Program overview
We designed our program with an emphasis on comprehensive ophthalmology education with rotations in the subspecialties of ophthalmology.
In your first year in ophthalmology, your primary duties include the supervision of the walk-in or emergency clinic, daily refractions and complete ophthalmic examinations. You will assist in the operating room 1½ days/week and perform a variety of ocular procedures as the primary surgeon. You’ll complete 12 months of clinical work including rotations in Geisinger pediatric ophthalmology and strabismus as well as neuro-ophthalmology.
In your second year, you’ll have a rotation away from our home institution at the Lancaster Basic Science Course held at Colby College in Maine for six weeks in the summer between your first and second years. You’ll also have a rotation at the Wills Eye Hospital in ophthalmic pathology, which lasts two months in the spring of your second year. You’ll also have rotations in retina, glaucoma, neuro-ophthalmology, pediatric ophthalmology, and low vision and contact lens.
During your third year, you’ll be responsible for inpatient systemic disease consultations and the management of more complex ophthalmic cases under appropriate attending supervision. You’ll perform the full range of intraocular surgery and laser surgery and are responsible for pre-, intra- and post-operative care under appropriate attending supervision. Rotations in your third year include retina, oculoplastics and neuro-ophthalmology. As a third-year ophthalmology resident, you’ll act as chief resident for a six-month period assisting the residency director in the administrative duties of the residency and organizing the on-call schedule, grand rounds, morbidity and mortality conferences, pathology conferences and guest lectures.
On call
Primary call responsibility is distributed among our six residents. In general, the first and second years divide weeknight call evenly, and the third-year residents act as backup call for the first-year residents. Third-year residents can participate in the majority of surgical cases in their role as backup. Additionally, when first- or second-year residents are away on rotation or at courses, accommodations to share call will be made. From January until April, while one of the second-years is away for the pathology rotation, the call is divided among the remaining residents.
During the week, call starts at 5 p.m. and ends the following morning at 7 a.m. An attending ophthalmologist is always on call as backup for surgical cases and assistance with complicated patients.
First- and second-year residents will take call approximately 33–34 days every six months out of the year and weekend call nine times a year. Third-year residents will take approximately 25–26 call days every six months and weekend call nine times a year.
Curriculum
The majority of your didactic instruction in basic and clinical sciences in ophthalmology is covered during the morning lecture series from 7 a.m. to 8 a.m., Monday through Friday. Monthly schedules for this lecture series — as well as any scheduled afternoon, evening or weekend — are posted and circulated to all staff and residents. The design and curriculum is the responsibility of the residency director who coordinates the lectures based on each subspecialty.
We rotate each set of didactic ophthalmology lectures for residents on a 12- to 18-month schedule to ensure repeated exposure to each subject and to make sure residents don’t miss anything during their three years. Our curriculum is supplemented by the Institutional curriculum, the Wills Eye pathology rotation in ophthalmic pathology, invited guest lectures and the Lancaster course in basic science in Waterville, Maine.
Your progress will be monitored informally through discussion and observation in the clinic and formally through the Ophthalmic Knowledge Assessment Program test given nationally each spring. These tests assess your performance and the performance of the residency in individual subtopics. We also monitor didactic lecture attendance through a sign-in sheet.
Clinical case presentations occur at grand rounds each Friday, the morbidity and mortality conference, pathology CPCs, and in conjunction with individual subspecialty didactic lectures. Journal club is held monthly, and chief residents attend monthly departmental administrative and quality improvement meetings.
As a resident, you’ll present clinical case material at grand rounds and occasional fluorescein angiogram conferences, and you’ll present cases for discussion to guest lecturers. Chief residents organize and present morbidity and mortality rounds and pathology conferences to the staff and other residents. Pathology lectures incorporating clinic material are offered monthly for one hour in a CPC format.
Medical students receive instructions through a series of didactic lectures by the attending physicians, which are aimed at their level of expertise in ophthalmology. Residents may attend the basic lectures, and the medical students are invited and encouraged to attend the regularly scheduled conferences and ophthalmology lectures for medical students.
First-year ophthalmology residents supervise students in walk-in clinic. All residents and staff help provide medical students with one-on-one supervision at other times. On average, two students rotate at any one time. We use a similar chain of command and required responsibility when rotating residents from emergency medicine, internal medicine and family practice. These residents rotate for three to four weeks on an elective basis.
Curriculum
- Optics, refraction, contact lenses, low vision
- Uveitis and ocular tumors
- Retina and vitreous
- Neuro-ophthalmology
- Pediatric ophthalmology and strabismus
- Corneal and external diseases
- Glaucoma
- Lens and related anterior segment surgery
- Oculoplastics including orbit, eyelids and adnexa
- Ophthalmic pathology
- Refractive surgery
- Ethical issues, socioeconomics of healthcare, cost-effective medical practice
Special characteristics of the program
The Geisinger Ophthalmology Department is made up entirely of full-time faculty whose offices and practices are located in the eye clinic. During your entire residency, you’ll follow your own patients and provide continuity of care. This model helps you develop deeper patient relationships and observe the natural progression of diseases such as diabetes. Attending staff participate in clinical research including national trials, which provides them with involvement in a herpetic eye disease study and anterior ischemic optic neuropathy trials.
Finally, we believe residents optimally develop their surgical skills when permitted sufficient time, experience and supervision. Residents halfway through their first year begin performing cataract surgery as the primary surgeon, which provides them with sufficient time and experience to develop those important skills. All surgical cases are completed under the direct supervision of our full-time faculty. There are no fellows in the Department of Ophthalmology, which protects the primary or the resident and their education. Overall, three primary elements ensure our surgeons are well trained: the time to develop skills; a rich, varied and extensive surgical experience; and teaching exclusively by experienced, fellowship-trained subspecialists.
Charitable work
We encourage residents in the Department of Ophthalmology to participate in community service through organizations such as Habitat for Humanity and their local religious organizations. We also hope our residents will participate in a program called Mission Cataract, which started in California in the early 1990s. This program provides free screening and cataract surgery to patients who have no insurance or ability to pay for surgical care. The program offers a free screening clinic day followed by an operating day two weeks later.
Last year, Mission Cataract helped 20 patients receive the free gift of sight. We hope involvement in programs like these will provide you and other residents with new perspectives about the ethics of medical care and need to care for patients regardless of their ability to pay. We hope it will encourage you to care for underserved populations throughout your career.