• How to Have a Great Year in Residency

    The start of any residency is always a little hectic, to say the least. To help get you off to a good start – whether this is your first year or your third – the YO Info editorial board thought you could use a few tips for a great year in residency. Here’s their advice.

    First-Year Residents

    1. Read daily. Reading the BCSC is certainly helpful (see #2), but it is also important to read about each patient condition that you saw on a particular day.
    2. Read all of the BCSC books at least once. Set a reading timeline and establish a protected time to read (think: when your pager’s quiet!). Ten pages of the BCSC per day should just about get you through the series within a year.
    3. Be a team player. Do not leave the clinic until everyone is done.
    4. Smile when you get that 2 a.m. phone call. After all, you matched in ophthalmology.
    5. Buy an atlas. The only way to know what you're seeing is to have seen it before — preferably with illustrations.
    6. Realize that you are essentially starting over. Basically nothing you have done so far in medical school or internship is directly related to the tasks required of you as an ophthalmology resident. You went from running codes and caring for ICU patients as an intern to struggling with how to turn on the indirect ophthalmoscope or obtaining a decent refraction. The learning curve is very steep. You will feel like you are drinking from a fire hose!
    7. Become really good at basic clinical tasks: checking IOP, refracting, administering drops, taking fundus photos, injecting for FAs, measuring corneal topography, OCT, etc. These tasks will likely be delegated to others in your future practice, but if you are familiar with them now, you will have a better appreciation for the quality of these tests when done by others.
    8. Spend quality time with your family.
    9. Learn to deal with unavoidable conflicts and setbacks (personal and residency related); it will help you maintain balance.

    Second-Year Residents

    1. Practice suturing under the microscope.
    2. Create a step-by-step list of various surgeries.
    3. Listen to your senior residents and attendings dictate. Volunteer to dictate. There is no better way to learn the steps of a surgery than to review or repeat them in an organized construct.
    4. Learn as many techniques as you can. In a few short years, there may be no one around to ask for help. Take full advantage of your instructors and mentors.
    5. Be courteous, flexible and helpful at all times and in all interactions. You will quickly accrue a positive reputation as well as political capital, two things that are invaluable.
    6. Seek out difficult cases. Now is the best time to schedule that rock-hard cataract, as you will have a skilled attending at your side.
    7. Never be afraid of asking questions, seeking advice, or admitting mistakes. You are not expected to know everything. Communication with colleagues and attendings is key.?

    Third-Year Residents

    1. Focus on cataract surgeries. Learn how to perform an anterior vitrectomy and how to remove an IOL from the eye.
    2. Mentor a first-year resident.
    3. Try to improve one major item in your program.
    4. Use the Q&A books for the OKAP exam, including the Chern and the MEEI books for preparation. The Wills course and the San Antonio course are also very helpful.
    5. Provide a service for your community (e.g., vision screening, mission trip, etc.).
    6. Learn as much about the business of ophthalmology as you can. When you enter practice, you will be thrown into the pseudo-free market and are expected to understand business matters. Seek out courses at the Academy’s Annual Meeting (specifically the YO lecture series) to learn the basics. Pay attention to marketing techniques used within your program or by practices in your community. If your university is offering seminars on financial matters, attend them and take notes!

    Editor’s note: Residents enjoy a free membership in the American Academy of Ophthalmic Executives, the Academy’s practice management arm, which entitles you to a host of resources on the business side of ophthalmology.

    General Advice

    • Maintain decent health. Getting enough sleep, eating right, exercising and having regular check-ups are important. — Pedram Hamrah, MD
    • Practice skills that will encourage the development of dexterity in your non-dominant hand. Eat, shave, brush your teeth, etc. — Lauren Eckstein, MD (a tip learned from her mentor, Uday Devgan, MD)
    • Getting through the BCSC once each year, but especially your first year, is paramount. Yes, you're busy. But your job as a resident is to read and learn. Do it. I literally tallied up how many pages were in each book, figured out how much time I had till the OKAP exam, and then set up a reading schedule so that I would read through them all, plus have time to do a four-week review. I know they say that the OKAP exam does not count for anything because they're not allowed to use the scores when you apply for fellowships or jobs. So what. All your attendings will know how you did, and this is your chance to show them how hard you've been working. It makes a difference and they will treat you differently. Plus, it motivates you to learn. — Natasha Herz, MD
    • The better you do on OKAPs, the better you will do on the boards. — Lance Kugler, MD
    • The business of ophthalmology is important, but so is advocating for your patients and your profession. Be a member of your state ophthalmology society as well as the Academy. State societies and the Academy collaborate on a multitude of programs and activities – join both teams!

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    About the contributors: Lauren Eckstein, MD, is an assistant professor of ophthalmic plastic and reconstructive surgery at the Scheie Eye Institute at the University of Pennsylvania. 

    Pedram Hamrah, MD, is an assistant professor of ophthalmology and the director of the Ocular Surface Imaging Center at the Massachusetts Eye and Ear Infirmary, Harvard Medical School. 

    Natasha Herz, MD, is a cornea specialist in private practice near Washington, D.C. 

    Lance Kugler, MD, is a director of refractive surgery at the University of Nebraska and specializes in refractive and cataract surgery in a private practice. 

    Robert F. Melendez, MD, is a comprehensive ophthalmologist and partner in a private practice in New Mexico.