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The emphasis in this twelve-month period is to develop basic ophthalmologic skills and fundamentals of diagnosis and treatment of eye disease. Approximately 40 percent of the time is scheduled in the Emergency Room and Comprehensive Ophthalmology Service, where junior residents examine and follow general ophthalmic patients under the supervision of the attending staff. An introduction to ophthalmic surgery is an integral part of the first year, including participation in a surgical curriculum where each resident is paired with a faculty mentor to learn surgical techniques in the wet lab. First year residents perform pterygia and extracapsular cataract extractions with the Chief Resident.
The Cornea and Refractive Surgery Service affords an opportunity to participate in the management of large numbers of patients with corneal, anterior segment and external disease problems and patients who have elected refractive surgery.
On the Retina Service, residents become familiar with fundus pathology, learn to interpret fluorescein angiograms and manage patients with macular disease and diabetic retinopathy. Increased proficiency in the use of the indirect ophthalmoscope is also a primary goal in this rotation. The first year resident also prepares cases to present at the weekly macula conference.
On the Eye Plastics and Orbit Service, junior residents manage patients with a variety of oculoplastic problems and have the opportunity to work closely with the service director.
Each resident rotates in the Eye Pathology Laboratory, examining and reporting on the large volume of specimens received daily by this unit. This provides invaluable experience for the residents as they learn to make clinical-pathologic correlations.
On the Glaucoma Service, each resident learns the skills necessary for evaluating and treating patients with glaucoma related problems.
There is one rotation each year at the Boston VA Hospital. Residents see both general and subspecialty patients and participate in surgery appropriate to their training level.
Junior Residents cover the Emergency Room at Massachusetts Eye and Ear Infirmary on a nightfloat system.
During the Second Year, residents are provided the opportunity to further expand their knowledge base, refine clinical skills by managing patients with specialized and complex problems, and perform intraocular surgery.
On the Neuro-Ophthalmology Service, residents spend 2 blocks evaluating patients with neuro-ophthalmic problems. In addition, the residents on this rotation are responsible for providing ophthalmic consultations for all services of the adjacent Massachusetts General Hospital, thereby increasing their exposure to the ocular manifestations of systemic disease.
At the Boston VA Hospital, residents participate in glaucoma and retina laser treatments and plastics procedures in addition to seeing patients in clinics.
The Beth Israel rotation affords the residents an opportunity to participate in extracapsular cataract surgery. Residents see patients in the Beth Israel ophthalmology clinic and cover consultations at the Beth Israel Deaconess Medical Center and the Brigham and Women’s Hospital.
There are rotations on the Pediatric Ophthalmology Service at Mass Eye and Ear as well as another rotation at Children’s Hospital where residents gain experience in the diagnosis and management of eye disease in children, including strabismus surgery.
The rotation on the retina service gives residents an opportunity to perform scleral buckles and retinal lasers. In addition, there is time to work in retina clinics, including time with one of the leading ERG clinicians.
There is time at the Cambridge Health Alliance to perform extracapsular cataract surgery as well as portions of phacoemulsification cases.
There is an additional rotation in Oculoplastics. During this time, residents have an intensive exposure to patients requiring ophthalmic plastic and orbital surgery.
Interspersed throughout the year is the opportunity to perform cataract surgery with the Chief Resident.
The third year offers a period of intensive ophthalmologic surgical training. Senior residents perform a full range of ophthalmic surgical procedures, including large numbers of cataract operations with intraocular lens implantations. General goals include the refinement of knowledge, judgment, technical skills, and the development of professional maturity essential to the well-trained ophthalmologist. Although the resident learns to function independently, assistance, back-up, and coverage is provided by a large and dedicated attending staff.
Senior residents have major responsibilities in the Comprehensive Ophthalmology Service, where they work-up, manage, and follow patients with a wide spectrum of ocular pathology, including all patients requiring cataract surgery.
Night and weekend call is divided to provide continuing back-up for the junior resident on-call as well as admission of emergency cases. All open globe surgeries are performed by senior residents under the supervision of the Chief Resident.
Senior residents also rotate again onto the Glaucoma Consultation Service, where they evaluate and manage patients, as well as participate in their surgery.
There is an intensive surgical rotation at the Boston VA hospital where senior residents perform cataract extractions and open procedures.
Seniors also rotate at Togus Veterans Administration hospital in Togus, Maine. As the only VA hospital in Maine, it is the primary referral center for complex ophthalmological problems. A high volume of intraocular and laser procedures are performed under the direction of the Chief of Ophthalmology. The outpatient facilities, equipment and operating suites are state-of-the-art.
Senior residents also rotate on the Cornea service where they manage patients with a wide spectrum of disease and participate in corneal transplants.
Senior residents on the Retina Service manage patients with vitreo-retinal pathology ranging from routine to complex. There is time in the clinic and operating room with one of the leading melanoma specialists in the world.
There is also a seven-week Elective Period. Currently, residents may select to spend this period at the Aravind Eye Hospital in India. There is an opportunity to perform a significant number of intraocular procedures in modern, well-equipped surgical facilities. As an alternative elective, residents may select additional clinical or research experience in a chosen field of interest at Massachusetts Eye and Ear Infirmary.
There are many didactic sessions throughout the year including: Friday morning lecture series (2 lectures each Friday covering all topics for all residents), Grand Rounds every Wednesday, Chief Resident rounds for Junior residents 3 days per week, subspecialty rounds (Cornea club, Uveitis rounds, Macula Conference, etc), and OKAP review sessions. In addition, there are several yearly events including the Chandler visiting professorship, Fellow’s course, Resident’s course, and the new yearly cataract course (held in June for Intermediates).
Residents who graduated in 2007 received substantial experience in: cataract procedures, strabismus surgeries, corneal surgeries, glaucoma lasers, glaucoma filters, vitreoretinal surgeries, retinal lasers, oculoplastics procedures, and open globe repairs. Residency graduates are fully equipped to begin a career in general ophthalmology or to pursue further fellowship training.
The emergency room is covered by junior residents on a nightfloat system. In addition, junior residents work shifts on weekend days from 8 a.m.-6 p.m. Intermediate residents take call from home on some of their rotations. In addition, intermediates work short shifts in the emergency room on evenings of the first 2 blocks to allow for junior resident teaching in the emergency room by the seniors. Senior residents take back-up call from home.
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