Program Structure

Introductory Courses

First-year residents begin their training with a concentrated 3-week course in July entitled “Introduction to Ophthalmology.” This course acquaints residents with ophthalmic terminology, instrumentation, and examination techniques and is designed to facilitate the transition from general medicine and/or surgery to ophthalmology. Through a series of lectures and practical sessions in the clinic (ie. tutoring in refraction, use of the indirect ophthalmoscope), residents learn to recognize and manage a variety of ophthalmic problems, such as conjunctivitis, orbital cellulitis, and ruptured globes. By the end of the course, residents are able to conduct eye examinations, describe their physical findings, and present the salient features of the history and physical examination.

Integrated Internship

The Ophthalmology Residency at Rutgers New Jersey Medical School has a joint internship program (PGY1) with the Internal Medicine Residency that commenced in July 2020. The joint internship includes three months of ophthalmology experience. During those three months the interns will receive broad ophthalmology exposure through 2 week rotations in general and specialty clinics (glaucoma, retina, cornea, neuro-ophthalmology, oculoplastics, among others), as well as the in-patient consult and Emergency Department Ophthalmology services. PGY1 residents also attend all lectures and clinical conferences while rotting in Ophthalmology.

Rotations

Each of the 3 years of the residency is divided into 5 rotations, each lasting approximately 10 weeks. After completing the course entitled “Introduction to Ophthalmology”, incoming first-year residents are ready to start their rotations.

The First Year

Following the introductory course, residents begin a series of five 10-week rotations in the first year. Two of these rotations are spent at University Hospital: one involves staffing the General Eye Clinic and the second involves staffing each of the subspecialty clinics. In the General Eye Clinic, the first-year resident is responsible for day-to-day management of the inpatient and consult service as well as examination of all emergency patients. In contrast, the subspecialty first-year resident rotates each week through each of 6 different subspecialty clinics: retina, cornea, neuro-ophthalmology, low vision, contact lens, and uveitis. Additionally, the subspecialty first-year resident spends 4 days per month in ophthalmic pathology, reviewing ocular histopathology slides from our extensive slide collection as well as from pathology specimens obtained during surgeries in the previous week. The subspecialty experience provides early exposure to the management of a variety of problems, both common and complex, in each of the ophthalmic disciplines. In both the general eye and subspecialty clinics, first-year residents are continually mentored by both attending physicians and more senior residents.

Of the 3 remaining first-year rotations, 2 are spent at the Veterans Affairs Medical Center and 1 at the Jersey City Medical Center. Each of these rotations provides opportunities for first-year residents to begin assisting in intraocular surgeries. Following an introductory microsurgery course held early in the year (see below), first-year residents begin performing their first cataract extractions at these affiliated hospitals. By the end of the first year, residents will have performed about 5 intraocular surgeries and assisted in several dozen others.

First-year residents provide a major portion of the Institute’s inpatient care and perform physical and ocular examinations on patients in the clinic as well as private patients.

The Second Year

During the second year, residents rotate through 3 subspecialty services: retina, glaucoma, neuro-ophthalmology, and pediatric ophthalmology/strabismus. On these rotations, residents work closely with faculty and are responsible for the inpatient, outpatient, and surgical management of all patients on their service. During the glaucoma/neuro-ophthalmology rotation residents manage patients with complex glaucomas, master gonioscopy and optic nerve examination, integrate structure and function testing and analysis into patient care, and perform all glaucoma lasers including peripheral iridotomy, laser trabeculoplasty and cilioablation. On the glaucoma service the resident spends one half day a week in the operating room assisting on dozens of glaucoma surgeries and performs several glaucoma procedures as surgeon in preparation to their glaucoma rotation as a senior resident. While on the neuro-ophthalmology service residents take care of patients with complex disease both on the in-patient and out-patient services under the guidance of experienced neuro-ophthalmology faculty. The second-year retina rotation includes 2 days per week in the operating room at University Hospital, where the resident is first assistant on all vitreoretinal procedures. The remaining 3 days are devoted to the outpatient clinical care, under the supervision of the full-time faculty. The resident evaluates patients with retinal disorders, provides laser photocoagulation for retinal vascular disease, and interprets fluorescein angiograms. Given their level of responsibility and close working relationship with the faculty, residents on the subspecialty rotations function essentially as clinical fellows.

The remaining 2 rotations comprise 10 weeks each at the Jersey City Medical Center and the Veterans Affairs Medical Center. Both of these affiliates provide additional surgical experience with more advanced techniques in anterior and posterior segment surgery as well as in ophthalmic plastic surgery. As a result of the experiences at these affiliated hospitals, residents may expect to have performed multiple intraocular procedures by the end of their second year.

The Third Year

Third-year residents complete 2 subspecialty rotations at University Hospital in glaucoma / oculoplastics and cornea / refractive surgery. Here again, residents work closely with faculty and function essentially as clinical fellows. The resident doing the cornea rotation, for example, devotes time to the operating room, the Cornea and Laser Vision Institute (in Teaneck, NJ), private cornea practice, and cornea clinics, working one-on-one with full-time faculty members in each setting. The unique experience at the Cornea and Laser Vision Institute — one of the few resident rotations of its kind in the country — ensures that the resident will get exposure to collagen cross linking, excimer laser refractive surgery, femtosecond procedures and other refractive techniques by the end of the rotation.

During the remaining 3 rotations, the third-year resident functions as Chief of the Ophthalmology Clinic at each of the 3 affiliated institutions and is responsible (under the supervision of the attending physicians) for all patient care rendered by the service. At each institution, the resident undergoes rigorous surgical instruction in phacoemulsification, tube shunt and trabeculectomy, cornea surgery, ophthalmic plastic surgery, and vitreoretinal surgery, again, under close, individual supervision of clinical faculty. Moreover, during each of the 10-week rotations at Jersey City Medical Center and the Veterans Affairs Medical Center, third-year residents supervise more junior residents in the clinic and in the microsurgery practice laboratory. The third year is one of intense surgical training, and, by the end of the year, each third-year resident will have performed over 200 major ocular procedures as primary surgeon, each procedure assisted by an attending physician.

In the absence of fellows all complex anterior segment and subspecialty surgery is performed by residents under the direct supervision of the academic faculty.

Interaction with Faculty

The close resident-faculty interaction afforded in our program allows the faculty to devote increased time for individual instruction, promotes productive resident research based on individual interests, and guides the faculty when providing recommendations for those residents seeking subspecialty training or jobs in practice after their residency. Residents assume full responsibility for the clinical and surgical care of all patients on the advanced subspecialty rotations and participate in the complex surgical procedures that are normally reserved for fellows.

Didactics

All didactic lectures, rounds, and conferences are conducted at the Doctors Office Center, the central teaching facility of this program. The didactic schedule comprises lectures and conferences on Monday, Wednesday, and Friday mornings and are conducted primarily by the full-time faculty.

On Monday mornings, lectures will alternate among the neuro-ophthalmology, retina, cornea, and glaucoma services. A Fluorescein conference is held each Wednesday morning (except the fourth Wednesday of the month) at 7:00 AM and is attended by all first-year residents. The retina resident is responsible for preparing this conference.

On the fourth Wednesday morning of the month, the first-year residents will attend an ophthalmic pathology lecture by Dr. Mirani in the Department of Pathology, followed by a 30-45 minute review of all pathologic specimens generated the previous week.

The second Friday morning of each month is a dedicated academic day with lectures and case presentations by the different services. No resident clinics are scheduled during that time.

The first and third Friday (and fifth, if applicable) of the month, all residents are required to attend the Mortality and Morbidity conference run by Dr. Khouri and Dr. Zarbin at 6:30 AM. On the first Friday morning of the month at 7:00 AM, a neuro conference or a retina lecture is held. The third Friday morning of the month is dedicated to Orbital Conference, a multispecialty conference involving orbital surgery, neuroradiology, and pathology. The third-year resident on the plastics rotation (two cases) and the second-year neuro resident (one case) are responsible for preparing and digitizing these cases so they can be archived. Grand Rounds are held the third Monday evening of each month, which includes a resident lecture followed by the main presentation.

First-year residents are sponsored by the department to attend the optics review course held one weekend in March at Baylor in Houston, Texas. A skill transfer suturing wet lab is conducted for the first year residents by Dr Khouri in July at the beginning of the year at DOC as part of their introductory course. The glaucoma service organizes a glaucoma surgery wet lab under Dr Khouri annually in the summer during which residents practice techniques used in glaucoma tube shunt surgery. Finally, the department offers an introductory microsurgery phacoemulsification wet lab course every August to orient new residents to the surgical aspects of ophthalmology.

All residents have access to a state of the art surgical simulator (EyeSi) located at the East Orange VA hospital with a specialized curriculum for phacoemulsification and vitreo-retinal surgery.

Research

Resident research projects are mandatory, and the faculty participates actively in guiding residents in their research endeavors. Second- and third-year residents are required to complete a research project and to present the results at the annual Resident/Alumni Day Meeting. Travel funds are available for residents whose abstracts are accepted for presentation at national meetings (Table 1), such as the Association for Research in Vision and Ophthalmology or the American Academy of Ophthalmology.

Duties and Benefits

First-year residents are on 24-hour in-house call approximately once every sixth night. Second-year residents are on 24-hour in-house call on average once every 35 nights (covering Friday nights only), or a total of 10 times per year. Second and third year residents also cover 20 Saturdays of in-house call a year (two Saturdays per resident per year). Third-year residents are on back-up call for surgical emergencies when they are on rotations at University Hospital and Jersey City Medical Center. All residents receive 4 weeks of vacation over the course of the year. Residents are sponsored by the University to attend scientific meetings if they submit abstracts that get accepted for presentation.