Helping Ophthalmology Residents Fall in Love
How the residency program at Wills Eye instils competence, confidence – and a life-long passion for the field
Tara A. Uhler, Laura J. Heinmiller, John Cropsey | | Longer Read
Whatever students and residents might think on the road to becoming an ophthalmologist, medical school and residency do not last long. As Director of the Ophthalmology Residency Program at Wills Eye, I have the privilege of working with people in just a snapshot of their time across the whole medical educational spectrum – from undergraduate medical education (UME), through graduate medical education (GME), to continuing medical education (CME). For residents, training is just the beginning of the next step of their journey.
After internship, there are only three years in which we have to provide both a solid foundation, and a springboard for life-long learning and skill acquisition. And that is both a challenge and an opportunity. A former resident likened residency to a trip to a theme park: there are so many rides and not enough time to ride them all as often as you’d like – a good analogy. The ability to meet that challenge and opportunity is the shared mission of any training program. To succeed, we need all parties engaged at every level – and we are incredibly fortunate to have that at Wills Eye, and in ophthalmology in general. We have eager trainees ready to soak up every minute of this time, and to take advantage of each experience; we also have a wide range of educators.
Applicants and advisors often ask what type of residents we want to train. More specifically, they ask what we hope our graduates will do. My answer: we want to equip residents to pursue whatever career they wish, and to do so with competence and confidence. Ophthalmology trainees are life-long learners – and they need to be; our field changes quickly, and people change throughout training and their careers.
What individuals want to achieve and specialize in, what technology and techniques are available, and howhealthcare is delivered will continually evolve throughout our lives. Of course, our training program cannot be everything to everyone, but we can provide the clinical and surgical foundation to support any career in eye care. We can provide the environment, opportunity, and introductions to support further future development and differentiation throughout the educational spectrum, across generations, and around the globe.
It is important to mention that we can only accomplish the above because of the incredible network of global, national and local organizations, and individuals that support us. The ophthalmology community is one huge collaboration of educators,
mentors, innovators, patients, staff, donors, and volunteers at institutions and organizations supporting eye training and eye health worldwide. Their individual and collective efforts allow us to provide all trainees with a solid foundation to pursue any career, including ones not yet imagined.
We all start out as pluripotent stem cells, and we should all retain the ability and need to adapt, evolve, and reinvent both ourselves and our profession as we develop. We hope our graduates use the foundation and opportunity they receive at the Wills Eye ophthalmology residency to fall in love with the field and their careers, over and over again.
We Are Family
By Laura J. Heinmiller
I feel very fortunate to have completed my residency at Wills Eye Hospital, having graduated with the 2013 class. From watching the giants in our field shape the standards of care, to seeing the most diverse and unexpected cases in our emergency room, I graduated with a quiet confidence that I, too, could manage the toughest, most challenging patients with grace and expertise. There
is no doubt that the education and experience you receive prepares you for your future – whatever path that may be. My co-residents have embarked on many different journeys from academia to private practice, to working with industry and creating their own hybrid models.
The Wills education doesn’t stop when you move on: I know I can always call on my mentors for a second opinion or advice, even halfway across the country. However, the best part of Wills goes well beyond medical education. For me, it is the personal relationships and valuing the role of the family. It is a place where the fact that I was pregnant while interviewing and again as a chief resident was celebrated. I wasn’t made to feel ashamed for wishing to grow my family. I remember interviewing at another program and asking about residents having children, to which one of the current residents replied, “We don’t really do that here,” which was a real eye-opener. Seeing Julia Haller, Kammi Gunton, Carol Shields and many other strong female role models thrive both as clinicians and mothers inspired me to follow my dream of having a large family, with five amazing
kids. They epitomize my belief that you can in fact “have it all and do it well.”
The people I met during my time at Wills remain some of my dearest friends today. These are deep, true friendships based upon a mutual effort and grind we put in to achieve our education and pursue our goals. Continuously working to cover for each other, juggling call schedules and clinic coverage, and always ending our days together in the clinic that was finishing last, ensuring no one left before all the work was completed. I suffered an unthinkable tragedy during my chief year at Wills, when my older brother suddenly passed away. I was immediately enveloped in support and allowed any and all flexibility to grieve. I never once felt alone.
The friendships started at Wills are so strong because they come from respect and sacrifice. In fact, they are so meaningful that I named a child after my dear co-resident Mila and am honored to be godmother to her child. It goes without saying that the education you receive at Wills is second to none, but the true magic lies in the sense of family, support and encouragement that is woven throughout the hospital.
A Safe Bet
By John Cropsey
How the Wills Eye training program prepared John Cropsey to set up an ophthalmic clinic in Sub-Saharan Africa
“I’ll bet you a thousand bucks, you’ll never move to Africa!” Those were the words of Bill Benson, retina specialist at Wills Eye, after asking me what I wanted to do with my life when I arrived for my first day on the Retina Service. My dream was to open an eye hospital in Sub-Saharan Africa that would be a center for training local eye care specialists. Wills had decided to roll the dice and take a chance on this crazy dreamer, and Benson felt the need to call my bluff, as he thought I had clearly hoodwinked the selection committee with a bit of snake oil. Over a decade later, here I am, working full-time in Africa, and not a day goes by that I don’t think of Benson and countless others who poured their lives into me at Wills Eye. The sky was the limit at Wills. If you were motivated, you could learn everything you wanted and needed from some of the best in the field, and have a total blast doing it.
I knew I would be seeing a lot of cancer in Africa, given my experience growing up at a mission hospital in Togo in West Africa. That’s why, any time I had a chance, I’d try to catch a surgery with Jerry and Carol Shields, but it was a bit like the story of Zaccheus, trying to catch a glimpse through the crowds. There was always a massive entourage of fellows and visiting doctors gathered round, and I was just a lowly resident. Miraculously, they would call me out of the crowd, have me scrub in with them and really let me get into the action. Today, our little eye clinic at Kibuye Hope Hospital in Burundi treats many patients with advanced cancer and provides the only retinoblastoma treatment center in the region with a population of 15 million. To this day, I write to Carol and Jerry Shields regularly for advice on tough cases.
On the other end of the spectrum, there is the bread and butter of eye care the world over, cataracts. Robert Bailey and Mark Blecher, the Directors of the Cataract Service, courageously allowed me to learn and then perform the first manual small incision cataract surgery (MSICS) at Wills. MSICS is the key to eliminating unnecessary blindness from cataracts in the world. Then there is the bane of glaucoma, a huge problem that I face daily. Last week alone I operated on four young people, ranging in age from seven months to 27 years old, all presenting with cup-to-disc ratios of 0.99, with pressures in the 50s and 60s. I was most thankful for the many trabs and tubes I got to do under the supervision of George Spaeth and Marlene Moster, to name just a couple of great glaucoma specialists at Wills.
What really gets my heart rate going is when I have to venture into the territory of other specialties – like ENT or neurosurgery – that don’t exist here. When I’m doing an optic nerve sheath fenestration or trying to get a CSF leak to stop, that’s when I’m thankful for spending time with unflappable, stonecold surgeons like Jurij Bilyk. Thanks to my training at Wills, Kibuye also offers the only corneal transplantation and vitreoretinal surgical services in the country – thanks to Sadeer Hannush and Joseph Bilson, respectively. My co-residents provided all the memories, and Tara Uhler and Julia Haller gave us this wonderful place to learn and thrive. Of course, I have to mention Brad Feldman for pioneering the Wills Eye Center for Academic Global Ophthalmology and its fellowship program. And if you’re curious to know: yes, Bill Benson was good for the thousand bucks!
Director of the Ophthalmology Residency Program at Wills Eye Hospital. She is also an Assistant Professor at Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Pediatric ophthalmologist at Park Nicollet Eye Care, Saint Louis Park, Minnesota, USA.
Professeur d’Ophtalmologie, Université Espoir d’Afrique, Chef de Service, Ophtalmologie, Hôpital Espoir de Kibuye in Burundi, Clinical Instructor at the University of Michigan Department of Ophthalmology and Visual Science, Adjunct Clinical Instructor at Wills Eye Hospital’s Center for Academic Global Ophthalmology, and Adjunct Clinical Instructor at the Rwanda International Institute of Ophthalmology in Kigali, Rwanda.
