What is your advice for ophthalmology’s Class of 2020?

For graduates and residents, the spring of 2020 promised to be a special time as they took the next step in their careers in ophthalmology in the “Year of the Eye.”

A pandemic has a way of changing even the best laid plans, and by March it became clear that 2020 wasn’t going to be a normal year, particularly for ophthalmologists.

According to the American Medical Association, some 30,000 medical students are graduating this spring, with a number of ophthalmologists among the ranks.

At Ophthalmology Times,^® we have asked members of our Editorial Advisory Board to offer their advice to the Class of 2020.

“This is an emblematic year for Ophthalmology: Year 2020 … the number that defines our profession, the standard that reflects our ‘success,’” said Ashley Behrens, MD, chief of the division of Comprehensive Eye Care KKESH/WEI Professor of International Ophthalmology, The Wilmer Eye Institute, Johns Hopkins University.

Dr. Behrens also noted that it also is the number of a year when the world was badly hurt.

“Is this some sort of a special sign? Yes! Class of 2020 you are unique and will be remembered for decades,” she said. “You are survivors and at the same time builders of a new and better world! You will have the chance to make a real change in the course of humanity. God bless you, and congratulations!”

Norman B. Medow, MD, FACS, director, pediatric ophthalmology and strabismus, Montefiore Hospital Medical Center, and professor of Ophthalmology and Pediatrics, Albert Einstein College of Medicine, noted that seldom have medical students been exposed to so much in such a short period of time.

“Many of you, in the Class of 2020 have acted as physicians, confidants, relatives, clergy and mourners,” he said. “You are to be commended, congratulated, and complimented. I am proud to count you all as colleagues. You will never forget the last six months of your medical school education. Please keep up the good work.”

Uday Devgan, MD, in private practice at Devgan Eye Surgery, Los Angeles, and partner, Specialty Surgical Center, Beverly Hills, noted that all physicians are lifelong learners.

“Our medical school professors explain that half of the things that we learn may turn out to be not false or useless in the future, and the challenge is that we don't know which half is which,” he advised. “We continue to learn, every day and every year for the entirety of our careers. What I learned in residency was great, but it is not how I perform surgery now.”

Dr. Devgan urged graduates not to worry if they finished their residency or fellowship with fewer surgical cases than expected.

“When you realize that half-way up the learning curve is 1,000 cataract surgeries, does it matter than you did 150 instead of 300 cases in your training?” he said. “You will learn more in the first couple years of practice than you learned in all of your years of training up to that point. The only constant in medicine is change, and we must be able to evolve and adapt in order to deliver the best for our patients.”

Robert Osher, MD, professor of ophthalmology at the College of Medicine of the University of Cincinnati, and medical director emeritus, Cincinnati Eye Institute, urged graduates to be safe, and guard themselves and their families.

“An invisible threat and the invincibility of youth are ingredients in a recipe for disaster,” he said. “Without your health and that of your loved ones, nothing else is important.”

Second, Dr. Osher urged graduates to be conservative with finances.

“It is always good to invest in yourself but now is not the time to accumulate insurmountable amounts of debt,” he said. “You also should remain focused on education.”

With all of the distractions, Dr. Osher cautioned that it can be easy to lose focus on your craft.

“Continue to learn and question what you are doing, now and for the remainder of your career,” he said. “Prioritize, giving appropriate time to family, friends, fitness, and faith. You should refuse to be paralyzed by fear. Lastly, be honest, guarding your integrity, and be optimistic.”

Michael E. Snyder, MD, a member of the board of governors of the Cincinnati Eye Institute, and chairman of the Clinical Research Steering Committee, and professor of Ophthalmology, University of Cincinnati, pointed out that for the Class of 2020, these are uncertain times, without question.

“What is certain is that there will be other uncertain times and other unprecedented events,” he said. “There always will be. There always has been.”

Dr. Snyder noted that as a graduating medical student, most decisions about the path following graduation - the "what will I do and where?" - were likely long completed before the full awareness of COVID-19 set in.

“For graduating residents, some of you may have fellowships already established, some of you may already have secured jobs, and others may still be searching for the right fit for your next career step,” he said. “Irrespective of which group you may fall into, I suspect that more than the average anxiety may approach this next step due to the profound changes occurring in the economy, the practice of medicine, and daily life.”

Dr. Snyder also noted that jobs may have evaporated, and perhaps some fellowship have closed, though he said he has heard of none.

“Most important at this time is to take care of your own health and those whom you love,” he said. “Take care of your patients and your fellow citizens.”

Irrespective of today’s challenges, Dr. Snyder said the future for the Class of 2020 looks bright.

“Ophthalmology offers an unparalleled level of care that prior generations could have only dreamed of,” he said. “Technology and techniques are excellent and will continue to improve. This pandemic may be a speed bump, but will not likely be a brick wall.”

And the demography of the ophthalmic patient base will continue to seek care.

“If one’s start in training, fellowship or practice is a bit daunting due to the pandemic around us, when looking with a long term perspective, it will be just one adaptation to which we will have had to adjust,” he concluded. “To paraphrase the main tenet of evolutionary biology, it is not the smartest, the strongest, nor the luckiest that survive and thrive, but the most adaptable. Accordingly, it seems a good strategy to keep focused on the long term and embrace whatever inevitable changes come your way - and adapt.”