First year residents rotate through retina, glaucoma and general clinics at MWHC, MGUH, and WRB, as well as assist in surgery at these locations. Caseloads are adjusted to the expertise and experience of the first year residents.
A basic science course at the beginning of the first year serves as an introduction to ophthalmology. The course is held Monday through Friday, and the occasional Saturday, for a period of four weeks. In the afternoons, residents learn to perform an ophthalmologic examination by doing histories and eye examinations on MWHC, MGUH and WRB patients. They also begin to learn the fundamental procedures of refraction, tonometry, retinoscopy, biomicroscopy, gonioscopy, indirect ophthalmoscopy, visual field interpretation and the use of the potential acuity meter.
Residents gain experience in retinal disease, diagnostics and therapeutics at make fundus drawings of the detachment cases and assist in surgery on many of the cases they have drawn. The residents also assist on vitrectomies. They learn to interpret fluorescein angiograms and optical coherence tomography (OCT) images both in the daily clinic and in the monthly fluorescein conferences. The residents, under direct supervision, perform retinal and intravitreal injectio
The weekly glaucoma review board at MWHC features five to seven problem cases completely worked up and presented to the subspecialty attendings by the residents assigned to the glaucoma service. In addition, the glaucoma subspecialty clinic at MGUH allows the resident the opportunity to participate in the diagnosis and management of a large number of private attending glaucoma patients. Gonioscopy instruction is carried out in a one-on-one manner. The residents, under direct supervision, perform laser trabeculoplasties and iridotomies.
The balance of the first year is devoted to the diagnosis and therapy of patients in the general eye clinics at MWHC, MGUH and WRB, including emergency and consultative cases. The first year residents are introduced to the operating room early in the year, first observing, and then assisting in surgery. Residents obtain advice from the attendings for any clinical finding or therapy of which they are unsure, and patients examined by residents during clinic hours are directly supervised by attending physicians. Practice surgery utilizing both skin and microsurgical techniques is performed throughout the year, and is emphasized at several wet labs during the year.
Residents also participate in a low vision clinic at MWHC, affording them the opportunity to learn management principles pertinent to this unique patient group.
At the conclusion of the first year, residents have developed a functional facility in all of the standard diagnostic techniques, as well as a solid grounding in the diagnosis and management of a variety of eye diseases. Case histories, clinical examinations and minor incisional and laser surgical procedures are performed with competence. Extensive experience as first assistant in a wide variety of intra- and extra-ocular cases gives them a solid foundation in operating room comportment and procedures. They have presented a research poster during the annual Residents' Day.