The path to learning ocular surgery is a long and challenging one, but it is enjoyable and worth the investment to bring sight to our patients. True success requires years of dedication and the passion to consistently learn from every case and evolve your technique every year.
During the years of residency and fellowship training, basic surgical skills are acquired relatively quickly and the fundamental techniques and procedures are learned. Because this part of the learning curve is the steepest, there is a frustration barrier that must be overcome to get your hands to do what you need. No one is born knowing how to suture with 10-0 nylon monofilament, so extensive practice in the wet lab is instrumental in learning. Similarly, manual dexterity must be developed in both hands with particular attention paid to bring the non-dominant hand up to par with the dominant hand. Modern day cataract surgery is two-handed and the older, one-handed techniques are not as safe or efficient.
The blue line in our graph is the young doctor who cannot find the drive to push past the frustration barrier to become an ophthalmic surgeon. As such, this doctor will drop out of training, switch to a different medical specialty, or choose to be a medical ophthalmologist who does not perform surgery.
Completing residency training will allow the ophthalmologist to acquire a reasonable surgical skill set and to become a competent surgeon, but not to become a true expert with the highest level of surgical skill and judgment.
The red line in our graph is the surgeon who is able to get past the frustration barrier and become a competent surgeon. But the passion and the drive to be better, simply is not there. This doctor will be stuck in this zone of mediocrity forever and will simply do the techniques that were learned back in residency training. We have all seen the surgeons who continue to perform older, outdated procedures because that is what they learned decades ago and that is where their comfort level lies. The critical question to ask is, “Am I doing the best for my patients and am I giving the surgery that I would want to receive?”
Uday Devgan, MD, FACS
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Dr. Devgan is in private practice at Devgan Eye Surgery in Los Angeles and Beverly Hills. He is clinical professor of ophthalmology at the Jules Stein Eye Institute at the UCLA School of Medicine and Chief of Ophthalmology at Olive View-UCLA Medical Center. Dr. Devgan owns and runs CataractCoach.com, a free teaching website where a new article/video is posted every day.