Q&A: Mentorship key to preparing next generation of ophthalmologists
One welcome consequence of the COVID-19 pandemic is that people are seriously talking about health disparity and lack of access to care in communities of color, Eydie G. Miller-Ellis, MD, told Healio/OSN.
In addition to holding the positions of professor of clinical ophthalmology at the Perelman School of Medicine at the University of Pennsylvania and director of the glaucoma service and vice chair of faculty affairs at Scheie Eye Institute, Miller-Ellis is also vice chair for inclusion and diversity at Penn Medicine and is committed to mentoring programs that open opportunities for underrepresented minorities.
Healio/OSN spoke with Miller-Ellis about her career accomplishments and advice for advancing underrepresented minorities in the field of ophthalmology.
Healio/OSN: Has the national dialogue on health disparities changed the way you practice?
Miller-Ellis: I have always been very much aware of health disparities and go out of my way to try to support patients who I know have access issues. Now that there is more organizational awareness, I can speak more freely — to residents, fellows, students, my colleagues — and people are much more open to doing something about it. I hope we have transitioned to a point where more resources and more intellectual energy will be applied to the issue of health disparities.
Healio/OSN: What accomplishment are you most proud of that has served to advance representation of the Black and brown community in the field?
Miller-Ellis: Since 2007, I have been co-director of the Rabb-Venable Excellence in Ophthalmology Research Program through the National Medical Association with my friend and colleague, Mildred Olivier, MD, who is a glaucoma specialist in Chicago. The program’s mission is to increase the number of underrepresented minorities in ophthalmology, as well as academic medicine. The program, founded in 2000 by Dr. Lenworth Johnson, is named after Dr. Maurice Rabb Jr. and Dr. Howard Phillip Venable, two outstanding African American ophthalmologists who broke barriers in medicine and our specialty, and trained many Black ophthalmologists. The Rabb-Venable program guides students through the competitive process of applying to ophthalmology residency and provides students, residents and fellows the opportunity to network with and find mentors among other Black ophthalmologists. By participating year after year, we build a support structure, starting from when they are a medical student, extending through residency and fellowship, and then continuing once they are in practice or become junior faculty.
Healio/OSN: As your career has advanced, what hurdles have been the most difficult to clear?
Miller-Ellis: We all have challenges along the way. Some have to do with gaining professional credibility and being known for clinical excellence, and then there are issues in terms of your more public persona. What I found to be really challenging was public speaking. When I started, it was really difficult for me. I got advice from my peers and mentors on how to better present myself — on stage, at meetings, especially during question and answer periods. I found it to be incredibly anxiety-provoking, sometimes still do, but I am much better at it now.
Healio/OSN: What advice would you give to someone who is challenged by public speaking?
Miller-Ellis: Practice. Practice in the mirror, record yourself, practice with a friend, practice with a mentor. Your mentors and friends need to help you hone your presentation skills by being tough critics because you must be able to both present your work and answer questions from the audience. Another thing that I would advise is to prepare to speak up early. For example, as a panelist, I think of a couple of points that I want to make and then do my best to make them at the beginning of the session. If you wait too long to say something, the opportunity may be gone. I can’t tell you how many times I have thought of a response, doubted myself and then listened to someone else say exactly what I was thinking. Then it is harder to come up with something significant to say.
Healio/OSN: How do the American Academy of Ophthalmology and National Medical Association (NMA) Ophthalmology Section differ regarding opportunities for underrepresented minorities?
Miller-Ellis: Both groups have different yet essential roles. The National Medical Association was founded in 1895 when, due to racial segregation, Blacks were not permitted to join the American Medical Association. Even though that is no longer the case, the NMA continues to be the collective voice of African American physicians and patients. There are challenges that Black doctors and medical students face that are not experienced by the majority population. For me, the NMA Ophthalmology Section is a safe space to discuss those challenges, to see how others overcame barriers and to form lifelong relationships. Section members are very accomplished and include ophthalmology department chairs and resident program directors, successful private practitioners, and both the current and a past president of the AAO. Our annual meeting has outstanding educational content. We are passionate about improving opportunities for minority students, residents and faculty, many of whom had their first opportunity to present on a national stage at our annual meeting. The Rabb-Venable Excellence in Ophthalmology Program is an essential part of this opportunity structure.
The AAO represents the entire profession of ophthalmology and is key in terms of advocacy, setting policy and education. The society is very inclusive, which is great because diversity of ideas within any organization makes it better. The AAO has really stepped up in its commitment to diversify our profession through the Minority Ophthalmology Mentoring (MOM) program. The AAO has partnered with the Association of University Professors of Ophthalmology to help underrepresented in medicine (UiM) students become competitive applicants for ophthalmology residency through mentorship and educational activities. There are a lot of talented UiM students who will make amazing ophthalmologists but may not learn about the field until later in their medical career. The MOM program focuses on first- and second-year medical students, invites them to the AAO annual meeting to provide early exposure to our field and encourages AAO members, regardless of race, to become mentors.
Healio/OSN: What is your approach to fostering interest in ophthalmology in medical students?
Miller-Ellis: The first thing is just to introduce students to the idea of ophthalmology. A lot of medical schools don’t require an ophthalmology rotation, and some don’t even have an ophthalmology department. They put us in the ultra-subspecialty category, when the reality is we provide primary care for the eye . The eyes reflects so many systemic diseases so you can still be a complete doctor, plus there is a lot of cool technology to diagnose and manage our patients.
I tell medical students that when you are learning something new, everything is exciting and interesting, but ask yourself: “Am I still going to be excited about this in 15 or 20 years?” I have been an ophthalmologist for more than 25 years, and my answer is a resounding “yes.”
Healio/OSN: Do you have a mentorship philosophy?
Miller-Ellis: As a mentor, it is important to empathize with my mentee so that I can give them advice. Encouraging them to think in a broader way is part of that, but as someone who has been both a mentor and a mentee, I need to remember what it was like to be in their position, to have the same worries and concerns as the person I am mentoring, in order to have credibility. Part of being a mentor is guiding someone through difficult situations as well as presenting them with opportunities and advice to help them move forward. When you have lived through things, you have a broad perspective, and you can help them see a bigger picture.
I also learn from my mentees. Every technological advance that I have adopted, I learned from a resident or medical student or people who are way younger than me.