educator and mentor while maintaining a reputation as a clinician performing clinical research and developing skills as an administrator.
Both of us have now served as departmental chairs, a position replete with challenges and frustrations. However, for both of us, a passion to create, facilitate and build, all while maintaining our unique clinical expertise, has fueled our success.
YOs without such a niche risk becoming one of many. By identifying and developing your own personal “flow,” your career satisfaction and success will always outpace (and outlast) decisions made purely for practical reasons.
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About the authors: Nicholas J. Volpe, MD (neuro-ophthalmology), and Lee M. Jampol, MD (retinal diseases), both practice ophthalmology in Chicago, where they serve on the ophthalmology faculty at Northwestern University’s Feinberg School of Medicine. Dr. Volpe also chairs the department and succeeded Dr. Jampol in this role.
References
1 www.medscape.com/slideshow/2018-compensation-overview-6009667#38
2 Pianosi K, Bethune C, Hurley KF. “Medical student career choice: a qualitative study of fourth-year medical students at Memorial University, Newfoundland.” CMAJ Open. 2016;4(2):E147–E152.
3 Schmidt LE, Cooper CA, Guo WA. “Factors influencing US medical students’ decision to pursue surgery.” J Surg Res. 2016;203(1):64–74.
4 Gedde SJ, Budenz DL, Haft P, Tielsch JM, Lee Y, Quigley HA. “Factors influencing career choices among graduating ophthalmology residents.” Ophthalmology. 2005;112(7):1247–1254.
5 Csikszentmihalyi, M. Flow: The Psychology of Optimal Experience. New York: Harper and Row, 1990.