Dr. Rami Shasha, MD, FRCSC, Dip. (ABO) - Interview
- Atanas Bogoev M.D.
- May 4
- 6 min read
Today in our interview with inspiring ophthalmologists, we are introducing Dr. Rami Shasha, MD, FRCSC, Dip (ABO)! Dr. Shasha is a double board-certified ophthalmologist in both Canada and the United States, with extensive surgical training from the Ivey Eye Institute (read his full bio here).
Dr. Shasha is internationally recognized for pioneering several cataract surgical techniques, including the widely cited "Shasha Sequence," and for his innovative work in complex anterior segment surgeries.
A passionate educator, Dr. Shasha has produced over 2,300 surgical teaching videos and holds multiple accolades, including many global awards. His work continues to impact ophthalmic education and surgical excellence worldwide.
What inspired you to pursue ophthalmology as a career, and what aspects motivated you?
Dr. Rami Shasha, MD, FRCSC, Dip. (ABO): Yeah, it’s a great question. There are no ophthalmologists in my family. When I turned 16 and got my driver’s license, my grandfather developed AMD and was referred to an ophthalmologist. I took him to his appointment, and right then, I was hooked—the surgery, the lasers. Of course, I kept an open mind, and when I got into medical school, I explored all other specialties. But ophthalmology stuck with me.
There’s a famous quote: "You don’t choose your specialty; your specialty chooses you." I resonate with that. What drew me in was the mix of medicine and surgery, and the finesse of intraocular surgery. That’s basically how I got started in ophthalmology.
Tell us about the challenges you faced during residency and training. How did you overcome them?
Dr. Rami Shasha MD, FRCSC, Dip. (ABO): There are always challenges in residency, and they can vary every five years. For example, during COVID, many residents didn’t have the opportunity to do any kind of surgery.
One common concern is whether residents are getting enough surgical volume. I was proactive—I spoke to my program director, showed how many cases I had done, and asked for more. They adjusted my schedule so I could gain more experience.
Getting the right variety is important too. Surgical numbers are something all residents think about. Another challenge is figuring out what to specialize in. That’s why it’s important to get exposure to different areas within ophthalmology.
How did you approach surgical volume and the cases you had? Did you reflect on them?
Dr. Rami Shasha MD, FRCSC, Dip. (ABO): Absolutely. We are very lucky now because we can record our own cases. If your training facility doesn’t allow recording, advocate for it. We learn by doing surgery, but also by watching recordings of our own cases and those of other surgeons online.
We’re very fortunate—back in the '90s, you had to order VHS tapes from surgeons around the world. I recorded my cases and wrote down after each one what I did well and what I could improve.
I sought feedback from my preceptors, which helped me grow quickly. I also used the wet lab frequently, and that was a key part of my learning.
If you do the same, you can expect that your learning curve will go very quickly.
Did you use any simulation during your training?
Dr. Rami Shasha MD, FRCSC, Dip. (ABO): Great question. At the time, simulation wasn’t as popular. We used pig eyes, which are okay, but modern simulators like SimulEye and Bioniko are excellent. They’re more reproducible than pig eyes and cleaner. Of course, there is a cost, but they are great for practicing suturing and other skills, and you can get direct feedback from preceptors.
How did the Shasha Sequence Technique in cataract surgery came to be in 2019?
Dr. Rami Shasha MD, FRCSC, Dip. (ABO): When people ask how to develop a new technique, I always say: don’t try to come up with one—let it happen naturally. This came from doing difficult cases. In complex cataracts, sometimes pieces don’t rotate, and it’s not always due to poor hydrodissection.
So, instead of forcing rotation, I developed a bimanual technique where the chopper manually dissects the hemi-nucleus and brings it to the center for bisection. It started as a necessity in complex cases, but it can be used in routine cases too, as it avoids rotating and stressing the zonules.
It seems this technique is useful even in posterior polar cataracts or anterior capsule tears?
Dr. Rami Shasha MD, FRCSC, Dip. (ABO): Absolutely. In posterior polar cataracts, rotating can stress the posterior capsule. This technique avoids that. It's very useful in many scenarios. The downside is it requires strong bimanual skills.
I recommend surgeons train both hands—not by brushing teeth with the non-dominant hand, but by writing or drawing with it, which better simulates intraocular surgery.
And of course, the more difficult the case, the higher the demand for bimanual technique.
What drives your educational approach as a leading educator in anterior segment surgery?
Dr. Rami Shasha MD, FRCSC, Dip. (ABO): Like with surgical techniques, my teaching evolved naturally. I started during residency by posting mnemonics on Instagram—not surgeries, just ways to remember rare syndromes. This was in 2016. I didn’t do it to build a following; I just enjoyed it.
Later, I started posting surgical videos, especially highlighting specific challenges or techniques. Instagram has short attention spans, so I keep videos concise and zoom in to show exactly what’s happening. That helps people quickly grasp key points. I often film in the morning and post that same day.
What advice would you give a young ophthalmologist just out of residency if they want to walk a similar path?
Dr. Rami Shasha MD, FRCSC, Dip. (ABO): Good question. I gravitated toward complex cases naturally. Not everyone has that inclination, and that’s okay. But everyone has a niche, and once you find it, it won’t feel like work. If you do enjoy complex cases, start by taking them on.
Let your colleagues know you want these cases. Most won’t want to do them, so they’ll refer them to you. That’s how I built my complex practice—by letting people know I was interested and by being persistent.
You also designed the Shasha Shield. Could you explain what that is and how it helps in surgery?
Dr. Rami Shasha MD, FRCSC, Dip. (ABO): Sure. Sometimes we need to pass needles blindly through the conjunctiva and sclera into the sulcus. That’s risky because the needle might catch the anterior capsule, causing a tear. I developed the Anterior Capsule Shield, later called the Shasha Shield.
It goes through a paracentesis, fans out over the anterior capsule, and protects it during needle passes. Even if the needle hits the shield, it’s metal-on-metal, not tissue. This helps prevent catastrophic complications.
How do you go from recognizing a problem to creating a solution?
Dr. Rami Shasha MD, FRCSC, Dip. (ABO): It’s instinctive. I see something in surgery and think, "There must be a better way." I wasn’t trying to innovate—these ideas just came to me while driving or reflecting after surgery.
How do you manage your educational efforts, clinical duties, and your personal interests?
Dr. Rami Shasha MD, FRCSC: Surgical video editing can seem time-consuming, but the more you do it, the faster it becomes. I can make a video in 5 to 20 minutes now. I enjoy doing it, so it feels like a hobby. Ophthalmology gives us great work-life balance, so I have time for hiking, travel, guitar, sports—many things. Being well-rounded helps you stay refreshed and more effective at work.
Record all of your videos, because many interesting parts happen in the cases where you do not expect.
What advice would you give to YOs who are passionate about education and want to share content online?
Dr. Rami Shasha MD, FRCSC, Dip. (ABO): Now is the perfect time. Use Instagram and YouTube. You can even post the same video on both. Platforms like LinkedIn tend to blur surgical videos, so they’re less ideal. Start now—every year it gets harder as more people join. Don’t post for likes. Just post because you enjoy it. Don’t worry if a post isn’t well-received. Post what you think is valuable and move on.
Don't post for the sake to grow, post because you enjoy it and it will grow naturally.
What educational resources do you recommend for young surgeons who want to grow their skills?
Dr. Rami Shasha MD, FRCSC, Dip. (ABO): Watch videos online—you can learn from surgeons all over the world. If you're more hands-on, visit other ophthalmologists, attend conferences with wet labs, or do short observerships. We are globally connected now. Even after training, spend a week or a month learning from someone new.
There are thousands of surgical videos online now. This is the perfect time in history to be an eye surgeon.
To wrap up, could you tell us about your plans and current projects?
Dr. Rami Shasha MD, FRCSC, Dip. (ABO): I’m currently working on a project to solve issues with suture entanglement. My overall focus is developing new techniques and making surgery easier and safer.
I’m also interested in how Artificial intelligence will influence medicine and surgery. AI has a role in decision-making and management, and it’s here to stay. Personally, I’m always trying to improve, even small things like which surgical tape works best. My mindset is constant refinement and growth, both professionally and personally.
Did you enjoy this interview? Check out our other interviews with inspring ophthalmology professionals.
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