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Subspecialties Cornea / Ocular Surface, Professional Development, Refractive

COS He’s a Jolly Good Fellow

What led you to cornea and refractive surgery?

Even as a child, I wanted to be a physician. There were none in my family but, at junior high, my best friend’s father was a hand surgeon. I was intrigued by his life and his passion – he was my first inspiration. What attracted me to ophthalmology is that it is a unique specialty that combines both surgical and medical aspects. I knew I wanted to specialize in cornea and refractive surgery from the get go.

What are your main missions as COS president?

COS has been around for 80 years now, and we really want to mark that in our annual meeting in June. I really want to help promote COS in the international arena. We – and I guess Canadians in general – often tend to be a bit discreet and sometimes overly humble, but we really have a lot of initiatives, projects, guidelines and educational activities going on. I’d like to promote these globally – and garner some support from fellow societies who might like to join us in our unique programs.

More in the national arena, it’s all about “the three Os” – ophthalmologists, optometrists and opticians. It’s already started in Canada, but one of my goals is to help formalize the formation of provincial eye health councils – collaborative groups that present a single voice to government. More locally and internally at COS, we have a huge responsibility to our membership. As our society has grown, we’ve really had to define the “COS umbrella” and consider how we’re going to keep the different subspecialty and special interest groups engaged; we need to present a single voice for ophthalmology to our patients, the media, the population, as well as government.

What’s a normal day like?

Every day is different! Taking into account the 168 hours in a week, I prefer to talk about life balance instead of the usual work-life balance, because everything is important. Over a week, I have two busy clinic days – one for refractive surgery and one for cornea, as well as three surgical days including anterior segment surgery, cataract and glaucoma, as well as cornea and refractive surgery. Around these, I am busy with COS responsibilities. I also teach a fair bit, and I’m involved in research at my clinic. And somehow, I make sure I exercise regularly!

You’ve served as a Lions Eye Bank medical co-director – what are your thoughts on the system in Canada?

Canada is an amazing country, but when it comes to corneal transplants and organ donations in general, even developing nations are more functional. We should use the examples from other countries, where corneal tissue is available when needed, rather than waiting for a cornea to become available and treating it like a relative emergency. I think a lot of things need to change, and although some legislative changes have occurred, we really need more education, a shift in the culture, and more financial support. We must better live up to the expectations of the type of country that we are.

What is currently exciting you in the field?

The whole field is exciting, but I would narrow it down to diagnostics and the evolution of surgical techniques. I’ve found that I’m constantly learning things that weren’t even discussed during my training or residency – things like higher-order aberrations or meibography. With surgical techniques the extremes amazes me; we have simple but revolutionary techniques, such as DMEK, which rely on manual dexterity and a fundamental knowledge of biology, all the way to “science fiction” femtosecond lasers that allow us to make micrometer incisions on different layers of the cornea. Surgical transfer courses are highly popular in our COS meetings, and have really evolved over the past 5–10 years to the point where every single year we see the great advances in instrumentation, techniques, and the approaches that can best help our patients. Things are moving so fast and are just so exciting that I’m in awe of everything we can do from a diagnostic and surgical perspective.

In 10 years’ time, what do you hope to have achieved?

I think of career evolution in five different stages, and although they might overlap there is progression to them: education, collaboration, building and disseminating our skills, consolidation, and finally, transcending. I think we all leave a mark in the world, so I hope to focus on transcending – whether it is education or administration – or even my own personal family life. I recently completed a physician CEO program at the Kellogg School of Management and I think this will pave the way for the final two stages!

What are your notable career highs?

The day-to-day highs are incredible: removing the patch and seeing the patient smile – or hearing how quickly a technological procedure has changed someone’s life. I am grateful and appreciate the career I’ve had; I think ophthalmology is the best job! I also get a momentary high every time I try a new technique or new procedure...

An incredible career milestone was finishing my residency and becoming certified. Having grown up in Mexico, being certified by the Royal College of Physicians and Surgeons of Canada was unimaginable. A final high was becoming president of COS. Now, I’m in a position to hopefully contribute and give back to the country and community that has allowed me to be where I am today.

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