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    In Pursuit of Momentum

    I am a firm believer in momentum and it being one of the most powerful forces in the universe. Those who know their physics may take issue with that statement, but I refer to the abstract as opposed to Newtonian mechanics. The capacity to harness energy, success, progress, and triumphs can feed into a positive feedback cycle if cultivated ap­propriately. Once a catalyst is ignited and a subsequent chain of activations takes place, it is very difficult to stop that forward motion. This is true in the workplace, politics, interpersonal relationships, fitness, any passion, and—of course—in our profession. Like any chain reaction, activation energy is critical, and overcoming inertia is half the battle.

    The Utah contingent gathers on the Hill during Congressional Advocacy Day 2022.

    CONGRESSIONAL ADVOCACY DAY. The Utah contingent gathers on the Hill during Congressional Advocacy Day 2022.

    At no point along the timeline of becoming an ophthalmologist are things easy or convenient. Medical school admission is competitive and requires focus and dedication during the premedical journey in undergrad. Medical school itself requires an immense amount of time to learn the anatomy, physiology, pathology, pharmacology, and management of multiple organ systems. And the ophthalmology match is among the most competitive of all medical and surgical subspecialties. Ophthalmology residency is intense: we speak our own language; the learning curve to the basics of the slit lamp and dilated fundus exam is steep and requires time to master; and call can be brutal. On top of that, residents participate in weekly didactic curriculums, grand rounds, journal clubs, and research prior to graduation. They also study for and take the OKAPs every year and attend wet labs and conferences. They do all of this while learning how to be a microsurgeon in order to protect sight and empower lives. Fellowship is usually just as busy if not busier than residency itself. Then aspiring ophthalmologists must take board examinations and transition to life as an attending—maybe in a different state, different center or practice, and different OR setting. Everyone has families, significant others, and friends outside of work that require time, attention, and love. At the end of the journey to becoming an attending ophthalmologist, we find ourselves in our 30s. There is seemingly little time or space in the life of a busy resident, fellow, or young ophthalmologist to fit other priorities into the schedule. It is hard to overcome the inertia of the status quo. However, when it comes to advocacy, I would posit that we must—and attending April’s Congressional Advocacy Day, held in conjunction with the Mid-Year Forum, is a great opportunity to build momentum toward change.

    The first Congressional Advocacy Day and Mid-Year Forum I attended was in 2019 as a second-year ophthalmolo­gy resident at the University of Cincinnati. An ensuing global pandemic led to the cancellation of in-person meetings, but I was still able to attend the 2020 and 2021 Virtual Congressional Advocacy Days and Mid-Year Forums and was able to attend Mid-Year Forum 2022 in person during fellowship. Attending Mid-Year Forum four times during training was not easy and required careful scheduling of studying, call, vacations, clinic and surgery, and life outside of work. I found myself on late flights and twilight drives, but always more energized on returning home than when I left.

    We sacrifice so much of our youth and our lives to becoming physicians and ophthalmologists in order to care for patients, but ultimately there are many external political, financial, and regulatory forces at play that control how that care is delivered. To passively acquiesce to the status quo is simply not acceptable.

    It has never been easier for residents to attend Mid-Year Forum, thanks to the support of Advocacy Ambassador Program scholarships through state and subspecialty societies (aao.org/mid-year-forum/advocacy-ambassador-pro­gram). Many residency programs will even allow the time and resources to go to Capitol Hill. Residents, fellows, and all ophthalmologists must find the energy to move beyond inertia into momentum to advocate for our profession.

    The future of ophthalmology is predicated not only on our ability to care for our patients, but also on our efforts to impact and guide the external forces that influence the delivery of care. Attend Mid-Year Forum 2023; I promise the experience will be worthwhile and you will carry the energy through your life and career.

    Arjan Hura, MD
    Young Ophthalmologist Advocacy Subcommittee Member,
    Los Angeles

    Editors’ note. Learn more about Mid-Year Forum 2023 and how to register for it at aao.org/myf.

    WRITE TO US. Send your letters of 150 words or fewer to us at EyeNet Magazine, American Academy of Oph­thalmology, 655 Beach Street, San Francisco, CA 94109; e-mail eyenet@aao.org; or fax 415-561-8575. (EyeNet Magazine reserves the right to edit letters.)