What it is in ophthalmology: Shadowing Dr. Arnold
As a medical student, have you ever wondered what it is like to specialize in ophthalmology? Meet Barbara J. Arnold, MD, Ophthalmologist and AMA’s Featured Physician Specialized series “Shadow Me”, which offers advice directly from physicians on life in their specialties. Check out his ideas to help you determine if a career in ophthalmology might be right for you.
AMAs Specialty Guide Simplifies the specialty selection process for medical students by highlighting major specialties, detailing training information, and providing access to association information. It is produced by FREIDA™, the AMA residency and scholarship database®.
Learn more with WADA about theophthalmology medical specialty.
“Shading” Dr Arnold
Practice setting: Practice solo.
Type of employment: Self-employed in Sacramento, California.
Years of practice: 49.
A typical day and week in my practice: Four days a week, I see patients in the office between 8 am and 4:30 pm One day a week is reserved for outpatient surgery in a surgical center belonging to the hospital, 11 kilometers from the office.
When the procedures are done, the rest of the day is mine to wander the garden centers for plants, to shop for groceries or to run errands during the day. When my kids were young, ending the day early was part of the plan so I could take them to soccer practice, piano lessons or boy scouts, or on school trips.
Being self-employed has given me flexibility and control over my schedule so that I can prioritize parenting opportunities. Now that I’m a grandmother, I have the same priorities and I always make room for school trips and dance lessons.
Weekends are remarkably free as most ophthalmologists in our greater Sacramento area have come together to provide weekend call coverage on a scheduled rotation one year in advance.
The most stimulating and rewarding aspects of ophthalmology: Getting patients to better control their diabetes is one of the biggest challenges in ophthalmology.
Patients may not come for treatment until they lose their vision due to retinal bleeding or cataract formation, and diabetes control is urgently needed to avoid other systemic complications of the disease. diabetes.
Conversations can range from reducing hypertension to avoiding renal or peripheral vascular complications. They show up for an eye exam, but we’re only dealing with the tip of the iceberg in the effort to get their health back. People are afraid of losing their sight, which is why adequate physical activity and good food choices are often reinforced during office visits.
Also, the challenge of preliminary authorisation for eye exam visits may cause delays in care. Patients may be part of a new health plan but have not yet received a primary care physician, and often that primary care may be a nurse or medical assistant who does not have a sense of urgency to refer. eye-threatening complaints. Managed care for Medicaid patients is sometimes more like rationed care, as individual visits must be pre-authorized and case notes must be forwarded before the next visit is authorized.
The most rewarding aspect is the joy of improving a patient’s vision and helping them to function independently again or to see well enough to return to work or care for their home.
Some patients have gone for months without being able to recognize family members. They must overcome the fear of having an operation and becoming functional again.
Some people arrive in a wheelchair because they can’t see where they are going, and after surgery they can get around on their own. Expressions of gratitude from patients keep us morale high.
How does life in ophthalmology has been affected by the global pandemic: My office never closed during the pandemic. We followed the American College of Surgeons guidelines not to do elective surgery for six weeks initially, and some patients were almost hysterical that they couldn’t be considered urgent.
When they couldn’t see walking or working, we put them at the top of the list for surgeries in May. There was a backlog because not all surgery centers opened – the place where I do most of my surgeries only reopened in mid-August due to understaffing . I was lucky that a competing surgery center was willing to take some of these patients, but the type of insurance was definitely a factor. Private surgical centers were unwilling to accept payments below their cost.
It took a year to plan our backlog, but people are recovering from the fear of leaving home and are eager to be seen.
The long-term impact of the pandemic on ophthalmology: The long-term impact will be careful patient planning, so that we have safe distance and efficient turnaround times that reduce wait times while leaving room in the daily schedule for those with urgent needs. Our office is ready to receive those in need of care.
Three adjectives to describe the typical ophthalmology specialist: Perfectionist, compulsive, and detail-oriented describe most of those in ophthalmology.
Ophthalmologists are a compassionate group, sensitive to the needs of patients.
How does my lifestyle match or differ from what I imagined: It’s better than I imagined. I was the first in my family to go to college, so I had no idea what would happen after training. But I had dreamed of making art and becoming a painter, so immediately after the residency I started taking art classes.
Making art taught me a lot about the power of observation. Painting is also like meditation and helps counterbalance the intensity of my professional life. I now teach painting classes, including sessions for other ophthalmologists at our National Summer Women in Ophthalmology Symposium. I have also had 12 consecutive years of teaching painting for students with severe visual impairments. It is very rewarding to pass these skills on to others.
Skills that every doctor-in-training should have for ophthalmology but will not be tested for board review: The skills of being a good listener and a good observer of the whole patient, beyond the eye exam. Also, the ability to relate to the patient and not just the driver or the family member who brings them, which is an art that is difficult to measure on board exams.
A question physicians-in-training should ask themselves before continuing ophthalmology: Am I interested in specialist care for love of the profession or for its earning potential?
Books every medical student interested in ophthalmology should read: I provide books for students to read when I volunteer in elementary classrooms. These are books suitable for all ages. I encourage students to read historical biographies to see how determination for education and perseverance resulted in remarkable contributions.
At the age of 9, in the fourth grade, I read The First Female Doctor: The Story of Elizabeth Blackwell, MD, written by Rachel Baker, then reread it as a medical practitioner to appreciate the strength and willpower of America’s first female physician.
Another motivating biography is Madame Curie: a biography of Eve Curie, written by his daughter. Madame Marie Curie has the rare distinction of having received two Nobel Prizes, and her granddaughter, Hélène Langevin-Joliot, now aged 94, is a nuclear physicist. I tell the children that Curie was a single mother raising two children after her husband died in an accident, and that single parents can still be good scientists.
I have now had the joy of seeing my daughter and my granddaughter read the same biography. Watching my 8 year old granddaughter zoom book report to the rest of her class from a distance was very inspiring. It was amazing to think that in second grade she could understand both the excitement of discovering a new element and the need at the time to seek studies in Paris because women in Poland didn’t were not admitted to higher education. Young people need to read about how to overcome obstacles.
Cut for stone, by Abraham Verghese, MD, is another book that I recommend. It offers a fantastic glimpse into a life of missionary medicine in Ethiopia and then acceptance of modern medicine in America.
Online resource students interested in ophthalmology should follow: The American Academy of Ophthalmology is a trusted resource for eye education, and medical students are welcome to attend national academy educational meetings.
Plus, the annual Women in Ophthalmology Summer Symposium is a great reality check: being in the same meeting rooms as practicing physicians and having access to easy conversations about the state of the practice.
Quick insights I would give to students considering wherephthalmology:Spend time in a practicing ophthalmologist’s office, follow us and ask us questions. When I visited offices as a medical student, I found ophthalmologists to be balanced, caring, and genuinely interested in their patients and others.
In addition, the AMA provides ophthalmology mentorship opportunities, which often begin at the community level and involve visits to county medical society board meetings. These provide excellent opportunities to attend state legislative days and learn more about advocacy. You can accompany doctors on visits to legislators’ offices, either in capitals or in their district offices. Elected officials are interested in the opinion of students: the future of medicine requires a lot of guidance and new faces are welcome.
Mantra or song to describe life in ophthalmology:“Somewhere above the rainbow, ”from“ The Wizard of Oz. ”Dreams Come True!