Women in ophthalmology series: Dr Alexandra Miere encourages young ophthalmologists to step out of the comfort zone

March is Women’s History Month, and the 8th of March is International Women’s Day. Throughout the next several weeks, Ophthalmology Times Europe is celebrating the impact of women in the industry with a series of video interviews showcasing female leaders.

In service to this theme of female leadership, we spoke with Alexandra Miere, MD, PhD, who is an Associate Professor of Ophthalmology, University Paris Est Créteil, France. Earlier this year, the French Retina Society awarded Dr Miere with the Gabriel Coscas prize for excellence in research.

Dr Miere told Ophthalmology Times Europe about the mentors who have guided her, the lessons she’s learned throughout her career, and how the industry as a whole will change in the years to come.

Here’s her advice for the next generation of ophthalmology leaders.

The below transcript has been lightly edited for clarity

Hattie Hayes: Hello, I'm Hattie Hayes, editor of Ophthalmology Times Europe. March is Women's History Month and gender equity is the topic of our cover story in March. Throughout this month, I'll be speaking with women in the industry about their careers and leadership, and sharing advice for new ophthalmologists. Joining me today is Dr Alexandra Miere. Dr Miere, I'm so excited to have you here. Thanks for speaking with me.

Alexandra Miere, MD, PhD: Thank you for the kind invitation. It's a pleasure to be here.

HH: All right, to start off: What's something that you know now that you wish you had known earlier in your career?

AM: I wish I'd known many things actually, that I got to learn with time. Maybe the first thing I wish I'd known earlier on is that time is finite, and we cannot expect ourselves to do everything. So it is very important to try to prioritise what is really important for us. And these questions about what we want to accomplish and what is important have to be asked, I think early on. We should pay ourselves first, from a time perspective. We must make time to prioritise things that matter to us, or that interest us, and not just think, what's in the best interest of our co-workers or our department head, et cetera. 

And then of course, I learned how important it is to have a work-life balance, how important it is to nurture it–despite the sometimes very fragile equilibrium, with the never-ending avalanche of emails, meetings, deadlines. And of course, last but really not least, is that communication skills and networking are really, really important. I wish I'd known that from the very beginning. But you will want to develop your own peer base over time and to maintain relationships with your peers. So really, networking is really, really a very important thing to know early on.

HH: What do you expect will be the biggest challenge for young professionals entering the field of ophthalmology in the next few years? And similarly, what do you expect will be the biggest opportunity?

AM: Well, the biggest challenge and the biggest opportunity for young professionals will be digital technology, in particular, artificial intelligence [AI]. Of course, I'm a bit biased, because it's a field I'm working in. But I mean, we've all seen that AI models are more and more used in specialties dealing with images in the last few years, particularly in ophthalmology and radiology. And they will surely lead to a paradigm change in the ways we screen, diagnose and follow up with patients. So as a young professional, I think that it's really, really important to try to understand these emerging models, how they work, but also the algorithmic biases and how to mitigate them. And of course, needless to say, that we have to learn to mitigate our own biases, like the confirmation bias, the automation bias, as well, in order to gain insight from what the models can teach us.

It's very interesting because there was a study in 2023, called Clinician of the Future¹, in which about 50% of clinicians actually found it desirable to use AI for clinical decision-making and for training, but also the majority of the respondents indicated that it would be desirable for doctors to be digital experts. So in this unfolding narrative of AI applications in ophthalmology, I think, the clinician of tomorrow–so this is for young professionals!–is really destined to be a fusion between medical expertise and digital prowess.

HH: I'm glad that you mentioned networking earlier, because I would love to know about your experiences. Could you tell me about a mentor figure who has positively impacted you, and how they helped your personal and your professional development?

AM: Yeah, of course, this is a great question. And I think every time I'm talking about mentorship, a phrase from La Rochefoucauld comes to mind, that "nothing is as contagious as example." I think this is one of the key roles that a mentor figure plays in our lives, to be an example for us.

In the last 10 years, I had the chance to find a very intellectually stimulating environment in the [Le Centre Hospitalier Intercommunal de ] Créteil retina team, led by Professor Eric Souied who has been my mentor, and professors who have gave me actually the support, the encouragement and the honest feedback I needed to in order to contribute more significantly to both the department but also to grow as a clinician scientist, and as a person. And I don't know, I think that when it comes to academia, unlocking individual potential is not only a question or a matter of personal will or hard work. But mentorship plays a really essential part. And it is very important to have clear expectations about the mentoring relationships. The mentors have to take into account their biases that they may bring into the relationship.

Finally, the mentorship relationship is a source of learning for both the mentor and the mentee. And needless to say, of course, character skills in our mentorship relationship are as important, if not more important, than scientific ones. So yeah, that has been my experience. And interestingly, recently, I had the chance to see how other high-performing teams work, as I am currently an Honorary Research Fellow at Moorfields with Professor Pearse Keane. And it is very interesting to see different styles of leadership and mentorship relations unfolding in a different workplace culture. So maybe it's valuable even to have multiple mentors, as long as you're able to learn from each mentor distinctly and to apply the teachings when you become a mentor yourself.

HH: What advice do you give to younger ophthalmologists who, especially women, are looking for their first mentorship opportunities?

AM: I think my first advice would be to fight against the inertia of staying in a place where there's no place, no room for professional or personal growth. Even if that means getting out of the comfort zone, I don't know: changing departments, changing cities, changing even countries. This is a big part of my personal story. But this also reminds me a bit of the story from Dino Buzzati's novel, The Tartar Steppe, in which we see that resignation in face of a situation ultimately closes all prospects of fulfillment. So if something isn't working, you have to change. Change the setting completely, I think. And of course, you need a lot of courage and initiative to find the place and a mentor that will help you thrive. For women in particular, I think that female role models make an enormous difference to young people in training. And this has been shown in multiple publications previously, so it is very important. And for young ophthalmologists in general, but also young women ophthalmologists, I think that they needn't be discouraged by the potential unconscious biases they may encounter. They have to continue to grow their grit.

And I'm sure that this will lead toward the path of greater equity in our specialty, but also in academic positions or editorial positions in ophthalmology. So to find a mentor, I think you have to stray beyond your comfort zone and cultivate your network – again, this is really of paramount importance – and to be very proactive in the journey to success.

HH: That's all great advice, and I'm very excited to share it with the world. Thank you so much for speaking with me.

AM: Thank you very much for inviting me.

Reference

1. “Clinician of the Future: Elevating global voices in healthcare.” Elsevier. Published August 2023. Accessed March 2024. https://www.elsevier.com/clinician-of-the-future