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Department of Ophthalmology & Visual Sciences

Residency Program : FAQs

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.

 

Q: What are some of the outstanding strengths of your program?

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>90th percentile by RRC resident surgery log database, most recent data) 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 feel this is an important feature of a training program since interpersonal conflicts can lead to a less than optimal learning experience. 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 17 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.

Brand new intramural in-house ocular pathology experience
This year the continued growth of our program has allowd us to recruit one of the most outstanding recently alumni, Dr. David Lewis, who completed an ophthalmic pathology fellowship with the revered Daniel M. Albert, M.D., M.S. The program strongly believes that this new intramural experience will stregthen the residents' understanding of pathological clinical conditions and should allow more extensive exposure to ocular pathology than our former external rotation.

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Q: What is the accreditation status of your program?

A: The Residency Review Committee (RRC) of the Accreditation Counsel on Graduate Medical Education (ACGME) fully accredited our program most recently on June 10, 2010, with our next visit expected May, 2013. We received a three year accreditation time period - a significant vote of confidence by the RRC. 

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Q: How well do the residents learn modern phacoemulsification cataract surgery?

A: Extremely well. University Medical Center Hospital and the VA Medical Center in Big Spring possess the latest Alcon Infinity phacoemulsification units with all options which allow incision sizes as small as 2mm. We also have an active phacoemulsification laboratory with 4 stations complete with Legacy 20000 or master 10000 Phaco units here at the parent institution. Resident access to this laboratory is 24/7 and tissue for educational and/or research use is available from our own in-house Eye Bank (as well as animal tissue from regional packing houses).

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Q: Does the program use surgical simulation as part of the surgical curriculum?

A: The program is in the process of integrating surgical simulation into our surgical training program. The VA Medical Center in Big Spring provides the latest dedicated ophthalmology surgical simulator from EyeSi, manufactured by VRmagic, for our residents while they are on their VA rotation in Big Spring, and we expect to acquire a second unit in Lubbock soon. 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.

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Q: What is the typical surgical load for graduating residents?

A: Below is the most recent information from the RRC database which shows our overall surgical experience to be at the 95th percentile of programs nationally.

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Q: Can you give me an idea of the typical resident rotation schedule and clinical load?

A: Our clinics at Texas Tech are arranged in a modified blocked schedule around our sub specialty 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.

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Q: Which rotations do residents complete outside of Lubbock?

A: PGY-3 and PGY-4 residents spend a total of approximately four months in each year at the VA Medical Center in Big Spring, divided into two rotations of two months each..

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Q: Do you have surgical fellows?

A: Not presently, and there are no plans to do so. The faculty of the department remains committed to resident education as our primary educational mission.

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Q: Are you going to a four-year program?

A: Not unless the American Board of Ophthalmology requires four years for "board eligibility".

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Q: Are you planning to change program size or number of residents?

A: Yes, we plan to increase to four residents per year. We currently have institutional approval and associated funding; however, we pan to coordinate this expansion with an expansion of faculty over the next 2-5 years in order to maintain our very favorable faculty to resident ratio.

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Q: How do your residents do once they leave your program?

A: The performance of our alumni can be measured in several ways:

Obtaining fellowships
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 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.

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Q: Are there possibilities for training at Texas Tech for my PGY-1 year?

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.

Contact :  Brandi McKinnon

                 Resident Coordinator

                 Department of Internal Medicine

                 806-743-3155 x 237

             

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Q: What changes do you foresee in your program during the next five years?

A: Residency Program Expansion

Given the remarkable growth of our teaching practice (as witnessed by our resident surgical numbers) and the manpower shortage within ophthalmology, we are moving forward with our plans for expansion of the residency to four residents per year. Working through the regulatory approval process will take some time and our time frame is not yet firmly established, but we are moving in this direction and have secured the necessary institutional financial support.

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Q: When does the interview committee decide upon its rank list and will I have any feedback from the committee regarding my standing after the interview?

A: Our program strictly 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 feel free to contact the residency program director, Dr. Mitchell, at any time.

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Q: Is there a moving allowance or professional development fund?

A. Presently, we offer a $500 moving allowance to incoming first-year residents whose move is greater than 100 miles. In addition, a $1400 Professional Development allowance is available to each resident for professional travel and professional supplies such as examination lenses and loupes

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Q: Is the job market for ophthalmologists in the United States promising?

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 in our training program.

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 CGME is now calling for expanded physician graduate medical education training positions, noting that the demographics now strongly suggest that we will have a physician undersupply, certainly by 2015, at the current rate of production. This is certainly welcome news to all those interested in a career in our beloved field.

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Q: Where do your alumni tend to practice after they complete the residency?

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.

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Q: What research opportunities and funding are available to residents?

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.

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Q: Do you train residents in refractive surgery?

A: Together with a number of clinical faculty performing lasik and advanced surface ablasions with our late model Alcon Excimer laser. We are committed to the concept that excimer laser refractive surgery should be a core portion of comprehensive ophthalmologist training. Our residents are some of the very few residents in the United states who get hands on primary surgeon experience (Class 1) with both PRK and Lasik-either conventional or CustomCornea as the patient needs and inclusion criteria allow. Any of our senior residents would be delighted to tell you of their personal experience in this regard.

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Q: What kind of long-term relationship does your department have with its alumni?

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.

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Q: How involved are the faculty with the residents in terms of extracurricular or social activities?

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, an informal picnic to welcome the new residents in September/October, the annual Christmas department-wide function, and various journal clubs occasionally done at noontime or after hours

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Q: Are there any questions you think I should ask in addition to the above?

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 your time permits.

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Q: What do your residents say about your program?

A: Resident comments emphasizing particular strengths of the program they feel warrant special attention include the following:

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Q: How competitive is the Ophthalmology Match Program?

A: The latest match information is available at : http://sfmatch.org/residency/ophthalmology/about_match/match_report.pdf

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Q: What qualifications would increase my chances of matching with Texas Tech?

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:

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