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University of Pennsylvania Health System

Department of Ophthalmology

Ophthalmology Education

Clinical and Surgical Rotation Information

WalkerAll rotations are at one of our four outpatient facilities:

  • Scheie Eye Institute (SEI)
  • Children's Hospital of Philadelphia (CHOP)
  • Hospital of the University of Pennsylvania (HUP)
  • Philadelphia Veterans Administration Medical Center (VA).

In addition to rotations on general adult and pediatric ophthalmology services, significant portions of the residency are devoted to sub-specialty education including:

  • retina and vitreous surgery
  • medical retina
  • neuro-ophthalmology
  • oculoplastics
  • glaucoma
  • contact lens
  • corneal and external disease
  • uveitis
  • low vision
  • adult motility
  • ophthalmic pathology

Each resident is scheduled for at least one half day of continuity clinic throughout the three years to permit long term follow-up of post-operative patients and patients with chronic problems as well as to provide follow-up care to patients seen as emergencies while on call. In essence, the continuity clinic allows each resident to build a practice of patients for whom he or she is the primary physician.

Structure of the Rotations

First-Year
Retina (SEI and VA) 10 weeks
General Ophthalmology (HUP) 10 weeks
General Ophthalmology (VA) 10 weeks
Corneal/External Disease/Glaucoma 10 weeks
Pathology/Oculoplastics (SEI) 10 weeks

Second-Year
Neuro-Ophthalmology (HUP, SEI, CHOP, and VA) 10 weeks
General Ophthalmology (VA) 10 weeks
Pediatric Ophthalmology/Oculoplastics (CHOP) 10 weeks
Retina (SEI and VA) 10 weeks
Cornea/Glaucoma (SEI) 10 weeks

Third-Year
General Ophthalmology/Surgery (SEI) 10 weeks
General Ophthalmology/Surgery (VA) 10 weeks
Pediatric Ophthalmology (CHOP) 10 weeks
General Ophthalmology/Surgery (HUP) 10 weeks
Clinical Selective 10 weeks

Description of the Rotations

First Year – Comprehensive Ophthalmology
During the first year of residency, emphasis is placed on developing examination skills and acquiring the knowledge to facilitate ophthalmic differential diagnosis.

Approximately 2/3 of the first year is devoted to evaluating and managing patients with general ophthalmic problems. The Comprehensive Ophthalmology Services at SEI, the VA, and HUP are well supervised by attending physicians.

In addition, the first year resident has a broad and extensive experience in the Oculoplastics Service (including operating experience), the Ophthalmic Pathology Service, the Cornea Service, and the Glaucoma Service.

The first of two rotations on the Retina Service is during the first year. The resident is assigned twice a week to the resident retina clinic and the resident laser clinic, both supervised by a full time attending. The resident also works with attending physicians as they see patients and perform surgery. There is extensive experience with laser surgery and diagnostic techniques including fluorescein and ICG angiography and ultrasonography.

Residents participate to some extent in the evaluation of patients involved in numerous prospective randomized clinical trials. In each assignment, the resident functions both independently with appropriate supervision as well as in an observational role, providing the greatest opportunity for learning from the broad clinical exposure.

Involvement in eye surgery begins early. During the first year, residents practice operative techniques with attending physicians. In addition, residents assist regularly and perform some intraocular surgery themselves during the first year.

Drs. Schindler and Volpe

Second Year – Focus on Subspecialties
Second-year residents have their first of two rotations at the Children's Hospital of Philadelphia. The rotation is dedicated to the medical and surgical care of children with eye problems. Residents obtain extensive surgical experience and perform inpatient consultations as well as outpatient clinical evaluations. Ample opportunity is provided to participate in sub-specialty related clinics, such as craniofacial, genetics, and contact lens clinics. Residents obtain broad exposure to pediatric problems and perform strabismus surgery as primary surgeons.

The neuro-ophthalmology resident works at all four hospitals. There is extensive outpatient, inpatient, and consultative experience as well as experience with pediatric neuro-ophthalmology and the surgical management of adult strabismus.

The VA rotation is oriented towards outpatient general ophthalmology as well as surgery. Residents perform laser surgery and cataract surgery during this block.

The experience on the Cornea and Glaucoma Services is complementary to that which occurs during the first year. Residents have increasing clinical and surgical responsibilities on these services during the second year.

Finally, on the retina rotation, the experience is broadened from the first year with increasing medical and surgical responsibilities. During the second year, in both the Retina Service and the Glaucoma Service, the residents are introduced to and learn how to perform laser procedures using the argon, krypton, dye, and YAG lasers.

Third Year – Surgical Training
The third year is designed as an intensive period of supervised training in ophthalmic surgery. Collectively, the rotations provide a significant surgical experience in anterior segment, laser, eye muscle, and retina, and vitreous procedures. In all circumstances, residents are carefully supervised by attending physicians and participate in both the pre- and post-operative care of patients.

As the surgical senior at the Scheie Eye Institute (10 weeks), the resident is responsible for emergency call as well as eye trauma surgery. The surgical senior also gains experience in cataract and glaucoma surgery.

Similarly, at HUP and the VA, residents spend a significant period of time managing patients in the perioperative period and performing ophthalmic surgery. At CHOP, residents have increasing responsibility for participating in clinic, consultations, and surgery.

Finally, residents are given the opportunity to pursue academic endeavors during the elective block that will enhance their training and knowledge. The educational program undergoes constant re-evaluation and therefore is subject to change based on discussion at the monthly meetings with the Program Director and Department Chair as well as on recommendations from the faculty.

 

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