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OPHTHALMOLOGY

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					                                                                                                  OPH



                               OPHTHALMOLOGY - Parkland
                                 GOALS AND OBJECTIVES


ROTATION COORDINATOR                                     Amer Shakil, MD
                                                         Surgery Curriculum Leader
                                                         Dept. of Family Medicine
                                                         214-648-1350

ROTATION SPECIALTY FACULTY                               Preston Blomquist, MD
                                                         Ophthalmology Program Director
                                                         Parkland Eye Clinic
                                                         5323 Harry Hines
                                                         Dallas, TX 75390-9057

ROTATION CONTACT                                         Carol Ware
                                                         Education Coordinator
                                                         214-648-3182
                                                         214-648-9061 (fax)

CALL FREQUENCY                                           No call

VACATION                                                 No vacation allowed in this 2 week

ROTATION DAYS/HOURS                                      Ophthalmology Clinic
                                                         Parkland Out patient Clinic Bldg
                                                         Fourth floor
                                                         Monday- Friday
                                                         8:00am- 5:00pm

                MON              TUE              WED              THUR              FRI
AM              Eye Clinic       FMC              Pediatric Eye    FMC               Eye Clinic
                4th floor                         Clinic                             4th Floor
                                                  at CMC
PM              FMC              Conference       Eye Clinic       Eye Clinic        FMC
                                                  4th Floor        4th Floor

Residents spend 20 hrs (five ½ days) per week on ophthalmology rotation. Out this 16 hrs (four
½ days) in Parkland outpatient clinic setting and 4 hrs (½ days) per week is in outpatient clinic
setting in Children’s hospital. In addition they spend 16 hrs (four ½ days) in the FMC and 4 hrs
(½ days) per week for family medicine didactic sessions per week.

INTRODUCTION

The family medicine PGY-3 ophthalmology rotation is a half-month experience in outpatient
ophthalmology. The resident will see patients’ four half-days a week in the FMC and will attend
the Wednesday afternoon family medicine conferences.

EDUCATIONAL GOALS


                                                                             Revised May 18, 2009, MPP
                                                                                                  OPH



At the end of the rotation the resident should be able to:
Patient care
Manage and assess a large area of the common edge problems due to experience and readings,
and clinical attendings
Take a focused eye related history, do and document a full eye exam, and establish a treatment
plan on common eye problems
COMMUNICATION
Discuss eye problem with patient and family in practical language.
Discuss eye problem effectively with staff, colleagues, faculty, residents and fellows.
MEDICAL KNOWLEDGE
By lectures readings, and clinical exposure the resident gains a knowledge based and a variety of
clinical eye issues
These are:
1.       Given a patient with any one of the following complaints, obtain an appropriate history,
         perform an appropriate exam, propose an appropriate differential diagnosis, and
         diagnostic plan for the following:
    a. poor vision                                         e. foreign body
    b. eye pain                                            f. inflamed eyelid
    c. red eye                                             g. trauma
    d. “spots” in front of the eye                         h. acute visual loss

2.        Given a patient with any of the following diagnoses, propose an appropriate plan of
          treatment, including distinguishing between what is appropriate in the family medicine
          setting and which require referral and at what point:

     a.   cataracts                                       l.   blepharitis
     b.   amblyopia                                       m.   scleritis, episcleritis
     c.   strabismus                                      n.   uveitis
     d.   nasolacrimal duct abnormalities                 o.   diabetic retinopathy
     e.   conjunctivitis                                  p.   keratitis
     f.   trauma                                          q.   optic neuritis
     g.   glaucoma                                        r.   herpes
     h.   retinal detachment                              s.   retinal artery and/or vein occlusion
     i.   orbital and periorbital cellulitis              t.   pterygium
     j.   hordeolum                                       u.   r. corneal abrasions
     k.   chalazion

3.        Perform the following procedures, demonstrating appropriate preparation of the patient,
          technical performance, and post-procedure management of the patient:
     a.   visual acuity testing                       f. removal of foreign body
     b.   color vision testing                        g. hordeolum drainage
     c.   fluorescein staining of cornea              h. slit lamp exam
     d.   measurement of intraocular pressure         i. fundoscopic examinations
     e.   gross visual field determinations           j. i.application of patch and shield

4.        Discuss the following:
     a.   growth and development of the eye               e. visual impairment
     b.   problems of aging                               f. motor alterations
     c.   infections                                      g. neoplasms
     d.   immunologic problems


                                                                              Revised May 18, 2009, MPP
                                                                                                   OPH



    h. ophthalmologic manifestations of                   m. pharmacology
       disease                                                   a. topical effects
    i. degenerative diseases                                     b. systemic effects
    j. glaucoma                                                  c. ocular effects of systemic
    k. CNS conditions affecting the eye                             medications
    l. toxicity

EVIDENCE BASED PRACTICE
1. Solve eye problems using EBM to improve patient care

SYSTEM BASED LEARNING
2. Access eye related resources in the community and Parkland Hospital to assist in eye care to
patients

PROFESSIONALISM
  1. Work together with dermatology staff and dermatology consultants to improve patient
     care, decrease cost, promote wellness, provide patient education, and prevent disease.
  2. Practice ethical medical care.
  3. Demonstrate responsible behavior with dermatology consultants and their patients.
  4. Follow all policies of the program and Parkland Hospital and respect the policies of
     CMC and UTSW.

EDUCATIONAL OBJECTIVES
In order to accomplish the goals, the resident will:
    1. Complete evaluations of a variety of patients seen in the eye clinics, the ER and on
        hospital consults.
    2. Participate in daily interactions with families of patients in the clinic.
    3. Read about at least one clinical aspect of one case daily.
    4. Discuss cases with fellow residents and attending physicians to clarify knowledge and
        refine skills.
    5. Request feedback on performance regularly and incorporate that feedback into daily
        activities.
    6. Complete and maintain an accurate procedure log in timely manner.
    7. Complete Med Challenger Family Medicine modules on ophthalmology
    8. Read appropriate reference material as recommended by faculty in the various areas of
        the rotation.

FAMILY MEDICINE CLINIC

The resident will be in clinic 4 half-days a week during this rotation and will also attend
Wednesday afternoon family medicine conferences.


EVALUATION PROCESS

The resident will be evaluated by the preceptor using the standard family medicine evaluation
form. Satisfactory completion of the rotation will be determined by the director of the family
medicine residency program in consultation with the preceptor.




                                                                               Revised May 18, 2009, MPP

				
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