OPHU-4001 - Clinical Ophthalmology

OPHU-4001 - Clinical Ophthalmology

Elective Title: Clinical Ophthalmology
Course Number: OPHU-4001
Elective Type: clinical Duration/Weeks: 4 Max Enrollment: 2
Prerequisites: Successful completion of Year 2
Additional Requirements: Successful completion of Fam Med, Int Med or Surgery clerkships before you can enroll. Visiting students should submit a CV, USMLE scores & transcript to the course director to be considered for this elective. (1 student max for period 9)
Responsible Faculty Director: Aishat Adebayo, MD Periods Offered: 1-13 including holiday period 8 
Coordinator: Clarissa Mora & Rene Vela III Other Faculty: n/a
Location to Report on First Day:
Shayna Bell, University Eye Center, 2nd floor, Rm 2.220 409-747-5434 on Monday 8:30am on the first day of rotation.

The goals of the course are determined by the needs of each student. Emphasis may be placed on the type of eye problems likely to be encountered in the type of practice anticipated by the student, i.e., the student seeking Pediatrics may spend time in the Pediatric Eye Clinic, the future Neurologists will want to see nerve and field problems, and primary care doctors need to be exposed to the various common ophthalmological problems seen in a general practice.

1. Elicit and evaluate the history in a patient with ocular complaints (including those complaints that may signify systemic disease).
2. Perform a thorough eye examination (excluding refraction and sophisticated field testing).
3. Evaluate the common causes of red, inflamed eyes and be able to differentiate conjunctivitis, keratitis, uveitis, acute glaucoma, and foreign body trauma.
4. Evaluate and manage most types of minor ocular trauma (foreign bodies, minor lid lacerations, etc.), and recognize / initiate emergency measures for major eye trauma (e.g. hyphema, major lacerations of canaliculus or lid margin).

Description of course activities
Activities consist of rounds, one-on-one assignment to advanced resident or faculty for observation leading to participation in the clinic, observation of surgery in the O.R. Attendance to all lectures and conferences assigned to residents is required. In period 9 only, there will be 4 students allowedto enroll instead of 2.

Type of students who would benefit from the course
Students planning on a career in Ophthalmology, Internal Medicine, Pediatrics, Family Medicine, Neurology, Surgery and Emergency Medicine.

Weekly Schedule
  Clinical Activities (estimated schedule)  
Day of Week   AM   PM
Monday Clinic: 8:00 am Clinic: 5:00 pm
Tuesday Clinic: 8:00 am Clinic: 5:00 pm
Wednesday Lecture/Clinic 7:30 am Clinic: 5:00 pm
Thursday Clinic: 8:00 am Clinic: 5:00 pm
Friday Surgery 8:45 am Surgery: 5:00 pm

 Average number of patients seen per week: 30
 Call Schedule: No call required, optional if interested.

Research Activities (estimated schedule)
Activity Hours per Week
Faculty Contact-Time
Self-Directed Study

Method of Student Evaluation
1.  Clinical Observation
  A. Where are students observed on this elective?
    Inpatient Service   Ambulatory   Surgery   Standardized patients
Patients simulators   Other
  B. Frequency - How often are students observed clinically?
  C. Format - What method(s) are used to document the student's clinical performance?
    Daily oral feedback   End of period oral feedback   Written feedback

2.  Oral Presentation
  A. Audience - To whom does the student present?
    Dr. Aishat Adebayo and/or other faculty
  B. Frequency / Duration of Presentation(s)?
    1-2 hours weekly. Period 13 will accept one student and have limited faculty assignments due to Winter holiday break.
  C. Format - What guidelines are set for the student's presentation?
    Students review cases found in Case Studies for Ophthalmology, answer questions and present to faculty. Students are also asked to present a patient as well as a short presentation about the patient's diagnosis. All students are required to make a presentation at Grand Rounds for the residents and faculty one time at end of elective.
  D. Assessment - Who assesses the student's presentation performance?
    Self-assessment   Peer assessment   Faculty assessment
  E. Method of content selection
    Current cases  Student-selected topic   Assigned topic

3.  Written Assignment (H&P's, notes, papers, abstracts, etc.)
  A. Frequency of written assignment(s)?
  B. Format - What guidelines are set for the student's written work?
  C. Length of written assignment(s)?
    Abstract   Annotated bibliography   1 - 2 page paper   3+ page paper
  D. Are recent references required?   No    If yes, how are they selected?
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
  F. Audience - Who assesses the student's written performance?
    Peer Assessment     Faculty Assessment     Other

4.  Examination
    Oral   Written multiple choice   Written essay / short answer   OSCE

5.  Extra Course Activities
  What expectations do you have for the student to demonstrate participation in the elective (e.g. small group activities, seminars, thoughtful questions, providing resources, journal club, resident lecture attendance)?
    Students are to attend resident lectures (some begin at 7:30 am and others begin at 5:30 pm) and work with either Dr. Adebayo or assigned faculty. Participation in clinic or OR is documented by supervising resident or faculty signature. Interested students may attend a monthly journal club, but are not required to present articles.

6.  Additional Costs
  Please list any additional costs and/or purchases (books, materials, movies to watch, etc.) that are required for this course. Include an estimated total cost. If there are no additional costs, please enter "None".

7.  Other Modes of Evaluation
  Please explain below.
    Standard elective grade form completed by supervising faculty. There is no formal examination. Ophthalmic Objective checklist, patient logs of clinical and surgical cases seen in clinic/O.R., and patient presentations with faculty/residents. Grand Rounds presentation on the 4th Wednesday of the rotation with the assistance of faculty members and residents is required.

8.  If this course is an Acting Internship, please complete the following:
  A. Objectives for the AI should relate directly to the Entrustable Professional Activities (EPAs). Each AI should describe how the four key Year-4 EPAs that our school has identified as being Year-4 skills are assessed. The Year-4 objectives are:
1. Entering and discussing orders/prescriptions.
2. Give or receive patient handover to transition care responsibility.
3. Recognizing a patient requiring urgent or emergent care and initiating management.
4. Obtaining informed consent for tests and procedures.
Specify how the student will be given formative feedback on their clinical skills.

Year-4 students should demonstrate mastery of EPAs they developed in the clerkship year, including recommending and interpreting common diagnostic and screening tests, and performing general procedures of a physician. They should be able to demonstrate masterfully and independently skills they mastered in Years 2-3, including efficiently performing comprehensive admission-notes and succinct daily progress notes and perform accurate, concise, and hypothesis-driven clinical presentations, form clinical questions and retrieve evidence to advance patient care. They should be able to demonstrate basic understanding of and beginning mastery of collaborate as a member of the interprofessional team and identify system failures and contribute to a culture of safety improvement.

List advanced clinical skills that a student will be assured an opportunity to practice.

How specifically will this AI build on developing skills from the clerkship year to prepare students for internship?

What opportunities will typically be available to all students who take this AI (procedures, required presentations, etc.)? What opportunities may be available based on patient load/presentation or student initiative (ie. Writing a case report)?

An AI should have expectation of a minimum of 32 hours per week of clinical responsibilities. Duty hours should be capped at ACGME limits for an intern, thus up to 24 hours followed by 4 hours of activities related to patient safety, education, and handoff. Students cannot work more than 80 hours per week averaged over 4 weeks. They can only have 1 day off in a 7-day work week with 8 hours off between shifts.

Clinical responsibilities will vary depending on specialty, but how is the student functioning with work commensurate to a PGY1 with an appropriate level of training?

How is the student demonstrating drawing clinical conclusions and/or developing a management plan and documentation as an intern would do?

How and by whom will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?

Acting Internship students often seek letters of recommendation following their experience. How many different Faculty will work directly with the student and have knowledge of the student's abilities to detail in a written evaluation? Describe the degree of supervision and interaction with faculty vs. residents or other providers and how feedback will be obtained if more direct work is with residents or other providers.