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Residency Information

 

Overview
Facilities
Shiley Eye Center Campus
UCSD Medical Center Hillcrest Eye Clinic
VA San Diego Healthcare System
Rotations
First Year
Second Year
Third Year
Academic Program
Resident Selection
Life as a Resident

Overview:
The goal of the UCSD Ophthalmology Residency Training Program is to facilitate the acquisition of the knowledge, skills, clinical judgment and attitudes necessary to become an Ophthalmologist who can provide skilled and compassionate care to patients. Over the three years of the program, residents are provided with the facilities and clinical exposure that help them gain mastery of the knowledge and judgement needed, assuming increasing levels of responsibility for the medical and surgical management of patients with a wide variety of acute and chronic Ophthalmological disease. We recognize that Ophthalmological education continues beyond the residency training years and therefore emphasize the importance of self-directed study habits.

The program has three residents at each level of training. Each resident is exposed to a high volume and wide variety of patients, as well as to one-on-one teaching from attendings throughout their training, with a graded increase in expectations and responsibilities.

The surgical experience of the UCSD Ophthalmology resident is outstanding. In the latest ACGME analysis of resident surgical case log system (class of 2005), compared to other US programs, UCSD ranked 98th percentile in cataract surgery, 97th percentile in Orbit and Oculoplastic surgery, and 94th percentile in overall surgery. These percentiles refer to cases in which the resident was the primary surgeon.
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Facilities:
The resident rotates through 3 sites during training: the Shiley Eye Center, UCSD Medical Center Hillcrest and the VA San Diego Health Care System. Each site has a different “flavor” with differing populations of patients and degrees of resident responsibility. Although the resident mainly sees outpatients, there are a substantial number of inpatient consultations, especially at UCSDMC, with exposure to the Ophthalmological manifestations of systemic disease. At all sites the resident is supervised by attendings, in accordance with UCSD and VA policy, with one-on-one teaching, and with increasing responsibility for decision-making expected according to the level of training.

There are over 55,000 annual patient visits to the Shiley Eye Center in La Jolla. The VA Eye Clinic has over 10,000 annual visits and at the UCSDMC Hillcrest Eye Clinic, housed in a former county hospital, the residents see several thousand patients per year. The patients come from all walks of life, but even in the faculty practices at the Shiley Eye Center, residents are full participants in the evaluation of the patients.

The Shiley Eye Center http://eyesite.ucsd.edu/index.htm is a state-of-the-art free-standing outpatient facility with 24 fully equipped examination lanes. Groundbreaking for another 14 lanes will occur within the next few months.

A full range of ancillary services is provided, including digital photography, visual field testing, ultrasonography, wavefront analysis, corneal topography, OCT, GDX, Argon, Krypton and YAG lasers, optometric and low vision services and an optical shop. The Shiley Eye Center surgical suite contains three dedicated operating rooms as well as preoperative and recovery space.
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The Shiley Eye Center campus includes:

  • The Weyland Resident Library where, in addition to books and access to the electronic collections of the UCSD Medical Library, there is equipment for preparation of presentations such as a scanner, an LCD setup and printers.
  • The Shiley auditorium, where Grand Rounds and other educational events are held.
  • The Abraham Ratner Children’s Eye Center, a facility designed for the needs of the pediatric population. There are currently 4 exam lanes but this is to be expanded to 8.
  • Basic and clinical research facilities including the Hamilton Glaucoma Center, the Jacobs Retina Center, and laboratories dedicated to corneal research .

  • The Division of Community Ophthalmology

Funding has been obtained for a microsurgical practice laboratory at the Shiley Eye Center, complete with video capability. Currently the residents are able to obtain practice eyes via the OR in addition to having an annual surgical wetlab, which will continue.

A short walk from the Shiley Eye Center are the Thornton Hospital with 119 beds, the Perlman Ambulatory Care Center, and the Moores Cancer Center, all sources of referral to the Shiley Eye Center.

 

UCSD Medical Center Hillcrest Eye Clinic has 7 examination lanes and is part of the UCSDMC complex that includes a 434 bed hospital and ambulatory care facility about 20 minutes drive from the Shiley Eye Center. UCSDMC is a level I trauma center. UCSDMC serves a wide range of patients including the indigent. The Eye Clinic has ancillary services including photography, visual field testing, lasers, ultrasound, and a procedure room. There is also an operating room used for ophthalmic cases. As well as outpatient clinics the Hillcrest Eye Clinic provides Ophthalmology consultations for inpatient services, including the neonatal intensive care unit. There is a medical library at Hillcrest as well as a resident room in the Eye Clinic with online access to UCSD’s electronic collections.

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VA San Diego Healthcare System is a 238 bed hospital and outpatient facility less than 1 mile from the Shiley Eye Center and about a minute’s walk from the UCSD Medical School. The VA Eye Clinic has 7 fully equipped examination lanes (upgraded from 3 within the last 2 years) with a procedure room, as well as lasers. All ancillary testing is available. Each examination lane has its own computer for EMR and access to the electronic journal and book collection of the UCSD Medical Library. The VA has an operating room dedicated to ophthalmic surgery. Optometric services including Low Vision and Contact Lenses are also available.

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Rotations:

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.

Although there are block rotations in most of the subspecialties at the Shiley Eye Center, the resident in fact will see patients in all the subspecialties during all three years of residency since the resident is also assigned to subspecialty clinics during Hillcrest and VA rotations. In some subspecialties such as Pediatric Ophthalmology and Oculoplastics the block rotation is done both in first and in third year. Thus, the resident’s exposure to patients with subspecialty problems is not just limited to the time spent on the block rotation and not just limited to one level of training. There is also extensive exposure to comprehensive Ophthalmology throughout the three years of residency.

The rotations have also been designed with surgical development in mind. There is assigned OR time during all three years of residency, although the most time is assigned in third year. In this way, the surgical opportunities are not only limited to more senior years.
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First Year:
The first two weeks of first year are spent in orientation as well as “Ophthalmology Boot Camp” in which the new resident is taught most of the practical skills that are needed to start in the clinic, in addition to ancillary testing such as ultrasound, corneal pachymetry, visual field testing, wavefront analysis, OCT, keratometry, introduction to Ophthalmic photography, introduction to the OR, low vision, and the use of the various lasers. During this two weeks the first year resident is does not take first call but is assigned to “shadow” an on-call resident to become familiar with on-call procedures.

There are three rotations in first year:

VA/Cornea: About three months are spent at the VA Eye Clinic, followed by 6 weeks on the Cornea Service.

  • At the VA Eye Clinic, the resident sees patients in the general eye clinic as well as in Neuro-Ophthalmology, Retina, Strabismus, Cornea, Glaucoma and Oculoplastics. The first year resident is assigned to the OR for two hours weekly allowing early graded introduction to surgery. Monthly the resident also goes to the OR with the oculoplastics attending, and there is also monthly OR time with the retina and cornea attendings.
  • On the Cornea Service the resident attends faculty clinics and has exposure not only to external disease and cornea but also refractive surgery patients and general Ophthalmology.

Hillcrest: About 4 months are spent at UCSDMC Hillcrest, where the resident sees patients in the general eye clinic as well as clinics in Cornea. Retina, Oculoplastics, Pediatric Ophthalmology and Neuro-Ophthalmology. In addition the resident is responsible for seeing inpatient and ER consults, affording the resident exposure to the Ophthalmological manifestations of systemic disease. The Hillcrest resident is also assigned to Ocular Pathology for two hours per week. The Hillcrest resident accompanies the pediatric ophthalmologist to examine babies with ROP.

Pediatrics/Oculoplastics: About three months are spent on the Pediatric Ophthalmology service, followed by 6 weeks on the Oculoplastics service. On both services the first year resident is introduced to increasing levels of surgical care in addition to seeing patients in the clinic.

  • On the Pediatric Ophthalmology Service the resident see patients mainly at the Ratner Children’s Eye Center, but also partakes in a weekly clinic at UCSDMC Hillcrest. This includes examination of babies with ROP in the neonatal intensive care unit. Once a month the resident partakes in a multidisciplinary craniofacial clinic at the Children’s Hospital. In addition the resident partakes in the monthly multidisciplinary Thyroid Eye Clinic at Shiley.
  • On the Oculoplastics Service, the resident sees patients at the Shiley Eye Center as well as at the VA and Hillcrest. The resident sees Neuro-Ophthalmology patients one morning a week. Once a month the resident partakes in a multidisciplinary craniofacial clinic at the Children’s Hospital. In addition the resident partakes in the monthly multidisciplinary Thyroid Eye Clinic at Shiley.
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Second Year:
The resident is sent to the Wills Board Review Course in early March.

In second year there are three rotations:

Cornea/VA: About three months are spent on the Cornea Service at the Shiley Eye Center, followed by 6 weeks at the VA Eye Clinic.

  • On the Cornea Service the second year resident attends faculty clinics, gaining deeper and more extensive exposure to this subspecialty.
  • At the VA Eye Clinic, the resident sees patients in the general eye clinic clinics in Neuro-Ophthalmology, Retina, Strabismus, Cornea, Glaucoma and Oculoplastics. The second year resident is assigned to the OR for two hours weekly, with increasing surgical responsibility, building on the VA rotation in first year. The resident also goes to the OR monthly with the oculoplastics attending, and with the cornea and retina attendings.

Glaucoma: About 4 months are spent on the glaucoma rotation at the Shiley Eye Center.

Retina: About 4 months are spent on the Retina Service. This includes clinics and OR at the Shiley Eye Center, 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 UCSDMC Hillcrest.
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Third Year:
This is very much a surgical year, with the resident refining surgical skills in all areas, building on foundations from first and second year. The third year residents are sent to the AAO.

VA: There are two rotations to the VA, totaling about 8 months. In both rotations, the resident sees patients in the general eye clinic as well as his/her own preoperative and postoperative patients. In addition there are clinics in Retina, Strabismus, Cornea and Glaucoma and Oculoplastics.

Oculoplastics/Pediatrics: About three months are spent on the Oculoplastics Service, followed by 6 weeks on the Pediatric Ophthalmology Service. On both services the third year resident is given surgical responsibility for the patients.

  • On the Oculoplastics Service, the resident sees patients at the Shiley Eye Center as well as at the VA and Hillcrest. The resident sees Neuro-Ophthalmology patients one morning a week. Once a month the resident partakes in a multidisciplinary craniofacial clinic at the Children’s Hospital. In addition the resident partakes in the monthly multidisciplinary Thyroid Eye Clinic at Shiley.
  • On the Pediatric Ophthalmology Service the resident see patients mainly at the Ratner Children’s Eye Center, but also partakes in a weekly clinic at Hillcrest. This includes examination of babies with ROP in the neonatal intensive care unit. Once a month the resident partakes in a multidisciplinary craniofacial clinic at the Children’s Hospital. In addition the resident partakes in the monthly multidisciplinary Thyroid Eye Clinic at Shiley.
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Academic Program:
On Monday afternoons during the academic year all residents attend the Basic Sciences Lecture Series, given by faculty with some guest lecturers in addition. This runs a two-year cycle covering all subspecialty topics and is followed by weekly Grand Rounds. After Grand Rounds there is an additional conference, which might include a guest speaker or a quiz.

  • There is a monthly Core Lecture Series arranged by UCSD that covers a wide range of ethical and medicolegal topics.
  • There is a bimonthly Pathology CPC, and bimonthly M&M Rounds.
  • Journal clubs are held during the academic year, usually about twice monthly. These emphasize the skills needed to critically review the literature.
  • Case conferences are held by various faculty during the week, mainly attended by the resident on the individual service.
  • The second year residents are sent to the Wills Board Review Course in March each year. The third year residents are sent to the AAO.

Although the emphasis of our Residency Training Program is clinical, we also recognize the importance of scholarship and the perspective gained by being involved in some research. Each resident is expected to take advantage of the many research opportunities available in the Department. The faculty have a wide range of interests and, in the most recent data available from NIH, our Department ranked among the top 15 Ophthalmology Departments in the US in NIH awards http://grants1.nih.gov/grants/award/rank/MedSchool_Departments.cfm?Department=OPHTHALMOLOGY

Resident research may range from clinical to laboratory work, depending on the interests of the resident. A venue for presenting the research is the Annual Residents, Fellows and Alumni Day, and each resident is expected to present their project before graduation.

There is departmental support for any resident who is selected to present research at a national meeting such as ARVO, ASCRS, AAO, etc.
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Resident Selection:
The UCSD Department of Ophthalmology takes 3 residents per year, exclusively through the Central Application Service (CAS) provided by the San Francisco Matching Program http://www.sfmatch.org/residency/ophthalmology/index.htm. In addition to the CAS materials, we have a short supplementary application http://eyesite.ucsd.edu/residency/docs/res_app2.pdf. General UCSD Policies regarding eligibility for residency training at UCSD can be found on the UCSD Graduate Medical Education website http://ogme.ucsd.edu/.

We interview fewer than 10% of our applicants on two interview days in November or December. While no absolute selection criteria exist, the Residency Selection Committee considers:

  • Academic credentials (e.g.: USMLE scores, performance in medical school, performance on clinical rotations)
  • Evidence of academic potential
  • Evidence of commitment to Ophthalmology
  • Personal statement
  • Letters of recommendation
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Life as a Resident:

Housing
UCSD’s Housing Office maintains a list of local apartments (http://offcampushousing.ucsd.edu/ 858-534-3670). In general, affordable housing is available in all parts of the city and within easy commuting distance from the Shiley Eye Center, the UCSD Medical Center, and the VA Medical Center.

Vacation:
Residents have 4 weeks vacation per year.

San Diego:
San Diego County is a region of diverse and incomparable natural beauty that covers 4,258 square miles along the beautiful Pacific Coast. Bordered by San Clemente to the north, Mexico to the south, and the Palomar, Cuyamaca, and Laguna Mountains to the east, the county’s 2.6 million residents are at home with the sun, surf, mountains, deserts, and international flavor of our city. San Diego is the second largest city in California and the 8th largest city in the United States. San Diego’s Mediterranean climate is considered by many to be the most moderate and pleasant in the United States. Average temperatures in January and August are 55 degrees and 73 degrees respectively, with an average of 265 clear, sunny days per year.

San Diego is a sporting paradise with a multitude of activities available within easy access. Ocean swimming and other aquatic sports such as surfing, water skiing, kayaking, skin diving, sailing and fishing are enjoyed throughout the year. You can enjoy tennis and golf, as well as biking, hiking, mountain climbing, and jogging year-round. As a UCSD resident you have access to many of the recreational facilities on campus http://recreation.ucsd.edu/, as well as the Mission Bay Aquatic Center http://www.missionbayaquaticcenter.com/.

For the more adventurous, there is a hang-gliding and paragliding port opposite the UCSD campus, near the Salk Institute. If you miss the changes of season, you can drive up the local mountains to Julian in the fall for apple season. Be sure to visit the Eagle Gold Mine while you are there. If you hanker for a taste of winter, Big Bear resort is an easy drive for skiing and snowboarding, or, for those who like a longer drive and a bigger mountain, Mammoth is six hours’ drive north on Rt395.

In addition to excellent restaurants, San Diego and its environs also boasts a rich cultural life, including theaters, museums, and music venues ranging from opera to outdoor concerts at the Embarcadero to the intimate jazz or flamenco clubs of the Gaslamp Quarter. The La Jolla playhouse is on the UCSD campus and has often premiered productions that later go onto Broadway. San Diego is home to the world famous San Diego Zoo, which is housed within the expansive, lush grounds of Balboa Park, as well as the San Diego Wild Animal Park.


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