BLOG: Maximizing surgical training in residency for ophthalmology
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There are several ways to maximize your surgical training during residency.
Prepare, prepare, prepare.
Preparing technical skills early in the wet lab and on simulators is key. The sooner you have started trying to apply surgical techniques, in any setting, the sooner you will start actively learning. I’m probably not the first one to mention this, but I’d like to offer one more suggestion: Watching a skilled surgeon manage difficult pathology in a case is critical to learning. Be mindful of how the surgeon holds their instruments, maximizes their view and drapes the patient. Going back and watching an experienced surgeon after learning the steps of a procedure should feel like taking a master class.
Follow up on patients after the patient is no longer in your care.
Keep a surgical journal and follow up on outcomes, good and bad. I learned the most from my more challenging cases. Critically, I learned sometimes even with a longer time to recover, patients can still gain 20/20 vision. Following up on patients and outcomes, even when I was no longer on a “rotation” or the patient was not specifically in my care, really helps you counsel future patients with whom you may have similar challenges.
Get familiar with lens calculations early on.
This will help with optics, understanding effective lens position and moving things toward a more sophisticated understanding of how to get patients to 20/20. While the IOLMaster (Zeiss) and Lenstar (Haag-Streit) calculations can seem daunting at first, taking time to learn how to interpret these can enhance understanding and also help you recognize when the data are poor — and thus avoid a major refractive error.
Ask for feedback and take that feedback.
Get comfortable working with different faculty with different communication styles. Even a quick debrief after a case can be hugely helpful when reviewing your own film later. Along this line of thinking, the best advice I got about being efficient was to stop thinking about being efficient, and instead focus on doing each step of surgery correctly before moving to the next portion of the procedure.
Think long term while in the short term.
Focusing on the end game will make you a better surgeon and more prepared in the long run. Recording the phaco settings on a machine can help you hit the ground running in fellowship or private practice, but also can help as you move from hospital to hospital in terms of finding consistency with your cases. Moreover, paying attention to how different instruments feel to you in surgery, for example, the Koch spatula vs. a chopper, can help you spot when an instrument may have a defect after sterilization and help you stay ahead of the curve when doing cases.
“You are never wrong to do the right thing,” even if it takes time and ends up being more circuitous than expected.
- References:
- Chiang A, et al. Preparing for and maximizing your surgical retina training. Retina Today.
- Modi K. Bringing surgical training into focus. Glaucoma Today.
- Siatkowski RM. 8 keys for a successful ophthalmology residency. YO Info.
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