(in addition to PGY-2 Level goals)

Medical Knowledge

• To describe the epidemiology and perform screening for routine and more advanced primary and secondary open angle glaucoma.
• To describe the treatment of disturbances of aqueous humor dynamics.
• To describe the more complex etiologies for, evaluation of, and treatment of glaucoma (e.g., angle recession, inflammatory, steroid-induced, pigmentary, pseudoexfoliative, phacolytic, neovascular, post-operative, malignant, lens particle glaucomas; plateau iris; glaucomatocyclitic crisis; iridocorneal endothelial syndromes; aqueous misdirection).
• To describe more advanced tonometric and tonographic (if applicable) methods (e.g., diurnal curve).
• To describe more advanced optic nerve and nerve fiber layer anatomy in primary and secondary glaucoma and to recognize typical and atypical features associated with glaucomatous cupping (e.g., rim pallor, rapid progression, central acuity loss, hemianopic or other non-glaucomatous types of visual field loss).
• To describe more advanced forms of perimetry (e.g., kinetic and automated static visual fields) and perimetry strategies (e.g., threshold testing, supra-threshold testing, special algorithms).
• To describe the principles, indications, and more advanced anatomic findings and gonioscopic features of primary and secondary glaucomas (e.g., plateau iris, appositional closure).
• To describe the principles of medical management of more advanced glaucomas (e.g., advanced POAG, secondary open and closed angle glaucomas, normal tension glaucoma)
• To describe the features of, recognize, and treat primary angle closure glaucoma and aqueous misdirection.
• To describe the clinical features of, recognize, and treat less common etiologies of ocular hypotony.
• To describe the results and apply the conclusions to clinical practice of the major clinical trials in glaucoma (e.g., Glaucoma Laser Trial, Normal Tension Glaucoma Study, Advanced Glaucoma Intervention Study, Ocular Hypertension Treatment Study, Early Manifest Glaucoma Trial and Collaborative Initial Glaucoma Treatment Study).
• To recognize and treat the various adult secondary glaucomas.
• To describe the features of primary infantile and juvenile glaucomas.
• To describe and apply specific medical treatments of more advanced glaucoma.
• To describe the principles of laser treatments of glaucoma (e.g., indications, techniques, and complications, use of various types of laser energy, spot size, laser wavelengths).
• To describe the surgical treatment of glaucoma: (e.g., trabeculectomy, combined cataract and trabeculectomy, glaucoma drainage devices, MIGS, and cyclodestructive procedures, including indications, techniques, and complications).

Patient Care

• To perform argon or YAG laser peripheral iridotomy for routine angle closure glaucoma.
• To perform laser trabeculoplasty for uncomplicated glaucoma.
• To perform cyclophotocoagulation.
• To perform routine first surgical glaucoma procedure.
• To describe and manage a flat anterior chamber.
• To perform routine revision of filtering blebs.
• To recognize and treat glaucoma surgery bleb complications.

Professionalism

• To treat patients with respect and compassion at all times
• To treat clinical and administrative staff with respect
• To treat medical students with respect and strive to create an atmosphere conducive to education
• To arrive on-time for clinical experiences
• To prepare in advance for surgical experiences
• To work to become part of the clinical team
  • To work with the faculty, staff, fellow and other residents on the service to determine your responsibilities
  • To remain flexible and offer to help out with the responsibilities of others when you can
• To remain visible and available to participate in clinical care throughout the clinical session. If you leave the clinical care area make sure that other members of the service know where you are and why
• answer your pager within 10 minutes of being paged.

Interpersonal and communication skills

• To communicate your name and role on the service to patients and their families.
  • "Hello, I'm Dr. Resident, I'm a resident working with Dr. Attending today."
• To present patients to the attending in a succinct but complete way
• To maintain timely and legible medical records
• To talk when you should be talking, listen when you should be listening

Practice-based learning and improvement

• To learn to recognize feedback from faculty, fellows, fellow residents, patients and students
• To accept that feedback constructively and work to improve based on it
• To accept your role as a teacher as well as a learner. Work to educate students, fellow residents, faculty, staff and patients

Systems based practice

• To work for the benefit of your patients to communicate with other health care provider
• To act as an advocate for your patient within the health care system
• To become aware of the costs of diagnostic and therapeutic interventions. Consider these costs as you recommend and prescribe these interventions.