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Outstanding Female Leader in Ophthalmology | July/Aug '20

Outstanding Female Leader in Ophthalmology:
Janice C. Law, MD

Dr. Law is an Assistant Professor of Vitreoretinal Surgery and Diseases at Vanderbilt Eye Institute, Director of Medical Student Education at Vanderbilt University Medical Center and Vanderbilt Eye Institute, and Chair of the AAO Young Ophthalmologist Committee.

Please share with us your background.

I come from a family of educators. From an early age, I heard discussions at the dinner table on how student assessments measure not only student learning but also faculty teaching. Fast forward, as I continued along in my medical training, I personally experienced the impact of excellent teachers, mentors, and education programs that were dedicated to evolving teaching methods and cared about learner outcomes. When I finished my chief residency at Kresge Eye Institute in Detroit, I realized I wanted to join an education team that could affect positive change and paradigm shifts in adult learning theories within ophthalmology. At that time, ophthalmology—a skill-based field—was still being taught nationwide with a lecture-based and PowerPoint format! How was this possible?

After my fellowship in vitreoretinal surgery at Vanderbilt Eye Institute, I stayed to become the institute’s first Associate Residency Director. I assisted the Program Director in developing a robust educational program that would have sound competency-based assessments and hands-on workshops as teaching tools to help residents develop a foundation of skills. After 7 years serving as an Associate Residency Director, I took on a new opportunity as the Director of Medical Student Education for Ophthalmology to further expand our ophthalmology programs at the level of undergraduate medical education. At this time, my work and efforts are focused on improving the medical knowledge, competencies, and diagnostic skills of each graduating medical student class at Vanderbilt University School of Medicine.

Through my work with residents, fellows, and students early in my career, I found my why in mentoring trainees and young physicians to help them realize and reach their fullest potential. This aligned well with an opportunity to join the AAO’s Young Ophthalmologist (YO) Committee, first as a member of the YO Info Editorial Board, then as a full member of the YO Committee, and now as the Chair of the YO Committee. I have been blessed to be inspired and surrounded by amazing talent and excellence within AAO leadership and staff and to receive strong mentoring and guidance as I continue to grow professionally as a leader.

One of my desires in the role of YO Chair is to give young ophthalmologists a place to belong and connect inside the parent organization of the AAO. Another focus is to continuously assess the unique needs of young ophthalmologists as they evolve along with the changing landscape of health care and the growing body of knowledge of patient care. Our committee is dedicated to offering young ophthalmologists exclusive programming to address their level of needs and concerns as they grow to be successful ophthalmologists. We have developed the L.E.A.P. Forward program, a leadership and advocacy session that engages and equips YOs and challenges them to be leaders in their communities, practices, states, and nationwide. Through our YO Lounge programming at the AAO annual meeting, we connect with YOs and collaborate with other young ophthalmic leaders around the globe. We have a shared goal of connecting young ophthalmologists to learn from each other and share knowledge to improve education and patient care.

Lastly, addressing burnout and improving physician wellness have become a focus of my everyday encounters with my colleagues and trainees. I have a child who was born with a genetic deletion, leading to developmental delay and many organ system problems, with effects on his eyes and vision. Many who know my story know that navigating this life journey has forced me to refocus my efforts, align my passions for mentoring and teaching, and bring awareness and change in myself and others to improve physician wellness and reduce physician burnout.

What is the focus of your recent research?

My recent work involves creating and testing an effective model for teaching and assessing direct ophthalmoscopy skills in medical students. Direct ophthalmoscopy might be seen as a dying skill, but it is one of the diagnostic skills that remains relevant in undergraduate medical education. Since it is impossible to see what students see during an examination, we utilize standardized patients with known optic nerve pathology and create a 3x3 board of optic nerve photos, with normal and pathologic images. After performing an examination, the student selects the photo that most resembles the optic nerve of the presenting patient.

Recently, due to COVID-19, I have had to pivot how we teach this close encounter skill. For safety reasons, we have chosen to teach this skill using model practice eyes that we created using a camera film cannister we call the eye (I) can, a retina photograph embedded at the end of the cannister, and a 2-mm hole in the cannister lid as the pupil aperture. I am now studying the effectiveness of learning direct ophthalmoscopy using this practice model eye versus a purchased simulation model with variable lens focus as a substitute teaching model during a pandemic.

What has your experience been collaborating with industry?

Industry partners play a crucial role as educators to ophthalmology trainees. I remember early in my residency traveling to Dallas and Chicago for the Alcon Cataract Course to learn the basics and advanced techniques of phacoemulsification. Industry representatives help troubleshoot, offer insider tips, and serve as a sounding board for innovation in techniques. As a retina fellow, my eyes were further opened as I learned of new surgical instrumentation advances coming down the pike and ways to make surgical care more efficient and safer through relationships with industry. Additionally, pharmaceutical companies inspire us to aspire for the best treatment options possible for the most difficult diseases and provide means for making them affordable to our patients. Just last week, Allergan and Regeneron assisted me with my annual hands-on intravitreal injections skills workshop for residents and interns at Vanderbilt, equipping me with eye models, demo injectors, and simulation platforms to help learners get that tactile response needed to learn a new skill.

Industry also plays an important role in supporting a lot of the educational programming we bring to our AAO YO sessions at the AAO annual meeting. Industry collaboration allows us to reach even more young ophthalmologists or members in training. With industry-partnered activities and publications, our young ophthalmologists have the opportunity to have resources for a successful career at their fingertips.

In your opinion, how is the role of women in ophthalmology evolving?

We are making progress, but it could be faster! Women are rising to leadership positions and, importantly, are accepting positions as leaders of professional societies, on industry advisory boards, and as chairs of academic departments. Several women in our field have broken the glass ceiling, including Ruth Williams, MD, President of Wheaton Eye Clinic; Anne Coleman, MD, President of AAO; Tamara Fountain, MD, President-Elect of the AAO; and Lisa Nijm, MD, JD, CEO of Women in Ophthalmology (WIO). These giants are bringing us along with them on their leadership journeys and showing us that we can also aspire for those challenging roles—roles that may seem impossible to integrate well with a practice and home life. We now have an all-time high number of female department chairs, including Kathryn Colby, MD, PhD; Joan Miller, MD; Joan O’Brien, MD; Joanne Shen, MD; Sophie Bakri, MD; and Penny Asbell, MD, FACS, MBA, to name a few. In order to get to this top level, one traditionally first demonstrates achievements at the podium and in research. However, the tenure clock for research tracks aren’t always kind to women who need time off for maternity leave(s), and many talented women are likely missing from this academic ladder pursuit.

To move the needle, women must continue to promote other women, help each other succeed and stand out, offer opportunities, and sponsor each other. Organizations such as WIO, Women in Retina (WinR) through ASRS, and Ophthalmology Moms Group (OMG) on Facebook provide the peer support and education required to shed imposter syndrome in the work setting. We must continue to show up and to bring others along the way.

What hurdles do you feel women in health care still face?

Women in health care continue to face gender gaps in salary, proper acknowledgment of achievements, and promotion into positions of leadership or national podium presentations. A recent article showed that female ophthalmology residents are likely to graduate with lower surgical volumes than their male counterparts.1 There are many variables that come into play; however, awareness of this disparity is an important first step. Bringing such inequalities to light may encourage and empower women to be active participants who seek opportunities in all areas of life and not just during their early careers.

One related challenge is balancing or integrating family care and practice before burnout strikes. As many of us know or have experienced personally, professional mothers are often said to be on double duty. Once the professional day ends, the second shift at home typically begins. COVID-19 has made double duty more challenging, especially if there is a pull to work from home to care for children during virtual or distance learning, further widening the gap of possible salary disparity, opportunities, and increasing burnout.

What advice can you offer to young female ophthalmologists who are still in training or just beginning their careers?

Three points of advice come to mind immediately.

1. Negotiate your first contract well because your first contract will affect your next. Learn contract negotiation and mediation, and do not be afraid to ask for what matters to you. Read Never Split the Difference and Crucial Conversations, for starters.

2. Find and write down your why. If you don’t know what this means, watch Simon Sinek’s TED Talk or read his book Find Your Why. Successful leaders (and physicians) who know their why can start to build their path and develop a meaningful career trajectory. This helps with burnout and improves satisfaction in home and work life. I do believe that, at first, early career physicians should say yes to most opportunities that open up. But then, 3 to 5 years in, you can start aligning your opportunities with your why. Don’t forget to preserve the things you do outside of eye surgery and clinic that bring you joy and fill your passion. In one of her amazing talks, Mildred Olivier, MD, once said, “Know who you were before the world told you who you should be.” Know yourself, and don’t forget your why.

3. Don’t miss out on networking opportunities. Networking starts now and never stops. Bring in peers and colleagues and help them make connections as well. My professional soulmate, Purnima Patel, MD, reminds me to always meet new people in every setting. Get to know people authentically. There is so much to gain from these deeper relationships. You’re also never too young and it’s never too early to be a mentor. Reverse mentoring (mentoring someone traditionally older than you in a cross-generational approach) is just as influential. It is a two-way relationship. Mentoring also leads to new and important networks.

Can you propose a unique or creative idea that may help women in ophthalmic practices?

Strive to be a leader in your ophthalmic practice, your hospital board, your surgery center, or your state’s medical society or ophthalmic society. There needs to be more women at the board level. This can benefit your ophthalmic practice at so many levels, especially broadening your network and referrals. These roles and experiences can help women strengthen communication skills, negotiation expertise, and improve practice reputation. Each leadership role helps women to build upon skills. Look for leadership development programs (LDP) that are offered through these organizations or be nominated to participate in the AAO LDP. Through the AAO LDP, I learned ways to improve how I communicate, present at the podium, advocate, negotiate, lead meetings, etc.

I have also had the unique experience of working with a life coach and an executive coach, both of which I recommend. These coaches helped me to streamline my administrative work and research, while focusing on my why. Another skill I’ve learned through coaching is to recognize when I am triggered by imposter syndrome or when I let perfectionism paralyze my progress. The pearls learned from coaching and LDP training can help women become more efficient and confident in the multiple domains we work in. This will pay dividends, as it is useful in everyday clinical and surgical practice, teaching, and non-ophthalmology work and home life.

1. Gong D, Winn BJ, Beal CJ. Gender differences in case volume among ophthalmology residents. JAMA Ophthalmol. 2019;137(9):1015-1020.

PUBLISHED WORKS

  • Ahmed H, Law JC, Felsted D, et al. Matching ophthalmology amidst Coronavirus Disease 2019 (COVID-19): lessons that went viral. J Acad Ophthalmol. Accepted for publication.
  • Schmuter G, Tooley AA, Chen R, Law JC. Social media in ophthalmology: the educational and professional potential for medical students. J Acad Ophthalmol. 2020;12:e41-e45.
  • Law JC. Making the most out of meetings. In: Women in Ophthalmology: A Comprehensive Guide for Career and Life. Springer Nature Publications. In review.
  • Patel S, Law JC, Cherney E, Recchia F, Kim S. Air vs gas tamponade during macular hole repair surgery [published online March 27, 2020]. J VitreoRetinal Diseases. doi:10.1177/2474126420914276.
  • Sumarriva K, Uppal K, Ma C, et al. Arginine and carnitine metabolites are altered in diabetic retinopathy. Invest Ophthalmol Vis Sci. 2019;60(8):3119-3126.
  • Law JC. Trauma to the posterior segment. American Academy of Ophthalmology Interactive Cases for Medical Students. December 2018.
  • Law JC, Golnik KC, Cherney EF, et al. The Ophthalmology Surgical Competency Assessment Rubric for Panretinal Photocoagulation. Ophthalmology Retina. 2018; 2(2):162-167.
  • Law JC, Breazzano MP, Eliott D. Aicardi syndrome. J Pediatr Ophthalmol Strabismus. 2018;55(5):344.
  • Date, R, Law JC, Abrams, GW, et al. Branch retinal artery occlusion. eMedicine. June 2006, revised 2018.
  • Breazzano MP, Law JC, Nickols HH. Intraocular granulocytic sarcoma following endogenous endophthalmitis. Ophthalmology Retina. 2017;1(3):187.
  • Law JC, Breazzano MP, Eliott D. Scleral buckle infection with Pseudallescheria boydii. Ophthalmic Surg Lasers Imaging Retina. 2017;48(8):676-678.
  • Golnik KC, Law JC, Ramasamy K, et al. The Ophthalmology Surgical Competency Assessment Rubric for Vitrectomy. Retina. 2017;37(9):1797-1804.
  • Breazzano MP, Law JC, Lavin PJ. Simultaneous traumatic central retinal artery occlusion and optic neuropathy. Ophthalmology. 2017;124(11):1661.
  • Christiansen SM, Oetting TA, Herz NL, et al. Twitter at the 2014 and 2015 annual meetings of the American Academy of Ophthalmology. Ophthalmology. 2016;123(8):1835-1837.
  • Sternberg P, Law JC. Communicating to local politicians. The Ophthalmologist. September 2016.
  • Roybal CN, Sanfilippo CJ, Nazari H, et al. Multimodal Imaging of the retina and choroid in systemic amyloidosis. Retinal Cases and Brief Reports. 2015;9(4):339-346.
  • Law JC, Shah RJ. Road-testing Alcon Ultravit high speed vitrectomy probe. Retina Times. Winter 2013.
  • Law JC, Yeh S. Clinical pearls for uveitis: five dos and five don’ts. YO Info. July 2012.
  • Law JC, Recchia FM, Morrison DG, Donahue SP, Estes RL. Intravitreal bevacizumab as adjunctive treatment for retinopathy of prematurity. J AAPOS. 2010;14(1):6-10.
  • Agarwal A, Law JC, Tarantola RM. Late onset retinal degeneration: an entity not to be overlooked. Retinal Cases and Brief Reports. 2010;4(3):257-261.
  • Reddy RK, Lalezary M, Kim SJ, et al. Prospective Retinal and Optic Nerve Vitrectomy Evaluation (PROVE) study: findings at 3 months. Clin Ophthalmol. 2013;7:1761-1719.
  • Law J, Sternberg P. Retinectomies and retinotomies. In: Retinal and Vitreoretinal Diseases and Surgery. Jaypee Highlights Medical Publishers; 2010; 28:459-472.
  • Recchia, FM, Law JC. What should I tell a myope about RD risks after cataract or refractive surgery? In: Curbside Consultation in Retina. Thorofare, NJ: Slack Publications; 2010: 9-11.
  • Tarantola RM, Law JC, Recchia FM, Sternberg P, Agarwal A. Photodynamic therapy as treatment of chronic idiopathic central serous chorioretinopathy. Lasers Surg Med. 2008;40(10):671-675.
  • Law, JC, Sternberg P. Not just a PVD: differential diagnosis of flashing lights. Retinal Physician. November 2007.
  • Law JC. Arranging a schedule for the OKAP exam. Pearls in Ophthalmology. March 2007.

PROFESSIONAL SOCIETY MEMBERSHIPS

  • American Academy of Ophthalmology (AAO) | 2004–Present
  • Tennessee Academy of Ophthalmology | 2007–Present
  • Nashville Academy of Ophthalmology | 2007–Present
  • American Society for Retina Specialists (ASRS) | 2009–Present
  • Women in Ophthalmology (WIO) | 2011–Present
  • Tennessee Medical Association | 2013–Present
  • American Academy of Ophthalmic Executives (AAOE) | 2015–Present
  • Association for University Professors in Ophthalmology (AUPO) | 2015–Present
  • American Eye Study Club | 2016–Present
  • American Medical Association (AMA) | 2015–2017
  • Association for Research in Vision and Ophthalmology (ARVO) 2004–2010

HONORS AND AWARDS

  • Top 30 Favored Faculty, Vanderbilt University School of Medicine | 2020
  • Geoffrey David Chazen Award for Innovation in Medical Education | 2020
  • Academy for Excellence in Education, Vanderbilt University Medical Center | 2019–Present
  • Bridge Builder Award, Vanderbilt Eye Institute | 2019, 2017, 2015
  • Laura L. Wayman Award for Meaningful Contributions to the Profession of Ophthalmology, Inaugural Recipient | 2019
  • Emerging Leaders Award, WIO | 2018
  • Alpha Omega Alpha Honor Society | 2017–Present
  • Secretariat Award for Member Services, AAO | 2016
  • Achievement Award, AAO | 2016
  • Leadership Development Program, Graduate, XVII, AAO | 2015
  • Secretariat Award for State Affairs, AAO | 2015
  • Commitment to Advocacy Award, Vanderbilt Eye Institute Faculty Representative, AAO | 2015
  • State Government Affairs Special Recognition Award for Engaging Residents in Advocacy, AAO | 2013
  • Donald J. Gass Fellowship Award, Vanderbilt Eye Institute | 2008
  • Marius Juzych Golden Apple Teaching Award, Kresge Eye Institute, Wayne State University | 2007
  • Plous Leadership Award, Kresge Eye Institute, Wayne State University | 2006
  • Sherman Johnson and Frances Battle Johnson Fund, Cleveland Foundation Scholarship, Wright State University School of Medicine | 2001
  • University Honors Program, Miami University | 1999
  • Microbiology Department Honors, Miami University | 1999
  • Phi Beta Kappa Honor Society, Miami University | 1998
  • Mortar Board National Senior Honor Society, Pleiedes Chapter, Miami University | 1998
  • Harrison Scholar, Presidential Scholarship Award, Miami University | 1995–1999

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