Over the past decade, the department of Ophthalmology at AUBMC has expanded to include at least one subspecialist in almost all subspecialties of the discipline, from cornea and anterior segment diseases, medical retina and electrophysiology, vitreoretinal surgery, refractive surgery, uveitis and immunology, pediatrics & strabismus, glaucoma, and oculoplastic surgery.
Refractive surgery, in specific, has been rapidly expanding, in terms of new procedures being performed every year, number of state of the art technology platforms acquired over the course of the last few years and number of procedures performed. In parallel to a significant rise in the clinical and surgical arm, refractive surgery research has been constantly picking up momentum as reflected by the large number of international presentations including many invited lectures in key meetings, as well as the published papers in top Ophthalmology journals. The very recent recruitment of additional highly trained subspecialist to join in January 2017 will help in bolstering the subspecialty into a full-fledged division, with a mission to provide the best refractive surgery care in the region and to extend AUB educational mission for the whole region by providing top-notch training experience in refractive surgery based on deep understanding of science and technology.
Description of the Program The goal of the refractive surgery fellowship is to provide comprehensive training in refractive surgery (clinical, surgical, and research) for physicians that have completed their training in Ophthalmology. The program conforms to the general guidelines approved by the Association of University Professors of Ophthalmology (AUPO) Fellowship Compliance Committee, March 2016. A period of two years of clinical and research experience will be required to provide subspecialty fellows with a deep knowledge base enabling them to provide optimal assessment and management to patients with refractive issues.
The fellow’s primary responsibilities during the day will be in the refractive surgery clinics at the Ophthalmology department at AUBMC where she/he will participate in the care of patients under the direct supervision of the refractive surgeon in order to receive direct feedback on the clinical evaluation of patients so as to enhance and clarify findings on the examination, and to assist in formulation of the proper diagnosis and management. All new patients will be thoroughly examined by the fellow; patients who have been previously seen will be given an in- depth evaluation that will help direct ongoing management. The fellow will be responsible for the preoperative evaluation of patients, will assist in surgical planning, will scrub to assist during surgeries, and will be involved in the postoperative management and care of these patients.
The fellowship will offer comprehensive training in the medical assessment and surgical management of a wide variety of refractive problem, including corneal irregularities using corneal topography and tomography, wavefront irregularities diagnosed by ocular and corneal wavefront aberrometers, optical coherence interferometry, appropriate manifest refraction, laser vision correction, customized laser correction, lens based refractive surgery, limbal relaxing incisions, inlay surgeries, and corneal ring segments. Through progressively increasing participation, the fellow will gain autonomy in clinical decision-making and treatment.
Faculty There will be three faculty: Shady Awwad, associate professor, Alain Saad, assistant professor and Joanna Saade, clinical instructor, all fellowship trained in refractive surgery, supervising the fellow at all times.
Curriculum Competencies The fellow will be exposed to a very broad variety of refractive surgery problems, encompassing almost every aspect of the subspecialty. She/he will learn to evaluate patients, order and make sense of different diagnostic platforms, go through a clinical decision making process, implement the surgical plan chosen, and be ready to deal with the potential complications which might ensue.
Diagnostic tests include corneal topography and tomography, corneal and ocular wavefront aberrometry, corneal and anterior chamber ocular coherence tomography, high frequency ultrasonography, partial coherence interferometry, specular microscopy, and contrast sensitivity testing.
The surgical aspect include femtosecond LASIK, alcohol-assisted PRK, Transepithelial PRK, Customized ocular and corneal wavefront-guided laser vision correction, phototherapeutic keratectomy, intrastromal conreal ring segment insertion, corneal cross-linking, phakic intraocular lens insertion, toric and multifocal intraocular lens planning and implementation in cataract surgery, limbal and arcuate relaxing incisions, and intraocular lens calculation in eyes with previous keratorefractive surgery.
Call Frequency During the fellowship, the fellow will not be obligated to take routine eye emergency calls. For those emergencies that involve refractive surgery, the fellow will be expected to be available to the on call ophthalmology resident for consultation.
Teaching Opportunities The fellow will have the opportunity to teach AUB Medical School students, visiting students from other medical schools and other residents in the clinical setting.
Research Opportunities Research is a core requirement in the refractive surgery fellowship. The fellow will have to take on several research projects and to present them at least once a year in a regional and international meeting.
Evaluation To ensure that the fellow acquires adequate knowledge, his/her performance will be monitored carefully during the course of the fellowship. She/he will have an individual quarterly conference with the program director to assess and discuss training progress. Upon the completion of her/his training, the fellow will be provided by a summative evaluation of her/his performance and competence to practice without supervision at the end of each year. This evaluation will be a part of the permanent record maintained by the Department and the GME office. The Fellow will evaluate his/her experience with individual faculty at the completion of each year of the program.
Requirements The fellowship is at PGY5 level. An applicant for the refractive surgery subspecialty training must have achieved initial certification in Ophthalmology. In addition, applicants from outside AUB must have a passing grade in the clinical part of the International Council of Ophthalmology exam or the Arab Board of Ophthalmology in addition to English language proficiency exam.
Funding This position will be funded by the department of Ophthalmology through an annual fund commitment from Medicals International, a biomedical company, with the annual stipend allocated for the PGY5 level.