Prof & Pupil: From Medical School to Residency, and Beyond

"The only thing worse than being blind is having sight but no vision."  -Helen Keller

Jay talks with Mike and Louie about which skills best carried over between medical school and ophthalmology residency. They realize how important it is to stay connected to other specialties. 

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LC: Dr Sridhar, for someone going into ophthalmology, which skills from other clerkships helped you out a lot during residency? 

JS: Thats a phenomenal question Louie. The cop out answer is all of them contribute because the most important skills to develop are a strong work ethic and a dedication to approach patients compassionately, intelligently, and efficiently. You gain that skill over time via repetition regardless of subspecialty rotation. I will say that the major principles I learned in general surgery about hemostasis, minimizing surgery duration, and tying good square surgical knots all were extremely applicable during ophthalmology residency. Understanding internal medicine is critical given how many systemic conditions manifest in the eye. You would be surprised how often you are the first doctor to tell a patient they have hypertension or diabetes. Even malignancies such as leukemia may be first noted on funduscopic examination. 

MV: I just started Internal Medicine today and have my Surgery block next, so I’ll definitely keep those points in mind throughout these rotations! I often hear others claim that ophthalmology is this isolated niche where you “put away your stethoscope” and forget about the rest of the body, but it’s great to hear how that is far from the truth. Thanks for the great perspective, Dr. Sridhar.

JS: When I interviewed Dr. Craig Greven he referenced how ophthalmologists sometimes isolate themselves from other parts of medicine and how we cannot forget the importance of communicating with our non-ophtho colleagues. Never forget how frustrating it could be as a student on a primary care rotation to either not know what happened at a patients subspecialist appointment or to not be able to reach the subspecialist with questions. This will reinforce your feeling of responsibility to send accurate and useful letters to your referring primary care physicians as an ophthalmologist. 

LC: I completely agree. It's so easy to forget how specialized the knowledge is. Our acronyms make documentation more efficient but often make it less interpretable for general practitioners. I'm starting to realize how important it is to effectively communicate the implications of the diagnoses and management plans we create .

JS: And acronyms vary from institution to instruction! I did not realize this until I started fellowship, but even similar programs can have very different ways of saying the same thing. Similar to how a sub sandwich in Miami is a hoagie in Philadelphia. 

LC: One thing I noticed on my clerkships was that whenever a patient has anything eye related, ophthalmology is consulted. What criteria would you say warrants a consult? For example dry eye or viral conjunctivitis could potentially be managed by the general team. Or is it better to be safe than sorry? 

JS: A great question and one we should save for a bigger piece next week. Come by for next weeks post and we will discuss inpatient consults.

To be Continued...

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-Adapted from a real conversation between The Professor (Jay Sridhar) and The Pupils (Louie Cai and Mike Venincasa).