Clinical Rotations PGY1 - PGY4

Clinical rotations are designed to offer a step-graded advancement to the ultimate goal of independent practice of ophthalmology with all of its technical, moral, and ethical responsibilities. Rotations designed with surgical development in mind include assigned OR time through all three years of residency.

The exposure to patients with subspecialty problems is not limited to just the time spent on a specific block rotation. These patients are seen in all subspecialties during all three years of residency while also on Hillcrest and VA rotations.

PG Year 2

“Ophthalmology Boot Camp” is held the first of July, right after our GME orientation, and can last up to two weeks, depending on the calendar. Residents are introduced to a variety of ancillary testing as well as to practical skills needed to begin work in the clinic. During Boot Camp, new residents on call will “shadow” a senior resident to familiarize themselves with on-call procedures.

First-year residents see a variety of patients during rotations at Hillcrest, Shiley, and the VA.

• Hillcrest:
  ‍
  Four months are spent at UCSDMC Hillcrest where the emphasis is on developing skills in the Comprehensive Ophthalmology clinic. The resident is exposed to ophthalmological manifestations of systemic disease as well as trauma during ER and inpatient consultations. In addition, the resident sees patients in weekly cornea and retina clinics, bimonthly oculoplastics clinic, as well as two hours per week in ocular pathology. The resident is also assigned to the OR on Fridays when cases are available.
• VA:
  
  Approximately four months are spent at the VA Eye Clinic where the resident sees general eye care patients as well as those in Neuro-Ophthalmology, Retina, Strabismus, Cornea, Glaucoma, and Oculoplastics. The resident is assigned to the OR, with increasing surgical responsibility. The resident also goes to the OR monthly with the Oculoplastics and the Cornea and Retina attendings.
• Cornea:
  
  Six weeks is scheduled on the Cornea Service during the PGY2 year at the Shiley Eye Institute and the VA Eye Clinic. The resident attends faculty clinics to gain deeper, more extensive exposure to this subspecialty.
• Pediatric Ophthalmology:
  
  A total of seven weeks is scheduled during the PGY2 year during which residents see patients in clinic at the Ratner Children’s Eye Center and participate in a weekly clinic at UCSDMC Hillcrest which includes examination of ROP babies (retinopathy of prematurity) in the neonatal intensive care unit. In addition, the resident sees Neuro-Ophthalmology patients two mornings a week and attends the monthly multidisciplinary Thyroid Eye Clinic at Ratner which is staffed by departmental physicians specializing in Neuro-Ophthalmology, Oculoplastics, and Strabismus.

PG Year 3

The resident is sent to the Wills Board Review Course in early March.

Second-year residents have rotations in the five sub-specialties of Cornea, Glaucoma, Oculoplastics, Pediatric Ophthalmology, and Retina, plus an Elective/Neuro rotation.

• Cornea:
  
  Nearly three months is schedule on the Cornea Service at the Shiley Eye Institute and the VA Eye Clinic. The second-year resident attends faculty clinics to gain deeper, more extensive exposure to this subspecialty.
• Glaucoma:
  
  About three months are spent on the Glaucoma rotation at the Shiley Eye Institute.
• Retina:
  
  About three months on the Retina Service includes clinics and OR at the Shiley Eye Institute, a weekly clinic at the AIDS Ocular Research Unit at the Jacobs Retina Center, a weekly retina and laser clinic at the VA, and a weekly retina clinic at UC San Diego Medical Center in Hillcrest.
• Oculoplastics and Pediatric Ophthalmology:
  
  About three months is scheduled for Oculoplastics and Pediatric Ophthalmology during which residents are introduced to increasing levels of surgical care in addition to seeing patients in the clinic. For Peds, residents are supervised as they take on greater responsibility for patients as a continuation of their PGY2 rotation. On the Oculoplastics Service, the resident sees patients at the Shiley Eye Institute as well as at the VA and Hillcrest. The resident attends a monthly multidisciplinary craniofacial clinic at the Rady Children’s Hospital as well as the monthly multidisciplinary Thyroid Eye Clinic.
• Elective/Neuro:
  
  Although the emphasis of training is clinical, it is important to recognize the importance of scholarship and the perspective gained by being involved in research. Each resident is expected to take advantage of the many research opportunities available in the Department, especially during the Elective rotation which is focused on research activities. An Orientation to Research is offered at the start of each year with guided activities, timelines, and research mentors assigned. This seven-week rotation allows for time in neuro-ophthalmology plus additional time to work on a required research project.

PG Year 4

Third-year residents are sent to the American Academy of Ophthalmology’s annual meeting.

Although residents are brought into surgery early on in their training, this is very much a surgical year, with the resident refining surgical skills in all areas and building on foundations from their first and second year.

• VA:
  
  Encompassing about nine months of the PGY4 year, the VA rotations includes about 13 weeks on the telemedicine rotation, as well as seeing patients in the general eye clinic for cases related to Retina, Strabismus, Cornea, Glaucoma, and Oculoplastics. Residents are even more involved in surgery and see their own patients preoperatively and postoperatively. The resident also spends one day each week for a few months at the US Naval Regional Medical Center/San Diego (Balboa Hospital) to take part in their Refractive Clinic, leading to certification for the resident.
• Elective/Neuro:
  
  Another four weeks of this rotation garners more neuro experience and more time to complete the annual research project.
• Shiley:
  
  During this rotation, residents see patients from all the primary subspecialties and take a greater role in all surgeries.