Wise Words for the Graduating Retina Fellow

Advice from the experts on how to ensure a smooth and successful transition into practice.

By David Ehmann, MD
 

The saying “Time flies when you’re having fun” could not be more true. On June 30th, my vitreoretinal surgical fellow colleagues and I will leave the nest for good—and with it, all the comforts, familiarity, and safety of surgical training. For most of us, this will end a decade of training that has demanded 100% commitment and a lot of sacrifice in order to learn the profession we love.

Whether in academics or in private practice, we will all soon face the excitement and challenges of starting and building a practice. At the same time, many of us will face other exciting changes, such as moving to a new location, buying a home, and starting a family. Of course, there will also be a significant increase in income that some of us may feel ill equipped to manage properly. Was the Notorious B.I.G. right when he said, “Mo’ money, mo’ problems,” or is there a tried-and-true path to financial freedom?

Without a doubt, the first year in practice will have challenges professionally, personally, and financially. To ensure the smoothest transition possible, I asked several of my mentors for their wisdom on the matter. Below is what they had to say.

Carl D. Regillo, MD

The first year in practice can be challenging. It is important to keep in mind that learning does not stop at the end of fellowship. In addition to the technical aspects of practice (eg, when to operate, what exactly to do in the OR, etc.), you must also work on addressing patient needs and expectations. Thus, it is important to learn how to effectively and efficiently communicate with patients. Just as with medical knowledge and surgical skills, this will take years of experience to master.

Use the free time you have early on to get to know the area near your new place of practice to help you determine where to buy a home. Being familiar with your surroundings and getting to know the local referring doctors will also help you to foster a solid referral network. Lastly, although income may increase significantly after fellowship, expenses also rise quickly, especially if one has a growing family, so proceed with caution and exercise restraint regarding large purchases such as a home and cars.

Sonia Mehta, MD

My advice to retina fellows starting their first year of practice is to always focus on what is best for your patients. Taking excellent care of them will build your career more than anything else. I take the time to listen to my patients, understand what is bothering them, and explain their conditions to them. Patients appreciate the time and effort spent on their care, and when a patient returns to his or her referring doctor, family, or friends and praises you for this, it is your best marketing tactic. Avoid criticizing another physician or retina specialist in front of your patients; it is rare that anything good will come from this practice.

Richard S. Kaiser, MD

Clinical advice upon starting a practice:
• Take your time with patients.
• Personally meet all of your referring doctors.
• Be extra nice to all those who help you—from the file clerk to the office manager.
• You can always perform an elective surgery at a later date.
• If you find yourself thinking about it, put on a buckle.

Life advice:
• Rent, do not buy (50% of retina specialists leave their first job).
• Pay off your debt before you buy a sports car!
• Always have a lawyer read any contract before you sign it.
• Watch for high fees and biases when selecting a financial advisor.
• When in doubt, ask for advice. Even if you are not in doubt, ask for advice.

Julia A. Haller, MD

Some of the best advice that I have ever heard on building a practice when starting out came from the famous Wills pediatric ophthalmologist Joseph H. Calhoun, MD, who said that the key is to be the three As: Able, Affable, and Available.

When I started out, I saw patients on Fridays because most other clinicians did not want to. Because I was essentially the last man standing at the hospital, I was “lucky” enough to see a lot of the end-of-week retinal detachments and endophthalmitis cases. That makes you a lot of friends quickly, as does being willing to drop everything and speed to the rescue of your cataract colleagues when a lens goes south in the OR.

Also, you will be so busy you will need to remember to have a date night every week with your significant other. Schedule things like vacations and trips way in advance so you have something to look forward to.

Allen C. Ho, MD

• Spend time with your family and friends.
• Enjoy free time if you are not so busy in year 1. After working continuously through training, it can be a challenge to manage free time.
• Take some time to meet your community of eye care colleagues and foster new relationships.
• Explore interests that you may not have had time to dive into because of the demands of medical training.
• Lean on your mentors and colleagues from training to help with clinical challenges and to evolve research interests. At the same time, mentor someone who may benefit. In essence, remember to give back.
• Create a foundation of balance in your life, whether it be reading or running—whatever your interest. Work will only get busier as you move forward, and balance helps when work gets demanding.

 

Section Editor Murtaza Adam, MD
• second-year retina fellow at Wills Eye Hospital in Philadelphia, Pa.
madam@midatlanticretina.com

Section Editor David Ehmann, MD
• second-year retina fellow at Wills Eye Hospital in Philadelphia, Pa.
dehmann@midatlanticretina.com

Section Editor Sundeep Kasi, MD
• second-year retina fellow at Wills Eye Hospital in Philadelphia, Pa.
skasi@midatlanticretina.com

 

Julia A. Haller, MD
• professor and chair of ophthalmology, Thomas Jefferson University; ophthalmologist-in-chief, Wills Eye Hospital, both in Philadelphia, Pa.
• member of the Retina Today editorial advisory board
@JuliaHallerMD; jhaller@willseye.org

Allen C. Ho, MD
• director of retina research, Wills Eye Hospital; surgeon, Mid Atlantic Retina; professor of ophthalmology, Thomas Jefferson University, all in Philadelphia, Pa.
• chief medical editor, Retina Today
achomd@gmail.com

Richard S. Kaiser, MD
• professor of ophthalmology, Sidney Kimmel Medical College, Thomas Jefferson University; associate surgeon at Wills Eye Hospital; codirector of the Wills Eye Hospital retina fellowship program, all in Philadelphia, Pa.
• member of the Retina Today editorial advisory board
kaiserrick@aol.com

Sonia Mehta, MD
• assistant professor of ophthalmology, Thomas Jefferson University; and attending surgeon, Wills Eye Hospital Retina Service/Mid Atlantic Retina, all in Philadelphia, Pa.
smehta@midatlanticretina.com

Carl D. Regillo, MD
• director of the Wills Eye Hospital retina service; professor of ophthalmology, Thomas Jefferson University, both in Philadelphia, Pa.
• member of the Retina Today editorial advisory board
cregillo@aol.com


Tags: fellowship
 

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About Retina Today

Retina Today is a publication that delivers the latest research and clinical developments from areas such as medical retina, retinal surgery, vitreous, diabetes, retinal imaging, posterior segment oncology and ocular trauma. Each issue provides insight from well-respected specialists on cutting-edge therapies and surgical techniques that are currently in use and on the horizon.