PGY-3 Goals & Objectives

PGY-3 Goals & Objectives

(In addition to PGY·2 Level goals)

 

1)  Medical Knowledge

Fundamentals:  to describe and demonstrate understanding of:

  • Advanced retinal anatomy and physiology

Diagnostic Studies:  to describe the principles behind and indications for:

        o   fluorescein/indocyanine green (ICG) angiography as applied to retinal vascular and other diseases (e.g., phases of the angiogram, indications)

                    o   ocular coherence tomography

                    o   8-scan ultrasonography

                    o   basic electrophysiological tests (e.g., electroretinogram [ERG], electro-oculogram [EOG], visual evoked potential (VEP), dark adaptation).

Peripheral Retinal Disease: to describe and demonstrate basic understanding of the signs of and treatment for:

  • peripheral retinal disease and vitreous pathology (e.g., vitreous hemorrhage, retinal breaks).
  • peripheral retinal degenerations:  lattice degeneration, pavingstone degeneration and indications for prophylactic treatment
  • various types of retinal detachment (e.g., exudative, rhegmatogenous, tractional)
  • retinoschisis (e.g. juvenile, senile)
  • choroidal detachment

Macular Disease:  to describe and demonstrate basic understanding of the signs of and treatment for:

o   age-related macular edema

o   Choroidal neovascularization (e.g., ARMD, histoplasmosis)

o   High myopia

o   Macular dystrophies

o   Macular pucker (e.g., epiretinal membrane)

o   Macular holes

o   Cystoid macular edema

o   Central serous Choroidopathy (retinopathy)

o   Optic pit and secondary serous detachment

o   Parafoveal telangiectasia

Retinal Inflammatory Diseases: to describe and demonstrate basic understanding of the signs of and treatment for:

  • Serpiginous Choroidopathy
  • AMPPE
  • Birdshot Choroidopathy
  • PIC
  • Multifocal choroiditis
  • Retinal vasculitis

   Retinal Infectious Diseases: to describe and demonstrate basic understanding of the signs of and treatment for:

o   ARN

o   Toxoplasmosis

o   Acute Bacterial Endophthalmitis

o   Fungal Endophthalmitis

o   Syphilis

Hereditary Retinal and Choroidal Diseases: to describe and demonstrate basic understanding of the signs of and treatment for:

  • Gyrate atrophy
  • Choroideremia
  • Retinitis pigmentosa
  • Cone dystrophies
  • Stargardt's disease
  • Best's disease
  • Congenital stationary night blindness

Hereditary Retinal and Choroidal Diseases: to describe and demonstrate basic understanding of the signs of and treatment for:

o   Phenothiazine

o   Hydroxychloroquine/chloroquine toxicity

                        o   Tamoxifen

Retinal Vascular Diseases: to describe and demonstrate basic understanding of the signs of and treatment for:

  • Arterial and venous obstructions
  • Diabetic retinopathy
  • Hypertensive retinopathy
  • Peripheral retinal vascular occlusive disease
  • Acquired retinal vascular diseases
  • Ocular ischemic syndrome
  • Sickle cell retinopathy

Principles of surgery: to describe indications for and complications of:

  • retinal detachment repair (e.g., pneumatic retinopexy, scleral buckling, vitrectomy).
  • surgical vitrectomy (e.g., mechanics, instruments, indications, and technique).
  • special vitreoretinal techniques
  • Macular hole repair
  • Epiretinal membrane peeling
  • Complex vitrectomy for proliferative vitreoretinopathy
  • Use of heavy liquids and intraocular gases (e.g., perfluorocarbons)
    • laser photocoagulation for conditions including
  • diabetic macular edema
  • diabetic retinal neovascularization
  • other causes of retinal neovascularization
  • retinal tears

Major studies in retinal diseases:  describe the findings of studies including:

  • Diabetic Retinopathy Study (DRS)
  • Early Treatment of Diabetic Retinopathy Study (ETDRS)
  • Macular Photocoagulation Study (MPS)
  • Diabetes Control and Complications Trial (DCCT)
  • o Branch Vein Occlusion Study (BVOS)
  • Central Vein Occlusion Study (CVOS)
  • Comparison of AMD Treatment Trials (CATT)
  • Standard Care Versus Corticosteroid for Retinal Vein Occlusion (SCORE)
  • Collaborative Ocular Melanoma Study (COMS)
  • Diabetic Retinopathy Vitrectomy Study (DRVS)
  • Endophthalmitis Vitrectomy Study (EVS)
  • Age-Related Eye Disease Study (AREDS)
  • Anti-VEGF Antibody for the Treatment of Predominantly Classic Choroidal
    • Neovascularization in AMD (ANCHOR)
  • Minimally classic/occult trial of the Anti-VEGF antibody Ranibizumab In the treatment of Neovascular AMD (MARINA)

 

2)  Patient Care:  To perform:

o   indirect ophthalmoscopy with scleral indentation

o   ophthalmoscopic examination with contact lenses, including pan-funduscopic lenses

o   interpretation of fluorescein and ICG angiography

o   interpretation of retinal imaging technology (e.g., ocular coherence tomography)

o   interpretation of basic ocular imaging techniques (e.g., B-scan echography, nerve fiber layer analysis)

o   fundus drawings of the retina, showing complex vitreoretinal relationships and findings

o   surgical assisting with scleral buckling

o   surgical assisting with vitrectomy