Ophthalmology PGYIII

Description of Rotation or Educational Experience

This is a two-week rotation performed in a private ophthalmology group practice location.  This rotation will increase knowledge of ocular diseases and teach skills a Family Medicine physician will need in providing primary care of the eye. In addition, periodic ophthalmological conferences are delivered at the regular noon meetings.

Goal I: To prepare the resident for appropriate primary eye care and appropriate specialty referral.

The resident is expected to:

·         Follow the ophthalmologist in their outpatient clinic gaining a one on one learning experience.

·         Attend three ½ day continuity clinics in the FMC.

·         Self Study “Basic Ophthalmology”.

Patient Care

Goal

Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.  Residents are expected to:

Competencies

• Eye exam
• Identify infection of the eye
• Identify foreign bodies in the eye
• Identify cataracts

Objectives

• Proficiency in ophthalmological history and examination.
• Performance and evaluation of test for color vision, visual acuity, and visual field.
• Demonstrate proper use of ophthalmoscope and slit lamp.
• Performance and interpretation of fluorescein stain of conjunctiva and cornea.
• Removal of foreign body from the eye.
• Demonstrate understanding of analgesia and antibiotic therapy to the eye.

Medical Knowledge

Goal

To integrate basic medical knowledge with an in-depth learning experience to detect and manage

 problems of the eyes.  Essentials of the block rotation are:

Competencies

• Understand and manage infections of the eye:
  • Conjunctivitis
    • Viral
    • Allergic and bacterial
  • Chalazion, hordeolum, blepharitis, stye, infected meibomian cyst
• Understand and manage trauma of the eye:
  • Foreign body
  • Chemical and heat injury to the eye
  • Corneal abrasion
  • Corneal ulcer
• Recognize refractive errors
• Manage and diagnose the following:
  • Glaucoma
  • CNS problems affecting the eye
• Recognize cataracts and other degenerative diseases
• Manage and diagnose cause of eye pain and the acute red eye.
• Prevention of Amblyopia in children
• Recognize manifestations of systemic disease including:
  • Diabetes mellitus
  • Retinopathy
  • Hypertension
  • Temporal arteritis
  • Myasthenia
  • Thyrotoxicosis
  • Wilson’s Disease
  • Marfan’s syndrome

Objectives

The resident will

• Conduct self study on the above topics from Basic Ophthalmology (textbook distributed at beginning of rotation).
• Understand the anatomy and physiology of the ocular system's normal growth, development, and variants.
• Conduct an office evaluation, diagnosis, and treatment of diseases of the eyes.
• Become familiar with the tests and procedures used in evaluating the patient visually and medically.
• Develop an appreciation for specialty teamwork in managing patients and when consultations and/or referrals are indicated.

Practice- Based Learning and Improvement

Goal

Residents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life long learning.  Residents are expected to develop skills and habits to be able to:

Competencies

• Identify strengths, deficiencies and limits in ones knowledge and expertise.

Objectives

·         The resident will assess his/her understanding of ocular diseases and examination of the eye. The resident will learn when ophthalmologist referral is appropriate and improve her/his ability to provide for basic eye care in her/his FMC.

Systems Based Practice

Goal

Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care.  Residents are expected to:

Competencies

• Coordinate patient care within the health care system relevant to their clinical specialty

Objectives

• The resident will understand that care of the patient requires close and frequent consultation with an eye specialist and know when to encourage consultation for their patients.

Professionalism

Goal

Residents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles.  Residents are expected to demonstrate:

Competencies

• Sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation

Objectives

• The resident knowing that urgent or emergent eye care may be necessary to preserve vision must advocate for all groups of patients regardless of their ability to render payment or their personal circumstances.

Interpersonal and Communication Skills

Goal

Residents must demonstrate interpersonal and communication skills that result in the effective exchange of information with patients, their families, and professional associates.  Residents are expected to:

Competencies

• Communicate effectively with patients and families across a broad range of socioeconomic and cultural backgrounds

Objectives

The resident must be able to discuss and describe complicated ophthalmologic disorders in a language that their patients can understand.

Teaching Methods

Teaching will be one on one with resident and ophthalmologist.

Assessment Method

At the conclusion of each resident rotation, the residency coordinator sends a formative-type, rotation-specific performance evaluation form to the rotations’ supervising physician.  When the completed evaluation is returned, the resident physician and the resident’s faculty advisor review the evaluation and attest to reviewing it by signing/initialing the form.  Next, the program director reviews and attests to the document.  Once all three have reviewed and attested the evaluation, it is included in the resident’s permanent file. 

Each resident is asked to evaluate the rotation and supervising physician(s) at the end of the rotation.  The resident’s faculty advisor and program director review the evaluation and attest to reviewing it by signing/initialing the form. These evaluations are filed together by resident year.

Educational Resources

Distributed at the time of rotation:

Basic Ophthalmology Textbook for Medical Students and Primary Care Residents by the American Academy of Ophthalmology, 8^th Edition.