Residency Training Program
The goal of the Yale Ophthalmology Residency Program is to train future leaders in both clinical and academic ophthalmology. In order to achieve this mission, the resident’s day-to-day responsibilities has been meticulously structured be maximize the educational experience.
Program at a Glance
In the first year of training, residents master examination skills and management of the general ophthalmology patient.
In the second year, residents focus on medical and surgical evaluation and management of the specialty patient.
In the third year, complicated surgical management is the focus.
During the first year of training, residents’ time is typically structured as follows:
- three months at the West Haven VA Medical Center, staffing the general ophthalmology clinic;
- three months on the hospital-based Clinic Service at Yale-New Haven Hospital;
- three months on the combined Ophthalmic Plastic Surgery and Ophthalmic Pathology rotation;
- three months on Neuro-ophthalmology and Pediatric Ophthalmology/Strabismus rotation.
During the first year, residents typically perform, as primary surgeon:
- one extracapsular cataract extraction,
- 5-10 glaucoma laser procedures,
- 20 ophthalmic plastic surgery procedures,including temporal artery biopsy, blepharoplasty, ptosis repair, lid tumor resection, and lid laceration repair.
During the Hospital- Based Clinic and Ophthalmic Plastic rotations, there are also extensive opportunities to assist senior surgeons in a wide variety of anterior segment and ophthalmic plastic procedures.
During the second year of training, residents spend rotations of three months each in Cornea and External Disease/Refractive Surgery/Uveitis, Glaucoma, and Vitreoretinal Surgery, as well as three months at the VA Medical Center.
- While on the Cornea service, residents are exposed to a wide variety of corneal and external disease problems. Experience includes:
- surgical experience: assisting on penetrating keratoplasty, with a graded introduction to placing corneal sutures of high structural and refractive quality;
- exposure to a wide range of tertiary care uveitis patients in the Uveitis Clinic;
- exposure to the Contact Lens service.
During the Vitreoretinal rotation, residents work with four retina faculty members and two clinical fellows. Experience includes:
- exposure to t he nuances of a peripheral retinal examination, including scleral depression and retinal drawing; .
- evaluation of ophthalmic echography, fluorescein angiography, and electro-physiology;
- operative experience: scleral buckles, and opening and closing vitrectomy cases, assisting on complicated vitrectomies.
On the Glaucoma rotations, residents interact with three full-time attendings and a clinical fellow. Residents will :
- learn various examination techniques, including:
- anterior chamber angle evaluation
- optic nerve evaluation
- the use of diagnostic studies such as visual field testing, ultrasound biomicroscopy, and optic nerve and nerve fiber layer imaging
- gain exposure to a wide range of medical and surgical therapeutic modalities for glaucoma
At the VA Medical Center, the second-year resident is responsible for running a busy, general clinic. Subspecialty clinics are held at the VA in all major areas. During this rotation, the resident typically will:
- perform 10 to 15 extracapsular cataract extractions (ECCE), and begin to make the transition to phacoemulsification;
- perform three ophthalmic plastic surgery cases per week.
The third year of residency training includes:
- a three- month rotation at the Hill Health Center;
- the three-month combined Ophthalmic Plastic Surgery and Pediatric Ophthalmology/ Strabismus rotation, during which one month is spent in the Bahamas at the Princess Margaret Hospital;
- two three-month rotations at the VA Medical Center,
The VA Medical Center provides the bulk of the Class 1 (primary surgeon) anterior segment surgical experience during the residency. With the introduction of modern cataract surgery technology, including phacoemulsification, clear cornea incisions, foldable lenses, and topical anesthesia, a dramatic increase in OR efficiency has ensued. As a result, the cataract surgery volumes at the VA Medical Center have doubled over the past five years. Third year residents at the VA typically perform around 120 phacoemulsifications a year. In addition, third year residents usually perform 4-8 trabeculectomies, several vitrectomies and scleral buckles, and 1-2 penetrating keratoplasties.
The rotation at Hill Health Center provides additional clinical and surgical experience in a public health care community eye clinic. The Yale full-time faculty and voluntary community faculty supervise the clinics. A variety of surgical cases are generated from this clinic, including 10-15 phacoemulsifications per rotation. An expansion is underway to include onsite diagnostic testing and laser treatment.
The three-month the combined Ophthalmic Plastic Surgery and Pediatric Ophthalmology/Strabismus rotation allows the 3rd year resident the opportunity to hone specialized surgical techniques.
A unique aspect of the Ophthalmology residency at Yale is the four-week rotation at Princess Margaret Hospital in Nassau, Bahamas. During this time, the senior resident provides a large portion of the eye care for the island’s indigent population. Typically, 30 anterior segment procedures are performed, including ECCE, phacoemulsification, anti-metabolite trabeculectomy, and traumatized globe repair. Two U.S. fellowship- trained ophthalmologists, who practice on the island, work closely with the resident in a supervisory and consultative fashion, and a Yale faculty member visits for one week during each rotation. This rotation allows residents to develop a newfound sense of autonomy in patient management, as well as an appreciation for the epidemiologic issues facing a developing country.