Inside the residency pyramid

Ophthalmology is one of the most desired specialties in Morocco. Oftentimes, ranking systems make it extremely competitive. Once in residency, it is a whole new world. Every resident has already dealt with all kinds of pathologies in the emergency room without bothering the specialist on call. However, when it comes to the eye, referral was the only way. Hence, ophthalmology remains a mystery club until one gets in. Seniority is a responsibility that we all aspire to and mentorship is an angular stone in the learning curve. When young ophthalmologists of Morocco (YOMs) look up to their professors and mentors, this close relationship plays a tremendous role in the shaping of the future ophthalmologist’s persona. I often compare the residency setting to a Pyramid. E.g. A first-year resident who suspects a tear on fundus examination looks at it with a couple of co-residents who seek the first available senior resident’s insight; this one is more of a cornea person, but looks at it and confirms a peripheral retinal tear and hesitates between a pars plana vitrectomy with gas tamponade or a pneumatic retinopexy and goes to his or her co-senior resident who is a retina lover. The retina lover cracks the case and recommends pneumatic retinopexy; he or she then seeks advice from one of the professors who performs it routinely, who agrees on the decision and assists in the OR. Thus, the retina lover performs the surgery, the cornea enthusiast starts thinking if he or she should join the club and the young residents get to watch pneumatic retinopexy for the first time. And this is the pyramid that saves the day, every day, every time. On the other hand, surgical training is more like a rollercoaster. All Residents are impatient to perform their first surgery. In fact, the first cataract surgery is a call for celebration, Semper. The learning starts from the very first week of residency, by learning the proper selection and preparation of patients, from the quick surgical fix of a stubborn chalazion to the most complicated surgeries. And because “Practice makes Perfect”, simulation is taking more and more place in the learning curve. The route to becoming the Ophthalmologist we all aspire to become is certainly not a direct line. But until we are there, with the right mindset and the proper focus, there are certain memories in residency that we all cherish, like that first time we were able to perform a correct gonioscopy, that first time we spotted a macula-on RD and the look on the face of that first performed cataract case that regained a 20/20 vision after removing the eye patch. Imane Tarib MD is Ophthalmology Senior Resident at Department of Ophthalmology B, University hospital Ibn Sina, Rabat, Morocco

Tags: ESCRS Marrakech 2020