Ophthalmology

Ophthalmology Residency Educational Experience

Overview

Residents will evaluate patients in the WJB Dorn Veterans Administration Hospital (VAH) eye clinic, Palmetto Health Ophthalmology resident clinics, Palmetto Retina clinics and Palmetto Health Baptist Parkridge Clinics. Inpatients are seen as consults at Palmetto Health Richland Hospital, which is adjacent to the Palmetto Health Ophthalmology main clinic. First and second year residents work primarily in primary eye care continuity clinics with exposure to specialty clinics. First and second year residents also spend time in the operating room assisting surgical procedures. Second year residents become more involved in the operating room and help supervise first year residents. Third year residents supervise all junior residents, perform the majority of the surgical procedures and repeat key specialty areas of their choosing originally introduced in the second year.

The goals of the program:

  • To become an integral member of the team of educators who teach medical students and other medical residents ophthalmology
  • To become aware of and to promote the mission and goals of our medical school and hospital
  • To acquire core knowledge required to function as a higher-level resident
  • To develop skills and behaviors required to optimally interact with patients, staff and physicians in the provision of a quality service both in ambulatory clinics and in the hospital setting
  • To become involved and understand the role of ophthalmic research in promoting and developing new techniques and strategies to improve the overall eye health of our community
  • To prepare at least one original research project that could be presented at a national convention

Year One

Residents are based in the primary eye care clinics at WJB Dorn Veterans Administration Hospital (VAH) and at Palmetto Health Ophthalmology Clinics. These continuity clinics are comprised of both routine comprehensive patients as well as specialty patients. Complex ocular conditions may be seen in routine resident clinics and are referred into resident specialty clinics. Residents focus on learning and performing examination skills, collecting exam data and determining differential diagnoses and treatment plans on a case by case basis. Surgical skills are developed through exposure and assistance in the operating room, in office procedures and 24/7 access to a wet lab equipped with surgical equipment and pig eyes. Surgical skills are developed and applied to extraocular procedures, such as oculoplastics and pediatrics. First year residents will also rotate through a low vision clinic.

  • Several required sessions in the wet lab to practice specific procedures

  • Learning specific components of surgery–machine and pedal settings, microscope operation, etc.
  • Learn and demonstrate adequate ocular incisions on animal eyes
  • Learn in depth the ocular anatomy of all ocular structures
  • Operating room exposure in different specialty clinics (glaucoma, retina, pediatrics, etc.)
  • Experience in daily resident clinic (both at the VA and at Palmetto Health Ophthalmology Clinic)
  • Experience with on-call ocular emergencies
  • First year residents see an average of 10-15 patients a day in clinic and are responsible for consults and overnight call.

Year Two

This year is primarily devoted to expanding the resident's experience in ophthalmology specialties, guiding first year residents, running resident clinics and becoming comfortable in the operating room. Month-long rotations are provided in the areas of cornea, glaucoma, oculoplastics, neuro-ophthalmology and the VAH eye clinic. These specialty rotations are held in the Department of Ophthalmology in close working relationships with our faculty. During the second year, residents hone their skills progressing to intraocular surgery.

  • Several required session in the wet lab to practice more advanced procedures
  • Hands-on surgical cases with close supervision of attending
  • Daily clinic experience with more advanced patient cases
  • On-call experience with traumatic and emergency cases
  • Mentor first year residents on call, hospital ER consults, and in clinics

Year Three

Residents have an administrative role in the residency program at this level. They act as supporting back up for second years during consults and clinics. They lead didactics, BCSC reviews and wet labs. Third year residents act as the leaders and chiefs of the program.Third year residents perform the majority of all operating room surgeries and manage the postoperative clinics as well as provide patient care to continuity clinics. Key specialty rotations are repeated to maximize individual learning experience and highlight individual interests.

  • The final year is spent split between the operating room and rotating through clinics
  • Elective clinic rotations allow exposure to specific ophthalmologic interests
  • Chief residents will be tasked with mostly surgical and advanced cases
  • Mentor the first and second year residents; teaching opportunities in the operating room

Didactic Program

Our program has an extensive and rigorous didactic program to adequately prepare residents for the annual OKAP test and boards following graduation. Didactics are held every Friday afternoon during designated lecture time. In addition, evening lectures are held throughout the week by visiting lecturers including fluorescein-angiogram conference, journal club, wet labs and specialty topics. Presentations from local ophthalmologists, as well as specialists across the state and southeastern region, provide residents with in depth evidence-based background knowledge as a foundation to build quickly advancing clinical skills.

The residents also give weekly grand rounds and present M&M video cases in review of cases that were seen in clinic. Review of past cases allows an open-forum discussion provoking different thought processes from each of the residents and faculty which provides for individual growth as well as team-building amongst the resident classes.

Residents also have the opportunity to practice and prepare their clinical skills in vitro prior to surgical procedures on humans. The residents are given access to a fully stocked wet lab of bovine eyes to practice procedures and more fully understand ocular anatomy early on in their residency training.

One of our most prized didactic components is that of our phenomenal OKAP review. The BCSC books are provided to every resident on July 1 of their first year. A comprehensive reading schedule is implemented to ensure that each resident has read the entirety of the BCSC series by December. The residents meet every Wednesday morning to review that week’s required reading assignments. Quizzes are administered after each book is completed and the residents have monthly OKAP quiz bowl for further repetition of topics.

Monthly journal clubs are held at local restaurants with a panel of local ophthalmologists. This format allows residents an opportunity to discuss new, upcoming technologies and procedures as well as traditional studies with practicing physicians of the community.

Community outreach to educate other clinical staff outside the specialty of ophthalmology is performed by the residents. Residents help explain basic eye care protocol to different health care professions. This helps to educate the entire health care population about how to properly take care of patients with eye care needs. Also, it allows these programs to consult with patients for their eye care needs more efficiently.

Research projects must be performed by each resident over the course of their three-year ophthalmology residency. Each resident chooses an area of interest and works closely with one of the faculty members to conduct research. On resident graduation day each June, junior residents present their research project updates and graduates present their research outcomes.

Posters, Publications, etc. Each resident is required to participate in at least one instance of publishable scholarly activity over the three-year period