PGY-2 Goals & Objectives

Medical Knowledge

  • To describe the basic anatomy, embryology, physiology, pathology, microbiology, immunology, genetics, epidemiology, and pharmacology of the cornea, conjunctiva, sclera, eyelids, lacrimal apparatus, and ocular adnexa.
  • To describe congenital abnormalities of the cornea, sclera, and globe (e.g., Peters’ anomaly,microphthalmos, birth trauma, buphthalmos).
  • To describe characteristic corneal and conjunctival degenerations (e.g., pterygium, pinguecula,Salzmann, senile plaques of the sclera, keratoconus).
  • To describe, recognize, and evaluate peripheral corneal thinning (e.g., inflammatory, degenerative, dellen-related, infectious, allergic).
  • To recognize the common corneal dystrophies and degenerations (e.g., map-dot-fingerprint dystrophy, Meesman’s dystrophy, Reiss-Buckler dystrophy, Francois dystrophy, Schnyder dystrophy, congenital hereditary stromal dystrophy, lattice dystrophy, granular dystrophy, macular dystrophy, congenital hereditary endothelial dystrophy, Fuchs’ dystrophy, posterior polymorphous dystrophy, Salzmann’s degeneration).
  • To recognize the common corneal inflammations and infections (e.g., herpes simplex, syphilis, interstitial keratitis).
  • To understand the fundamentals of corneal optics and refraction (e.g., keratoconus).
  • To describe the fundamentals of ocular microbiology and recognize corneal and conjunctival inflammations and infections (e.g., Staphylococcal hypersensitivity, simple microbial keratitis,simple conjunctivitis, trachoma, ophthalmia neonatorum, herpes zoster ophthalmicus, herpes simplex keratitis and conjunctivitis).
  • To recognize the basic presentations of ocular allergy (e.g., phlyctenules, seasonal hay fever, vernal conjunctivitis, allergic and atopic conjunctivitis, giant papillary conjunctivitis).
  • To recognize and treat lid margin disease (e.g., Staphylococcal blepharitis, meibomian gland dysfunction).
  • To describe the features of, diagnose, and treat (or refer) vitamin A deficiency (e.g., Bitot spots, dry eye, slowed dark adaptation) and neurotrophic corneal disease.
  • To describe the basic differential diagnosis of the acute and chronic conjunctivitis or “red eye” (e.g., scleritis, episcleritis, conjunctivitis, orbital cellitus, gonococcal and chlamydial conjunctivitis).
  • To describe the basic mechanisms of traumatic and toxic injury to the anterior segment (e.g., alkali burn, lid laceration, orbital fracture, etc.).
  • To understand the mechanisms of ocular immunology and recognize the external manifestations of anterior segment inflammation (e.g., red eye associated with acute and chronic iritis).
  • To describe the basic principles of ocular pharmacology of anti-infective, anti-inflammatory and immune modulating agents (e.g., indications and contraindications for topical corticosteroids and antibiotics).
  • To recognize corneal lacerations (perforating and non-perforating), pterygia that may requiresurgery, corneal and conjunctival foreign bodies.
  • To diagnose and treat corneal exposure (e.g., lubrication, temporary tarsorrhaphy).
  • To describe the epidemiology, differential diagnosis, evaluation and management of common benign and malignant lid lesions, including pigmented lesions of the conjunctiva and lid (e.g., nevi, melanoma, primary acquired melanosis)
  • To describe the epidemiology, classification, pathology, indications for surgery, and prognosis of common malpositions of the eyelids (e.g., blepharoptosis, trichiasis, distichiasis, essential blepharospasm, entropion, ectropion) and understand their relationship to secondary diseases of the cornea and conjunctiva (e.g., exposure keratopathy).
  • To recognize and describe the treatment for a chemical burn (e.g., types of agents, medical therapy). 
  • To describe the etiologies and treatment of superficial punctate keratitis (e.g., dry eye, Thygeson’s superficial punctate keratopathy), blepharitis, toxicity, ultraviolet photokeratopathy, contact lens related).
  • To describe the symptoms and signs, testing and evaluation for, and treatment of exposure keratopathy and dry eye (e.g., Schirmer testing).
  • To recognize the anterior segment manifestations of systemic disease (e.g., Wilson’s disease) and pharmacologic side effects (e.g., amiodarone vortex keratopathy).
  • To recognize, list the differential diagnosis, and evaluate aniridia and other developmental anterior segment abnormalities (e.g., Axenfeld’s, Rieger’s, Peters’ anomalies and related syndromes).
  • To understand the surgical indications (e.g., Fuchs’ dystrophy, aphakic/pseudophakic bullous keratopathy), surgical techniques, and recognition and management of postoperative complications (especially immunologically-mediated rejection) of corneal transplantation (e.g, penetrating, lamellar). 
     

Patient Care

  • To perform external examination (illuminated and magnified) and slit lamp biomicroscopy, including drawing of anterior segment findings.
  • To administer topical anesthesia, as well as special topical stains of the cornea (e.g., fluorescein dye and Rose Bengal).
  • To perform simple tests for dry eye (e.g., Schirmer test).
  • To perform punctal occlusion (temporary or permanent) or insert plugs.
  • To perform simple corneal sensation testing (e.g., cotton tip swab).
  • To perform tonometry (e.g., applanation, tonopen, Schiotz, pneumotonometry).
  • To perform techniques of sampling for viral, bacterial, fungal, and protozoal ocular infections (e.g., corneal scraping and appropriate culture techniques).
  • To manage corneal epithelial defects (e.g., pressure patching and bandage contact lenses).
  • To perform removal of a conjunctival or corneal foreign body (e.g, rust ring).
  • To perform epilation.
     

 

Professionalism

  • To treat patients with respect and compassion at all times
  • To treat clinical and administrative staff with respect
  • To treat medical students with respect and strive to create an atmosphere conducive to education
  • To arrive on-time for clinical experiences
  • To prepare in advance for surgical experiences
  • To work to become part of the clinical team
    • To work with the faculty, staff, fellow and other residents on the service to determine your responsibilities
    • To remain flexible and offer to help out with the responsibilities of others when you can
  • To remain visible and available to participate in clinical care throughout the clinical session. If you leave the clinical care area make sure that other members of the service know where you are and why
  • answer your pager within 10 minutes of being paged.
 

Interpersonal and communication skills

  • To communicate your name and role on the service to patients and their families.
    • "Hello, I'm Dr. Resident, I'm a resident working with Dr. Attending today."
  • To present patients to the attending in a succinct but complete way
  • To maintain timely and legible medical records
  • To talk when you should be talking, listen when you should be listening
 

Practice-based learning and improvement

  • To learn to recognize feedback from faculty, fellows, fellow residents, patients and students
  • To accept that feedback constructively and work to improve based on it
  • To accept your role as a teacher as well as a learner. Work to educate students, fellow residents, faculty, staff and patients
 

Systems based practice

  • To work for the benefit of your patients to communicate with other health care provider
  • To act as an advocate for your patient within the health care system
  • To become aware of the costs of diagnostic and therapeutic interventions. Consider these costs as you recommend and prescribe these interventions.