The goal of the Yale Ophthalmology Residency Program is to train future leaders in both clinical and academic ophthalmology. In order to achieve this mission, the resident’s day-to-day responsibilities has been meticulously structured to maximize the educational experience.
Program at a Glance
In the first year of training, residents master examination skills and management of the general ophthalmology patient.
In the second year, residents focus on medical and surgical evaluation and management of the specialty patient.
In the third year, complicated surgical management is the focus.
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Each year consists of five even-divided rotations. During the first year of training, the year is divided into:
- Two rotations at the West Haven VA Medical Center, staffing the general and subspecialty ophthalmology clinics;
- One rotation combining Ophthalmic Plastic Surgery, Ophthalmic Pathology, and Ophthalmic Oncology;
- One rotation combining Neuro-ophthalmology and Pediatric Ophthalmology/Strabismus;
- One rotation at the Yale-New Haven Hospital Clinic and Consult Service. The resident runs their own clinic in the mornings for patients with ophthalmic emergencies, staffed by Yale full-time faculty and volunteer community faculty, which provides a great opportunity to follow the same patients through the full course of their ophthalmic emergencies. The resident also acts as the primary ophthalmology consultant, fielding all daytime consults in the hospital. Every resident agrees that this rotation provides the greatest breadth of experience in the first year.
During the first year, residents typically perform, as primary surgeon:
- 5 strabismus surgeries
- 10 anterior segment/glaucoma laser procedures
- 20 ophthalmic plastic surgery procedures, including temporal artery biopsy, blepharoplasty, ptosis repair, lid tumor resection, and lid laceration repair
- 50 intravitreal injections
During the Hospital-Based Clinic and Ophthalmic Plastic rotations, there are also extensive opportunities to assist senior surgeons in a wide variety of anterior segment and ophthalmic plastic procedures.
During the second year of training, residents spend rotations in Cornea and External Disease/Refractive Surgery, Glaucoma, and Vitreoretinal Surgery, as well as two rotations at the VA Medical Center. While on the Cornea service, residents are exposed to a wide variety of corneal and external disease problems. Residents expect:
- to assist on lamellar and penetrating keratoplasty, with a graded introduction to placing corneal sutures of high structural and refractive quality
- a step-wise introduction to performing cataract surgery
- exposure to the Contact Lens service.
During the Vitreoretinal rotation, residents work with the full time retina faculty members and two clinical fellows. Residents expect to learn:
- the nuances of a peripheral retinal examination, including scleral depression and retinal drawing;
- evaluation of ophthalmic echography, fluorescein angiography, and electro-physiology;
- how to perform scleral buckles, and opening and closing vitrectomy cases, assisting on complicated vitrectomies.
On the Glaucoma rotation, residents interact with the full-time faculty and a clinical fellow. Residents will:
- learn medical management of glaucoma
- learn various examination techniques, including:
- anterior chamber angle evaluation
- optic nerve evaluation
- the use of diagnostic studies such as visual field testing, ultrasound biomicroscopy, anterior segment OCT, and optic nerve and nerve fiber layer imaging
- gain exposure to a wide range of medical and surgical therapeutic modalities for glaucoma as well as post-operative glaucoma patient
At the VA Medical Center, the second-year resident is responsible for running a busy, general clinic. Subspecialty clinics are held at the VA in all major areas. During this rotation, the resident typically will:
- perform two to five phacoemulsification cataract surgeries
- perform three to five ophthalmic plastic surgery cases per week
- perform more than twenty retinal laser procedures
- perform approximately forty anterior segment/glaucoma laser procedures
The third year of residency training is divided into the following five rotations:
- One rotation at the Cornell Scott Hill-Health Center staffing a community-based general ophthalmology clinic where you are exposed to a largely under- and un-insured population that is predominantly Spanish speaking. This is a resident-run clinic, though Yale full-time faculty and volunteer community faculty, which supervise the clinics. The resident acts as the primary surgeon on all surgical cases generated from this clinic. The resident can expect to perform 20 cases from this site, including cataract, trabeculectomy, and pterygium.
- One comprehensive ophthalmology/Uveitis rotation where the resident will hone their general ophthalmology skills and will also have exposure to a wide range of tertiary care Uveitis patients in the Uveitis Clinic.
- Two rotations at the VA Medical Center provide the bulk of the Class 1 (primary surgeon) anterior segment surgical experience during the residency. The strengths of the VA surgical experience are high volume clear-corneal incision phacoemulsification cataract surgery, trabeculectomy, glaucoma drainage device implantation, and minimally-invasive glaucoma surgeries (MIGS). Third year residents at the VA typically perform around 120 to 150 phacoemulsifications a year. In addition, third year residents usually perform 10-15 trabeculectomies or tubes, and 1-2 penetrating and lamellar keratoplasties.
- One rotation divided between Pediatric Ophthalmology/Strabismus and a one month international experience, during which the resident spends one month in the Bahamas at the Princess Margaret Hospital. This rotation allows the resident to hone surgical techniques necessary for strabismus surgery as well as gain confidence in managing complex pediatric cases.
A unique aspect of the Ophthalmology residency at Yale is the four-week rotation at Princess Margaret Hospital in Nassau, Bahamas. During this time, the senior resident provides a large portion of the eye care for the island’s indigent population. Typically, 30 anterior segment procedures are performed, including ECCE, phacoemulsification, anti-metabolite trabeculectomy, and globe trauma repair. Two U.S. fellowship- trained ophthalmologists, who practice on the island, work closely with the resident in a supervisory and consultative fashion, and a Yale faculty member visits for one week during each rotation. This rotation allows residents to develop a newfound sense of autonomy in patient management, as well as an appreciation for the epidemiologic issues facing a developing country.