"In medicine, however, you cannot afford to be poor at any aspect of your work because in most instances it directly influences someone's health."    -Jay Sridhar

Jay continues the convesation with Mike and Louie about clinic vs. OR, and how preferences can shape your career.

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LC: Do you find it's common that people tend to shape their careers around their forte or do most ophthalmologists have relatively balanced practices? Also a related question: If during my training I discover that I'm better in clinic than in the OR, would it be more effective to hone that strength or spend more time improving my weaknesses?

JS: Tough questions that I will not pretend to be smart or wise enough to answer well. The most I could say is that when you read about or talk to successful people in general life they talk about maxing out strengths. The more you do something, the better you get (see Malcolm Gladwell's 10,000 hour theory) and if you are good at something already the ceiling should be higher.

In medicine, however, you cannot afford to be poor at any aspect of your work because in most instances it directly influences someone's health. What you can do is tailor a career to strengths; maybe stop operating and focus on research if that's your love and strength, or refer complex ocular oncology patients to another doctor who is a specialist. Maybe the most important talent you can have as a physician is to know your limitations, work hard to improve what you can, and ask for help when you need it.

However, as a resident your goal should be to be as good as possible at everything. It's too early in your training to punt on operating, for example, and the ACGME has basic requirements in terms of knowledge base and skills that are necessary to graduate an ophthalmology residency. So if you realize you are deficient seek help from mentors and work to improve.

LC: Those are wise words and very applicable to our medical training now as well. Even if we know we're going into ophthalmology, we have a duty now to excel as medical students for we never know when our knowledge may be useful and aid in the care of a patient. Who knows how the future of medicine may be like, and we have all the possible tools to be prepared to handle anything.

MV: I agree with Louie and really like that analogy! It's nice to hear about the variety of exposures we will receive, and also about the ability to customize our career to our interests.

When you were going through medical school and deciding on ophthalmology, did you know/assume that you'd prefer the OR over clinic, or was that a preference that came out during residency or fellowship?

JS: I had no idea because I loved both the clinic and the OR for ophthalmology. As a resident I actually preferred clinic in some ways; the OR lends itself to simultaneous excitement and anxiety when you are starting since the only way to avoid complications completely is to not operate at all. But as a fellow as I gained in confidence operating full-time as a retinal surgeon the OR slipped ahead in my personal rankings.

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