Resident Education
Clement Chow, MD, on his first-year experience
First-year residency in ophthalmology is challenging and stressful to anyone, no matter where you go. But the gradual transition, excellent attendings in every subspecialty, diversity of cases, and surgical experience as a first year made it fun and exciting. We don't start taking call until Labor Day, which gives us two months of transition period to build our basic knowledge and exam skills. At the general eye clinic, we see a vast diversity of patients, both bread and butter and specialty specific cases. These are our own patients that we get to follow for the 3 years that we are here, and for whom we primarily make clinical decisions (with the support and advice of senior residents, fellows, and attendings at all times). Because of the size of our program, call is only every 6 days, and we get to arrange our own schedule among the first years (very flexible!).
The learning experience has truly been excellent. Our VA attending, Dr. Lunde, is one of the best teachers I have encountered. He spends unlimited hours with us one-on-one at the wet lab until each of us feels comfortable about cataract surgeries. So far I have done two cataract surgeries as a primary surgeon and plenty of laser procedures at the Jesse Brown VA (within walking distance). Our oculoplastics attendings, Dr. Setabutr and Dr. Braslow, let you be the primary surgeon in many plastics cases.
Every Wednesday afternoon, we have Dr. Mieler and Dr. Lim who go over interesting retina cases with us; this is invaluable since much of retina is about pattern recognition. In the two month neuro-ophthalmology rotation, you get to be one-on-one with Dr. Gilbert, who will teach you everything you want to know about neuro-ophthalmology. Finally, our "superman" chairman Dr. Azar spends time with us and his fellows in a small group setting every Wednesday evening to go over interesting cornea cases. He truly is an amazing teacher. With such great learning experience, in addition to a 2-week trip to Japan next year, 5 weeks of vacation/conference time, $3,000 educational funds, our own Illinois Eye Review course before OKAPS, the dynamic city of Chicago, I would not hesitate to choose this program again if I had to match again.
Anthony G. Finder, MD (assistant clinical professor):
Why I enjoy working at IEEI
When I lost my office lease a couple of years ago, I decided to give up the business of general ophthalmology private practice, but I was not yet ready to retire from the profession. The professional activity that I have always found most satisfying and rewarding has been my relationship with ophthalmology residents, both in the Michael Reese program and at the Illinois Eye and Ear Infirmary. I am now pleased to be serving as a volunteer attending in the Comprehensive Eye Clinic and am enjoying ophthalmology more than ever.
The clinic's patient population routinely provides an abundance of interesting and challenging cases that present with a range of clinical pathology far more varied than I had encountered in private practice. The world-class faculty, the excellent ophthalmic techs and other support staff combined with the state-of-the-art technological resources available at UIC all contribute to excellent patient care and create an environment most conducive to learning. Moreover, the Illinois Eye and Ear Infirmary’s symposia, lectures and grand rounds offer unparalleled opportunities to enhance my knowledge base and to contribute further to the high quality of care our patients receive.
The residents with whom I work bring to their patient care an impressive amount of technical knowledge to which I contribute my years of chair-side experience and patient communication skills. I endeavor to help residents apply their knowledge to create an effective treatment plan for each patient. During their presentations and the dialogues that follow, their astute questions and curiosity serve to sharpen my focus and often to revise my thinking about case diagnosis and management. Teaching and learning flow in both directions during these productive and gratifying collaborations. I also enjoy observing the camaraderie, mutual respect and cooperative spirit that characterize the relationships among the residents themselves. As was the case during my own residency at Michael Reese back in the '60's, the more senior residents willingly assume the role of teachers to their juniors, to the mutual benefit of all.
In short, I am delighted to be able to further my own education and am privileged to participate in the training of the bright, young future stars of the profession I love.
Quan (Donny) Hoang, M.D., on his second-year experience
Northwestern University, B.A., Chemistry, Integrated Science, and Biology
University of Illinois at Chicago, M.D., Ph.D, Neuroscience/Biophysics
Evanston Northwestern Healthcare, Evanston, IL, internship
Why he chose UIC
Having spent a good part of my training at UIC, I knew what I was getting into. I wanted a program where I would be happy, as well as one that would meet my training needs. I wanted a program that would not only teach me, but one at which I would feel comfortable "asking the dumb questions," because I feel within the answers to the basic questions are the fundamentals that allow you to be a thorough future clinician, therefore approachability of attendings was key in my decision.
In terms of happiness, all programs say that attendings are approachable and nice, I felt UIC was exceptionally so. Specifically, for me, I also looked for a place that both had strong clinical and research components. With Dr. Azar at the helm, I knew that research would be strongly encouraged and supported. Additionally, the program already had a wealth of established basic and clinical researchers, with multiple new hires that have enhanced our training experiences.
What is different from first to second year?
By the second year we have completed all the rotations and have the basics down. We know the Department and the faculty, and the attending physicians count on us for our assessments of patients. During this year we spend two months on each service.
For the two months of the year, we take call for the first years as they are getting down the basics in the general eye clinic and shadowing us on-call. We teach them the ropes, demonstrate certain procedures, and call them in on interesting cases or emergencies. Then by Labor Day we no longer take first call for the University Hospital. We do still take primary call for the veteran's hospital which is much lighter, and which is shared with Northwestern's ophtho program. Call is now taken a week at a time, with every other week covered by Northwestern.
We also perform more surgeries and a greater variety of them during the second year. We'll perform strabismus surgery on peds, intravitreal injections and retina lasers on Retina, Subtenon injections, tap and injects on Uveitis, and more glaucoma lasers and some cataract surgery, core vitrectomies and scleral buckles for example.
read more »Quan (Donny) Hoang, M.D., on his second-year experience
(Continued)
In the second year we are required to complete the bulk of our a research projecteither in basic science or clinical research with the intent of presenting it at the Department's annual Alumni day in June at the end of 2nd or 3rd year. Personally, I am working in a basic science laboratory, and employing electrophysiological and molecular techniques to study gap junctional and hemichannel communication between retinal pigment epithelial cells in a heterologous system.
Finally, this is the year we decide on future planswhether to practice general ophthalmology or to apply for a fellowship.
The main reason why second year is amazing is that it fulfills what you imagine residency should be when you're applying. As a first year, you're learning all the basics, with your time predominately in the general eye clinic, but as a second year, you finally get to see all the rare and crazy stuff that made you love ophthalmology in the first place. Additionally, you get to work one-on-one and get to know attendings on a personal level. As a second year, reading "rare disease" in the BCSC seems almost comical, seeing that I would commonly see 3 of the same "rarely encountered disease" on the same day in the Uveitis clinic. Also, you see the complicated diseases...For example, I saw a patient who was an ophthalmologist himself from Saudi Arabia, who was working in Canada, and came to see Dr. Fishman in our Inherited Retinal Disease Service. I also saw a family who stopped by en route from Argentina to Shanghai for their little girl to see Dr. Miller in Pediatrics, and a family that flew in from Greece to have their son's surgery by Drs. Azar, Lim and Vajaranant.
But this isn't uncommon across all residency programs, as there are plenty of programs with amazing attendings that draw patients from all across the world. What I enjoy is that all of these "famous" attendings at UIC are so approachable and down-to-earth.
One day in the life of a second-year resident (Uveitis Service)
| 7:30am: | Morning report led by either senior residents or attending |
| 8 to 9am: | Morning lecture by attending |
| 9am to 12:30am: | New patients in Uveitis clinic, which is very reminiscent of the TV show "House M.D.", and very similar to internal Medicine...in that the challenge for new uveitis pts is establishing the diagnosis, and since we are a referral center, a major part of this is sifting through the massive amount of past history including past diagnoses and treatment attempts. There are 6-7 scheduled new patients, and 6 doctors (2 attendings, 3 fellows and 1 resident). We then sit down in front of a chalk board, and present as if we are on an Internal Medicine rotation again, so that everyone can discuss and guess the differential as you are talking. |
| 1pm to 5pm: | Usually 40+ follow up patients (with known diagnoses) seen amongst the fellows/residents, and staffed with either of the 2 attendings. |
Debra Goldstein, MD: Two days in the life of a uveitis attending
Wednesday
Wednesdays are our surgical days. The day starts at 8 for me (a bit earlier for the fellows), getting patients ready for surgery to start at 8:30. The majority of our cases are cataracts, with an occasional steroid or ganciclovir implant. The cataract cases are often challenging. 360 degrees of posterior synechiae, epilenticular membranes and mature white cataracts are not unusual. We usually do 4 cases in the morning, leaving time to grab a bite of lunch, before starting the afternoon session. Wednesday afternoons are for seeing patients, doing laser or other minor procedures, and reviewing the charts from the previous week. This chart review is a highlight of our service. We usually have two fellows on the service, and they join me, Dr Tessler, the uveitis resident if they are available, and any medical students on the rotation to go over each patient from the previous week. This is an opportunity to review labs, and teach about the particular patient and their disease. The rush is on to finish clinic by 5 pm, in time for Grand Rounds.
Thursday
Thursdays are busy days on the service. In the morning we see only new patients, trying to limit scheduling so that there is one patient scheduled for each attending, resident and fellow. Uveitis patients often have complicated ophthalmic and medical histories, and may have been seen by multiple ophthalmologists prior to referral to us. Our scheduling allows time for an extremely detailed history, review of systems, assessment of the prior work-up, and examination of each patient. The entire team will get to examine each patient, and participate in the discussion of the case.
Afternoons are much more rushed. All afternoon patients have already been seen by us at least once, so they do not require quite as much time. The visits are more complicated than comprehensive clinic patients, however, as the patients are often on immunosuppressive therapy for their uveitis, which we manage ourselves. We usually see 40 to 50 patients in the afternoon, and each patient is seen and reviewed by Dr Tessler or me. The aim is to provide the best possible patient care, while also providing in-depth teaching to the fellows, residents and students on the service. We have a great range of pathology in this clinic. The two most common diagnoses are probably ocular sarcoidosis and idiopathic disease, but we also see a lot of anterior segment disease related to JIA (juvenile idiopathic arthritis) and HLA-B27 and posterior segment inflammation caused by VKH, Behcet’s disease, toxoplasmosis, AIDS, syphilis and other entities such as the white dot syndromes that are rarely seen outside of uveitis clinics. read more »
Margaret Wong, MD: A fellow’s perspective
Uveitis is a unique service in ophthalmology here at UIC; it is the only service that integrates the internal medicine "team" concept with that of the clinic feel. Our patients usually have multiple medical problems that need to be pieced together with their eye disease, and present with complicated histories. There is a team made up of attending physicians, fellows, residents, and medical students. We see patients and talk about them as if on "rounds," where everyone participates in the discussion of the history, differential diagnosis, examination, and treatment plans. We are truely a teaching-focused service. We see patients with immunologic and infectious diseases, for example sarcoidosis, Vogt Koyanagi Harada's Disease, Behcet's Disease, syphilis, tuberculosis, and toxoplasmosis, to name a few, on a daily basis. We are a tertiary referral clinic, and new patients are referred from a wide variety of specialists from around the Midwestern United States, such as general and subspecialty ophthalmologists, internists, pulmonologists, etc. Our patients have usually been through many doctors' offices before reaching ours, and it is our responsibility to put the story together and diagnose the problem and provide a treatment plan. Thus, we have very ill patients who have come to us as a last resort. We often end up treating their systemic diseases along with their eye problem. These are amongst the most appreciative patients, and the ones that make us enjoy our job the most.
