EDUCATION FOCUS 2023
Making the Rounds with Our Ophthalmic Hospitalist
Past Reflections Program Overview
Message from Outgoing Vice Chair of Education Jeff
Pettey, MD, MBA
“Find a job you enjoy doing, and you will never have to work a day in your life.”
—Mark TwainLeading the John A. Moran Eye Center’s education mission has been a gift of a lifetime. The combination of generous faculty, engaged residents, and supportive leadership forged a strong amalgam for education innovation. Our shared commitment to innovate and advance ophthalmic education is evident in the quality of our trainees and national renown of the program.
“Do the best you can until you know better. Then when you know better, do better.” —Maya
AngelouThat is not to say the past 10 years have been without challenges and growing pains. We’ve expanded our program, overhauled our curriculum to a flipped classroom model, and navigated the COVID-19 pandemic. We’ve doubled down on our commitments to underserved communities and addressing social determinants of health. As an institution, we’ve augmented our diversity, equity, and inclusion education and mentorship. Finally, as trainees have come up against inevitable challenges, I’m proud of our culture rooted in humanism and empowerment.
“The most reliable way to predict the future is to create it.”
—Abraham LincolnAs I consider the future of Moran’s education mission, I’m delighted to pass the reins to a fresh collection of talented leaders to take us to greater heights. We have an unprecedented level of talented and engaged educators ready to build on our successes and bring new ideas and innovations to the table. I am nothing but bullish about the trajectory and future of the Moran Eye Center and its education mission. I’m grateful for the partnership and support of my dedicated colleagues and look forward to a new chapter as clinical vice chair.
Looking Forward
What Moran’s education program achieved under the leadership of Jeff Pettey, MD, MBA, and his predecessors is nothing short of astonishing. Moran has grown to be a Top 5 residency program, earning national and international recognition for our educational programs. My first goal as I assume the vice chair of education position is to ensure we continue the amazing growth trajectory of the past decade.
When I look forward to the next 5-10 years, I am most excited about the growing number of new faculty who are passionate about education. In the past few years, we have added several outstanding faculty members whose primary interest is residency education and training. I hope to develop this core group into an educational team, with each focused on a specific critical aspect of residency training, including things like clinical care, surgical training, community outreach, advocacy, and research.
Another major focus will be additions to our surgical curriculum. Our residents already enjoy one of the most robust surgical residencies in the country, but with the growth of our faculty, we are hoping to develop an advanced microsurgical curriculum that goes beyond the fundamentals. Through this, our residents will gain advanced surgical skills during their training.
Finally, with Salt Lake City’s tremendous growth over the last few years, we have an eye to expand our program by an additional resident in the years to come. Expanding the program will allow us to better serve our patient population and allow our residents more opportunities to serve our community, with a particular focus on those underserved areas where access to care is currently a challenge.
Moran Eye Center at a Glance
July 1, 2021 — June 30, 2022
Patient Visits: 153,369
Surgeries: 7,999
Research Grants: $9.57 Million
Clinical Trials/Studies: 90+
Publications: 270 +
EXCEPTIONAL TRAINING
In a typical three-year period, one Moran resident, on average, performs about 740 surgeries and procedures. More than 300 are cataract surgeries — 86 is the national requirement.
57 presentations and 39 publications by Moran trainees in 2022.
3 4 0+ Moran-trained ophthalmologists practicing in 45 U.S. states, the District of Columbia, Puerto Rico, and 2 countries.
Message from Incoming Vice Chair of Education Rachel G. Simpson, MDMoran's First Ophthalmic Hospitalist
Emphasizes Patient-Based Learning, Continuity, and Collaboration
Theresa Long, MD, balances her love of teaching with clinical and surgical skills as she guides first-year residents through three months of consult rotations. Ophthalmic hospitalists like Long evaluate medically complex or critically ill hospitalized patients with emergent and urgent ophthalmic conditions and collaborate with other hospital services to provide interdisciplinary care. Here, she shares insights about her new position.
Patient-Based Learning
Doing rounds with ophthalmic residents in hospital settings—from the ER to pediatric wards—allows them to learn how to manage clinically complex patients experiencing a range of ocular pathologies. Because residents actively assess patients, it’s the perfect scenario for patient-based learning.
In most cases, I directly observe the residents taking patient histories and performing exams while I scribe for them. Some residents prefer to watch and learn as I take the lead. It can go either way. Then I ask key questions of the resident. What is your differential diagnosis? What are your next steps in management? What are your plans for follow-up? If they miss something, we work together as a team to address it and identify what it was. It’s terrific training for oral boards.
“My time on the consult rotation was a richly educational experience. It gave me the confidence to care for a myriad of patients under the supervision of an excellent mentor. Without a doubt, this rotation has enhanced the educational quality of residency at the Moran Eye Center.”
—Mubarik Mohamed, MD, residentContinuity
The consults rotation requires residents to think like a clinician from day one. They’re assigned a patient and will often follow that patient through his or her hospitalization. The resident may even see the patient in another subspecialty clinic for follow-up once they have rotated off service. At the beginning of each month, we talk about the resident’s goals. After they identify an area they want to gain more experience in, which could be anything from neuro-ophthalmology to oculoplastics or retina, we ensure they have a chance to develop their skill set. It’s an adult learning philosophy where the learner is in the driver’s seat and an excellent confidence-builder.
Collaboration
Since we have access to faculty practicing in every subspecialty at Moran, residents often get unique consulting benefits. A resident, for example, may consult with neuro-ophthalmology for a stroke workup, or with the cornea service while caring for a patient in the burn unit.
At the other end of the spectrum, I learn from residents. That can happen when we’re between cases and talking about papers they’ve been reading, or when they’ve been researching a case and I ask them what they have learned.
I also try to share literature on such things as landmark treatment trials related to the pathologies we’re treating.
The rotation allows me to share pearls for various types of exams with residents in other services, such as ER. For instance, they need to learn the difference between an abrasion and an ulcer, and how to use a slit lamp.
Of course, all of this is only possible with departmental support that prioritizes quality patient care and resident education.
Learn More
The Ophthalmic Hospitalist Interest Group (OHIG) provides comprehensive information for ophthalmologists interested in this emerging field. More information can be found at ohig.org.
Theresa Long, MD, left, and resident Mubarik Mohamed, MD, discuss a case as part of their consult rounds.Moran Hosts Ukrainian Physicians in Observership Program
Training ophthalmologists worldwide is a core component of Moran’s education and outreach programs. So when the European Society of Cataract and Refractive Surgeons sent out a call to support Ukrainian ophthalmologists in 2023, Vice Chair of Education Jeff Pettey, MD, MBA, and team jumped at the opportunity.
Th rough a grant from the Sidra Tree Foundation, the Global Outreach Division hosted Daryna Dikunova, MD, and Oleksandra (Sasha) Melnyk, MD, as part of Moran’s International Observership Program.
“The invasion of Ukraine has devastated the eye health of their people, from traumatic injuries to patients no longer able to secure needed eye medications. Drs. Melnyk and Dikunova are bravely committed to Ukraine and serving their people,” says Pettey. “Our partnership will continue to grow and we look forward to future collaborations in more peaceful times.”
W hen they applied for their observerships, Dikunova and Melnyk had already logged almost a year dealing with complex eye traumas caused by missile strikes and other war-related injuries.
A lthough she worked as a vitreoretinal specialist and led the ophthalmic emergency department at her hospital in Dnipro, the war challenged Dikunova in new ways.
“I am on the eastern border, and so many soldiers need our help. I had done a few vitreoretinal surgeries a week, but since the war, I’ve ended up doing 10 or more a day,” she says. “At Moran, I learned about different approaches to various procedures, including oculoplastics. I also saw pathologies I had only read about. I’ve learned new ways of approaching diagnoses and patients and a lot more about available treatments for diseases like uveitis. I love teaching and can’t wait to share it all.”
Melnyk comes from Rivne in western Ukraine. Just six months after her residency, she began working in a trauma setting.
“Every day at Moran, I’ve learned something new,” she says. “Neuro-ophthalmology has been particularly important, especially related to eye trauma. We are dealing more and more with retinal detachments, so learning about scleral buckling was super helpful and exciting. I am going back home with all kinds of new techniques and levels of understanding.”
The Global Outreach Division hosts up to 20 international physicians annually to spend up to three months at Moran training in a subspecialty, shadowing ophthalmologists in the clinical and surgical environment, and learning surgical techniques in a wet lab and on simulators. Nurses may also train in the program .
James Tweeten, MD: Close Ties After Residency
A Boise, Idaho-based ophthalmologist who has practiced for 33 years, Tweeten credits immersive resident training and inspiring Moran founders for a fulfilling career.
What drew you to ophthalmology?
In medical school when I saw my first cataract surgery, I knew that ophthalmology was the field I wanted to pursue. The ophthalmologist performing the procedure was so enthusiastic. I hadn’t met anyone that excited about their profession before and that really drew me in. I think that’s a pretty common theme in ophthalmology: we love what we do.
Why did you choose the Moran Eye Center for your residency?
I was sold on Moran’s residency program after a two-week externship at Moran during my fourth year of medical school. Everyone was so kind to me, and I could tell how tight-knit and passionate their team was. Though Moran was a smaller program at the time of my residency, from 1986-1989, they had the greatest surgery volume out of any residency program I was looking at. I knew I needed to be at Moran after that experience.
Who or what was your greatest influence during your residency?
Many of my teachers had a great influence on me. Drs. Alan Crandall, Randall Olson, and Mano Swartz were especially powerful mentors. I was able to operate frequently with Dr. Crandall and Dr. Olson attended my first cataract surgery. I also did a post-graduate medical retina fellowship with Dr. Swartz so they all had a profound impact on me. As far as I’m concerned, all of my success in cataract surgery is based on the initial training I received from them.
Later on, I was invited to the American Academy of Ophthalmology Preferred Practice Patterns board by Dr. Olson. It’s been such a pleasure working with him all these years. I continued on the board and published the Cataract in the Adult Eye PPP release in 2021 with my fellow committee members.
I get emotional thinking about the program and Dr. Olson because I still feel so connected to my experience there after all these years. I’m so grateful for what the residency program provided; it was the best educational experience I’ve had.
65 Mario Capecchi Drive, Salt Lake City, Utah 84132
RESIDENT RESOURCES ONLINE
The Moran Eye Center’s residency program received the 2022 American Academy of Ophthalmology (AAO) Commitment to Advocacy Award at the Association of University Professors of Ophthalmology (AUPO) 2023 annual meeting.
In association with the AAO’s Advocacy Ambassador Program, the award recognizes the leadership of a training program whose residents engaged in positive advocacy for patients and providers, often including legislative involvement to develop effective health policy.
“The Department of Ophthalmology at the Moran Eye Center has demonstrated an ongoing commitment to engaging and educating members in training about the importance of
Academy Associate Secretary for State Affairs Laura K. Green, MD, (2nd from left) and Academy CEO Stephen D. McLeod, MD, (2nd from right) present the 2022 Commitment to Advocacy award to the Moran Eye Center during AUPO’s annual meeting in San Diego, Calif. Accepting the award on behalf of Moran are (left to right): Chandler Thompson, Jeff Pettey, MD, MBA, Rachel G. Simpson, MD, Randall J Olson, MD, and Meghan Johnson.
advocating for their patients and their profession, fostering Advocacy Ambassadors’ engagement with the Utah Ophthalmology Society (UOS), and collaborating closely with the UOS,” the AAO says in a statement.
“This award is a meaningful recognition for the many Moran faculty members involved in our education program and their support of advocacy,” says Vice Chair of Education Jeff Pettey, MD, MBA.
The UOS’s Advocacy Ambassador Program is a collaboration of state and specialized societies that support a Mid-Year Forum. At this annual forum, providers discuss policies that will impact their practices and develop strategies to implement new programs in their patient-care approaches.
