One postgraduate clinical year (transitional, medicine, pediatrics, or surgery) in a program accredited by the ACGME is required prior to entering the residency. The first year of residency begins with a two-week introductory course covering ophthalmic terminology, management of common ocular diseases and emergencies, use of instruments, and examination techniques. There are no clinical responsibilities during this time.
The curriculum is designed so that residents rotate through each of the subspecialties once for four months during their three-year tenure. The first-year resident spends time on the Vitreo-Retinal, Oculoplastics, and Cornea/Anterior Segment services. The resident is also introduced to patients that he / she will follow for three years in a comprehensive continuity clinic. One half day each week is devoted to an Ophthalmic Pathology practical experience under the guidance of our Ophthalmic Pathologist. First-year residents assist in intraocular surgeries and gain primary surgical experience in minor oculoplastic procedures (ex blepharoplasty, ptosis surgery, and other eyelid operations) as well as many more complex surgeries in the surgery center such as DCRs, enucleations, reconstructions, and exenterations. The residents also gain primary surgical experience with cataract extraction and anterior segment surgery such as ptyrigium excision. This is perennially a strong point of the residency program in that there is a well-developed online surgical curriculum and residents are able to get involved as primary surgeon much earlier than the vast majority of other residencies. Ninety-five percent of surgeries are performed in the brand new (re-opened January 2011) Ambulatory Care Center Surgery Center. This is located on the first floor of the Ambulatory Care Center and the ophthalmology clinics are on the second floor thus making it extremely convenient to move from one to another. First year residents also have protected pig-eye practice lab time each Wednesday (as well as 24 hr access) and have a constant supply of eyes to practice on with two fully functioning (AMO and Alcon) phacoemulsification platforms, an Alcon vitrector, and 3 operating microscopes. Call responsibilities allow the resident to become comfortable with the management of ocular trauma and other emergencies.
Second-year residents spend time in their comprehensive continuity clinic as well as with subspecialists in Pediatric Ophthalmology and Strabismus, Neuro-Ophthalmology, and Contact Lens. During the Pediatric Ophthalmology and Strabismus rotation, the resident gains primary surgical experience performing horizontal strabismus procedures. In the afternoons while on the four month Pediatric Ophthalmology service the resident is in charge of daytime hospital consults thus allowing dedicated time to address in house patients and not requiring the primary call resident to run from clinic to the hospital during the day. The four months spent on the Neuro-Ophthalmology course also allows the resident time to rotate with the on-staff optomotrists to gain exposure to contact lens fitting. During four months of the second year of residency, residents see patients in a busy eye clinic at the Fayetteville VA Medical Center (FVAMC) in Fayetteville, North Carolina, approximately 95 miles from Chapel Hill. During the FVAMC Rotation, residents have no call responsibilities and housing is provided. At FVAMC, residents see patients with a variety of pathology in a busy eye care clinic and perform laser procedures, minor plastics procedures as well as intraocular surgery as the primary surgeon.
Third-year residents gain additional primary surgical experience in cataracts and glaucoma procedures. Four months are spent on the Glaucoma service where residents gain valuable experience as primary surgeon and helping assist on a variety of glaucoma tubes and shunts as well as cataract extractions. Four months are also spent on the comprehensive rotation where residents further hone their intraocular surgery skills and are able to revisit specialties in which they are interested. During the comprehensive block the resident also spends every other Wednesday with Dr. Karl Stonecipher at The Laser Center in Raleigh gaining exposure to keratorefractive surgeries such as LASIK, PRK, and PTK. All residents have the option to become Visx certified and perform LASIK/PRK on their own personal patients at a discounted rate. The other third year four month block is spent back in Fayetteville, NC at the FVAMC where the resident works along with the second year resident and gains more primary surgical experience and allows residents to perform a large number of cataract, glaucoma, and oculoplastic procedures. Individual housing in a desirable area of town and a travel stipend are provided for both residents while at FVAMC and many residents return to Chapel Hill on the weekends (all of which are free from clinical duty) while on this block.
Each week during the first year residents take primary call on either Wednesday, Thursday, or Friday through Sunday. At any given time the two second year residents not at FVAMC take primary call on either Monday or Tuesday. Back up call is split between the second and third year residents not at FVAMC.
Quality teaching and adequate resident supervision are priorities of the faculty. One of the unique aspects of the program is that during the entire time at UNC, residents and faculty see patients in the same facility. Therefore, a faculty member is always available in the eye center to answer residents' questions, providing immediate feedback on challenging patients and maximizing learning opportunities. In addition, because there are few fellowships (1 Retina fellow and 1 Oculoplastics fellow) offered at UNC, the resident has 1 - on - 1 faculty interaction in the eye center and is the first assistant on almost all faculty surgeries. There is also ample opportunity for residents to develop their own teaching skills by instructing medical students and residents from other specialties who rotate through the department.
Experience is gained with formal and informal oral presentations at monthly Grand Rounds, weekly department rounds, and clinical case conferences. In June at the annual Residents' Day, residents present the results of research projects completed during the year under the supervision of a faculty member. Residents are required to complete one scholarly project during the three years at UNC and historically those projects have been clinical in nature. There is ample opportunity to get involved in clinical and basic science research but it is not forced upon the resident. Historically, approximately one half of residents have elected to pursue subspecialty fellowship training.