Louisville Medicine Volume 67, Issue 7 - Page 6

I REDISCOVERING THE JOY OF TEACHING When I started my private practice in 1992, I became a gratis faculty member with the University of Louisville Department of Ophthalmology. Having recently completed my training with the Department, I felt that it was important to stay in touch with the residents, assisting with emergency care and proctoring cataract surgery. As time progressed, my practice became busier. Thus, I became less available to assist the residents in surgery, but I kept a relationship with the Department by attending Grand Rounds and various lectures. Over the years, I found that I missed the one-on- one interaction with residents in the operating room. Early in 2018, one of my colleagues and former attending physi- cians, Dr. Richard Eiferman, approached me about an opportunity to begin teaching the University of Louisville Ophthalmology Res- idents refractive surgery, specifically Photorefractive Keratectomy (PRK) and LASIK. Dr. Eiferman had been in discussions with Johnson & Johnson Vision to support training of the residents at our Suburban Excimer Laser Center. Our laser center is located at Suburban Medical Plaza #1 next to Norton Suburban Hospital. The center began operations in 1996 when 13 physicians, including myself, came together to form a private group to purchase an Exci- mer laser so we could begin performing retractive surgery. In the early years, PRK was the primary procedure. When LASIK became more popular a few years later, the group invested in the additional necessary equipment. Eventually, we purchased a femtosecond laser in order to perform LASIK without a blade which made the proce- dure much safer and more predictable. There have been numerous improvements and upgrades to the equipment and procedure so that now it can be entirely customized for the individual patient producing excellent results. When we were approached by J&J Vision, there was only one other ophthalmology program in the country that they were sup- porting to train residents in refractive surgery, the prestigious Wills Eye Hospital in Philadelphia. Because our laser center owned J&J lasers and had a teaching relationship established with UofL Department of Ophthalmology through Dr. Eiferman, we were in an ideal position to provide refractive surgery training to the residents. To establish the training program, Dr. Eiferman, Dr. Mark Cassol and I were required to become certified instructors with J&J. Following our formal training, we began taking the UofL residents through the requisite steps for LASIK certification. Prior 4 LOUISVILLE MEDICINE to performing their first cases, they were required to register online with J&J, attend three lectures covering the basics of laser technology and finally take part in a wet lab with a certified J&J technician. Following these steps, the residents were ready to schedule their first cases. Dr. Eiferman had been working with the residents at the Department for some time and helped the residents screen patients in the eye clinic at UofL. Because of J&J’s support, the residents were able to offer the surgery to patients at a significant discount. Dr. Cassol and I served as LASIK proctors. The first cases took place in May of 2018. Two residents, Dr. Tala Kassm and Dr. Mark Mugavin, became LASIK certified in June of last year, having completed the required 10 procedures prior to their graduation from the UofL Residency program. To date, six more residents at UofL have become certified to perform LASIK making the UofL program one of the most success- ful training programs in the country. At the recent Fall Meeting of the Kentucky Academy of Eye Physicians and Surgeons, Dr. Kevin Lowder, a current third year resident at UofL, presented the initial results of the Refractive Surgery Training Program. The excellent results are shown in Figure 1. Complication rates have been very low. A survey has been completed by patients showing very high satisfaction rates. Due to the success of the UofL program, J&J has extended their support of the refractive surgery training program to the University of Kentucky Department of Ophthalmology. Two UK residents have recently completed their initial LASIK cases at our center. My involvement with the UofL and UK Refractive Surgery Training Programs has been most enjoyable. I had forgotten how much satisfaction there is in training residents. To see the excitement that the residents experience by learning a new procedure that most programs in the country do not even offer has been very fulfilling. I look forward to continuing this program which provides residents with an invaluable skill they can carry into the next step of their medical careers. As senior and seasoned physicians involved in the training of our newly minted young colleagues, we are constantly reminded of how we can make a difference in their professional development. Dr. Burns is a private practice ophthalmologist. His practice, Middletown Eye Care, is located in Middletown, KY.