Each residency program is organized differently but follows the general ophthalmology training guidelines outlined by the Residency Review Committee (RRC) of the Accreditation Council for Graduate Medical Eduction (ACGME). Most programs rotate residents among hospitals and services, mixing comprehensive clinical and surgical experience with subspecialty experience. Adequate instruction and clinical experience should be available in all subspecialties of ophthalmology.
Although identical accreditation requirements exist for all programs, there are structural differences among them. Some programs use hospitals remote from the primary training hospitals for some of the residency experience; other do not. Some programs send their residents to regional basic science courses; others provide the instruction internally. In some programs, instruction and surgical staffing are provided almost exclusively by full-time faculty, while others rely heavily on volunteer clinical faculty.
All training programs will have regularly scheduled didactic instruction in the basic and clinical sciences, including an exposure to ophthalmic pathology. Try to assess some of the less-tangible aspects of teaching. Is the faculty accessible to residents? Is the program weak in a particular subspecialty, and if so, is any attempt being made to compensate for weakness in the program, such as through guest lectures? Some programs use concentrated extramural basic science courses to supplement their own intramural lecture series.
An accredited residency program provides a reasonable balance between clinical experience and didactic instruction. The clinical component will include both supervised medical and surgical experiences. Each resident will participate in a clinical rotation schedule that includes primary responsibility for patient care and provides access to adequate examination facilities. The program should be organized to provide a stable, well-coordinated, progressive educational experience for the resident, in addition to providing high-quality health care to patients.
Surgical experience will include opportunities to work both as an assistant and as first surgeon and provides exposure to surgical procedures for a wide range of ocular conditions, such as cataract, strabismus, glaucoma, retina-vitreous and oculoplastic problems.
Residents should perform not only an adequate number of surgical procedures, but an appropriate variety of procedures. All resident performance should be adequately supervised both in the clinic and the operating room. At the same time, there should be sufficient resident responsibility to allow for growth and maturation of clinical and surgical skills.
The training of post-residency fellows may have an impact on a resident's surgical and clinical experience. The presence of fellows can be either beneficial or detrimental, depending on how their privileges and responsibilities affect residency training.
The research opportunities in ophthalmology training programs vary considerably, as do the research interests of residency applicants. If you are potentially interested in research, carefully investigate the research opportunities offered by the training program. Factors to consider include the availability of faculty, funds, space, equipment and research time.
Remember, however, that the primary purpose of residency training in ophthalmology is to produce a superbly trained clinical ophthalmologist who is prepared for a life-long education. Within that context, it is difficult to pursue intensive clinical or basic investigations; such activities may be carried out more profitably during the fellowship years.
Investigate the location of all clinical and teaching facilities associated with the program. Ideally, primary patient care facilities should be within reasonable distance of the academic department, and affiliated institutions should not be too far from the parent institution unless they provide equivalent educational opportunities with appropriate supervision.
In addition to the criteria discussed above, consider some less-tangible aspects of residency programs. With the large number of high-quality ophthalmic training programs available, these aspects may be important to your decision. Perhaps most important is the overall satisfaction and happiness of current residents. Are they pleased with the quality of their training? What are their long-term career goals? Do those residents who apply for fellowship training secure positions in the programs of their choice? Is there good resident/resident and resident/faculty interaction? Also consider the location of the medical center, the availability of cultural and recreational opportunities and the physical safety of the area.
To register for the SF Matching Program, complete the registration form and electronically submit it on the SF Match Web site. After completing the form and paying the appropriate registration fee online, you will be given online access to complete the CAS application.
The SF Match Web site also offers a listing of ophthalmology fellowships. Most of the fellowships are for clinical training after completion of your residency. A few fellowships will also consider pre-residency applicants, or research fellows who may not have a clinical license in the United States.
With few exceptions, all ophthalmology fellowships are filled through the Ophthalmology Fellowship Match, which is conducted in December, seven months before the start of the fellowship in July.