Cornea, External Diseases and Refractive Surgery - Clinical

Clinical Fellowship

The University of Ottawa Eye Institute offers a one-year post-residency fellowship in Cornea/ External Disease, Anterior Segment, and Refractive Surgery. This is a demanding, hands-on, clinical/surgical fellowship with research and teaching obligations. The training takes place predominantly at the Eye Institute, a 60,000-square-foot, tertiary- and quaternary-level care facility that spans two floors of the General Campus of the Ottawa Hospital. Overall, about 15,000 surgical eye cases and a total of 90,000 patient encounters occur every year at the Eye Institute (General Campus) and the Eye Care Centre (Riverside Campus). The fellowship produces a well-rounded subspecialist comfortable in managing complex cases using clinical acumen and surgical versatility acquired in an innovative teaching environment.

Competition between fellows and residents is a concern in many programs. This fellowship has been crafted to mesh with the residency program so that both the resident and Fellow experience superb medical and surgical training.

Objectives
  • To develop expertise in the medical and surgical management of disorders in Cornea, Anterior Segment, and Refractive Surgery.
  • To develop expertise in performing and interpreting diagnostics in Cornea, Anterior Segment, and Refractive Surgery.
  • To further develop medical teaching skills.
  • To develop a habit of constant learning and innovation.
  • To develop an understanding of the research process from design to publication.
  • To develop practice management knowledge (EMR, billing, scheduling, etc.).
Location

Medical, surgical, and research activities will predominantly take place at the University of Ottawa Eye Institute at the Ottawa Hospital (General Campus), the Children’s Hospital of Eastern Ontario (CHEO), and the University of Ottawa Medical School. The Eye Institute, CHEO, and the Medical School are all housed within the Ottawa Health Sciences Centre, a single medical campus located on Smyth Road. Educational opportunities may also arise at the Eye Care Centre (Riverside Campus) located very close to the General Campus.

Surgery

Cornea/Anterior Segment:

The Fellow will assist, perform, and later teach the following partial list of surgeries in both adult and pediatric settings: full-thickness penetrating keratoplasty (PK), endothelial keratoplasty (EK: DSAEK, UT-DSAEK, DMEK), deep anterior lamellar keratoplasty (DALK), superficial anterior lamellar keratoplasty (SALK), Intralase-enabled keratoplasty (IEK), lamellar and full-thickness keratoprostheses (KPros), iris reconstruction, dislocated lenses/IOLs, IOL exchange, secondary IOLs (iris-sutured, scleral-sutured, glued, anterior chamber supported, iris-claw), piggyback IOLs, artificial iris implants, ocular surface reconstruction with amniotic membrane, limbal stem cell transplants, anterior segment trauma, and limbal/pars plana approaches to anterior vitrectomy. Each surgical case is recorded digitally in high definition for teaching and presentation purposes. An advanced wet lab facility is available for the Fellow to enhance surgical skills and is used by the Attendings to investigate new and experimental surgical techniques. The wet lab is well equipped with surgical microscopes with video cameras, phacoemulsification machines, instruments, an Eyesi Surgical Simulator, and dedicated personnel to run the facility.

Cataract

This is not a fellowship in developing cataract skills as it is expected that the Fellow has mastered basic and intermediate phacoemulsification skills during their residency training. Residents on the Anterior Segment Rotation usually get priority to assist/perform cataract surgery and must achieve the objectives that have been set up for the Rotation. However, the Fellow is expected to be fully involved with the pre-operative assessment and post-operative follow-up of cataract patients to gain familiarity with issues surrounding advanced technology IOLs. Access to the newest IOLs from around the world is available through Health Canada’s Special Access Program.

Refractive

The Fellow will actively participate in the evaluation of patients seeking femtosecond LASIK, PRK, PTK, phakic IOL, collagen cross-linking, and intracorneal ring surgery. The VISX Star S4 IR excimer laser and IntraLase femtosecond laser are used in the refractive suite. Training on the use of these two laser platforms will occur early in the fellowship year. A dedicated Refractive Surgery team is in place to coordinate clinical trials, patient interactions, and the clinic/surgery schedule.

Clinics

The Fellow is expected to be present at the Eye Institute, regardless of scheduled clinical activities, between 8:00am and 4:30pm, Monday to Friday. All absences must be approved in advance. When not involved in clinical or surgical duties, time must be used to further academic pursuits such as research and teaching. When a Supervisor is away on vacation or conference leave, the Fellow can do research, participate in another Supervisor’s clinics, teach, take vacation, and/or perform another pre-approved academic activity.

Teaching

The Fellow is expected to teach residents and medical students informally in clinics and the operating room, and more formally in lectures, journal clubs, and Grand Rounds. The Fellow plays an active role in teaching residents by reviewing suturing techniques in the wet lab at the beginning of an Anterior Segment Rotation and helping to ensure resident teaching objectives are met during the rotation. The Fellow is responsible for organizing four journal clubs throughout the year. In addition, the Fellow is expected to do an informal, five-minute presentation each Tuesday afternoon to the Cornea Service on a recent article or a chapter from a Cornea text (Krachmer, Brightbill, etc.). Access to the latest Ophthalmology journals will be available online. Finally, the Fellow is expected to present an interesting or challenging case once a month to the Cornea Service.

Research

The Cornea and Refractive Surgery Faculty is involved with multiple clinical trials on an ongoing basis. The Fellow will be expected to be first author on at least one major research project. The Fellow is expected to present at a major Ophthalmology meeting (AAO, ASCRS, ESCRS, EuCornea, Asia Cornea, COS, etc.) and to submit a manuscript for publication in an Ophthalmology journal. The Fellow will also present at the University of Ottawa, Department of Ophthalmology Annual Research Day.

Conference

Conference leave must be approved by the Fellowship Director. Conference time may be taken if the Fellow is presenting at the meeting.

Call

The Fellow is expected to carry a pager/cell phone at all times. Throughout the year, the Fellow is the first point of contact for residents and clinics wishing to discuss an urgent Cornea consult. The Fellow is also expected to be available for weekend/closure clinics, resident calls, and emergency procedures that take place when a supervisor is on call (about 8-9 weeks total). The Fellow will share first call duties with other clinical fellows when residents are not able to take call (mock orals, OKAP, etc.). Finally, the Fellow is expected to be available for weekend follow-ups of post-operative and complex Cornea patients.

Vacation

Two weeks.

Evaluations

The Supervisors will perform formal evaluations of the Fellow’s progress in the fellowship every four months.

Funding

$30,000/year for a Fellow without funding support. Funding for research (including associated conference leave) is available on a competitive process through the Department of Ophthalmology Research Fund.

Application

This position is offered through the SF Match (Program # 4733) and uses its Central Application Service (CAS). Interested and qualified applicants should submit a personal statement, curriculum vitae, and three confidential reference letters through CAS. Non-CAS documents include medical school/residency transcripts and should be submitted to Ginette Snook. All Foreign Trainee applications to our program must go through the PGME office. Foreign Trainee candidates must apply on-line through the Fellowship application system. The application site for Foreign Trainees opens in July/August and the deadline for applications is September 30th for the next academic year. All Foreign Trainee candidates are expected to apply to both the SF Match and the PGME Foreign applications. Applications are due in the fall. Interview notifications will be made by end of October. Interviews will be held at the end of November. The Match takes place in December.

Contact

Kashif Baig, MD, MBA, FRCSC

Cornea Fellowship Director

University of Ottawa Eye Institute

501 Smyth Rd, Ste W6223, Box 307

Ottawa, Ontario, Canada, K1H 8L6

Tel: 613.737.8629

Fax: 613.739.6876

Email: baig247@gmail.com

Website:Dr. Baig

Ginette Snook

Departmental Education Program Coordinator

University of Ottawa Eye Institute

501 Smyth Rd, Suite W3248, Box 307

Ottawa, Ontario, Canada, K1H 8L6

Tel: 613.737.8899 x79422

Fax: 613.737.8836

Email: gsnook@toh.ca

Website: Eye Institute

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