Average Day for the 1st Year Resident
The one absolute truth about starting your first year in ophthalmology is the very steep, almost vertical learning curve. It is amazing how much you learn and get comfortable with within the first two months of residency. The first year residents take the majority of night call (four days of the week) including weekends, with second years responsible for three weekday calls. The third year is always available for back up during call, and the schedule is busy enough to get experienced, but usually light enough to get some studying in and relax also.
The year is split into three rotations of 4 months each, VA (Veterans Administration Hospital), PCC (Primary Care Clinic/University Hospital), and Private Clinics. Clinics usually start at 8:00 am and go until 4:00 - 6:00 pm depending on the rotation. The VA rotation is great for incoming residents as the pace is a little slower, and there are usually at least 2 attendings available to see patients and work with you on your basics. The first year is also responsible for ER coverage at the VA, but these patients can usually be worked into clinic. The PCC is the busiest 4 months of the year, and this is where you see the bulk of pathology, from end-stage diabetic eye disease to walk-in ruptured globes. You learn to focus your exam and prioritize your management of difficult and complicated patients. Even though this is a residents’ clinic, there is always an attending to see your patients with you. Again, first years are responsible for ER call during the day at University Hospital which can vary from no calls to 2-3 calls during summer trauma season. The first year performs all minor surgical procedures (chalazions, small lid lesions) during both the VA and PCC rotations. The Private rotation is excellent in terms of seeing how different specialty attendings handle patients in clinic and surgically. The first year resident’s involvement ranges from being only an observer in some clinics and surgeries to suturing and even being primary surgeon in some oculoplastics and peds cases. Day call includes floor call for Jewish and Norton Hospitals.
Surgically, the first year assists the third year in almost all their surgeries along with the attending. As the third year gets more experienced, the first year may perform some of the surgical steps as well, As far as primary surgeries go, the first years get about one cataract surgery per rotation. We have an excellent wet lab that is invaluable is helping you get ready for these. The first year also gets a lot of surgical experience during the private rotation.
We have didactics throughout the morning every Friday, and have one lecture/conference from 7:30 to 8:15 am on Mondays and Thursdays. These are great for preparing the residents for OKAPS, and there is definitely enough time to study in the current setup. During our Retina conferences and Grand rounds, each resident ends up presenting cases an average of once or twice a month.
Overall, the first year is pretty balanced in regards to clinics and didactics, and as long as you get most of your clinical skills and knowledge down, you are ready to focus on surgery and laser procedures during second year.
Hassan Shah ,M.D.