Success measured in many ways

"Money can't buy happiness. But then, happiness can't buy government-insured CDs."
-Bruce Willis as David Addison on "Moonlighting"

"Want to know which of your classmates will earn the most? Just take the class academic rank order and invert it."
-A guy in the medical school class ahead of mine

The other day I took the morning off from work to attend a ceremony at my daughter's school. She was being inducted into the Cum Laude (Honor) Society in recognition of her academic performance. (I know, I know. She must take after her mother.) This is a group of straight-A students.

Each year at this event, a distinguished speaker is invited to address the group. A perusal of the program revealed that past speakers included U.S. Supreme Court justices, well-known publishers, and other famous individuals. This year, the invited speaker was none other than the president of my university, William R. Brody, MD, PhD.

His introductory comments grabbed my attention. "At the beginning of every school year," said Dr. Brody, "I tell my faculty the same thing. 'Be nice to your students who get As and Bs because they are your future colleagues on the faculty, but be especially nice to your students who get Cs and Ds because they are the people who will have their names on the new buildings on our campus.' "

He went on to say that success in life is defined in multiple ways, that many skill sets are important, and that grades are only one measure of academic achievement. He also talked about being at the stage in his life when he found himself asking questions about what he has accomplished in his life, whether he has made an important difference, and whether he has helped others.

For ophthalmologists, success probably is measured by different metrics along the way. In college and medical school, we use grades. During internship and residency, it's about our patients doing well and the feedback from faculty, Ophthalmic Knowledge of Assessment Program (OKAP) exam scores, and the board exam. In practice, it's about building a large and loyal following of patients and referring doctors, the number of patients on whom we operated successfully to restore vision, and the financial success of our practices. In academics, it gets a little fuzzier sometimes: Did we inspire our students and junior faculty colleagues, did we teach them how to think better than before, and did we start them on the paths to successful careers?

The same day I heard Johns Hopkins University President Brody say that the ultimate philanthropy of today's C and D students would build future university buildings, I learned about a study from Ohio State University about the relationship between IQ and wealth. It turns out that intelligence has little to do with being rich.

Jay Zagorsky, PhD, a research scientist with the university's Center for Human Resource Research, found that people in the middle of the intelligence spectrum tend to have the fewest money problems. It's unclear why smarter people apparently earn good salaries but have trouble accumulating wealth, but one conjecture is that they can be overconfident and take excessive risks.

What should we conclude? Should we tell our children that, instead of trying for As, Bs and Cs are good enough and that they should spend time doing other things so they are more well-rounded? Instead of encouraging our residents to get outstanding scores on the OKAP and board exams, should we tell them that just passing is fine and that the extra effort involved in trying to be in the 90th or higher percentile is an example of diminishing returns? Should ophthalmologists working on recertification do the absolute minimum necessary and take as little time as possible away from their practices, patients, and families?