First Year Rotation Schedule
Traditional general surgery duties typically include the following one month rotations:
Additionally, there is an opportunity to do 2 or 3 months of elective time in Ophthalmology, and the balance of the year may include 2 or 3 additional electives, at the discretion of the General Surgery Program Director.
While on the Ophthalmology service, the intern is responsible for performing the procedures for fluorescein angiographies. They also assist in pre-operative preparation of patients for surgery. The intern has no weeknight or weekend call duties and is scheduled to participate with patient care under the supervision of the residents and attendings.
General (w/ Pediatric) Clinic: First year residents participate in the general ophthalmology clinic and begin to independently care for patients under the supervision of attending physicians. The general clinic is staffed by great technicians and several community ophthalmologists. The different community attending physicians have been the strength of this rotation by providing excellent supervision, education and a variety of sound practicing styles. The first year is part of a team with the technicians and staff which also includes an intern, a second year resident and a senior resident. The general clinic team also has a glaucoma half-day. The first year also spends two half-days in the pediatric ophthalmology clinic.
Cornea Clinic: The first year is the primary resident on the cornea service sharing time with the cornea attending physicians. There are two clinic days and two surgery days. As the primary resident on this rotation the responsibilities are many but the learning experience is great as are the opportunities to participate with procedures both in the operating room and clinic.
Plastics: This first year resident rotation is where residents work one-on-one with the Oculo-Plastics specialist. There is ample exposure to both in-office procedures as well as the operating room for the wide variety of pathology that is encountered.
Neuro-ophthalmology (w/Retina) Clinic: This rotation with our neuro-ophthalmology attending physician gives the first year resident a great experience with additional exposure to uveitis patients. There is also time spent gaining experience with the retina service both in the clinic and the OR.
After additional instruction with on-call issues, the first years begin to take first call responsibilities. The first years take thirty-two weeks of first call including the four major four day weekends. The second years take the remainder of the call.
Second Year Rotation Schedule
General Clinic: While there is a senior resident on service with the second year resident, this clinic has traditionally been considered the second year resident’s show to run with ample backup. Second years are responsible for the day to day clinic flow as well as in-patient adult ophthalmology consults. As described previously, the different community attendings are great physicians and their different approaches add tremendously to our education. The variety of pathology that is seen in the general clinic is fantastic. During this rotation the second year will have the opportunity for cataract surgery as the primary surgeon.
VA: The incredibly busy clinical service is balanced by two surgery days. Here the second year begins to build their volumes of surgeries as primary. The ophthalmology attending physicians at the VA are excellent teachers, and definitely make the transition into primary surgeon comfortable. Additionally, there is a half day dedicated to minor procedures such as injections, biopsies and laser surgery. The majority of the surgery will be cataracts but there is one oculoplastics surgery day a month as well as retina and glaucoma surgeries.
Retina: The primary resident on the retina rotation divides their time between our vitreo-retinal specialists. There are 2-3 surgery days per week but there are often added cases throughout the week. The Retina clinics provide exposure to diverse pathology. During these three months there is experience performing panretinal photocoagulation, focal lasers, and intravitreal injections. The retina service is supported by a full array of imaging modalities with residents learning to interpret findings side by side with attending physicians. Surgical cases likewise provide a diverse exposure and an opportunity to learn the basics of vitreoretinal surgery. In the operating room residents are involved as active participants with each case.
Pediatrics: The three months in the pediatric ophthalmology clinic are spent with some of the world’s foremost pediatric ophthalmologists. The resident participates in busy clinics where the basics of pediatric ophthalmology are learned with the fellow and attendings including ROP clinic. Surgery time is shared with the fellow but since there are three surgery days amongst the pediatric ophthalmologists, primary surgical numbers for the resident exceed the ACGME minimums. The resident is responsible for the inpatient pediatric ophthalmology consults.
General Clinic: The role of the senior resident here is primarily to back-up the second year resident and to perform the surgeries produced from clinic. These surgeries include cataract surgeries with our community physicians and staff general ophthalmologist. Select cases will also be performed with the cornea service as well as day trauma cases.
VA: During the VA rotation, the residents will perform the majority of their cataract surgeries which come with two dedicated surgery days per week. Additionally there is one oculoplastics day per month as well as scattered retina surgeries.
VA/Elective: On top of the traditional VA rotation, residents get a rotation with three VA clinic day and one VA surgery day. Surgeries consist primarily of cataracts. This rotation affords incredible flexibility for concentrating on special interests during the days not spent at the VA.
Glaucoma Clinic: The third year is the primary resident on this rotation with the glaucoma service. There are two surgery days in the week, one dedicated for resident surgery. Surgical and laser glaucoma procedures easily exceed ACGME minimums.
FA Conferences - 2nd & 4th Tuesday morning at 7:15AM with the retina faculty. Here imaging modalities will be correlated with clinical cases and discussed with graded questions weighted toward the lower level residents first.
M&M Conferences – 1st Tuesday morning at 7:15AM where 2 residents will present cases to discuss ways to improve patient care and clinical skills.
General Conferences – multispecialty conferences on the 3rd and 5th Tuesday that rotate between the different subspecialty services at the institute.
Academic Fridays – Every Friday afternoon is dedicated to academics with mandatory attendance by all residents except for the on-call team. Typically, there are three lectures given by attending physicians. The final hour is spent with residents proctoring an OKAP review session lead by one of the senior residents in a low stress environment without attendings.
Journal Club – Once a month residents and attending come together for a fun night of dining and education. Typically three articles are presented by residents for a discussion in a social atmosphere.
Resident Surgical Volumes
Cataract Surgery: 200-250 cases as Primary Surgeon
Open Globe Surgery: 10-20 cases as Primary Surgeon
Glaucoma Surgery: 5-20 cases as Primary Surgeon
Corneal Transplants: 1-2 cases as Primary, 10-20 as Assistant
Strabismus Surgery: 25-30 cases as Primary Surgeon
Oculoplastic Surgery: 30-40 cases as Primary Surgeon
Vitrectomy Surgery: Assist only
Laser Surgery: 50-75 Focal, PRP, YAG and LI’s