Advising Medical Students about Ophthalmology Electives and Residencies
2009, Volume 2, Number 1 19 Ophthalmic faculty members, especially those who direct medical student education, are influential in advising prospective residents about choosing elec-tives and evaluating residencies. As nearly as I can determine little formal attention has been paid to this important activity. For over 40 years I have been ad-vising medical students about ophthalmology; ini-tially at the Boston University School of Medicine and for the last 24 years at the Harvard Medical School where I currently direct medical student edu-cation in ophthalmology. The recommendations that follow are my personal opinions formed over decades and are offered in the hope that this essay will stimu-late others involved in advising medical students to respond with their criticisms and suggestions. Of course the duration and number of electives vary considerably among medical schools but there must be few that do not include them in their curricula. Electives are thus a medical school fact-of-life and without proper guidance students are at risk of mak-ing bad selections. I will start by discussing the type of elective from which I believe students should be dissuaded. With internship on the horizon, anxiety prompts students to attempt to redress their perceived clinical deficiencies before graduation. This leads to the all too common practice electing a month of cardi-ology, a month of radiology, a month of hematology, a month of intensive care, and so forth. Experience has shown that this is unnecessary as interns readily acquire on the job the skills necessary to perform effectively in their new role. In any case, students could not possibly fill most, let alone all, of the per-ceived interstices of their medical education. I have steered trainees away from this course without evi-dent ill effect on their internship performance. It makes no sense to squander electives to prepare for a one-year experience. Many students ask if they should take an elective that allows them to participate in laboratory research. Stu-dents gain the impression that their prospects for ob-taining an ophthalmology residency are enhanced if they have done some laboratory research . Sadly, they are correct! Even residency training programs that rarely produce laboratory investigators seem to give weight to laboratory research in assessing appli-cants. However, one can safely infer from the small proportion of our graduates (including those with PhDs) who undertake laboratory careers even part-time or temporarily, that laboratory research is liter-ally not for everyone. If a student has a genuine inter-est in, or curiosity about, laboratory research, even if only to sample the experience, and can identify an appropriate mentor, it is an excellent idea to allocate elective time to laboratory research. However, a one-month laboratory elective is insufficient for a student to gain much benefit from the experience. I encourage students to be honest with themselves and not to elect laboratory research solely to enhance their creden-tials. The same considerations apply to clinical re-search, except that a well-designed project performed under the direct supervision of a faculty member and with advanced planning that permits the student to hit the ground running can be accomplished in a month. At most medical schools only rising seniors and fourth-year students are eligible to take electives. While few students will have had exposure to the spe-cialty at that stage many, and perhaps most, of the students who have decided upon ophthalmology have already made their decision. However for the unde-Advising Medical Students about Ophthalmology Electives and Residencies Simmons Lessell, MD 1* 1 Neuro-Ophthalmology Unit, Department of Ophthalmology, Harvard Medical School, The Massachusetts Eye and Ear Infirmary, Boston, MA * Corresponding Author & e-mail: Simmons_Lessell@meei.harvard.edu Accepted for publication October 6, 2008 Revision received October 19, 2008 2009; 2: 19-22. Available via open-access on the web at http://www.academic-ophthalmology.com The author(s) have no personal financial interest in any of the products or technologies cited herein. Â 2009