The Mass. Eye and Ear Glaucoma Fellowship Program


The Glaucoma Fellowship at Massachusetts Eye and Ear began under the tutelage of Drs. Chandler and Grant in the mid-1960s and offers comprehensive training in management of glaucoma. Fellows will have extensive opportunities to participate in the clinical decision making and surgical care of a wide variety of glaucoma patients under the guidance of the Glaucoma Service Faculty. Our mission is to train fellows to manage the most difficult glaucoma cases while creating an atmosphere where one can explore career development through teaching and clinical research.

The number of fellows who grow into leadership positions after fellowship is astounding. For example, many become Professors of Ophthalmology, Glaucoma Service Directors, Academic Chairpersons, or Deans of medical schools. In addition, some graduates become community-based glaucoma specialists, who enrich their communities with their teaching contributions.

The fellowship is one year in length and is clinically and surgically intense. The fellow’s responsibilities include evaluating patients; taking call; providing consultation for inpatients at Massachusetts General Hospital; staffing the Mass. Eye and Ear Emergency Room; responding to patient requests for information; being available for emergency and routine visits; preparing charts and patients for laser and incisional surgery; assisting during glaucoma laser and incisional surgery; preparing articles for journal club; teaching residents and other students who rotate through the service; and other tasks as deemed necessary by the glaucoma faculty.

All applicants must be eligible for a full medical license per the Massachusetts Board of Registration in Medicine. International medical graduates must also be eligible for an H1B visa (eligibility includes passing all 3 steps of the USMLE test, and reporting results to Mass. Eye and Ear before the Match deadline). The requirements of full licensure can be viewed on the mass.gov website.

Clinical Facilities and Organization

Facilities
Glaucoma fellows will be involved in the delivery of care at the following locations:

1. Mass. Eye and Ear, Boston, MA
2. Jamaica Plain VA Hospital, Jamaica Plain, MA
3. Dr. Mark Latina's private office, Stoneham, MA
All facilities are fully equipped to provide glaucoma care. Some special features worthy of mention are the availability of dynamic contour tonometry, nailfold capillary microscopy, and numerous forms of optic nerve imaging including swept source OCT and enhanced depth imaging OCT.

Program Director: Louis R. Pasquale, MD

Associate Program Director: Ambika Hoguet, MD

Faculty:
Teresa Chen, MD
Iryna Falkenstein, MD
Cynthia Grosskreutz, MD, PhD
Mark Latina, MD
Pallavi Ohja, MD
Lucy Q. Shen, MD
Brian Song, MD
Angela Turalba, MD
Janey L. Wiggs, MD, PhD

Teresa Chen, MD, completed her residency at University of Illinois Eye and Ear Infirmary and her fellowship in glaucoma at Massachusetts Eye and Ear. Dr. Chen’s research focuses on developing novel optic nerve imaging technology and clinical issues related to pediatric glaucoma.

Iryna Falkenstein, MD, received her medical degree at Crimea State Medical University in 1997. After a surgical internship at Los Angeles County Hospital, she continued her ophthalmology training as a resident physician at University of Texas, San Antonio, followed by subspecialty fellowship training in Glaucoma at the University of North Carolina. Dr. Falkenstein's research interests are in the areas of secondary glaucoma and surgical outcomes of glaucoma procedures.

Cynthia Grosskreutz, MD, PhD, completed her residency and fellowship in glaucoma at Massachusetts Eye and Ear. She also received a PhD in pharmacology at the University of Iowa. She sees patients on the Glaucoma Service roughly three days per month as she is the Director of Translational Medicine at Novartis.

Ambika Hoguet MD, completed her residency at New York and Ear Infirmary and fellowship training in glaucoma at Bascom Palmer Eye Institute. She has a strong interest in teaching and is the associate director of the glaucoma fellowship. She is interested in the clinical and surgical management of complex glaucoma

Mark Latina, MD, completed his residency and fellowship in glaucoma at Massachusetts Eye and Ear. He is in private practice in Reading, Massachusetts. He is the inventor of selective laser trabeculoplasty and has over 32 years clinical experience.

Pallavi Ohja, MD, is a recipient of the prestigious Richard J. Simmons and Ruthanne B. Simmons Glaucoma Fellow Award, which honors a legacy of academic excellence. She completed medical school and residency training at Drexel University in Philadelphia, PA. She is interested in the use of novel devises in the delivery of medical therapy for glaucoma.

Louis R. Pasquale, MD, completed his residency at Temple University Hospital and a glaucoma fellowship at Johns Hopkins University Hospital. He is Director of the Glaucoma Service and Director of the Glaucoma Fellowship at Massachusetts Eye and Ear. His research interest involves detecting previously undiagnosed glaucoma using novel screening tools and understanding the pathogenesis of primary open-angle glaucoma and exfoliation glaucoma. Dr. Pasquale has an NIH grant to study gene-environment interactions as putative risk factors for primary open-angle glaucoma.

Lucy Q. Shen, MD, completed her residency and glaucoma fellowship at the Jules Stein Institute of University of California, Los Angeles. As a clinician scientist, she is interested in the use of imaging as a method for elucidating the pathogenesis of glaucoma.

Brian Song, MD, graduated from Johns Hopkins University with general honors and a BA in Public Health – Natural Sciences. Subsequently, Dr. Song completed his medical training at the University of Texas Medical Branch. He then completed a general surgery internship at Beth Israel Medical Center in New York followed by an ophthalmology residency at the Edward S. Harkness Eye Institute of Columbia University Medical Center. Currently, Dr. Song is a Harvard K12 Vision Clinical Scientist. The Harvard Vision Clinical Scientist Development Program offers a mentored and structured learning, research, and development environment to a select group of qualified clinically-trained candidates who desire to become independent leading clinical scientists in their respective fields. Dr. Song’s research focuses on the development and validation of a telemedical model for glaucoma screening and evaluation.

Angela Turalba, MD, completed her residency and served as Chief Resident at Massachusetts Eye and Ear. Subsequently she completed a glaucoma fellowship and joined the Glaucoma Service in 2010. She is an outstanding teacher and has a strong clinical interest in traumatic glaucoma.

Janey L. Wiggs, MD, PhD, completed her clinical residency and fellowship at Massachusetts Eye and Ear. She also completed research fellowships in molecular and ophthalmic genetics at Mass. Eye and Ear, and obtained a PhD in biochemistry at University of California, Berkeley. Initially, she joined the Mass. Eye and Ear staff and then later worked at the New England Medical Center. She eventually returned to Mass. Eye and Ear where she pursues her work on identifying genetic determinants of various forms of glaucoma. Her work is strongly supported by the National Institutes of Health.

Fellow Responsibilities

A. Clinical responsibilities 

A major portion of the fellow’s time is committed to direct patient care on the Glaucoma Service. The medical management of glaucoma cases, as well as the pre- and post-operative care of surgical cases is considered an essential aspect of fellowship training. It is not critical that the fellow see every patient, but it is very important that the fellow evaluate cases thoroughly, formulating a tentative diagnosis or differential diagnosis as well as a management plan. Fellows are expected to serve in the Emergency Department one session per week for six months. A detailed schedule of clinical responsibilities will be provided when the fellow starts in July.

Another major component of fellowship experience involves assisting in the operating room. Fellows are expected to be in the OR to ensure, to the best if their ability, that surgical plans are implemented. A surgical schedule will be provided, but there will always be add-on cases, and fellows are expected to assist on these cases at the discretion of the attending and the call schedule.

Glaucoma fellows will take call for the Glaucoma Service approximately every fourth week. The on-call fellow is responsible for all emergency medical and surgical admissions to the Glaucoma Service during weeknights and weekends. An assigned attending will be on call at all times and available for immediate backup of complicated cases, admissions, or surgical procedures. Any changes to the on-call schedule must be processed through the manager of the Glaucoma Service. If the fellow is unable to provide on-call coverage on any given pre-assigned week, then he/she must find coverage from amongst the other housestaff in the call rotation.

B. Educational responsibilities

Glaucoma lectures are held Friday mornings (dates and times will be posted). These lectures will be didactic in nature and cover all types of glaucoma and their treatments.

Glaucoma journal club will take place monthly. All faculty and fellows are expected to attend. Faculty and fellows will take turns presenting an interesting and important recent paper of their choice.

Grand Rounds is held on Thursday mornings at 8:00 am. All fellows must attend Grand Rounds. Once or twice per year, the fellow will be responsible for presenting a case at Grand Rounds.

Each year there is a “Fellows Course.” Each fellow is expected to write a review paper with faculty mentorship, which is submitted for publication. The theme of the Fellows Course dictates the topic for the paper.

C. Research responsibilities

There are many opportunities to do clinical research at Mass. Eye and Ear, and the fellow is encouraged to pursue a research project. In order to successfully complete a project a fellow is encouraged to conceive and plan their work before they arrive in Boston. The faculty will be happy to provide resources and assistance in this regard. While research is not mandatory, preference will be given to applicants who demonstrate strong clinical capabilities and a proclivity to research endeavors.

Fellows who have strong academic inclinations should be aware that Mass. Eye and Ear holds a career development grant allowing the institution to extend a K12 award to a fellowship-trained ophthalmologist. While competition for this award is typically fierce, Mass. Eye and Ear fellows who demonstrate strong research potential will be given careful consideration for this award. K12 awards give a graduating fellow junior faculty status with 80% protected time for research.

Review recent original peer-reviewed publications of the faculty. The purpose of the attached listing is to give the applicant an idea of the scope of glaucoma research interests at Mass. Eye and Ear.

Fellow Funding and Benefits
Please note: Clinical fellows must meet the requirements for full (unlimited) licensure in Massachusetts.

SALARY: Currently $52,000/year

MALPRACTICE: Malpractice premiums are fully paid by the Glaucoma Service.

HEALTH INSURANCE: Family health insurance will be provided through the benefits program of Massachusetts Eye and Ear Associates. Depending upon the plan selected, all or a large portion of the premiums is included in the benefits package.

VACATION AND SICK LEAVE: Each fellow is allowed 3 weeks (15 work days) per year. All time out must be pre-approved by the Glaucoma Service Manager and by the attendings affected by the fellow’s absence. The vacation may not be taken at the beginning or end of the fellowship.

PROFESSIONAL MEETINGS: Attendance and participation at appropriate meetings is encouraged. Fellows will be allowed one week (5 work days) to attend meetings, but coverage for missed clinics and call must be arranged. Fellows will be reimbursed for travel to meetings (AAO, ASCRS, ARVO, AGS, etc.) up to a maximum of $1500 per academic year if they present at the meeting they attend.

Glaucoma Fellowship Schedule

In the merged Harvard Glaucoma Fellowship, fellows will participate in three 4-month blocks. Fellows will spend one 4 month block with Dr. Mark Latina and 8 months with Mass. Eye and Ear faculty at 243 Charles St and the Jamaica Plain VA Hospital.

*Emergency Room staffing one half-day session for 6 months out of the year. Fellows generally complete this requirement while on the Mass. Eye and Ear  and VA blocks. If conflicts between presence in the clinic or going to the OR, the first priority is to be available for the OR.

Miscellaneous

Mail
An in-box for your mail and/or important messages is located on the Glaucoma Service. You should check your mailbox frequently for messages, patient-related matters, and other correspondence.

Paging
You are supplied with a pager that you must wear during business hours and also at all times when on-call. Please respond to your pages promptly. If you change the status of your beeper for any reason (in surgery, not available), please make sure you promptly reverse the status on your return to clinical duty.

Application Process

Applications can be found on the San Francisco Matching Program’s website at www.sfmatch.org [program #4171]. Only completed applications will be considered for interview. A completed application consists of a completed AUPO centralized application form and 3 letters of reference. Generally the deadline for receipt of completed applications is mid-October. Note that if the fellow matches, a staff application to Mass. Eye and Ear will also need to be completed immediately after the match. Interviews will take place at Mass. Eye and Ear in late October or early November. Any questions regarding the fellowship can be directed to Dr. Louis R. Pasquale via email at louis_pasquale@meei.harvard.edu.