Dilen Marian

Introduction

As competition ratios have increased for ophthalmology, the volume of resources, such as guides, question banks and interview prep has risen to match it. In terms of the journey of becoming an ophthalmologist, aspiring candidates have access to the map early on, with a clearly drawn destination and multiple landmarks preceding it. What is less clearly depicted are those small roads and hurdles between those landmarks.

Less attention has been given or discussed on how opportunities can practically be accessed. In medical school, a great deal of emphasis is given rightly to clear communication skills. A medical graduate should be able to have patient interactions which are clear, compassionate, and safe. They should be able to share their concerns about their patient and clearly handover. However, in medical school, there is less explicit time allocated to teaching students how to get involved with a given department, engage with projects or approach busy senior colleagues.

Specifically, there is no lecture series or workshop focused on sending a considerate email to a clinician, or how to communicate clearly to a busy registrar, nor how to convey initial enthusiasm and then provide consistent hours of effort. Nevertheless, these skills create the conditions in which opportunities arise for aspiring ophthalmologists.

This article therefore will not attempt to provide a list of what fellow ophthalmology applicants should do to develop a strong portfolio but instead highlight how important communication and networking skills can be in this pursuit.

The role of Networking and Communication

The term “networking” can perhaps sit uncomfortably in medicine. It may imply concepts such as opportunism, self-promotion or interactions primarily for personal gain. At its best however, networking can just mean the ability to enter a new professional environment in a respectful way. Good networking skills can be a bit ambiguous, but in general, they would involve being able to introduce oneself well at the right time, work diligently and be clear about your intentions. To be able to do that though, there must be a good understanding of the clinical pressures faced by the team.

It must be highlighted that being a good communicator, or good at networking doesn’t replace merit. Rather – having those skills creates the condition where hard work and merit can both be recognised. Having a deficit in those skills could mean that despite putting in the extra hours and effort, they might not be recognised by a busy ophthalmology department. In this sense, networking might be less about being so initially impressive in one single interaction, and more about developing trust, over time, and being someone who is both dependable and friendly.

Recommendations

Introductions are formative moments and it goes without saying that one in-person would be received better than a cold email. What perhaps is overlooked is the timing. We often schedule emails, so they aren’t sent at midnight, because we’re considering someone else’s time. We should make those considerations in person too. Recognising the right time sounds simple, but why not find the best time? There would be no harm in first asking our colleagues such as nurses, secretaries or ward clerks. Being polite and asking if a given clinician is very busy today or finding out which clinician is involved or interested in teaching would be valuable information pre introduction. In this way, setting matters a lot.

Most clinicians already understand that prospective applicants have a keen interest in the speciality. What they wouldn’t naturally know is whether an applicant is reliable and diligent. Perhaps then the introduction should be clear, and summarise briefly the aspirations they have, as well as previous projects you’ve worked on. In combination, with the right time, having this rough framework, might open doors that lead towards those essential landmarks in the portfolio. Clinicians, especially those earlier in training would more readily recall that medical school only briefly covers ophthalmology. Mentioning exams, you’ve sat, or courses you’ve already attended may show in the first instance that you’ve already gone one step beyond.

The combination of good timing and a simple framework for introduction are a good basis to begin, and applicants should also avoid the assumption that getting involved with a meaningful project or learning experience comes only from the most senior clinicians. SHOs, fellows and Registrars are perhaps closer to applications and could be already undertaking various projects that applicants can get involved in.

Conclusion

For applicants there is an understandable tendency to transform and reduce the portfolio guidance into a checklist. Of course, these achievements matter but upon reflection, this mindset seems to be exhausting at times and perhaps misses the deeper point of the portfolio. A more constructive perspective could be to consider the portfolio as a by-product of meaningful engagement and developing professional insight which all require high level communication and networking skills.