OPHTHALMOLOGY RESIDENCY TRAINING PROGRAM
The Medical College of Wisconsin graduate medical education training program in Ophthalmology is designed to prepare resident physicians to achieve sufficient professional ability to practice competently and independently in the diagnosis and management of medical and surgical diseases of the eye. Full-time faculty with a wide range of subspecialty interests and a commitment to teaching, a diverse patient population and excellent clinical and research facilities all contribute to the fulfillment of this objective.
Statement of Goals:
The goal of this program is to train resident physicians in developing the proper clinical judgment and surgical skills to care for patients with a wide variety of medical and surgical diseases of the eye. The training will allow resident physicians to develop sound academic principles, utilizing a learning environment with graded autonomy. Upon completing the residency, physicians are required to obtain competence in the six general competencies to the level expected of a new practitioner.
Outline of Training Program
All of our residents have the same rotations and therefore equivalent educational opportunities across our three institutions (Froedtert and Medical College of Wisconsin Eye Institute, Children's Hospital of Wisconsin and Veterans Administration Hospital). Each of the three institutions has excellent, well-equipped physical facilities for the examination of eye patients. Annual outpatient clinic volume and surgical volume for the three teaching institutions total approximately 50,000 outpatient visits and 4000 major surgical procedures.
The three institutions have different educational emphases: the Eye Institute being the site at which the residents participate in faculty clinics and surgery to provide broad exposure to all aspects of ophthalmology in a tertiary-care setting; the Children's Hospital of Wisconsin being the site at which residents gain experience examining children and familiarity with pediatric ophthalmic diseases and surgery; and the VA being the site at which residents have the most primary patient-care responsibility.
Froedtert and Medical College of Wisconsin Eye Institute
The Eye Institute is attached to Froedtert Hospital and the Medical College of Wisconsin and contains the ophthalmology training facilities. Outpatient clinics, four ophthalmology operating rooms, research laboratories, ophthalmology journal library and conference room are included in the eight floor Eye Institute building.
The resident rotations at the Eye Institute allow for a broad exposure to all aspects of ophthalmology in a tertiary care setting.
Teaching and supervision at the Eye Institute is provided by the full-time faculty members in the various subspecialties as well as comprehensive ophthalmology. Formal evaluation of the residents is completed after every two month rotation. Didactic and teaching conferences are held at the Eye Institute.
VA Medical Center Eye Clinic
The VA Medical Center Eye Clinic (VA) is the site at which residents at all levels of training have the most primary patient-care responsibility. The VA is located within ten minutes travel from the Eye Institute. Residents are provided a learning experience with graded autonomy for the care of ophthalmology patients that have both common and rare medical and surgical diseases of the eye. The opportunity to provide primary care to patients with a wide breadth of ophthalmic disorders, with progressive autonomy (under supervision), aids in preparing residents to practice competently and independently at the completion of residency.
Teaching and supervision at the VA is provided by Eye Institute Faculty as well as clinical faculty from the community. Formal evaluation of the residents is performed after every two month block. Residents on the VA rotation will continue to participate in the didactic and teaching conferences held at the Eye Institute. Resident case presentations for teaching conferences at the Eye Institute also utilize patients seen at the VA. The didactic and teaching conferences are scheduled at a time that does not conflict with scheduled patient care at the VA Medical Center.
The VA Medical Center Eye Clinic (VA) was completely renovated in 2005. The new clinic includes 12 fully equipped examination lanes, Photography and Angiography facilities within the clinic, and new patient check-in and waiting areas.
Children's Hospital of Wisconsin
The Eye Clinic located in the Office Building of Children's Hospital of Wisconsin is where residents rotate for their Pediatric/Strabismus rotation. The CHW Office Building is attached to Froedtert Memorial Lutheran Hospital and the Medical College of Wisconsin. The Eye Clinic has 4 exam lanes.
Dr. Mark Ruttum and Dr. Jane Kivlin provide resident teaching and supervision for the care of patients with pediatric ophthalmic diseases. Surgery is performed at Children's Hospital of Wisconsin and the Surgicenter of Greater Milwaukee (a Children's Hospital of Wisconsin facility located 3 miles from the hospital). The technical staff in the clinic consists of a certified orthoptist and a certified ophthalmic technician.
Residents on the Pediatric/Strabismus rotation will continue to participate in the didactic and teaching conferences held at the Eye Institute. Resident case presentations for teaching conferences at the Eye Institute should utilize patients seen at the Children's Hospital Eye Clinic. The didactic and teaching conferences are scheduled at a time that does not conflict with scheduled patient care at the Children's Hospital Eye Clinic.
Didactic and Teaching Conferences
Residents receive a structured didactic lecture series through the course of their residency training, providing instruction in the basic and clinical sciences pertaining to ophthalmology. The didactic lectures are based on a 18 month cycle, such that all residents receive each lecture twice during their training. Teaching and case presentation conferences (including Grand Rounds, Rotating Clinical Conferences, Morbidity and Mortality Conference, Fluorescein Angiography Conference and Cataract Conference) allows residents to establish a broad knowledge base in ophthalmology.
Surgical and Procedural Experience
Ophthalmology is a discipline in which surgeries and procedures are an important part of the specialty. Training and experience in these procedures is offered on many levels and by many modalities.
A fully equipped microsurgical practice laboratory is available for resident use. The laboratory is equipped with a Zeiss operating microscope with foot-switch activation, and many surgical instruments. Eye bank tissue and cadaveric animal eyes are available for surgical practice.
Residents are introduced to the laboratory early in their first year and are encouraged to use the laboratory throughout their residency. A surgical log is completed by each resident after their practice session and a log is kept for their practice surgical time and experience.
Residents are also taught on the various aspects of cataract surgery management utilizing a monthly Cataract Conference. Eye Institute full-time and part-time faculty members bring in cases and video tapes of surgical procedures for review and discussion, illustrating key points of surgical treatment and management. Residents are invited to bring video tapes and materials to discuss some of their own surgical experiences, particularly the third-year residents.
A structured, didactic, practical surgical skills curriculum has been developed, meeting monthly for an 18-month cycle. Monthly didactic and wet lab experience introduced residents to fundamental surgical principles and procedures with hands-on instruction and supervision by the faculty. These skills can then be reinforced in the surgical practice lab by the residents themselves at their own convenient times. The surgical skills practicum is conducted in the eye operating room, incorporating the actual equipment the residents would use during ophthalmic surgery. Incorporated into this curriculum is the annual Phacoemulsification Course held in Madison, Wisconsin, in conjunction with the University of Wisconsin-Madison and University of Iowa's Departments of Ophthalmology. It also includes the Orbital Dissection Course offered biennially.
Residents receive a progressive procedural and surgical experience through the course of their residency, based on the level of training and their individual progress. First year residents are supervised in the performance of certain anterior segment laser procedures, such as Yag Capsulotomy and Peripheral Iridotomy. First year residents assist in strabismus, cataract, glaucoma, retinal and oculoplastic procedures. In addition to assisting in the same procedures, second year residents are also supervised in performing strabismus surgery, glaucoma operations, and extracapsular cataract extractions with progression to phacoemulsification, as well as diabetic laser treatments and office based oculoplastic procedures. Third year residents have the majority of operative experience in cataract, oculoplastic, glaucoma and retinal surgeries. Third year residents continue to have an opportunity to perform diabetic laser treatments. Second and third year residents are also supervised in the surgical management of the trauma patient.
July 31, 2006