As spring turns into summer, graduation ceremonies start sprouting up everywhere. For those who work with trainees, it’s another reminder of time marching on as the next generation heads into the subsequent phase of their careers. While this is a joyful period for the graduates, it can be a time of trepidation for the attendings as a new class comes in and the training cycle resets.

I recently had the honor of being guest faculty for the Duke fellows’ advanced vitreous surgery course. It was a wonderful experience with interactive, hands-on opportunities for fellows and residents to learn different techniques from a variety of mentors. One topic that came up in conversation was how to prepare for the OR, especially when first learning to operate on the retina. We all have witnessed tremors during membrane peels, especially in the beginning. This brings up the question: What’s the best way to become a competent surgeon? Many believe that more practice is the key ingredient, and certainly repetition is an important element of mastering any new skill. 

Ultimately, I believe a large part of surgical skill boils down to state of mind. Practice may help by diminishing the anxiety and self-doubt that lead to greater difficulty. One of my mentors in fellowship would always remind us to drop our shoulders and relax our hands as we operated since the vice-like grips on instruments would hinder dexterity. I often add to that by encouraging relaxation techniques during procedures with steady breathing and calming your mind. One of my favorite books is The Inner Game of Tennis by W. Timothy Gallwey, which has great advice that extends to all aspects of life. One theme is quieting the inner voice that is commenting on our every win and mistake rather than trusting our subconscious mind to perform at our best. While it is certainly important to recognize mistakes, it is counterproductive to berate ourselves as that only increases the anxiety level and chances of making even more mistakes. 

As the academic year comes to an end, I wish to congratulate the graduating fellows and wish them all the very best as they start their careers in this great field. I’m also excited to meet the incoming class and pass along my bits of wisdom from over the years. Let’s continue to inspire one another and keep paying it forward. RS