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Creating A Window Into Ophthalmology
Fall means back to school, and for the Vanderbilt Eye Institute, it means a new crop of Vanderbilt medical students.
Vanderbilt School of Medicine students encounter the VEI at several points during their four years, and the VEI offers a variety of opportunities for them to explore ophthalmology more deeply. In 2008, Dr. Mark Melson – a new faculty member fresh out of his own fellowship – was recruited by Dr. Sternberg, VEI Chairman, to serve as the VEI liaison with Vanderbilt med students.
“Our goal is two-fold,” says Melson. “Give them some foundation in ophthalmology and encourage it as a potential specialty. When students are able to experience ophthalmology first-hand, they can really see what an exciting specialty it is – with amazing surgery techniques and highly advanced technology.” Dr. Melson coordinates the schedules of students rotating through the department. In the second year, there’s an eye exam workshop led by Karla Johns, a community ophthalmologist. The third year students must complete a general surgery clerkship, and one of their options is ophthalmology. In the fourth year, there’s a month-long rotation through the department. Melson explains, “Coordinating the students is getting more challenging as the VEI grows. Now we have more specialists and more satellite clinics.” But Dr. Melson sees the benefit of trying to attract Vanderbilt medical students: “There’s a strong group of med students at Vanderbilt, and more of them are applying for our residency slots. If we can turn out better and better ophthalmologists, we raise the profile of the Vanderbilt Eye Institute overall.” Vanderbilt medical students can also engage with the VEI through special courses and projects:
While the course titled “The Eye as the Sentinel of Disease” is at least a decade old, it got new leadership – and energy – last year when Dr. Paul Sternberg took it over. Sternberg now leads the course once a year and is assisted by Dr. Janice Law, who organizes the ophthalmology specialists who participate as session leaders.
Offered as an elective to 1st and 2nd-year medical students, the “Sentinel” course introduces them to the eye and demonstrates how problems in the eye can be a harbinger of systemic disease in the body. It also teaches them how other diseases and conditions – from lupus to sarcoid to pregnancy – can affect the eyes. Students choose a topic of interest and present a paper at the end of the course to VEI faculty. While the course doesn’t include much biology or basic science, students are taught to recognize eye disease and to use the eye examination as a tool to diagnose more far-reaching issues.
The Emphasis Program (see O’Day article, Fall 2010 issue) pairs a first-year medical student with a clinician-scientist or basic scientist who has a project and would like to mentor a student. Sometimes, the student has an idea he or she wants to explore and seeks out a specialist that could facilitate that exploration. “The objective of the Emphasis Program,” explains Dr. Denis O’Day, executive director of the program, “is to foster leadership and scholarship in medical students. We want the doctors who leave Vanderbilt to know how to think, to use the literature, to interact with their peers.” VEI mentors have had great success with Emphasis students, with one actually co-authoring a paper and presenting at a national conference.
A 2-day program for fourth-year students, the Capstone course was designed to teach future physicians the value of integrating research and clinical work. Students learn to ask the right questions and to evaluate the latest research literature. There are ten topics from which to choose, based on the student’s interests.
The daylong VEI course studies ocular angiogenesis, and how the isolation of VEG-F has helped in the development of anti-angiogenesis drugs. On the first day, VEI faculty members give presentations on prevalent eye diseases with an angiogenesis component, like diabetic retinopathy and age-related macular degeneration. Other presentations discuss the fundamental biology of angiogenesis in the eye and the development of strategies designed to arrest the angiogenesis process. The second day involves a journal-club style exploration of the academic literature. First there is a discussion of articles pre-selected by the topic leader. Next, there is a review and discussion of specific areas for student investigation. Finally, students make presentations to the group and the faculty preceptor on the particular areas they had investigated.
“As we offer more and more ways to experience ophthalmology,” says Dr. Melson, “the VEI is achieving the best measure of success: More Vanderbilt med students are interested in ophthalmology as a specialty and in Vanderbilt for their residencies.”