Resident Training

Education

The teaching activities of the department include weekly chief rounds and grand rounds that residents across all rotation sites participate in real-time, either in-person or virtually. Additionally, there are daily subspecialty lectures and a monthly didactic day that offer protected time for learning activities. Registration for selected local conferences is provided to residents. An annual board review course registration and travel with room and board for the American Academy of Ophthalmology’s annual meeting are provided to the senior residents.

Howard University, George Washington University, and Georgetown University form the Washington Ophthalmic Resident Consortium (WORC). This group promotes collaboration between the local ophthalmology programs.

Clinical Rotations

Howard University Hospital (HUH) Rotation

Structure:

Residents participate in daily resident clinics in different sub-specialties each day, including cornea/external diseases or comprehensive ophthalmology on Mondays, pediatrics and adult strabismus and retina on Tuesdays, glaucoma and comprehensive ophthalmology on Wednesdays, oculoplastics/orbit and retina or contact lens on Thursdays, and neuro-ophthalmology or retina and comprehensive ophthalmology on Fridays. Each clinic is supervised by a board-certified ophthalmologist and there are typically two to four PGY-1/PGY-2 residents and one or two senior (PGY-3 or PGY-4) residents in each clinic session.

Surgical rotations within the Howard University Hospital rotation begin in the PGY-2 year allowing for early exposure to the operating room and surgical techniques and a stepwise increase in surgical responsibility. Residents participate in a range of surgeries, including routine and complex cataracts, anterior segment, oculoplastics, retina, cornea, pediatrics and strabismus.

Additional non-surgical service within the Howard University Hospital rotation is as follows:

Pediatrics/Low Vision – This is a PGY-2 rotation. On this service the resident participates in Retinopathy of Prematurity (ROP) rounds with Dr. Smith-Marshall on Tuesday mornings, Dr. Smith-Marshall’s private pediatric clinic in Bowie, MD on Wednesdays, and Low Vision with Drs. Alibhai and Weinberg on Thursdays. On Mondays, Tuesdays and Fridays residents participate in the resident clinics at Howard.

Goals:

To master the eight-part ophthalmic examination
To perform and interpret all ancillary tests in ophthalmology
To establish a broad foundation of medical knowledge
To gain competence performing surgical procedures
To receive early exposure to management of low vision patients
To gain exposure to and develop competence in intraocular surgery

DC Veterans Affairs Medical Center (DC VAMC) Rotation

Structure:

One PGY-3 resident rotates to the DC VAMC clinic at a time for a four-month block. Residents participate in daily comprehensive clinic with additional experience in oculoplastics (including minor and OR surgeries), ophthalmic lasers (YAG capsulotomy, trabeculoplasty, iridotomy and iridiplasty), and intravitreal injections. Residents participate in 1-2 cataract surgeries weekly on Thursdays with Dr. Soo Shin. In addition to Dr. Shin, residents are supervised by several board-certified ophthalmologists, including Dr. Claude Cowan, Jr., Dr. Michelle Maiberger, and Dr. Rosalie Bair.

Goals:

To gain exposure to cataract and anterior segment surgery, including minimally invasive glaucoma techniques
To efficiently run a comprehensive clinic
To develop competence in anterior segment lasers including YAG capsulotomy, laser trabeculoplasty, peripheral laser iriditomy and iridoplasty
To be able to manage surgical patients pre-, peri- and post-operatively.

Orlando VA Rotation in Retina and Uveitis

Structure:

One PGY-3 resident rotates at the Orlando VA at a time for a four-month block. This resident participates in resident clinic in retina on Mondays, Tuesdays and Fridays. These clinics include a variety of retina pathology as well as in-office procedures, including retinal lasers and injections. On Wednesdays residents participate in electrophysiology lectures and procedures with patients under the supervision of Dr. Saad Shaikh. Thursdays are dedicated to retinal surgery in the operating room. On Monday afternoons, residents participate in uveitis clinic with Dr. Vimal Sarup, who is fellowship trained in retina and uveitis.

Goals:

To learn to examine, properly document and present a patient who presents with a retina or uveitis problem
To learn what management is appropriate in a given patient based on diagnoses and systemic issues
To understand basic concepts of surgery and in-office procedures, including intravitreal injections and laser photocoagulation of the retina
To understand various methods to visualize the retina
To become familiar with basic concepts in electrophysiology, how to clinically apply these concepts, and how to interpret ERG/EOG results
To become familiar with various uveitic diagnoses and complications of anterior, intermediate and posterior uveitis
To be able to coordinate treatment of uveitis with physicians managing systemic associations including infectious disease and rheumatology specialists

Orlando VA Rotation in General/Comprehensive Ophthalmology

Structure:

Two PGY-4 residents rotate at the Orlando VA at a time for total of two for a four-month blocks. Residents at this level participate in daily comprehensive resident clinics where they see a variety of pathology. Common diagnoses include glaucoma, cataracts, dry eye disease, macular degeneration, cornea ectasias. A broad optometric network handles most refractive errors and refers more complex cases and those requiring surgical intervention to this clinic. Residents participate in anterior segment laser clinics where they perform a variety of procedures, including YAG capsulotomy, laser trabeculoplasty, peripheral laser iridotomy and iridoplasty. Each resident performs cataract surgery 1-2 days a week for approximately 10-15 cases as primary surgeon each week. Some of these cases are done in combination with micro-invasive glaucoma surgery techniques or with femto-laser assisted techniques. A robust surgical volume is subsequently followed by the residents in post-operative clinics, where residents can follow the refractive outcomes and potential complications of their surgeries. Residents are supervised by several board-certified ophthalmologists, including Dr. Naazli Shaikh, Dr. Saima Qureshi, Dr. Brian Mikulla, and Dr. Son Ho.

Goals:

To function as leaders of the eye care team
To teach colleagues
To gain competency in cataract and anterior segment surgery, including femto-assisted laser cataract surgery
To gain exposure to minimally invasive glaucoma techniques
To efficiently run a comprehensive clinic
To develop competence in anterior segment lasers including YAG capsulotomy, laser trabeculoplasty, peripheral laser iridotomy and iridoplasty
To be able to manage surgical patients pre-, peri- and post-operatively

Education

At the start of training, residents receive a complimentary copy of the Wills Eye Manual, which is useful for the diagnosis and management of ocular diseases frequently seen on call. In addition, GME provides educational funds that are typically used towards the purchase of question banks, and ophthalmic texts, atlases or reviews. Through GME, residents and faculty have access to the GME Competency Education Program throughout the year. A medical library is also available to the residents, in addition to digital access to the American Academy of Ophthalmology Basic Clinical Sciences Course text.

Residents receive formal lectures in each of the ophthalmic sub-specialties by board-certified faculty in ophthalmology, neurology and pathology. These lectures typically precede daily sub-specialty clinics throughout the week. In addition, the third Thursday of each month is protected time for didactics and residents from all sites participate in person or remotely for this full-day activity. Invited guest speakers for didactic day are often local, private practice ophthalmologists who can add unique perspectives to the resident education. While rotating at the Orlando VA during PGY-3 residents also receive weekly fluorescein angiography and electrophysiology lectures.

Each week, residents also participate in-person or remotely in Chief Rounds and Grand Rounds. Chief Rounds are Tuesday afternoons and involve review sessions led by the senior resident or oral boards practice sessions and questions with the program director. Grand Rounds are Thursday afternoons and involve case presentations by residents or rotating medical students with feedback from peers and faculty in terms of diagnosis and management. Monthly journal clubs and quarterly morbidity and mortality rounds are also held during this time. Throughout the year, special workshops are also conducted during this time. Recent past workshops include a library resources review with our health sciences librarian, a well-being lecture with a local psychiatrist and a feedback workshop with our dean of faculty development. All residents participate in at least one research project and a quality improvement project each year. Information and outcomes from these quality improvement projects are integral to the improvement of the program and the department, and the safety of the patients that we care for.

In terms of board review preparation, in addition to oral boards practice sessions with the program director, the department provides an online review course to all residents leading up to the annual Ophthalmic Knowledge Assessment Program (OKAP) exam. Additionally, senior residents receive financial support from GME to attend an online or in-person board review course.

The department also organizes two named lecture symposia annually, where residents have the opportunity to present to a large audience of other residents, medical students, faculty and alumni. For each symposium, we invite a prominent ophthalmologist to give the named lecture. The fall symposium focuses on glaucoma cases and is followed by a glaucoma wet lab in the university’s state of the art simulation lab. The spring symposium is combined with the annual alumni conference and is an opportunity for residents to provide updates about their ongoing research projects.

In terms of supplemental surgical education, residents have access to the EyeSi Surgical simulator while in DC and also in Orlando, FL. The department sponsors at least 2 large wet labs annually with strong participation by residents, medical students and faculty. Additionally, residents participate in smaller monthly wet labs ranging from intraocular lens loading to amniotic membrane placement and intravitreal injections. Thanks to a generous recent donation, a large renovation to our wetlab at HUH is planned for the near future to include updated state-of-the-art equipment to further enhance the resident’s surgical education.

The department encourages all residents to submit their research for presentation at local and national conferences and eventually for publication in peer-reviewed journals. Our medical students and residents typically have strong representation the following annual conferences: National Medical Association (NMA) Rabb-Venable, Women in Ophthalmology (WIO), Association for Research in Vision and Ophthalmology (ARVO), American Academy of Ophthalmology (AAO) and others. Senior residents receive financial support to attend the annual AAO conference, the largest ophthalmic conference each year. In addition, residents who are accepted to present their research at any of these local or national platforms receive financial support from GME that can cover the cost of poster printing, attendance and/or travel. Faculty are also encourage to stay up-to-date with research and attend these conferences, with the financial support of GME and the department.

All local residents also participate in AAO’s annual Congressional Advocacy Day and Mid-Year Forum in April. During this meeting residents are able to participate, often for the first time, in advocating for our profession and our patients with their government representatives and learn some practice relevant information for approaching graduation and beyond, such as contract negotiation.

The program director, program coordinator and the chair attend the annual Association for University Professors of Ophthalmology (AUPO) where they access and share important information to improve the resident and medical student learning and training experience.

Through collaboration with other ophthalmology programs in the DC area, we are also able to offer residents several unique learning opportunities, including an annual month long ophthalmology introductory course for incoming PGY-2 residents, monthly fluorescein angiography and retina review lectures with the Retina Group of Washington, an annual retina symposium with the Retina Group of Washington, an annual ocular trauma course with the Uniformed Services University of the Health Sciences, an annual Low Vision Symposium with the Prevention of Blindness Society, an annual Ocular Inflammatory Summit with Stephen Foster, an annual Cherry Blossom Pathology course with George Washington Hospital, and an annual femto-laser assisted cataract surgery course with Wilmer Eye Institute.

Educational Goals

The principal goals of the residency program are:

To provide resident physicians with comprehensive clinical training, basic science teaching, and investigational research activity, that will enable them to practice ophthalmology competently and without direct supervision upon completion of the program.
To create a unique educational environment in order to produce committed health care practitioners, espousing the core competencies of compassionate patient care, outstanding medical knowledge, professionalism, excellent interpersonal and communication skills, and who continue to develop and improve in practice based learning and systems based practice as defined by the Accreditation Council for graduate medical education.
To create a scholarly environment in which the residents and faculty can jointly contribute to medical knowledge and continually evaluate and improve their practice based on critical appraisal of literature.
To exceed the minimal board certification requirements and provide residents the knowledge, skills and behaviors necessary to pass the board certification exam and to excel within the field of ophthalmology.