Mission

The mission of the SAUSHEC Ophthalmology Program is to provide the clinical and surgical experience, educational resources, and mentorship support that produces exceptional, compassionate ophthalmologists capable of providing care globally in an austere environment or military treatment facility and to have a positive influence on anyone that encounters our program.

Vision

To graduate residents that are well trained to provide the full spectrum of ophthalmic care for patients in the MTF and beyond. Additionally, it is our goal to train and develop military officers who understand the importance of military readiness and the unique aspects of military medicine.

Aims

• Produce competent and compassionate physicians who will be leaders in Ophthalmology.
• Educate residents on providing ophthalmic care globally, including austere environments.
• Promote excellence in the delivery of safe, equitable, affordable, and quality care.
• Serve as role models to the community for the promotion of wellness and lifelong learning.

Residents participate in joint lectures with University of Texas Health San Antonio approximately four hours a week. Each Friday morning is set aside for Grand Rounds and interactive lectures with UT, followed by Morbidity and Mortality (M&M) conference. Each month is dedicated to a different subspecialty. During this month, there is a subspecialty day in which surgical techniques are taught in a wet lab. There is also a service specific journal club once a month.

There are no elective rotations in our residency.

Post Graduate Year (PGY)-2 residents take primary home call every 6th night. PGY-4 residents back up the PGY-2 and take home call every 6th night. PGY-3 residents take primary home call each Thursday night, which works out to one call night every 6th week.

Training at the DOD's only Level 1 Trauma and Burn center, our residents are uniquely equipped to manage complex ophthalmic trauma. Further, our residents graduate with the highest refractive surgery numbers in the country. These surgeries are highly relevant to military readiness and maintaining the fighting force. In addition, one academic month is set aside for military specific curricula. Lecture topics include deployment ophthalmology, leadership, how to run a clinic, humanitarian missions, and off duty employment. Finally, our senior residents are given the opportunity to attend a surgical readiness mission- where they hone their surgical skills while providing a service to the host nation. Previous mission locations include Panama, Haiti, Honduras, Guatemala, and the Dominican Republic.

• PGY-2 residents: complete the Columbia Basic Science Course, a one month review course in New York City
• PGY-3 residents: complete the “Cataract Surgery Telling It Like it Is” course in Florida as well as the Ocular Trauma Lab in Maryland
• PGY-4 residents: attend the American Academy of Ophthalmology (AAO) annual meeting and participate in a trauma lab, location site varies

Cataract Simulation

• Eyesi Ocular Surgical Trainer – residents must complete the entire training program prior to starting cataract surgery
• Artificial Eyes – used to practice various techniques such as incision, capsulorhexis, hydro dissection, lens removal, lens placement, and suturing

Oculoplastic Surgery Simulation

• Cadaver Tissue at Orbital Dissection Course (ODC) – annual course held in August. This course has a combination of didactic training with afternoon wet labs on cadaveric tissue. Residents get the opportunity to review anatomy and practice skills such as suturing, flap creation, dissection, enucleation, evisceration, laceration repair, and fracture management
• Lateral canthotomy/cantholysis (LCC) Training System – models used to simulate retrobulbar hemorrhage requiring LCC

Open Globe Injury

• LCC Training System – as above

Ophthalmology Skills

• Eyesi Ocular Surgical Trainer – as above

Orbital Hematoma/Hemorrhage

• LCC Training System, Cadaver Tissue at ODC- as above

Perform Tarsorrhaphy, enucleation, evisceration, canthotomy/cantholysis

• Actual practice –Ocular Trauma Course – annual course held at Uniformed Services University in Bethesda that our 2nd year residents attend. This is a week-long course that is similar to the annual ODC. This is a Tri-service course where the residents receive lectures from all the ophthalmology subspecialties and perform wet labs on simulators and tissue models. This course is also attended by ophthalmology staff that are preparing for deployment, and by other residency programs in the Bethesda area
• Cadaver training at ODC, LCC training systems – as above

Perform Refractive Surgery: LASIK, PRK, and SMILE

• Laser Suite– residents are able to practice refractive surgery on artificial eyes

Perform Manual Small Incision Cataract Surgery and Minimally Invasive Glaucoma Surgery

• Katena Anterior chamber simulators

• Repair Eyelid Laceration

• Actual practice; Ocular Trauma Course; cadaver tissue at ODC

Leadership is an important quality in our graduating residents and is thus discussed and emphasized throughout residency. Leadership concepts are taught specifically during our military unique curriculum, and optional leadership reading materials are available to our residents. There are opportunities for residents to hold leadership positions within our program (chief resident), as well as within SAUSHEC GME (house staff officer, resident membership on all GME subcommittees, etc.). Our program has also been successful in sponsoring and supporting our residents in national leadership positions to include American Academy of Ophthalmology (AAO) and American Board of Ophthalmology (ABO) resident leadership positions.

Our residents have access to ample research opportunities and funding. Residents are required to complete two research projects during residency. One must be an Institutionally approved project, the other may be a Quality Improvement Patient Safety (QIPS) project. Residents present these projects at our annual regional research day and are encouraged to submit them to national conferences.

Residents participate in helping to improve the health care system for our patients. Residents are educated in quality improvement and patient safety (QIPS) principles through the completion of the SAUSHEC Ophthalmology QIPS core curriculum.

SAUSHEC Ophthalmology Residency focuses on developing future military leaders through mentoring and modeling. Funding is available for residents to attend at least one professional conference during residency when presenting a scholarly activity. Residents have given national lectures, research podium presentations, held national leadership board positions, and taught procedural courses at American Academy of Ophthalmology (AAO), American Society of Ophthalmic Plastic & Reconstructive Surgery (ASOPRS), American Society of Cataract and Refractive Surgery (ASCRS), North American Neuro-ophthalmology Society (NANOS), Association of University Professors in Ophthalmology (AUPO) and Association for Research & Vision in Ophthalmology (ARVO).

• Brooke Army Medical Center – San Antonio, Texas
• Wilford Hall Ambulatory Surgical Center – San Antonio, Texas
• University of Texas Heath – San Antonio, Texas
• Audie L. Murphy Veterans’ Administration Hospital – San Antonio, Texas
• MD Anderson Cancer Center – Houston Texas

Our program offers rotations to third-year and fourth-year medical students. Rotations are typically four weeks (one block) long and include exposure to acute care, trauma, subspecialty clinics, and the operating room. Students also participate with the residents in academics, labs, and simulation time. Fourth-year students applying to Ophthalmology have the option to complete a second rotation focusing on research. Students interested in rotating with our program should contact dha.jbsa.brooke-amc.list.saushec-ophthal@health.mil and follow guidance through SAUSHEC Graduate Medical Education regarding rotation logistics.

If you would like to schedule an interview with our program, please contact dha.jbsa.brooke-amc.list.saushec-ophthal@health.mil.

Program graduates take the American Board of Ophthalmology (ABO) written examination and oral exam. These exams are offered annually. To become fully board certified, applicants are eligible to take board certification exam 3 months following graduation. Applicants who pass the written board are eligible to sit for the oral board. Board eligibility is described on the ABO website. Graduates remain board eligible for up to seven years following completion of the residency.

Our program hosts rotators from medical schools, physician assistant schools, interns, and residents from other services. Residents are the primary teachers for these rotators.

Residents offered opportunity to teach courses and local, regional, national, and international conferences including ophthalmic trauma, emergency eye care, ophthalmic procedures, grand rounds case presentations, and morbidity and mortality surgical cases.

• Ophthalmic Plastic and Reconstructive Surgery
• Vitreo-Retinal Surgery
• Cornea/Refractive
• Pediatric
• Neuro
• Glaucoma
• Pathology
• Global

Residents are assigned or can choose a staff mentor. This mentorship lasts throughout the entire residency. Mentors and mentees meet quarterly, or more often if needed. Topics of discussion include academic and surgical progress, personal and career goals, and research.

• Resident well-being is a high priority in our department. Well-being activities include:
• Annual resident retreat (off site)
• 5th Friday Resident Wellness Days (team building activities)
• Annual Face Race (5k/10k/half marathon) for Ophthalmology, Otolaryngology, and Oral Maxillofacial departments
• Optional participation in Wellness Committee geared at optimizing program wellness and involvement with hospital-wide peer wellness and support groups
• Frequent off duty social gatherings and celebrations