Maximizing Medical Retina & Uvea Fellowship
Dr. Amit H. Palkar, MBBS, MS, DNB, FICO, FMRF
- Dr. Amit H. Palkar is Vitreoretina Consultant and Uveitis Specialist at Retina Speciality Hospital, Indore.
- He completed MS Ophthalmology from Lokmanya Tilak Municipal Medical College and General Hospital (Sion Hospital), Mumbai & joined as Assistant Professor in the same institute in 2015.
- He pursued Medical Retina & Uvea fellowship, followed by a Vitreoretina fellowship from Sankara Nethralaya, Chennai, 2019.
- He has 10 publications in peer-reviewed national and international journals. His special interests include, posterior uveitis, surgery for diabetic retinopathy and combined anterior and posterior segment surgeries.
- He is an avid novice graphic designer and runs an infographic portal – Oculographia 🔗 that facilitates learning ophthalmology infographically.
Q1. Why did you choose Medical Retina and Uvea Fellowship as your Superspeciality of interest?
A1. Retinal diseases and uveitis has been my interest in ophthalmology residency at Sion Hospital. Learning in a general hospital, I was fascinated to observe ocular findings in systemic diseases like tuberculosis, HIV-AIDS, Diabetic retinopathy and Rheumatology during peripheral ward calls. Cross referrals to eye clinics from the allied departments (Medicine, Surgery, Pediatrics, Trauma) got me interested in systemic ophthalmology. The subspecialty that resonated with my inquisitiveness was Medical Retina and Uvea.
Q2. Why did you choose Sankara Nethralaya for your fellowship?
A2. With this inquisitiveness, I often researched and attended sessions of the pioneers in this subspecialty, at important meetings and conferences. With a dream to learn from the masters, I prepared and decided to apply at Sankara Nethralaya for my fellowship training.
Q3. What were your areas of interests?
A3. Retinal vascular disorders, Macular diseases, Trauma, Posterior Uveitis, Cataract Surgery in uveitis.
Q4. Is it mandatory to have had some surgical experience before joining Medical Retina and Uvea Fellowship?
A4. I feel a certain degree of clinical skill set for retinal examination and preliminary understanding of retinal imaging techniques is very helpful. Surgical experience in cataract surgery helped me advance the learning curve to perform uveitic cataracts. However, with nonuniform residency in India, many post-graduates do not have access to advanced retinal services and fall short of exposure. This should not deter one from pursuing this fellowship.
Q5. Clinics, Research, Conferences and Surgery – please elaborate on each, your challenges and how you tackled them and experiences.
- The first and commonest challenge one encounters in fellowship is thorough retinal examination with scleral depression. The only way to master this art of examination is practise, practise, practise. Examine as many patients as you can during residency and fellowship. Keep a fixed target to read up at least two cases everyday that you examined and followed.
- Research never fails to daunt a fellow. Start with a case report/photo essay or case series, if no prior experience. Take help from colleagues and mentors. Read similar literature and understand the structure, scientific language, summary of the article. It takes immense patience and perseverance, but in the end, the feeling of being published is bliss. Every research starts with a research question.
- Identify your interests and choose your conferences. In my opinion, choose a meeting or conference to present your work and NOT vice-versa. Keep a track of submission deadlines. Plan travel, accomodation, registrations and sponsorships in advance. Conferences may reach deep into your pocket. Ensure they are good investments.
Q6. How to build a good rapport with your mentor?
- Step one is to understand your Mentor. Their inclination to clinical and surgical teaching, and research.
- Step two is to communicate with your Mentor. Clear your goals, discuss your difficulties and interests, ask for feedback.
- Step three is to help your mentor in their work. An active participation at clinical meetings, in the theatre, and academic activities will boost your rapport with your mentor.
Q7. How important is the support of your colleagues?
A7. A lot of learning in fellowship programs takes place in informal discussions with your colleagues. Be it at random in the cafeteria or a journal club. Sometimes when your routine gets on your nerves, your colleagues are the ones who can pull you through it.
Q8. How to cope up with the stress and not let it reflect in your work?
A8. As rightly said by Jocko Willink – “Discipline is Freedom”; following a set of activities daily sets you free of the trivial stress. Optimum stress is good for work efficiency. But if you find it reflecting in the work, take a pause and focus. At times, you may need to give yourself a break to reset your momentum.
Q9. Quick checklist for young aspiring Medical Retina and Uvea fellows to follow during their fellowship.
- Outline the topics and stick it on a wall. (e.g Retinal vascular diseases, Hereditary retinal disorders etc).
- List the skills to acquire. (Fellowship manual can come handy for this.)
- Classify all the pathologies you see in the day under the topics and understand how the patient was different from the one with a previous similar pathology.
- Read up at least two pathologies that you see in a day.
- Write down one new knowledge snippet, clinical or surgical skill and patient care tip that you learned everyday.