Ophthalmology Resident Training
Wake Forest Eye Center sees over 80,000 patient visits per
year, providing an ideal substrate for resident clinical experience.
clinical portion of the teaching program is structured with subspecialty
rotations in the mornings (where residents work side by side with attending
subspecialists in all major areas), and the Comprehensive Eye Service in the
First-year residents have one-month subspecialties to be visited
during the first year, gaining more familiarity with all areas of ophthalmology
early in training.
The second-year rotations are more intensive, and residents
are expected to function with a higher level of expertise.
philosophy is that exposure to all subspecialty areas during the first year is
important not only for patient care, but also as many post-residency
fellowships that require decisions early in residency training.
Comprehensive Eye Service
One unique feature of the program is a continuous care
clinic, the Comprehensive Eye Service (CES), in which residents care for their
own population of patients for the entire three years of their training.
general outpatient service allows residents to manage patients much like a
community ophthalmology practice, following their patients longitudinally for
the duration of their training period.
The CES provides an ideal opportunity
for clinical teaching and is supported by dedicated supervising faculty,
staffing, and Eye Center facilities.
Feedback from residents who have completed
our program consistently place high value on their CES experience; often
described as one of the “crown jewels” in our residency program. These
residents note that it fosters development of the clinical skills needed to
“hit the ground running” immediately after residency, whether for private
practice of fellowship.
Residents learn the ocular manifestations of systemic
disease first-hand as they participate in busy inpatient consultation service,
working with faculty in the evaluation of patients from the various medical and
surgical services at the Medical Center.
Trauma experience is also exceptional,
as Wake Forest Baptist Medical Center is a designated Level I Trauma Center,
and the Eye Center is a member of the National Eye Trauma System (NETS).
The training program is busy medically and surgically. More
than 32,000 major ocular surgeries are performed by faculty, residents and fellows
each year. These procedures include a full array of both outpatient and
inpatient procedures performed in the operating rooms of Wake Forest Baptist
Almost 800 additional procedures are performed yearly in the
minor operating suites of the Eye Center itself.
With this volume of surgical
experience, residents have an opportunity to perform many surgical procedures,
far exceeding recommended minimums set by the ACGME. For instance, residents
currently perform 250 - 300 or greater cataract procedures as primary surgeon
during their training (with set minimum of 86 by ACGME).
One third of the residents’ training
takes place at the W. G. (Bill) Hefner VA Medical Center in Salisbury, NC, a 45
minute drive from the Wake Forest Eye Center.
Many residents live just south of
the town, thus shortening their commute. Most of the time the residents
carpool, making access to the VA clinic more convenient.
During our annual
reviews the residents unanimously state that the drive to the VA is “worth the
effort” given the high volume of surgical and medical experience at the VA
hospital. This train of thinking was also reflected at our Annual Graduation
Ceremony, where the residents present the Dr. Altemare the Wake Forest University
Eye Center Residents Award for Excellence in Teaching. This award is given to
faculty members for their inspiring, challenging and effective teaching
methods, and who’s concern and respect is evident both in and out of the
During the first year of training, residents spend four
one-month rotations at the VA, and they spend two two-month rotations as a
second-year resident. Senior residents rotate through a continuous cycle
allowing each senior resident a full operating day each week at the VA.
Resident’s clinics are busy with many comprehensive and cataract patients, as
well as glaucoma and retina subspecialty consultations.
perform many lasers, intraocular injection, and minor procedures. The Veterans Administration
hospital has a full optometric service, which means that patients encountered
at the VA clinics are essentially ‘prescreened’ for pathology. This is
especially true with patients having cataracts, with a high percentage of
patients initially encountered at the ophthalmology clinic proceeding on with
the resident for cataract surgery. About 70 percent of resident cataract
surgery is performed at the VA, with 30 percent at the Wake Forest Eye Center.
Lectures and Conferences
The didactic schedule is designed to cover all of the
material in the AAO Basic Clinical Science Course (BCSC) in a two-year cycle,
allowing some flexibility for senior residents with their surgical schedule.
More than 170 hours of didactic lectures are provided each year by the
Wednesdays are reserved for didactic lectures and clinical
conferences, and all residents (including residents on VA rotations) are in
attendance at the Wake Forest campus.
Each Wednesday morning begins with a 7:15
am clinical conference in which all attendings, residents and fellows
participate, with residents presenting interesting, informative cases, or cases
needing multidisciplinary consultation.
Four to six hours of didactic lectures
are scheduled on Wednesday, covering the subspecialty areas in a rotating
Three hours on Wednesday afternoon are available for clinical time;
this clinical time is generally reserved for minor procedures, and also allows
the rotating VA resident to follow some of their long-term patients while on
Visiting professors also bring their expertise to the Eye
Center. The annual meeting is one such event with three invited lectures of
national or international status. Grand Rounds are also held, typically three
times a year, with visiting specialists participating in case conferences
(usually with patient examination and discussion)
Each resident is required to pursue a clinical research
project of his/her choice under the supervision of a faculty person and is encouraged to publish at least one paper in a peer-reviewed academic journal
before the training program can considered to have been successfully completed.
Residents are given specific instruction in presenting case reports and
scientific papers, and they benefit from superior audiovisual services for
academic and scholarly pursuits.
It is anticipated that residents will produce
at least a case report during their first year, with rigorous research projects
anticipated for the second and third year.
Second and third-year residents are
required to present the results of their research at the Wake Forest University
Annual Eye Meeting as a scientific talk; this is expected to be a
publication-worthy project. Residents who have papers or posters accepted at outside
peer reviewed meetings will typically be sponsored by the Eye Center to attend,
but this decision is made on a case by case basis.
All call is from home.
The first and second-year residents
take “first call”; so on average call is every sixth night. However, call is
more frequent on the Wake Forest rotations than when residents are on their VA
rotations, so there is some variability through the year.
Senior residents take
“second call” and thus are on call on average of one out of every three nights
for backup call. Senior residents are expected to come to the Eye Center after
hours as needed (admissions, emergent procedures, or when the junior residents
have clinical questions).
Faculty coverage is available at all times, and faculty
staff supervises all trips to the operating room, both scheduled and
The training program also supports fellows in retina,
cornea, and oculoplastics. Having fellows in these three busy services has been
a benefit to residency training, allowing more predictable educational
structure for residents rotating through these subspecialties. Resident
surgical volume has not been negatively affected by the addition of fellows to
Chairman: Craig M. Greven, MD
Residency Program Director: Timothy J. Martin, MD
Associate Residency Program Director: Paul J. Dickinson, MD
Residency Program Coordinator: Hannah McSawley