Picking the Right Mentor: Ophthalmology Edition

As outsiders looking in, most people understand that becoming a doctor is challenging. It is not difficult to comprehend that getting into medical school is hard, that the content is far from easy, or that doctors sacrifice a significant amount of time and effort in their pursuit of medicine.

What is difficult to comprehend is that after so much training many doctors never get the opportunity to practice in the specialty of their choosing. Here is what I mean:

The path to ophthalmology residency is the culmination of decisions made to that point. Each decision subsequently leads to a different experience. Each experience can change your view of a specialty or that specialty’s view of you.

Trying to analyze every decision you make in a four-year period is simply impossible. Breaking this up and focusing on the most important aspects of pre-clinical and clinical years makes the process easier to understand.

The first two years of medical school are essentially an extension of college, just learning more material in less time. Medical schools have done their best to integrate clinical medicine early into their curriculum but still predominantly focus on building a sturdy medical foundation.

The culmination of the first two years revolves around one exam: STEP 1. Historically, this exam has been described as the test that determines the rest of your life. You have one shot at it, so you better make it count. With a good score, your options for residency are wide open. However, with a bad score, your path to a competitive residency is not impossible, but definitely a more uphill battle.

Today, STEP 1 has been made pass/fail, removing the mania experienced by previous medical trainees in preparing for the exam. However, that does not mean that the first two years of medical school can be ignored. Actually, it’s quite the opposite. Now more focus will simply be placed on the evaluation of the clinical years, so the natural question becomes how to succeed there. The answer is simple: build a good foundation.

How do you do that? You work hard to gain a conceptual understanding of how the body works. This way, when you are a new student on your clinical rotations being pushed to think like a doctor instead of a textbook, you don’t have to worry about remembering physiology, pathology, and pharmacology, but instead impress your attending by thinking about what really matters – the patient.

Once you have succeeded in your first two years of medical school and it’s finally time to put your knowledge to work, you are hit with a strong reality. The doctors you work with have a massive influence on your impression of each specialty. With finite time allocated to each rotation, exposure is limited and the people you surround yourself with become exceedingly important.

There are countless stories of students absolutely knowing that they wanted to practice a specific specialty, say ophthalmology, then have a preceptor unwilling to teach and feel as if their rotation was a “waste of time”. This very well may be their only opportunity to experience the field and it can dissuade them from pursuing their dream.

At the same time, there are stories that are the exact opposite. A willing and passionate teacher has the ability to sway even the most disinterested student into considering a specialty. Ophthalmology is a prime example. Student exposure to the field is limited as it is not considered a core rotation; therefore, making the most of your elective is critical. Here is where mentors come in.

Here are the top 5 attributes students look for in an ophthalmology mentor:

There is a hierarchy in medicine with attendings at the top, residents in the middle, and medical students at the bottom. This hierarchy exists for a reason. The attendings have the most experience and knowledge while students have the least. It’s a system in place to keep patients safe while providing a structured learning environment for everyone else.

Does that mean that students should fear their attendings? Absolutely not. In order for you to learn from someone and even start considering them as a mentor, you need to be able to be yourself around them. You need to be allowed to speak freely and ask questions, albeit at the proper times. After all, they were once in your shoes too.

It’s called medical school for a reason. As a student, you are here to learn. In today’s day and age, we have the luxury of technology. The resources we have access to allow us to look up nearly anything in an instant, but medical school should not be entirely self-taught.

A good mentor understands what we have at our disposal and uses it as a supplement, not as a primary teaching tool. A good mentor will take time before, during, and after patient encounters to describe relevant teaching points.

Ophthalmology is a rapidly evolving field both medically and institutionally. Applying to ophthalmology residencies today is vastly different from applying 20, 10, or even 5 years ago.

By understanding what programs emphasize in their students, mentors have a better ability to coach their mentees into focusing on the proper aspects to strengthen their application.

We live in an era of analytics and it seems as if everything is being quantified in one way or another. The competitiveness of modern medicine has effectively turned students into walking checklists. Put simply, you need to meet the criteria to get a look.

If you are applying to ophthalmology, you likely already have great scores, experience, and even published papers. Something to give you an edge over the other applicants is research experience in ophthalmology. Having a mentor willing to conduct research with you—or who has a network of people who are—is a major plus.

Last but not least is connections. The bottom line is that most applicants are probably going to be good, if not great. Every applicant has more than likely checked every box on their hypothetical checklist, so how else can you get an edge?

You need to remember that during your residency, you are going to spend a lot of time with the people in your program. They become like family, so you may as well like them, and they may as well like you. That is why it’s so important to ensure the program is the proper fit, and programs know this.

The more people you know in the field the better. Not only can they vouch for your character but can also guide you to finding the program that is the proper fit for you. A mentor willing to help with this is invaluable.

Overall, medical school can be divided into two phases: preclinical and clinical.

During your preclinical years, the aspect you have the most control over is yourself. The more time and effort you dedicate towards building a strong foundation, the better.

Your clinical years are far more variable. Each student is exposed to a different set of faculty that will help shape their impression of individual specialties. Here, finding the proper mentor to help guide you towards your goals is imperative.