We welcome this opportunity to introduce the Department of Ophthalmology and Visual Sciences of Texas Tech University Health Sciences Center. The selection of a postgraduate program has a lifelong impact on your career, and we believe that faculty, patient diversity, the basic science and clinical curriculum, and the available facilities are all important factors to consider. We hope this material will better enable you to make this important choice.
Our mission is threefold: to deliver unsurpassed patient care, to pursue excellence in research, and to provide outstanding research and clinical training opportunities for future generations of our colleagues. Our faculty and staff are dedicated to excellence, and through that commitment, we have entered a period of steady growth, represented by new faculty and expanding educational opportunities.
Founded in 1972, our clinic serves a diverse population of patients representing the entire range of ophthalmic pathology -- a key ingredient of any ophthalmology training program. With referrals from all regions of West Texas, Eastern New Mexico, Southern Colorado, and Western Oklahoma, our clinical practice serves more than 25,000 patients annually. Our outpatient clinics are the cornerstone of the teaching program and are operated with emphasis on quality care and the philosophy that all patient encounters are part of the educational experience.
Our basic science research programs have established solid track records in developing well-funded and clinically relevant research. The Ocular Cell Biology Laboratory, opened in 1990, has a significant reputation in cell growth modification, including enhancement and inhibition. Our cellular biologist is working with major ophthalmic pharmaceutical and biotechnology companies, and the electrophysics unit is recognized as one of the finest in the country.
The vast majority of our clinics are staffed by full-time faculty physicians. Additionally, clinical faculty members in private practice and from the medical school conduct clinics and provide lectures regularly. Residents rotate among the various subspecialty services, and evaluations of residents and faculty members are completed after each rotation.
The department's basic science program has grown considerably to include highly respected researchers in broad areas of expertise, such as electrophysiology, visual psychophysics, cell growth acceleration and inhibition, and dynamic measurement of accommodation.
In addition to resident participation at an external basic science Course, full-time and visiting faculty members present a full range of lectures in the basic and clinical sciences.
VA Hospital Experience
Rotations to the Veterans' Administration Medical Center Hospital in Big Spring, Texas, provide each resident with experience in treating a large number and wide variety of ocular pathologies. Clinical instruction is provided by full and part-time clinical faculty.
Residents have the opportunity to work with physicians who are fellowship trained in every major ophthalmic subspecialty. Extensive training and experience in the interpretation of fluorescein angiograms and the diagnosis and treatment of medical retina disorders are integral parts of the program. Residents rotate on the neuro-ophthalmology, low vision, and contact lens services during their first year. Second year rotations include oculoplastics and pediatric ophthalmology, where residents are exposed to a full range of medical and surgical pathology. Extensive experience in surgical and non-surgical management of strabismus is obtained, and the pediatric eye exam and management of amblyopia is emphasized throughout all three years of training. Third year rotations focus on the medical and surgical management of patients with glaucoma, cataract and other anterior segment disorders, and vitreroetinal disorders.
Residents participate in a large variety of surgical cases. A surgical laboratory is conveniently located in our facility and is equipped for microsurgery, including phacoemulsification and corneal and vitreoretinal surgery. Graded surgical exposure insures that each resident develops confidence in treating disorders commonly encountered by the general ophthalmologist.
The Business of Medicine
The Department recognizes the need to offer our residents the opportunity, in addition to their clinical training, to explore and gain exposure to the business of medicine.Periodic interactive lectures and discussions are offered on the topics such as:
- Establishing/Selecting Practice Opportunities
- Practice Operations Overview
- Managed Care Overview
- Documentation and Coding Issues
- Practice Accounting & Finance
- Human Resource Management
- Contract Evaluation and Negotiations
.......and other contemporary topics.
To develop the necessary ophthalmology clinical skills for diagnosing and managing basic inpatient and outpatient ophthalmic problems, as well as developing research skills in clinical and/or basic science areas relating to ophthalmology.
- Complete the Ophthalmic Pathology rotation.
- Begin work on the American Academy of Ophthalmology‘s Basic and Clinical Science Course.
- Identify subject material for publication
- Make presentations at conferences, including monthly grand rounds.
- Take call on a rotational basis.
- Develop clinical diagnostic skills.
- Refraction techniques
- Slit-lamp examination techniques
- Indirect and direct ophthalmoscopy
- Interpretation of fluorescein angiograms
During the PGY-2 year, residents will work in the department‘s outpatient clinic under the supervision of faculty physicians and senior residents. Responsibilities will increase as clinical skills advance.During this first year, residents are expected to begin clinical or basic research projects, attend conferences and training sessions to promote development of clinical skills, and receive their introduction to surgery.
To develop increasing independence in the performance of examinations and procedures.
- Continue work on the American Academy of Ophthalmology‘s Basic and Clinical Science Course.
- Serve on rotations at the Veterans Administration Medical Center in Big Spring, Texas.
- Assist medical students, PGY-2 ophthalmology residents, and residents on electives from other departments.
- Serve as back-up call for PGY-2 residents on a rotational basis.
- Prepare manuscript for publication.
- Surgical skills
- Clinical skills
- Teaching skills
- Leadership skills
During this year, residents will assume greater responsibility in the day-to-day operation of the clinic by maintaining a sustained level of involvement with patients, medical students, primary care residents, and allied health personnel. Also during this year, residents are expected to increase their learning efficiency, as well as research and presentation skills. Surgery participation will also increase.
To achieve the clinical and surgical competence necessary for the independent practice of comprehensive ophthalmology.
- Complete the American Academy of Ophthalmology‘s Basic and Clinical Science Course.
- Continue to serve on rotations at the VA Medical Center in Big Spring, Texas.
- Achieve a high level of clinical and surgical competence.
- Assume increased leadership role in training medical students, other residents, and technicians.
- Organize and participate in conferences.
- Assist medical students, PGY-2 and PGY-3 ophthalmology residents, and residents on electives from other departments.
- Submit manuscript for publication.
- Surgical skills
- Independent decision making
- Teaching skills
- Investigative and presentation skills
- Leadership skills
Responsibilities during the PGY-4 year will approach those of a full staff physician, and surgical experience will be a major part of the year‘s development. By the end of residency training, physicians should be confident, competent, and highly ethical comprehensive ophthalmologists with a sufficiently strong clinical foundation to enter practice or to proceed with further training in academics for those who have an interest in subspecialty, teaching, or research careers.
Extending service beyond medical education programs are the Great Plains Lions Eye Bank, and the Laser Vision Institute.
The Great Plains Lions Eye Bank is a non-profit corporation supported by the Lions Clubs of District 2-T-2. Its mission is to obtain quality tissue for patients suffering from corneal blindness, to develop educational programs promoting donor awareness, to support health professionals and donor families in the donation process and to promote research for the prevention of blindness.
The Laser Vision Institute offers the opportunity for gaining experience in refractive and excimer laser surgery. Currently, a number of clinical faculty are performing LASIK, PRK, and LASEK at our Laser Center, which owns the latest scanning and active tracking laser - the LADARVision 4000 by Alcon, Autonomous and Summit. We are committed to the concept that excimer laser refractive surgery should be a core portion of the comprehensive ophthalmologist training program. Our senior residents generally performs hands-on PRK and LASIK - often reserved for fellows in many other programs.
Our Basic Science Research laboratories provide research opportunities for postdoctoral fellows, residents, and medical students. In addition, research opportunities are also available for students pursuing graduate degrees in basic or applied sciences at Texas Tech University or Texas Tech University Health Sciences Center. Our electrophysiology and visual psychophysics laboratory offers research opportunities to study patients with rare eye diseases. Those involved in our ocular cell biology laboratory currently investigate factors involved in cell growth, glaucoma, and retinal degeneration. The goals of these programs are to understand the pathophysiological processes involved in various ocular disorders and to develop new therapeutic agents.
Questions Often Asked by Resident Applicants and answers by Dr. David McCartney, M.D., Chairman
Over the years, resident applicants have asked many penetrating and perceptive questions. We have collated those questions and added a few we think applicants should be asking as well. While our residency training program has had remarkable stability for many years, the answers given below should be understood to be descriptive of our current status and our plans for the future, but do not constitute an obligation or warranty.
A: Faculty availability/supervision
The availability of our faculty for supervision and the tremendous amount of one-on-one teaching by faculty members is a unique feature of our program. During surgery, your faculty mentor will be an experienced, usually subspecialty trained, senior faculty member, not simply a more senior resident. We believe this high quality of faculty staffing, combined with our superior surgical numbers (for cataract surgery>98th percentile in 2016 by RRC resident surgery log database) translates to outstanding clinical and surgical training in general comprehensive ophthalmology.
Faculty and resident cohesiveness
We make a conscious effort to choose faculty members and residents who are team players and who get along well with peers in addition to having outstanding academic and clinical qualifications.We take a degree of pride in cultivating a friendly work atmosphere, knowing that this contributes to promoting an optimal educational experience. Residents have mentioned that they feel that department faculty stability is directly related to the stability and length of tenure (over 22 years) of our chair's office.
Optimal Patient Mix
Another important advantage of our program is our patient mix which is extraordinarily well-matched to the type of patients and diseases you will likely practice with the rest of your career. Many residency programs rely almost exclusively upon clinic populations who differ substantially in socioeconomic and educational parameters from the populations those individuals will provide care to following completion of the residency training program. Such training is less likely to prepare them as well for dealing with a predominately private patient population. Here at Texas Tech, a remarkably large proportion of our patient population for whom the residents have primary responsibility will be "private" by socioeconomic and educational measures, further enhancing your education as a physician.
A: The Residency Review Committee (RRC) of the Accreditation Counsel on Graduate Medical Education (ACGME) fully accredited our program most recently in 2017.
A: Extremely well. University Medical Center Hospital and the VA Medical Center in Big Spring possess the latest Alcon Centurion phacoemulsification units with all options which allow incision sizes as small as 2.2mm. We also have a microsurgery and phacoemulsification laboratory here at the parent institution. Resident access to this laboratory is 24/7.
A: We have 2 simulators available. One EyeSi anterior segment unit that is based in the Big Spring campus and one EyeSi anterior segment and posterior segment unit that is available 24/7 in the Sim Life Center at the Lubbock campus. While there is no present surgical simulation equipment available for the simulation of extraocular surgery, the commercially available system for intraocular surgery has been documented to enhance the surgical skills in a safe practice environment. We believe such laboratory enhancement will also increase the efficiency of our residents in the human operating room, allowing them to potentially increase their case load even further than our already very high numbers.
A: Below is the most recent information from the RRC database which shows our overall surgical experience to be at the 91th percentile of programs nationally.
A: Our clinics at Texas Tech are arranged in a modified blocked schedule around our subspecialty faculty. A typical clinic would be the Cornea / External Disease and Anterior Segment Clinic staffed by Dr. McCartney which generally has two or three residents, and we typically see from 18-28 patients per half day. This generally means that each resident, depending upon level, will see between 4 and 10 patients per half day.
A: PGY-3 and PGY-4 residents spend a total of approximately three months in each year at the VA Medical Center in Big Spring, divided into two rotations of six weeks each..
A: Not presently, and there are no plans to add a fellowship program. The faculty of the department remains committed to resident education as our primary educational mission.
A: Not unless the American Board of Ophthalmology requires four years for "board eligibility".
A: After a five-year planning process, our program was approved by the Residency Review Committee to increase from three to four entering residents per year in June 2015. We have no plans to expand the program further in the foreseeable future. The current four residents per year size is an optimal balance for resident surgical experience, call responsibility, duties, and our physical facilities.
A: The performance of our alumni can be measured in several ways:
On average, one-third of our residents desire and acquire a competitive fellowship. During the last ten years, we have had fellows train at academic institutions in Boston, Portland, Omaha, Philadelphia, Morgantown, Montreal, Los Angeles, Dallas, Salt Lake City, New York City, Atlanta, New Orleans and Albany.
Confidence of practice
It is somewhat remarkable that about two-thirds of our graduates do not choose to do a fellowship. I believe this provides clear evidence of the confidence our alumni feel about practicing general comprehensive ophthalmology once they have finished their training at Texas Tech.
A: Yes. We have an informal relationship with the internal medicine program which runs an outstanding straight medicine PGY-1 year. Doing your PGY-1 year here is not required, but is encouraged, in part because doing so would permit you to spend one month of elective time on the ophthalmology service, getting a head start on your residency. For this program, you must apply through ERAS.
Resident Coordinator - Department of Internal Medicine
A: Our program adheres to the A.U.P.O. and O.M.P. policy that residency programs will not initiate contact after the interview with applicants. If you as an applicant initiate contact, we are certainly free to return your phone call and are very willing to provide you with some feedback on your standing following the ranking. We will finalize our match list by the first week of January and should you have any questions regarding your standing, you may contact the residency program director, Dr. Mitchell, at any time.
A. Presently, we provide a $2,000 professional development fund for each incoming resident.The professional development allowance is available to fund professional travel, professional supplies, such as examination lenses and/or loops, and can be used for moving expenses as well.
A: The patient care needs for physician directed eye care will continue to increase
with our aging population. Despite manipulations of the delivery system by bureaucrats,
managers, and industry there will continue to be a significant need for quality, caring,
comprehensive ophthalmologists. This belief fuels our desire to provide you with the
most comprehensive clinical training and the maximum opportunity to compete for access
to patients, which will ultimately be based upon your training, abilities, clinical
outcomes, and efficiency of practice. We have made a conscious, collective effort
to incorporate these end goal realities into our curriculum.
In the Fall of 2000, the above beliefs were officially acknowledged in a presentation by an AMA Task Force on Physician Manpower. For the first time in nearly a decade, a large and leading organization took the position that we were facing a shortage in specialties broadly, including ophthalmology, in the next five to ten years. Further, in the summer of 2003, the Council on Graduate Medical Education reversed its historic 25 year stance against expanding the physician manpower pool at the medical school or graduate medical education level. The ACGME is now calling for expanded graduate medical education noting that the demographics now strongly suggest that we will have a physician undersupply.
A: Our residents tend to practice medicine in Texas, the Midwest, and West, with the least number of residents choosing the Northeast for a practice location.
A: Each faculty member to date has made themselves available as a faculty mentor to assist and guide residents in research projects. Each resident is expected to complete either a case report or a research project. Funding is available through the individual faculty research program and/or from other departmental funds. Educational leave is available on a case-by-case basis for meeting presentations. Dedicated research time is scheduled on Friday mornings during the PGY-3, 4 years while you are on the VA rotation.
A: We are committed to the concept that excimer laser refractive surgery should be a core portion of comprehensive ophthalmologist training. Our residents gain hands-on primary surgeon experience (Class 1) with surface ablation and class 3 experience with advanced LASIK procedures.
A: The Department sponsors an annual reception for the alumni at the American Academy of Ophthalmology Annual Meeting and, through the vehicle of an annual newsletter and various ad hoc contacts throughout the year, keeps up with the activities of our alumni over time. Naturally, as with all programs, the Department will be responsible for the rest of your career for credentials verification and letters of recommendation and verification to your future employers, hospital affiliates, and insurance plan credentialing offices. In this fashion, the Department very much views our relationship in the long-term perspective. As well, numerous resident and faculty alumni have become philanthropic partners of the Department through their support and gifts to the Department's foundation accounts.
A: The Department strongly supports the need for quality resident family life, while recognizing that the individual needs of residents will vary significantly depending upon their own personal situation. Currently, after hours activities in which the residents commonly participate include the annual resident graduation dinner in June, after an informal picnic to welcome the new residents in early fall and the AAO reception plus various ad hoc events.
A: At least one additional question comes to mind. An important measure of the success of a residency training program is the morale of its residents and staff. Although there are occasional personality reasons why an individual resident might be unhappy, it is certainly worthwhile to poll as many residents as possible about their feelings regarding their educational experience. In this regard, we make every attempt to give you maximum contact with as many residents as possible. If you have any additional questions you would like to pose, please feel free to call us. We will make every attempt to put you in contact with as many residents as possible.
A: Resident comments emphasizing particular strengths of the program they feel warrant special attention include the following:
- Primary experience with retinal surgery including hands-on experience with anterior and core vitrectomies and retinal buckle surgery.
- All major subspecialties are covered by 1-2 attending faculty.
- Coordination of internship for a smooth transition from the PGY-1 to PGY-2 years is available. This option is available only for residents who also match for their internship with our Texas Tech Internal Medicine program. Over the years, we have coordinated an opportunity such that, typically, two spots (occasionally three) within the Medicine program are available for a PGY-1 position for our residents. The Internal Medicine Department concentrates on trying to offer their elective month late in the year so that the elective can be done in Ophthalmology and the residents can thereby get a head start in transitioning to their residency program. This is ideal when the elective is able to be scheduled in June or May.
- The program presently does not routinely schedule educational conferences or other responsibilities (aside from call) on Saturday or Sunday.
- Reasonable call schedule
- Ample vacation is provided by the institution
- PGY-2 15 working days
- PGY-3 20 working days
- PGY-4 20 working days
- Attendance at the Annual Meeting of the American Academy of Ophthalmology is encouraged as a PGY-4 (educational leave noted above).
- Attractive health, dental, optical insurance for residents and dependents.
- Affordable local housing-many residents actually purchase their home due to the very attractive housing market
- "Thank you to everyone involved in my training and that of future ophthalmology graduates. The impact of the clinical/surgical/moral lessons learned will stay with me forever. Matching at TTUHSC was life-changing!" - Dr. Hari Bodhireddy
- "Thank you very much for helping me complete my residency. I am really enjoying practicing ophthalmology." - Dr. Richard Wong
A: The latest match information is available at : http://sfmatch.org/
A: Periodically, an applicant asks me the question, "What are you looking for in an applicant?" While the program recognizes the obvious reason for asking such a question we are happy to be quite open about our preferences in the qualifications of applicants, as we are really not looking for statements for self testimony about such qualifications, but rather objective evidence from your established record. Among the qualifications we value most are the following:
- Demonstrated interest in something bigger and higher than one's own professional and economic interests
- A superior work ethic
- Superior clock speed and ability to think on one's feet
- A superior intellectual capacity as demonstrated by past performance
- An honest, inquiring mind
- A strong personal commitment to self-education
- The possession of a strong moral compass which can serve as the foundation for development of exemplary professional ethical standards
- Sufficient flexibility in interpersonal relationships to allow a strong team player attitude
- Positive attitude and winning personality
- Evidence of a commitment to serving a cause larger than self interest.
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