Ophthalmology Residency Curriculum

First-Year Rotation

Durham VAMC  - (16 weeks) Residents work in a broad range of subspecialty and comprehensive clinics under the supervision of Duke attendings at the neighboring VA Eye Clinic. This rotation also offers a surgical introduction to clear cornea cataract surgery as well as numerous laser procedures and minor-room plastics procedures. The new clinic space is fitted with new state-of-the-art equipment (slit lamps and indirect with live video output, SD OCT, corneal topography, Zeiss Lumera surgical microscope, Alcon Infinity phaco machine, and Iridex and Lumenis lasers), a full time ophthalmic photographer, ample technician support, and surgical support staff.  Residents have autonomy in directing patient care, although an attending is always present.

Neuro-Ophthalmology – (8 weeks) First-year residents work with two full-time neuro-ophthalmology attendings in a busy referral clinic with the opportunity to see a broad range of pathology.

Consults, Research – (8 weeks) This rotation covers daytime inpatient and emergency department consults at Duke Hospital and offers time for research.  Consults are staffed during teaching rounds with an attending physician on a daily basis.

Comprehensive – (8 weeks)  First-year residents are introduced to comprehensive ophthalmology at the main Duke Eye Center.  This rotation also provides a chance to explore low vision services, and cornea subspecialties clinics and surgeries. 

Duke Subspecialties – (8 weeks) The goal of this rotation is to allow for early exposure to all ophthalmic subspecialties before the completion of the first year of training. Residents participate in pediatrics, glaucoma, surgical retina, medical retina, cornea, and oculoplastics clinics at Duke Eye Center.

Second-Year Rotation

Retina – (8 weeks) Residents spend time in a busy retina clinic focusing on clinical skills as well as the diagnosis and management of vitreoretinal disorders, working closely with full-time faculty members in medical retina, uveitis, ocular oncology and surgical retina.  Residents may assist in a wide variety of surgical cases including retinal detachment repair and radioactive plaque placement for ocular tumors, among many others..  A cutting-edge ocular imaging department at Duke offers exposure to the latest advances in diagnostic retinal imaging, including intraoperative SD OCT, video ICG angiography, as well as the opportunity for research at the Duke OCT Reading Center.

Glaucoma – (8 weeks) The large number of full-time Duke glaucoma faculty provide residents with unparalleled perspective on the diagnosis and management of all forms of glaucoma.  Residents will also have the opportunity to assist with minimally invasive glaucoma surgery and filtration procedures and perform tube shunt surgeries and lasers. 

Pediatrics – (8 weeks) Residents gain experience in the management of a wide variety of pediatric ophthalmologic conditions in a busy clinical setting.  Four full-time orthoptists offer a solid base in strabismus diagnosis and measurement. Time is also spent in the NICU on Retinopathy of Prematurity rounds and in the operating room performing strabismus surgeries and observing the removal of childhood cataracts and treatment of pediatric intraocular tumors.

Durham VAMC  - (8 weeks) Second-year residents function with more autonomy as they run a busy comprehensive ophthalmology clinic.  In addition, one day per week is dedicated to the operating room where residents perform clear corneal cataract extraction as well as a number of glaucoma surgeries.

Asheville VAMC - (8 weeks) Time is spent in both the clinic and operating room at the Asheville VA hospital.  Second-year residents spend one day each week performing cataract surgery.  Residents also have the opportunity to spend time with ophthalmologists at Asheville Eye Associates, a local private practice.  Fully furnished housing and parking is provided 10 minutes from the medical center.

Aesthetics - (8 weeks) Residents work in the pediatric, retina, oculofacial aesthetics and refractive surgery practices, seeing patients in clinic and assisting with procedures.  The resident also spends time performing oculoplastic surgery at the Durham VA.  One morning each week is spent with one of our two ocular pathologists reviewing the week’s pathology specimens.

Third-Year Rotation

Chief, Durham VAMC  - (8 weeks) The third-year resident at the Durham VA spends two days per week in the chief’s clinic and three days in the operating room performing a large number of sutureless clear corneal cataract extractions, vitrectomies, and glaucoma surgeries. 

Cornea – (8 weeks) Time is spent both in the clinic and OR learning the fundamentals of the management of corneal and external disease.  Residents are exposed to the latest techniques in corneal transplantation, including DSAEK and deep lamellar transplants, as well as refractive surgery. Residents are also certified for the use of the femtosecond laser.

Oculoplastics – (8 weeks) Residents work with two full-time faculty members in both the clinical and operative setting learning both functional/reconstructive and cosmetic oculoplastic procedures. The resident receives training in a broad array of surgical techniques and technologies

Chief, Asheville VAMC  - (8 weeks) Time is spent in both the clinic and operating room 2 days per week at the Asheville VA hospital.  Residents also have the opportunity to spend time with ophthalmologists at Asheville Eye Associates, a local private practice.

Research elective – (8 weeks) This unique rotation at Duke offers residents the opportunity to conduct basic science or clinical research at Duke, spend time studying ophthalmology abroad or pursue other related activities.  Previous residents have used this time to travel abroad to eye hospitals in Tanzania, East Africa, spend time working for the FDA on Capitol Hill, and collaborate with other Duke departments on biomedical engineering endeavors.   

Call

First-year residents take first call on a night float home call basis, and second-year residents serve as backup call, covering only Duke Eye Center and neighboring VA Medical Center. Third-year residents have limited call responsibilities during the 8 week rotation at the Asheville Medical Center.  All call is taken from home.  All emergency surgery is done by the second-year resident with the on-call attending physician. The call schedule is made by the residents after the first month.  

Surgical Experience

Resident experience in performing eye surgery is extensive and is distributed over the three year training period. Most residents perform an average of 250 cataract extractions, and assist in over 600 total surgical cases including cataract, glaucoma, cornea, strabismus, vitreoretinal and oculoplastics procedures. The surgical equipment in the Duke and Durham VA operating rooms is of the highest quality including video recording systems.  In addition, a practice surgery suite with phacoemulsification equipment is maintained at the Durham VA for use by the residents and fellows. The practice surgical suite includes an EyeSi surgical simulator in additional to two surgical stations and ample supplies. Residents undergo training with a structured wet lab curriculum prior to performing live surgery.