The first time I (P.S.) looked through a slit lamp, it was because a resident I barely knew waved me over and took the opportunity to teach me during a slow moment in clinic. That was my first real glimpse into ophthalmology, and it made me want to learn more. Opportunities for early exposure should not be left to chance.
Ophthalmology has all but vanished from the required medical school curriculum. Only 18% of US and Canadian medical schools required a clinical ophthalmology rotation in 2014, down from 60% in 2000. Moreover, structured mentorship programs are not perfect. In a 5-year review of one residency program’s formal mentorship program, only 18% of mentees felt the pairing had met their expectations, and mentees initiated just 8% of meetings. In a field this small, opportunity will not circulate on its own. Someone must go looking for it, and that someone is you.
BECOME A FAMILIAR FACE
Be present in the clinic. Spending time in a busy comprehensive or specialty clinic will educate you in ways that traditional career advice cannot, and it provides you direct face time with an attending. If your school assigns you an advisor, use your meeting with them to ask for an introduction to an affiliated ophthalmologist. When visiting the clinic, bring a notebook, don’t disrupt the flow of the room, and importantly, save your questions for the gaps between patients or the end of the day.
Then, take the most underrated next step available to you: come back. Anyone can shadow once, and attendings know it. The student who returns for the fourth Tuesday afternoon stops being a visitor and becomes a known entity, and familiar individuals are those who obtain access to research projects, mentorship, and eventually, letters of recommendation. Think of it as spaced repetition, except you are the flashcard and the attending is the learner. Each return visit is another review interval, and eventually, you stick.
SEND AN EMAIL THAT MAKES IT EASY TO SAY 'YES'
Cold emailing works. Attendings remember being a student, and many will respond to a courteous, specific message. When an email goes unanswered, the problem is usually the ask, not the fact that it came from a stranger. "Will you be my mentor?" is a hard email to answer. It asks someone who has never met you to agree to something with no defined parameters. "Could I join you in clinic on a Thursday this month?" is easy to answer because it requires one specific commitment on one specific day, and the recipient can say yes without wondering what they have signed up for.
Five sentences should be sufficient to explain who you are, note one specific reason you are writing to this person, express one concrete request, share your availability, and thank the recipient. Remember to attach your resume or CV to the message as well. If you do not receive a response within 2 weeks, follow up once. If you still don't hear back from them, do not take it personally or lose hope.
TAKE THE UNGLAMOROUS WORK SERIOUSLY
Many trainees are introduced to academic ophthalmology via chart reviews, data extraction, reference formatting, and Institutional Review Board submissions. These tasks are more than just busy work; they also serve as an audition. Reliability is scarce. Two habits make you easy to work with: (1) sending updates before they are requested, even when the update is "work in progress"; and (2) doing a thorough and reliable job, which builds trust. The student who delivers a clean dataset 2 days early is more likely to be offered the next project (and the one after that).
THINK AHEAD
Think about the mentoring roles you will need someone to fill, and remember that one person can often fill several. These include a clinical role model, a research mentor, an advocate for when programs rank applicants, and someone who knows your work well enough to write an outstanding letter of recommendation. In addition, do not overlook the importance of a resident mentor. A department chair or school-appointed advisor may not be able to tell you which away rotation is worthwhile or which program's culture meets your training preferences. A resident can, because they were making these very decisions within the past few years.
PASS IT DOWN
When your time comes, be someone who helps others. Answer the first-year's email. Show the visiting student around the clinic. Teach a brand-new learner how to use a slit lamp or indirect ophthalmoscope, exactly the way somebody taught you. Ophthalmology is still a specialty that many aspiring physicians encounter by chance. Until the curriculum catches up, our job is to make those encounters happen on purpose.
1. Moxon NR, Goyal A, Giaconi JA, et al. The state of ophthalmology medical student education in the United States: an update. Ophthalmology. 2020;127(11):1451-1453. doi:10.1016/j.ophtha.2020.05.001
2. Yamane MLM, Kassotis AS, De Moraes CG, Dagi Glass LR. Correlating ophthalmology exposure in medical school to applying and matching into an ophthalmology residency. Acad Med J Assoc Am Med Coll. 2020;95(11):1770-1776. doi:10.1097/ACM.0000000000003448
3. Yang S, Glass ST, Clements JL, Reznick LG, Faridi A. Outcomes of a five-year formal ophthalmology residency mentorship program. J Acad Ophthalmol. 2022;14(2):e178-e186. doi:10.1055/s-0042-1756133
