The 1st year begins with a full one month orientation that includes a comprehensive introductory lecture series and plenty of practical hands-on sessions. The rest of the first year consists of rotations in anterior segment, pediatric ophthalmology, retina, neuro-ophthalmology, and oculoplastics. In preparation for surgery, residents participate in a complete lecture series on cataract surgery, two microsurgical lab courses, and several microsurgical simulation modules. In addition, first years attend a month-long basic science course in Houston, which is fully sponsored by the Department.
The 2nd residents rotate through glaucoma, cornea, retina, and oculoplastics at Henry Ford Hospital and pediatric ophthalmology and strabismus at Children's Hospital of Michigan. Second year residents see patients in their own continuity clinic one day a week, and continue to generate surgical cases. They also run the emergency eye clinic with the first years, where there is ample opportunity to manage trauma and acute ophthalmologic emergency patients. Residents begin to assume major responsibilities as primary surgeon for cataract, oculoplastics, and glaucoma procedures. In addition, there is a high concentration of glaucoma and retina lasers reserved for the second year experience.
In the 3rd year, residents enjoy graduated clinical and surgical responsibilities. They continue to develop their own patient base from which surgeries are generated and operate approximately one day each week. Rotations include the resident's own continuity clinic, the Detroit Northwest Clinic, which introduces the residents to a high volume private practice with an elderly patient population, and the Chairman's Rotation. Third year residents manage the ocular inpatient consult service. The overall experience is broad and meets all ABO and ACGME requirements for training in comprehensive ophthalmology. Third year residents have flexibility to tailor their own clinic to emphasize their particular area of interest such as cataracts, retina, plastics or general ophthalmology.
Surgical training and experience is complemented by two microsurgery lab courses, formal surgical lectures and ongoing opportunities to practice in our on-site microsurgery lab and on our EYESi microsurgical simulator. Our program for microsurgery preparation is currently in three parts:
Part 1 - The Vascular microsurgery "rat lab" runs 2 hours per week for 5 weeks. With 4 residents per lab with 1 instructor, residents learn the basics of microsurgery under the microscope by dissecting and re-anastamosing the femoral arteries and veins of white lab rats.
Part 2 - The Ophthalmology Microsurgery Lab "pig eye lab" runs 3 hours per week for 12 weeks, beginning in March. Residents will gain knowledge and experience with the basic techniques of ophthalmic microsurgery and will acquire the skills necessary to create a cataract entry wound, trabeculectomy flap, paracenteses, and capsulorrhexis. They will also practice suturing with a goal of eight completed sutures in twelve minutes. Residents will develop a basic understanding of corneal, glaucoma, retina and muscle surgeries.
Part 3 - The EYESi Ophthalmic Microsurgical Simulator is used to teach methods as well as operational sequences and movements as preparation for surgery to the human eye. The EYESi provides basic training modules in cataract and retina surgery, simulating manual and surgical capabilities, as well as modules allowing the realistic execution of surgical operations. Residents will learn and become practiced with skills of pivoting, using 2 hands, microscope adjustment, using 2 feet with hands, and hand stabilization. Cataract modules include forceps, anti-tremor, capsulorrhexis, phacoemulsifications, and divide and conquer.