This residency prank is actually a lesson in clinical reasoning
Would you have fallen for it?
A chief resident certainly did. Presented with what sounded like a straightforward post-op cataract patient, he quickly became convinced the patient was developing endophthalmitis—only to discover the entire consult was an elaborate prank.
The viral TikTok is getting laughs among ophthalmologists, but it’s also arriving at the perfect time. As a new class of residents begins training this summer, the fake consult doubles as a lesson in recognizing one of the specialty’s most feared post-op complications.
The case tests one of ophthalmology’s biggest ‘don’t miss’ diagnoses
The scenario starts innocently enough. Shamir Khan, MD, a PGY-1 resident in UAMS’s ophthalmology residency program, calls Sam Karimaghaei, MD, the chief resident, about a patient who underwent cataract surgery 2 weeks earlier.
The patient has mildly decreased vision, a hazy cornea, elevated intraocular pressure, and some redness after rubbing the eye.
Dr. Karimaghaei immediately starts digging deeper. Was there an anterior chamber cell? Was the patient dilated? Did anyone perform a B-scan? Could they visualize the vitreous? How severe was the pain?
Then comes the detail that changes everything: A small hypopyon. Without hesitation, Dr. Karimaghaei concludes that the patient needs urgent evaluation because there’s a good chance he has endophthalmitis.
Seconds later, Dr. Khan breaks character: “You got punked.”
Related: Why the first weeks of residency matter more than you thinkWhy this prank makes an effective teaching tool
The reveal gets the laugh, but Dr. Karimaghaei’s response is exactly what educators hope to see.
Rather than anchoring on a routine postoperative course, the chief resident continually reassesses the differential as new information emerges. Each additional finding raises concern, prompting escalation instead of reassurance.
That’s what makes this case particularly timely during residency season. New interns are learning how to distinguish expected postoperative findings from true emergencies, while senior residents are sharpening the habit of asking the next question before closing the case.
In a follow-up video, Dr. Karimaghaei said that the prank call really reflects the culture of UAMS’s ophthalmology residency program.
“We really wanted to build a culture in our program where the junior residents could feel comfortable asking us questions, weren’t afraid of … making mistakes and raising any concerns that they have with patient care,” he says. “So truly I’m happiest that people recognize the culture that my coresidents and I strived to create.”
The patient never existed, but the clinical reasoning is real, and it’s exactly the kind of thinking that prevents life-threatening diagnoses from being missed.