Ready to start as Leigh Spielberg seeks his first job

Where will you be working next year?” asked Prof Jan van Meurs, my vitreoretinal fellowship director, on the first morning of my fellowship, just before we entered the operating room.

I felt an unpleasant wave of stress flow through my body. I hadn’t yet figured out my next step, despite my training hospital’s unwritten rule that a fellow will not be trained unless she or he already has a position waiting thereafter.

“I haven’t made a decision yet,” I replied. “But I’m working on it.”

Which I was. I had the advantage of having been trained in a well-known centre where an ambitious and focused resident can graduate with 300 solo phacos, 100 nights in the hospital on call and at least six months of subspecialty training even before starting a fellowship. So I figured there was legitimate demand for what I had to offer.

BECOMING AN EXPERT

But what did I want? How does one decide? What was I looking for? And, maybe just as importantly, what was I trying to avoid? My colleague ophthalmology resident, Niels Hoevenaars, had done some good research.

“There are 10 general ophthalmology positions within 10 kilometres of Rotterdam,” he said one day. “It’s as though every Dutch ophthalmologist is retiring this year. It’s incredible!”

That was great news for many of my colleagues, but this was not the case for retinal surgery. There were a few vacancies, but the location was either too far away, or I would be working solo. I was not yet interested in simply practising VR surgery independently without first further sharpening my skills under the guidance of a master. Even after a full year of intense vitreoretinal surgery training, I felt I owed it to my future patients to try to become a real expert in the field, not just someone who had taken only the necessary steps.

INTERPERSONAL INTERACTIONS

So I made a few phone calls to friends, acquaintances and ex-colleagues, all to get a feel for what was on offer. I responded to a few online advertisements and sent out several applications. Many practices were interested in adding vitreoretinal surgery to their portfolio, but there were no vitreoretinal surgery practices actively trying to enlarge their group.

Applying for work as a doctor is unlike most other job searches. A new colleague might remain for the rest of his or her career. Thirty-plus years! Once they’ve said ‘Yes’ to you, once you’ve signed a contract, you might be there forever, for better or worse. This makes them very interested in personality and interpersonal interactions, maybe even more so than ophthalmology skills.

I had heard someone say: “Any well-trained ophthalmologist will continue to improve as a physician, but an irritating colleague will be annoying for 30 years!”

So, those who interviewed me tended to take me out to lunch or dinner, to spend time with me.

“What are your interests? Hobbies? What do you do in your free time? Are you married? Do you have children? Have you done any interesting travelling?” they frequently asked. At first I thought these questions were intended to screen out applicants who might be away from the clinic too often, but I soon realised that they were instead intended to gauge the applicants’ well-rounded, sociable nature.

Occasionally a question or comment would throw me for a loop. “You look quite a bit like the young doctor who writes for EuroTimes,” said the chief of a very nice clinic in Belgium. “Have you ever read any of his articles? He writes all about his experiences as a resident in training.”

Umm… was he kidding? Was this a funny little test to see how I’d react to an unexpected question? An issue of EuroTimes was lying on his desk, between him and me. A young colleague of his leaned in to inform him that the writer and the person he was interviewing were one and the same.

He looked at me and we had a good laugh. I was very interested in working with him, but I would be the only vitreoretinal surgeon. Other interesting possibilities included a big-city solo practice that I had been offered to take over and transform into a private vitreoretinal clinic; joining a well-organised 10-doctor group in southwestern Netherlands; and various other part-time positions that would allow me to perform a great deal of elective macular surgery.

I was ready to do this, but not willing. At least not yet. Not at this stage in my career. I still had too much to learn from other, more experienced colleagues. But no offers from established groups were forthcoming, until I received a call back from…

...To be continued in a future issue of EuroTimes

Dr Leigh Spielberg is a vitreoretinal and cataract surgeon