My six-week elective in ophthalmology at Westmead Hospital in Sydney offered much more than technical mastery; it challenged my assumptions about patient care, teaching and the role of curiosity in medicine. Though my passion for eyes was ignited by my ophthalmology placement during medical school, my experience in Australia reshaped both my clinical approach and my professional identity.
Anatomy of the learning environment
From my first day at Westmead, it was clear that collaborative learning was deeply embedded in the department’s culture. Instead of a traditional, hierarchical, top-down apprentice model, I was welcomed into multidisciplinary case discussions where nurses, optometrists, registrars and fellows all contributed equally to patient care and teaching. This inclusive environment highlighted that delivering high-quality care is built on the integration of diverse perspectives, not just vertical knowledge transfer. More broadly, it made me reflect on how adopting this model of active, team-based learning in medical education could significantly enrich the experience and engagement of medical students on clinical placements and ultimately, patient care.
Rethinking the patient journey
My initial focus on technical skills quickly expanded to consider the patient’s perspective. In the diabetic eye clinic, I shadowed clinicians who spent more time exploring patients’ social determinants of health than performing examinations. Observing this, I learned that effective care must address financial pressures, cultural beliefs and mental health, all of which profoundly influenced adherence and outcomes. These elements underscored that delivering effective care requires looking beyond the eye to see the person.
"Even with access to interpreters, I saw how cultural nuances could be lost, which in turn affected patients’ understanding of their condition and treatment"
From mechanics to clinical insights
While I spent a good deal of time refining technical skills like slit lamp alignment, tonometry and gonioscopy, what stood out more was learning how to interpret investigations in the context of the patient in front of me. Rather than viewing imaging as an isolated data point, I came to understand its value when linked to real clinical decision-making. In discussions with registrars, I saw how longitudinal OCT findings, for instance, shaped management plans, escalated care or flagged systemic issues. This shift from performing techniques to understanding their implications over time, and the importance of continuity of care was where the real learning happened.
Intersections of culture and care
Westmead’s diverse patient population offered an opportunity to appreciate how ethnicity can influence both disease prevalence and presentation. I became more aware of the need to recognise conditions like angle-closure glaucoma, more common in East Asian populations, and diabetic retinopathy, disproportionately affecting certain migrant communities. At the same time, navigating consultations with patients who spoke limited English highlighted the critical role of high-quality translation services. Even with access to interpreters, I saw how cultural nuances could be lost, which in turn affected patients’ understanding of their condition and treatment. These experiences underscored that delivering good care requires not just clinical knowledge, but cultural and linguistic sensitivity embedded in the system.
Adapting surgical theatre etiquette
In theatre, I noted subtle differences: surgeons in Australia often paused mid-case to quiz students on anatomy, while in the UK such interruptions felt disruptive. These moments taught me the importance of adaptive etiquette: recognising when questions enhance learning and when silence preserves focus. It also highlighted the importance of context-specific professionalism and how educational opportunities can be shaped by institutional culture.
Unseen leadership lessons
Working alongside registrars who balanced clinic load with research and teaching revealed a triadic model of modern clinicians. I realised that leadership in healthcare extends beyond surgical skill, and rather encompasses mentorship, advocacy and lifelong learning. Observing these traits pushed me to think about the kind of clinician I want to become: not just skilled, but impactful in a broader sense.
Innovation through curiosity
Regular attendance at Westmead Institute lab meetings introduced me to experimental techniques including optogenetics and AI-driven visual field mapping. Rather than feeling intimidated, I felt energised by the culture of question-driven innovation. I presented a brief critique on potential biases in AI algorithms, sparking a lively debate that showed me the power of student-led inquiry to shape research agendas.
Systems in focus: NHS vs Medicare
Beyond clinical practice, I reflected deeply on systemic structures. Australia’s hybrid model meant some patients accessed care swiftly via private insurance, while others faced waiting lists similar to the NHS. This juxtaposition underscored that neither system is flawless; each necessitates ongoing evaluation of equity, cost and patient autonomy.
Beyond clinical competence
Navigating rent-sharing arrangements in Sydney, mastering public transport and forging friendships with fellow students and doctors challenged my resilience. Miscommunications, especially around medical terminology, were humbling, but ultimately strengthened my cross-cultural communication and reinforced the importance of humility when practising in unfamiliar settings.
A wider field of vision
By the end of my elective, I no longer saw myself solely as a student mastering ophthalmic clinical skills. Instead, I envisioned a role as a clinician-researcher-educator, dedicated not only to patient outcomes, but to system improvements and mentorship. The elective reframed ophthalmology from a speciality I admired to a platform for holistic impact.
My time at Westmead transcended technical proficiency; it broadened my understanding of healthcare as an interplay of people, systems and innovation. For future elective seekers, I emphasise the value of looking beyond the surface: engage with allied professionals, weigh systemic differences, and let curiosity guide you to unanticipated insights. True vision in medicine, I learned, is not only about what you see, but rather about how clearly you understand what lies beneath.
Declaration of competing interests: None declared.
