Resident Diary

Not Quite Finished Training

Clare Quigley

Life is for living—and not just for ophthalmology training. But anyone who goes through the training knows living is moulded around it, with its sometimes onerous requirements, for a while. Within training, there are the mandatory components, exams, logbooks, etc., but also an indistinct collection of activities you know you should engage in to improve your chances of progressing to the Consultant post you want. That includes different flavours of pursuing further development in research, management, or teaching. The training job, wonderful as it is, gobbles away precious time. Sometimes though, life bites back.

Galway-Dublin-SligoDublin-Cork-Dublin-who knows? Postgraduate training in most medical specialties in Ireland involves moving around and working in different units. It helps to have an understanding and sympathetic partner—and to give them good notice this is what to expect. “I may be relocating for a Despite the demands inherent in trainwhile. Six months, a year?” And ing, I can see now that this has been the then there are the lesser day-today incursions at home. “Sorry about this, there’s an online comfortable career stage, working in teams with a motivated Consultant who teaching session that I have to is backing us up and supporting our attend tonight. Can I disappear into the study? I’ll do bedtime learning, surgical and otherwise. if my Zoom session finishes on time. Oh, and I have a mandatory assignment for my online management course that I have to submit by the end of the week. I better take a couple of hours at the weekend to work away at that, if that’s ok for you to be on duty?”

But we must acknowledge that any career can be demanding on family life; it helps to think relatively. When the job starts to feel burdensome, I imagine being called in to do appendectomies or deliver babies in the middle of the night. And then what about the non-medical alternative, working away, doing long hours unhappily at a dull desk job to pay the bills?

Despite the demands inherent in training, I can see now that this has been the comfortable career stage, working in teams with a motivated Consultant who is backing us up and supporting our learning, surgical and otherwise. I am not so far now from qualifying, and I see the real world looming. With that certificate of completion of training, we are to be let loose, looking for gainful employment.

I had imagined, optimistically in retrospect, finishing training shortly. But having babies and training through the COVID19 pandemic does not lend to as full a logbook as I might otherwise have, and those events also reduce opportunities for networking professionally. I am discovering this as I apply for fellowship training. After another protracted job application and interview results in generous feedback, but no job offer, I pause. I attempt to reorient with my values. One kernel exists that can quieten any anxiety about where I’m going or what I’m aiming for at any particular time: love. Thinking about expressing love and how that looks in caring for people, whether that be removing a cataract or a skin tumour, or looking after a distressed person in the ED, has a definite calming effect. It does not matter so much, then, about career or speed of completion of training; I am doing good in fulfilling work, and as a trainee or not, that matters. At the start of training, when I was fresh to ophthalmology, I remember a steep learning curve. The job was challenging, and I was not proficient, needing to take advantage of helpful colleagues to show me how to do anything and everything. I remember willing myself to visualise the retina through a 90 D; eventually, the glimpses turned into steady images and progressed to detailed pictures—oh there, a retina tear! Patients, Consultants, and Registrars in Galway where I started out—thank you.

Now, training is going to make room for life for a difference. At work, I am walking slower, avoiding the stairs, taking the lift. I have been released from doing on-calls. I am operating— doing cataracts mainly—holding out from scrubbing in for long procedures, as I need to mobilise to stay comfortable. I am 35 weeks pregnant and counting.

The bump is big now. Some patients, especially women, comment. “Best of luck with your baby!” One woman called out after I finished her cataract. Most patients don’t say anything. I am confident that one man, when I was doing indirect PRP laser, felt the baby kick. I was lasering that awkward superior retina, leaning in from the side of the table, pressed up close to the man who was lying still, sub-Tenon’s block and sedation in. I fired at the blank retinal canvas at 12 o’clock. At that moment, the baby jabbed out a foot towards the patient, a gentle kick. Neither of us said anything. Life is due to take over from training soon, for a while.