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. New residents will spend time shadowing current residents and faculty during this time to allow for familiarity with the clinical exam.
The curriculum is designed to provide each resident strong exposure to each speciality. In Resident Continuity clinic, the resident is introduced to patients that he / she will follow for three years in their own clinics First-year residents will rotate through the Comprehensive, Neuro-Ophthalmology, Pediatric, and Retina services and will also spend time as the Consult resident.
First-year residents assist in intraocular surgeries and gain primary surgical experience in minor oculoplastic procedures (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 pterygium 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. All clinics are held in the newly opened (August 2013) Kittner Eye Center, roughly a 5-minute drive from the main hospital.
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 in a brand new, state of the art, surgical training facility. 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 sub-specialists in Pediatric Ophthalmology and Strabismus, Retina, and Advanced Cataract. Additionally, they will spend time on the Consult service. During the Pediatric Ophthalmology and Strabismus rotation, the resident gains primary surgical experience performing horizontal strabismus procedures.
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 light 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. Several 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. Additional time is spent on the Cornea/Refractive Service as well as on the Advanced Cataract rotation.
While on the Cornea/Refractive Service, Fridays are spent performing Refracticve Surgery with Dr. Karl Stonecipher and Dr. Julie Skaggs at the UNC Kittner Eye Center. 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, 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 residents while at FVAMC.
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. Fellows in Glaucoma, Retina, Cornea and Oculoplastics augment resident learning and are valuable resources. 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 two scholarly projects 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.