Download Ophthalmology - University of Nevada, Reno School of Medicine

Revised March 18, 2008
GOALS AND OBJECTIVES
RESIDENT CURRICULUM FOR OPHTHALMOLOGY
Rotation Coordinator:
Marietta Nelson, MD
Eye Clinic of Nevada
2800 N Tenaya Way # 102
Las Vegas, NV 89128
(702) 384-2020
OVERVIEW
EDUCATIONAL PURPOSE
Ophthalmology deals with diseases and disorders of the eye
The general internist needs to have competency in the initial diagnosis and management of acute
ocular disorders and in the appropriate and timely referral of eye diseases.
Teaching Methods
The rotation will be under the supervision of the attending ophthalmologist. The resident
will see consultations and patients as assigned by the attending ophthalmologist in the
outpatient eye center. The resident will obtain the initial data, write a consultation note,
and present the patient to the attending physician. The attending will confirm the
findings, teach about the case, and with the resident, craft the final recommendations.
The attending physician will teach based on case material. The resident and attending will
review and discuss any required reading.
Mix of Diseases
Patients present with a wide variety of ophthalmic problems including routine exams,
visual disturbances, ocular trauma and inflammation, and the ophthalmic consequences of
systemic diseases.
Patient Characteristics
The patient population is diverse, male and female, of all ages from adolescent to
geriatric, representing most ethnic and racial backgrounds, from all social and economic
strata.
Types of Clinical Encounters
Patient encounters occur in the office as initial consultations or ongoing care of patients
with ophthalmic diseases.
Common Clinical Presentations
Nearsightedness (myopia)
Farsightedness (hyperopia)
Presbyopia
Hordeolum
Dacryocystitis
Graves’ disease
Chalazion
Conjunctivitis
Pterygium
Pinguecula
Corneal abrasion
Dry eye and associated diseases
Iritis
Cataracts
Glaucoma
Diabetes mellitus retinopathy
Macular degeneration
Procedures
Tests of visual acuity, visual fields, and test for ocular motility
Direct ophthalmoscopy
Fluorescein staining of the cornea
Tonometry
Slit lamp examination
Resident Supervision
Residents will be supervised by the attending ophthalmologist.
The resident will see
consultations and patients as assigned by the attending ophthalmologist write initial and follow up
consult notes and review them with the attending ophthalmologist.
Didactic Teaching
Attending Teaching
Didactic discussions will be held regarding patients seen in consultation during
the month. Each resident is required to review common ophthalmologic topics.
Core Reading Materials
Bradford CA. Basic Ophthalmology for Medical Students and
Primary Care Residents, 8th edition. San Francisco, CA: The
American Academy of Ophthalmology, 2004.
Chawla HB. Ophthalmology: A Symptom-based Approach. Woburn, MA:
Butterworth-Heinemann, 1999.
Trobe JD. The Physician's Guide to Eye Care, 3rd edition. San
Francisco, CA: The American Academy of Ophthalmology, 2006.
Wu G. Ophthalmology for Primary Care. Philadelphia, PA: WB
Saunders, 1997.
Ancillary Educational Materials
Subspecialty Texts of Neurology, Pulmonary Medicine, Nephrology,
Endocrinology, Infectious Diseases, Rheumatology as well as General Medical
References (Harrison’s Principles of Internal Medicine, Cecil’s Textbook of
Medicine) are available 24 hours a day, seven days a week in the resident lounge.
Savitt Medical Library On-Line
Residents have access to the on-line services of Savitt Library (the main library of
the University of Nevada - Reno) via their computer in the resident room, Suite
300 of the 2040 W. Charleston Building. Access to this room is available 24
hours a day, seven days a week.
Full text is available for many peer-review journals including, but no limited to:
ACP Journal Club
Annals of Internal Medicine
British Medical Journal
Cancer
Circulation
Journal of the American College of Cardiology
The Lancet
New England Journal of Medicine
Stroke
Also available on-line:
Harrison’s Principle’s of Internal Medicine, 14th ed.
Merck Manual, 17th ed.
Guide to Clinical Preventive Services, 2nd ed.
The Cochrane Library
Medline and Grateful Med Databases
Pathological Material and Other Educational Resources
Pathological specimens are not anticipated.
Training Sites
Eye Clinic of Nevada
This venue is a private practice ophthalmology office of a clinical faculty
member.
Competency-based Goals and Objectives
Ophthalmology Rotation
Learning Venues
Evaluation Methods
1. Eye Clinic of Nevada
2. Self Study
A. Attending evaluation
B. Objective testing
C. Self evaluation
Competency Patient Care
Level Specificity
Not applicable –
this elective is
taken once during
residency
Learning
Venues
1
Evaluation
Methods
A, C
1, 2
A, C
NA
1
A, C
NA
1
A, C
NA
1, 2
A, C
NA
1
A, C
NA
1
A, C
NA
Competency : Medical Knowledge
Learning
Venues
Evaluation
Methods
Demonstrate knowledge of proper use of
diagnostic tests and medications:
Mydriatics
Topical anesthetics
Corticosteroids
Antibiotics
1, 2
A, B, C
NA
Demonstrate knowledge of normal
anatomy, physiology, and aging of the eye
and ocular function
1, 2
A, B, C
NA
Demonstrate knowledge of effects of
drugs on ocular function and disease
Demonstrate knowledge of effects of
1,2
A, B, C
1,2
A, B, C
Demonstrate competency in obtaining
ophthalmologic history from patients.
Demonstrate competency in physical
exam skills used to evaluate ocular
function and disease
Demonstrate competency in slit lamp
examination
Demonstrate competency in eye
protection
Demonstrate competency in tests of visual
acuity, visual fields, and test for ocular
motility
Demonstrate competence in fluorescein
staining of the cornea
Demonstrate competency in tonometry
Level
NA
Level
Glaucoma agents
NA
ocular drugs on systemic function
Competency: Interpersonal and
Communication Skills
Learning
Venues
Evaluation
Methods
Level
Interact in an effective way with
physicians, nurses and medical support
staff.
Demonstrate understanding of patient
preferences in diagnostic evaluation and
management
Maintain accurate medical records.
Serve as a patient advocate.
Understand and communicate impact of
visual loss
1
A, C
NA
1
A, C
NA
1
1
1, 2
A, C
A, C
A, C
NA
NA
NA
Competency: Professionalism
Learning
Venues
Evaluation
Methods
Level
Treat team members, primary care1, 2
givers, and patients with respect and
empathy.
Understand, practice and adhere to a code 1, 2
of medical ethics.
A, C
NA
A, C
NA
Competency: Practice-Based Learning Learning
Venues
Review the outcomes of patient care in
1, 2
order to reflect on the approach taken in
the delivery of care.
Utilize established practice guidelines for 1, 2
individual diseases to devise care
strategies.
Identify limitations of one’s medical
1, 2
knowledge in evaluation and
management of patients and use medical
literature (primary and reference) to
address these gaps in medical knowledge.
Evaluation
Methods
A, C
Level
NA
A, C
NA
A, B, C
NA
Competency: Systems-Based Practice
Learning
Venues
Evaluation
Methods
Level
Recognize the importance of the role of
support systems in the health of patients
with ocular disease.
Understand the role of the ophthalmic
consultant, including identifying the
different roles of ophthalmologists,
optometrists, and opticians.
1, 2
A, C
NA
1, 2
A, C
NA
EVALUATION
A. Of Residents
At the completion of each rotation, all clinical faculty are required to complete the
standard ABIM resident evaluation form. All clinical faculty are encouraged to
provide face-to-face feedback with the residents. The night-float resident is
evaluated by one of the three service attendings. In addition, residents may
receive interim feedback utilizing the ABIM’s Praise and Early Warning cards.
B. Of Rotation and Preceptor
All residents are encouraged to evaluate the rotation, and the clinical faculty
member, at the completion of the rotation. This evaluation form is included at the
end of this document. These evaluations are then converted to type and shared
anonymously with the clinical faculty.
The program director also discusses the rotation with the residents to ensure
rotation quality and satisfaction.
Ophthalmology Rotation Resident Check List
1. Evaluation reviewed at mid-month and end of rotation by the supervising faculty
member and resident.
2. Completed assigned readings
3. Attended all assigned activities (excluding scheduled time away, required clinics and
emergencies).
4. Completed required case report abstracts and/or posters if assigned by the supervising
faculty member.
5. Demonstrated understanding of the basic principals of ophthalmology.
6. Receive verbal feedback from attending at end of rotation.
Intern/Resident Signature_________________________
Date___________________
Supervising Attending Signature___________________
Date___________________
All items must be completed for rotation credit and checklist returned to the
Department of Medicine by the rotation’s end.