FEATURE ›› REAL-WORLD RETINA
REAL-WORLD RETINA:
Building Strength Through Connections with Colleagues
BY SUSAN WORLEY, CONTRIBUTING EDITOR
Young retinal physicians, in addition to mastering intricate technical skills, are expected to exhibit professional qualities, such as endurance, resilience and the ability to think independently. Consequently, on the threshold of a new career when they're still in the process of getting their bearings, it can be easy for self-reliant new practitioners to underestimate the importance of forming support networks.
“Networking is one of the most critical facets of career development in a field as small as retina,” says Svetlana Pilyugina, MD, a retina specialist still in the early years of private practice in California, and chief editor of New Retinal Physician. “The ties we begin to form in our early years of practice enrich us in many ways, often opening new doors and sometimes pointing us toward new career paths. In fact, my role as editor of this publication came about through such ties. More importantly, every effort to make new friends and acquaintances among colleagues generates new opportunities to learn from one another.
“We may go to the various meetings to deepen our scientific knowledge, but what happens outside the meeting rooms is just as significant,” she continues. “By sharing our stories and experiences during social hours, we gain valuable practical knowledge and support that is outside the scope of formal presentations, but every bit as important.”
PROFESSIONAL PEARLS
CARL C. AWH, MD
LEARNING TO REACH OUT TO OTHERS
Many new retina specialists are introduced to the world of professional networking during their residency and fellowship years, through programs that address the needs of those still in training. One notable offering during the final year of vitreoretinal training is the annual Retina Fellows’ Forum. This educational and social program, established 15 years ago and sponsored by industry, exposes fellows to the personal and professional value of interacting with colleagues as well as soaking up the wisdom of veteran practitioners.
At the most recent Fellow’s Forum, Yale Fisher, MD, of the Bascom Palmer Eye Institute, demonstrated the power of a personal story to move and enlighten colleagues when he delivered the 2014 distinguished guest lecture. During his lecture, Dr. Fisher described how a simple misunderstanding (that he attributed to his own fear and vulnerability) impacted his life and career, and could have been avoided if he had reached out to others for support. The silence among the 83 North American vitreoretinal fellows in attendance was testament to the eagerness with which they absorbed Dr. Fisher’s story.
“I explained that the fears that had caused this simple misunderstanding were unfounded,” says Dr. Fisher, “And I reminded the fellows of what Sophocles, the Greek playwright, had said: ‘to a man in fear, every leaf rustles.’ Instead of sharing with others an incident that troubled me, I kept it inside, and I ended up magnifying the problem in my mind. I learned the hard way that if you’re wrestling with a problem, it’s better to reach out to senior members of the practice or other colleagues who are in your camp.”
After his lecture, Dr. Fisher encouraged the fellows to view one another as allies.
“The fellows in that audience had been in intense competition with each other during their years of training, so it was important to point out that this was not only a time of great celebration, but also a time to stop thinking of those seated next to them as competitors,” he explained. “Now was the time to begin to recognize colleagues who had been helpful to them and who had earned their trust, and perhaps even make allies with those who had caused tension in the past. With the intense competition now behind them, I urged them to share their good times and bad times with each other, rather than attempting to deal with everything on their own. We all face problems at one time or another, and when we do, it’s important to resist the tendency to turn inward or run away.”
Many new retina specialists first recognize the value of turning to colleagues for advice while making early career decisions — as they ponder whether to work in an academic or private practice environment, and whether to pursue particular job opportunities. For some, the process of mulling over choices and weighing alternatives in dialogue with peers quickly becomes a lifelong habit.
“After my fellowship, I spent a couple of years in private practice,” says Anjali Shah, MD, a retina specialist at the Kellogg Eye Center in Michigan, and an instructor in ophthalmology at the University of Michigan. “And that’s when I discovered the value of having a network of former mentors and colleagues. I turned to them to get their thoughts on difficult or unusual cases, or on topics such as emerging treatments and how and when to use them. The opinions of my mentors played an especially significant role in my decision to make a career change.
“It was through discussions with colleagues that I came to realize how much I missed the collegiality and camaraderie of being in a bigger practice, with all the resources a university setting offers,” she adds. “I think at every stage of your career, there will be people who understand where you are and where you’ve been, and it’s by talking with those people that you gain a deeper insight into what it is you want to do.”
EARLY FORMAL NETWORKING
Formal networking options for retina specialists include an array of national and international organizations, such as the American Academy of Ophthalmology (AAO), the American Society of Retinal Specialists (ASRS) and the Association for Research in Vision and Ophthalmology (ARVO), many of which offer opportunities to get involved during residency and fellowship years.
“Each of these organizations offers a unique blend of educational and collegial support, so new practitioners may need to take time to research their offerings to determine which organizations are a good fit for them,” says Dr. Pilyugina.
Purnima Patel, MD, a retina specialist at the VA Medical Center in Atlanta, assistant professor of ophthalmology at Emory University, and a member of the Young Ophthalmologist (YO) committee of AAO, says she attended her first AAO annual meeting during residency. She is quick to point out that AAO members in their first 5 years of practice, as well as residents and fellows, are considered young ophthalmologists. The AAO provides many offerings to specifically meet the needs of young ophthalmologists, including specialists.
“Although I am a retina specialist, I think of myself as an ophthalmologist first, so I will always be an Academy member,” says Dr. Patel. “The services that AAO offers, including assistance with the recertification process and educational materials, are indispensable. As a YO committee member, I assist in developing the 4-hour YO program offered at the AAO Annual Meeting. We present career-related topics that aren’t covered in residency, such as contractual negotiations and ways to increase your value as a young employee.”
Dr. Patel enthusiastically participates in the advocacy efforts organized through AAO, which most recently have focused on issues, such as funding for the National Eye Institute and for veterans who have suffered eye trauma in battle. She also benefits from the Retina Subspecialty Day program offering by the AAO during its annual meeting. “The community of retina specialists is small, and I’ve found that a great way to get to know people is during the Subspecialty Day program,” she says. “During the 2-day program, developed by and for retina specialists, you hear about the latest research and listen to experts discuss hot button issues.”
Dr. Patel says the Academy also has an online retina community (aao.org/community/) that enables specialists to ask questions of colleagues and observe which topics are trending. Also a member of the ASRS, Dr. Patel says that together, the two memberships make it easy for her to keep up to date in her field.
AAO, ASRS and similar organizations often make memberships more affordable by lowering the cost of dues for young practitioners. However, because time and cost can be limiting factors for young specialists, it often makes sense to supplement one or two of these memberships with options that are closer to home.
LOCAL AND INFORMAL NETWORKING
“Involvement with state and local organizations can be a good way to establish a solid professional foundation,” says Dr. Pilyugina, who is a member of the California Academy of Eye Physicians and Surgeons (CAEPS), a statewide organization that represents both ophthalmologists and their patients. “CAEPS offers opportunities to interact with your community through legislative advocacy, public education and continuing medical education programs for ophthalmologists and their staff members.”
David Wu, MD, PhD, a retina specialist at Massachusetts Eye and Ear, and an instructor at Harvard Medical School, is a member of ARVO and ASRS, but says he relies more heavily on local and informal networks. Dr. Wu attends a local meeting of retina specialists in Boston every 4 months, which offers him the chance to meet local colleagues and discuss new or unusual surgical scenarios. “I’m also still in regular contact with my former co-fellows and the attending surgeons with whom I trained. Although we sometimes spend time just catching up on our lives, our conversations can easily turn to difficult surgical cases, and talking with colleagues is both fun and helpful,” he says. “At an academic center, grand rounds are also great opportunities to interact with faculty and continue lifelong learning.”
Brian VanderBeek, MD, MPH, a retina specialist at the Scheie Eye Institute and an assistant professor at the University of Pennsylvania, agrees with Dr. Wu about the value of local and informal ties. “I’m affiliated with AAO and ARVO, but informal networks have been far more central to my growth as a retina surgeon,” says Dr. VanderBeek. “There’s something to be said for being able to turn to people you know and trust, and being able to ask questions without fear of judgment. I’m fortunate to have joined a practice with two senior attendings who understand the trials and tribulations of a young retina specialist, and the intense pressure we can feel. They’ve been more than gracious with their time and advice when new or difficult situations have come up.”
Another networking option allows new retina specialists to establish a mix of formal and informal professional ties. “I’ve trained a number of fellows over the years, most of whom have gone into private practice,” says Philip Rosenfeld, MD, “And the first piece of advice I always give is: don’t be embarrassed to ask for help. Our profession has a long tradition of assisting new retina specialists during their first few years, and all of us enjoy sharing our knowledge. My second piece of advice is to get involved in clinical trials. When you’re just starting out, it’s one of the best ways to establish new ties with colleagues. Clinical trials provide an incredible education, in part because you really drill down into the details of various diseases, and you have a unique opportunity to follow patients. And, more importantly, you get to meet senior colleagues who will share valuable stories with you.”
THE GROWTH AND EVOLUTION OF INFORMAL NETWORKS
The great demand for informal collegial networks among new retina specialists can sometimes lead to the surprisingly rapid expansion of an informal group, and even to the unanticipated birth of a new formal organization. Indeed, that’s how Thomas Albini, MD, became an executive member of the recently formed Vit-Buckle Society.
“In January 2006, a group of my colleagues, who first met at the Fellows Forum and then became friends on the interview trail, began to get together informally at larger meetings to discuss surgical cases,” says Dr. Albini.
During informal dinner meetings, the fledgling group discovered intriguing variations in the way surgical techniques were performed in different parts of the country.
“There’s a great deal of variability in surgery — many ways to skin a cat, as I often put it,” says Dr. Albini, “And if you only see how something is done in your own environment, you won’t be exposed to a rich variety of other techniques. Something as fundamental as how a scleral buckle is attached to the eye — whether through sutures or scleral tunnels — can vary enormously. Our dinner meetings provided friendly, informal opportunities to learn about other surgical techniques.”
Between 2006 and 2012, attendance grew so rapidly that it was necessary to start turning people away, and begin searching for venues to accommodate attendees. In 2013, the Vit-Buckle Society established itself as a formal, dues-supported organization. Annual meetings now feature a lecture hall and stage, but Dr. Albini says the goal is to keep the atmosphere friendly and informal. The society avidly seeks members who have completed a fellowship program and have been in practice in the United States or Canada for less than 10 years. The group also welcomes more senior participants and, in the future, may begin to establish an international membership.
Two older prestigious organizations once started in much the same way. “The Retina Society is the oldest retina organization in the United States,” says Charles Barr, MD. “It began when Charles L. Schepens, MD, of Boston started inviting fellows to small, informal meetings about 50 years ago. He gradually extended the invitations to other academic specialists, and in 1968, it became a formal organization.”
Although interested specialists must apply to the Retina Society and undergo evaluation according to a point system, Dr. Barr says it is far from a closed society. “We’re very much looking to accept new members who’ve been in practice at least 2 years. Young members are the lifeblood of the organization; we’re eager to have them come in and teach the rest of us. There may be a misconception that we’re a purely academic society, and that simply isn’t true. Many of our members are in private practice, but they’re specialists who continue to be involved in research.”
Dr. Barr says most members of the Retina Society also belong to the Macula Society, an organization with similarly informal roots. Established in 1977 by Lawrence Singerman, MD, the Macula Society has a significantly larger international presence.
STAYING CONNECTED AND INFORMED
All specialists interviewed for this article agree that the friendly nature of the small retina community and the large number of retina meetings make it easy for new specialists to stay connected.
“Few weeks in the year go by without a retina meeting and it’s important to take advantage of what they have to offer,” says Dr. Albini “From year to year, the changes in the field are exciting, but also very rapid, and it’s important to keep reading and getting involved. It’s also crucial to maintain connections with your mentors, because unexpected situations will arise, and you’ll want to know you can turn to them for advice.”
Dr. Fisher, founder of Ophthalmic Edge, an online interactive educational forum, offers another piece of wisdom. Despite the value of exchanging information and ideas electronically, he cautions against relying too heavily on e-networking. “A significant amount of networking is done on the Internet, but I think something important is lost in such communication. There’s something about personal interactions that can’t be replaced by online networking. I encourage new retina physicians to spend plenty of time interacting with colleagues in person.” NRP
![]({"src":"/media/4qlehnek/52014.jpg","focalPoint":null,"crops":[{"alias":"thumbnail","width":1110,"height":700,"coordinates":null}]})