Advice for first-year residents

First-year residents, welcome to ophthalmology, by far the best field in medicine! The next 3 years are going to be exhilarating, nerve-wracking, fun, and will go by way too fast. The first few days and weeks can be the most stressful, especially since many of us come from medical school and internship without even the basics of ophthalmology know-how (we couldn't even do a basic ophtho exam on our first day!).

But don't fret-this happens every year, and everyone gets through just fine. You must have been pretty clever to get into an ophthalmology residency; furthermore, your faculty, your senior residents, the nurses, and staff are around to help.

We, too, are in a period of transition. Husam began his glaucoma fellowship on July 1, and Parag is now a third-year resident-the years pass so quickly. We thought we'd take this opportunity to reflect on our time as residents. Here are the best pieces of advice we can offer you. As the months pass and residency becomes busier, these seemingly obvious ideas are all too often forgotten.

Ophthalmologists often focus only on patients' eye problems and forget to consider the big picture. Is that orbital fracture from domestic violence? Does a patient's history of breast cancer have anything to do with her new complaint of diplopia? Is your patient with end-stage glaucoma still driving? Is your patient with macular degeneration depressed and suicidal? Do they miss appointments with you because they don't have insurance?

Not only must we care for the entire patient, but we must also remember that we are part of a team of doctors caring for that patient. For example, let the primary-care doctor know that the patient's diabetic retinopathy has progressed.

Read regularly

We know-this is very hard to do. The days are long, you're exhausted, and your significant other is already complaining that you're never around. The 13 volumes of the American Academy of Ophthalmology (AAO) Basic and Clinical Science Course (BCSC) are overwhelming to look at, not to mention densely written. Before you know it, the Ophthalmic Knowledge Assessment Program (OKAP) will come and go, and your BCSC will still be in its plastic wrapper. Do not let this happen. Our advice is to read regularly, whether it is a few minutes each day, or for a few hours every weekend. We also recommend starting with something easy to digest-the Chern Ophthalmology Review Manual is popular at our program.

Walk in your patients' shoes

Dealing with insurance hassles, waiting for hours at another hospital's emergency room, getting discharged without definitive treatment, navigating parking and transportation difficulties, not to mention waiting to see you in resident clinic-many of our patients have been through a lot before they finally get to the exam room, especially those who are indigent.

Add to this the stress and pain that accompany an eye injury, or the fear of going blind (the thought is on their mind, even if it is just a corneal abrasion). It can be difficult for any of us to remember our patient's point of view as Friday afternoon quickly becomes early evening and you still have patients waiting. But, do your best to imagine the patient's mindset. Spend time with them the way you would if you were seeing a big donor or hospital VIP. It is the right thing to do, and all your patients deserve that.

Be a team player/support your fellow residents

Even though ours is primarily an outpatient subspecialty, you and your fellow residents are still a team. You must always behave as such. Support each other. Don't speak badly about one another to colleagues, attendings, or members of other departments.