Dr. Muhammad Saad Asghar

Clinical Fellow FY2, Southend University Hospital, Essex

First Two Years of Medical School:

I was never that person who came into medical school knowing exactly what sort of specialist I wanted to be. I began this journey knowing that the feeling I got in knowing exactly what to do during someone’s time of illness, was something I could chase all my life. On first entering medical university, I was overwhelmed by the sheer number of specialties to which one could dedicate their entire life.

This concern of mine had to take a backseat though, as the demands of basic sciences studies took over my entire time soon thereafter. At my university, the first 2 years were dedicated to covering Basic Medical Sciences like Anatomy, Physiology, and Pharmacology, among others. Even though these 2 years did give me a good idea about what sort of basic sciences are involved in specialties like Cardiology, Neurology, or Pulmonology, I did not find myself gravitating towards any specialty.

Medical School Clinical Years & Wearing The White Coat

As our first Clinical Year drew closer, I began to research how best to make use of it online. One crucial decision I hoped to reach by the end of my medical university was that of specialty choice. And while I was scouring the internet for first-hand experiences & advice from doctors who have faced similar questions in their lives, there was one piece of advice that immediately resonated with me.

It went something like this: Wear the white coat of whatever rotation you are in. This phrase served as a reminder that whatever clinical rotation you happen to be in during medical university, wear the whitecoat of that department. Acting like that is who you are and who you will always be.

Be a Cardiologist if that is where you are rotating, be an ophthalmologist, be a Surgeon, be a Radiologist. Put yourself in the mind space that this is what you are passionate about & this is what you need to be the best at.

As a medical professional, if your goal in life is to practice within a specialty that is more than just a means of livelihood then it is of utmost importance for this specialty to hold meaning & importance to you as a person.

It is not enough to choose a specialty you will be working in for the rest of your life based only on logical deductions or advice from other medical professionals or people.

Therefore, to fully experience the clinical rotations in university & judge whether these suit you as a unique person, one must wear the white coat of that specialty. This will provide an unbiased & unadulterated idea of what it means to be a doctor in that specialty for you. I took this piece of advice to heart and ran with it.

Every clinical rotation I would attend, I would involve myself heavily in its day-to-day activities. I would make sure to go the extra mile for all my rotations, to fully immerse myself in the day-to-day roles of that specialty. Through this way of experiencing rotations, I gained an unbiased view of each specialty.

Experiencing Ophthalmology for the First Time

Once my Ophthalmology rotation began, I involved myself heavily in all aspects of day-to-day patient care. I was fortunate that our Educational Supervisor for rotation was a clinician who immensely appreciated participation. He would applaud & encourage volunteering students to get their hands on the slit lamp, ophthalmoscopes, tonometer, and other gadgets.

I quickly developed a love for the use of these gadgets in patient care. The way light was manipulated by an Ophthalmologist to manage health conditions was fascinating to me. As the rotation went on, I realized how little I had known about an Ophthalmologist’s work.

Our supervisor was also quite keen on having us students assist in surgeries whenever they happened. I would find myself transfixed by how the surgeon would use fine hand movements to place the tiniest of incisions and carry out some of the most fascinating surgeries I had ever experienced. All this was compounded by the fact that usually, the patients were anesthetized locally and were fully awake during the entire procedure. Communication between the surgeon & the patient during surgeries was a frequent practice.

Over the years, I have developed my own set of activities requiring hand-eye coordination, like playing musical instruments, video gaming, and touch typing. As a result, the hand-eye coordination needed to perform ophthalmic surgeries was also something that inspired & challenged me. The coordination needed to perform these surgeries was instantly impressive. Especially because the hand movements needed during Ophthalmic surgeries require far more dexterity & delicateness than that needed from a piano player for example. Without a doubt, eye surgeries require some of the most dexterous hand movements in the field of medicine.

Making My Decision

Then one day, it was finally my turn to assist with bilateral cataract surgery for an elderly gentleman who had severely blurred vision and was fully dependent on his family for care at home. The procedure went smoothly, and afterwards we went to assess the patient’s post-op vision.

Most of us who have never experienced the loss of vision are only aware of the effect loss of vision can have on other people. We know this from watching videos, hearing stories, or coming across someone who is blind. We can even imagine how it would feel momentarily if we closed both our eyes and tried to picture how that would feel for someone who is unable to see. Despite this ability to empathize or imagine, nothing really can prepare you for when you witness someone gain their vision back.

As the surgeon peeled away the protective eye cover from the patient’s eyes, I saw the realization dawning on his face. As he correctly identified the number of fingers held in front of him by the surgeon, he burst into tears. He fervently thanked the surgeon as he came to terms with getting his precious sight back.

By the end of the rotation, I had come across multiple such instances. One of the days as I was returning from rotation, I distinctly recall thinking to myself, I could see myself doing this every day of my life, a feeling which I had not experienced in the other rotations till that point.

I spent the remaining two years of clinical rotations with a similar attitude, making sure I experienced each rotation while “wearing its white coat.” In the back of my mind, my Ophthalmology experience still stood out, but I wanted to experience it all before finalizing my decision. When university ended, it was clear that Ophthalmology was the only specialty I felt a sense of belonging towards.

Conclusion & Final Words of Advice

If you are in a situation as a student where you are unsure about which specialty you are interested in, I will always recommend the same thing. It is to go into each specialty you rotate in with the attitude that this is what you are fully qualified and passionate about. Even though that might not be the case, it serves to give you an unbiased & unprejudiced view of how that specialty will affect you. It is a waste of opportunity to go through clinical rotations without involving yourself enthusiastically in the clinical activities because ultimately it is your own unique experience that will help you make an informed decision to choose a particular specialty in the end.

I have come across countless medical students regularly, who leave clinical rotations early to do other projects or self- study for exams (during allocated clinical teaching time). These are the same students who have reported being confused about which specialty they are interested in at the beginning of their foundation years. This then leads to the selection of specialties based more on logical reasoning, hearsay from other doctors, or in worst cases: desperation.

Another common scenario that I have often encountered is where a student quickly realizes on entering a specialty that it is not as “fun” or “fulfilling” as a certain someone had expressed to them. That is an inevitability, simply because we are inherently unique individuals, and the way we perceive/connect with our work is unique in comparison to someone else. Take everything that is told to you by doctors in their specialties with a pinch of salt and focus instead on getting an opportunity to experience the specialty for yourself. That will give you a much more informed opinion about whether the specialty suits you as a unique individual or not.

Work that could possibly take up the entirety of your life should certainly not be selected based upon just pros & cons or even opinions from other specialists. It should be something you look forward to, it should be something you feel happy to wake up and dedicate most of your day to, and it should be something that you decided to pursue because it appealed to your authentic self.