Clinical Rotations

The Stanford residency program provides a progressive acquisition of clinical and surgical skills. Clinical and surgical volume continues to increase as our faculty grows at Stanford and affiliated teaching hospitals.

After an initial 2-month period in July and August when first-year residents are paired with second-year residents for mentored “buddy” call, primary call is q10 weeknights and q5 weekends, divided evenly among first- and second-year residents. Weekend call is split so that residents cover either Stanford/Packard/VA or the Valley medical center for primary call. Third-year residents cover q5 weeklong backup call for all sites, divided evenly throughout the year.

First-year residents spend their first week transitioning to residency through individualized 1-on-1 attention and teaching from upper level residents and faculty in the clinic and through a special series of conferences and hands-on workshops that introduce the basics of clinical care, suturing, and interpretation of various ophthalmic imaging modalities. First-year residents spend one-fifth of the year on each of five rotations:

· VA medical center comprehensive/subspecialty ophthalmology rotation
· Santa Clara Valley Medical Center (county hospital) comprehensive/subspecialty ophthalmology rotation
· Stanford/Byers inpatient consults/pathology/elective rotation
· Stanford/Byers oculoplastics-optometry subspecialty rotation
· Stanford/Byers glaucoma-neuroophthalmology rotation 

This schedule provides a variety of patient care experiences, seeing complex pathology in a crowded county hospital, chronic and age-related disease in the VA population, and rare cases at the Stanford and Children's Hospital Eye Clinics. Each rotation also includes a weekly half-day of protected research/elective time so that residents can take advantage of unique opportunities at Stanford for career development. Residents begin to perform eye surgery in the first year, including minor procedures, such as pterygium and chalazion excision, as well as observing and performing parts of cataract surgery.

Second-year residents spend their first month reinforcing their knowledge of the fundamentals of ophthalmology during protected daytime didactics at the Bay Area Ophthalmology Course (BAOC). The remainder of the year is divided into five clinical rotations to improve clinical skills and to begin major responsibilities as a surgeon:

· VA medical center comprehensive/subspecialty ophthalmology rotation
· Santa Clara Valley Medical Center (county hospital) comprehensive/subspecialty ophthalmology rotation
· Stanford/Byers pediatric ophthalmology-optometry rotation
· Stanford/Byers retina-uveitis-oncology subspecialty rotation
· Stanford/Byers cornea-refractive-low vision rotation

Second-year residents begin to acquire more autonomy and have primary responsibility for cataract surgeries. They also take on a clinic leadership role in triaging consults and mentoring the first-year resident. As in the first year, each rotation also includes a weekly half-day of protected research/elective time.

Third-year residents serve in a chief resident capacity, with rotating administrative responsibility at Stanford/Byers for one-fifth of the year, as well as at the other ancillary sites. They spend the majority of the year performing high-volume surgery as primary surgeon. They also teach the junior residents in each hospital and take administrative responsibility for overseeing clinics and conferences. Chief residents have one block that is a flex/elective block while at Byers. Many chiefs use this opportunity to travel abroad for an international surgical experience. Other chiefs have also used this block to make use of the resources available at Stanford as a whole, including the Stanford Biodesign courses, research and innovation projects, and leadership development.