Reminiscing on residency: Dr. Efrem Mandelcorn on finding a specialty that combines your different skills and realizing how brief residency really is

When Dr. Efrem Mandelcorn began his residency at the University of Toronto, he didn't want to choose between medicine and surgery. It’s one of the first decisions young doctors face, and he was searching for a specialty that blended both ends of the treatment spectrum. He found that balance in ophthalmology.A medical specialty devoted to eye health, ophthalmology trains physicians to perform surgeries, prescribe medications and manage a range of conditions affecting one of the body’s smallest and most complex organs.“Ophthalmology mixed both. It also had aspects of psychiatry and plastic surgery, two specialties I really enjoyed in medical school,” says Dr. Mandelcorn. “On one hand, you have the most invasive of surgeries, dealing with the eye. On the other hand, you do a lot of counselling with your patients.”Once he chose the field, he faced another decision: which subspecialty to pursue. Despite the eye’s size, its intricate structures each lend themselves to different areas of expertise. The University of Toronto’s Department of Ophthalmology and Vision Sciences offers many differing fellowship programs. One of them—vitreoretinal surgery—is what Dr. Mandelcorn ultimately completed.At Toronto’s University Health Network (UHN), Dr. Mandelcorn now holds several roles. As chief of the Ophthalmology Department, he oversees services across UHN’s six major hospitals. He is also an attending vitreoretinal surgeon at Toronto Western Hospital. In a typical week, he spends one day in the operating room, three days seeing clinical patients and one on administrative duties.He is also part of an on-call rotation built to manage a shortage of ophthalmic surgeons across the Greater Toronto Area. Major hospitals like UHN’s St. Michael’s, Sunnybrook Health Sciences Centre and Toronto Western, share coverage to ensure patients can be seen during emergencies.“There aren’t that many retinal surgeons, so we cover other doctors on holidays and throughout the summer,” says Dr. Mandelcorn.The shortage is reflected across the country. There were 1,323 ophthalmologist in 2020, with 20.9% of those specialists over the age of 65, according to data published in the Canadian Journal of Opthalmology in 2023. The number of retinal specialists per 100,000 people in Canada also fell from 3.7 in 1995 to 3.48 in 2020.In Ontario alone, the backlog in ophthalmic surgeries peaked at 92,150 cases during the height of the COVID-19 pandemic between March to December, 2020. And while the number of cataract surgeries increased by 11% nationally in 2024 compared with 2019, the proportion completed within the recommended 112 days has not improved.Some provincial governments have recently proposed allowing optometrists to perform limited surgeries and laser procedures to ease wait times—plans that ophthalmologists have strongly opposed. Dr. Nina Ahuja, president-elect of the Canadian Ophthalmological Society, told the Canadian Press that handing over even minor surgeries to optometrists is “200% unsafe” for patients. For Dr. Mandelcorn, these pressures translate into intense workloads. “While I’m on call, I can see up to 70 surgical cases in a week,” he says.He is also co-director of the Donald K. Johnson Eye Institute at Toronto Western Hospital, which performs more than 6,000 ophthalmic surgeries each year. Beyond surgery, the institute is one of Canada’s largest ophthalmology research hubs and a major training centre with an internationally recognized fellowship program. Overseeing the program is one of the highlights of Dr. Mandelcorn’s career.“It’s an intense fellowship. For three months, the fellows are with me Monday to Saturday,” he says. Each year, he receives applications from around the world to fill just two to four spots. He has trained physicians from Australia to Egypt. In his office, he even keeps a map with photos of every fellow and a flag marking their country.“It has an amazing indirect outreach . . . we’ve been able to spread a cure for blindness around the world,” he says. 1. What is the biggest thing that residency taught you about being a doctor?It’s important to put the work in early. Residency is very hard at the beginning, and it may not seem like it, but it’s a very short period of time in your overall career. Doctors are typically in residency for four years, certainly in Toronto’s ophthalmology programs. You have two years of medical residency and two years of surgical residency, which is a very short time to learn under the supervision of other doctors. I learned to embrace every challenge. If you don’t do that from the start, you quickly lag behind and you don’t come out as strong as you could.Through all of that, you need to remain compassionate. You’re doing challenging work, learning a lot, and it’s stressful, but you learn that you need to maintain compassion both for yourself and for your patients.2. What is something you've learned further down in your career?Healing is complex. You have to look at the multiple levels of healing people. You have to help people feel good about their health. Part of it is communication. I always go back to the Golden Rule: do unto others as you would do unto yourself; treat others as you want to be treated. As you progress throughout your career, things become routine. You have to remind yourself that you’re dealing with a family and a patient who is worried. It makes the biggest difference to have a healthcare provider who is kind and cares.You’ll find that patients heal better when you approach them from a compassionate perspective. There’s an emotional component to healing, and you want your patient to feel good, trust you and be motivated to improve their health by following your instructions. You can really motivate someone by listening to them, making them feel heard and valued, and making their family part of the healing process.3. What is your number one tip for residents? Find the balance. As a resident, you will often come home tired and stressed, but if you only dedicate your time to training, you will lose out on so much of your life outside the hospital. Go out with your friends, exercise, spend time with your family and don’t neglect yourself. Find what helps you decompress so you don’t carry your work into your life and relationships, whether that’s exercising or a routine that helps you feel good. It’s important not to neglect yourself. If you build those habits in residency, you’ll carry them throughout your career.

Reminiscing on residency: Dr. Efrem Mandelcorn on finding a specialty that combines your different skills and realizing how brief residency really is

Register for free access or login.

Related Topics