Ophthalmic Pathology and Oculoplastics Fellowship

Program Directors     

Frederick A. Jakobiec, M.D., D.Sc.
Director, David G. Cogan Laboratory of Ophthalmic Pathology

Aaron M. Fay, M.D. 
Director, Oculoplastic Service

Other Available Faculty
Thaddeus P. Dryja, M.D.

Nancy Kim, M.D., Ph.D.

Anat Stemmer-Rachamimov, M.D.

Francis Sutula, M.D.

Manoj M. Thakker, M.D.

YEARS IN EXISTENCE:  14

LENGTH OF PROGRAM:  1 to 2 years

FELLOWS PER YEAR:  1

FUNDING SOURCES:       Verhoeff Fund for ½ of the total package for Eye Pathology portion; and ½ from the Oculoplastic Service for the Oculoplastics portion.

SELECTION CRITERIA:    Completion of ophthalmology residency; academic career objective; institutional professional position as an eye pathologist and/or oculoplastic surgeon available in advance; letters of recommendation; prior publications.

OVERALL EDUCATIONAL OBJECTIVES:

A: Ophthalmic Pathology Portion:

Goal I.  To obtain an understanding of the microscopic anatomy of the eye and the ocular adnexa.

Goal II.  To learn the histologic features of the responses of ocular tissues to injury and/or diseases.

Goal III.  To develop skills necessary to evaluate surgical specimens with the aim of formulating differential diagnoses that include ophthalmic diseases that are common in a modern clinical practice or that are rare but especially important because of their life-threatening or vision-threatening potential.

Goal IV.  To learn the traditional and newest, modern methods and techniques (immunohistochemical, immunoperoxidase, electron microscopic, etc.) used by pathologists to analyze specimens and how those methods help to distinguish a specific diagnosis among a long list in a differential diagnosis.

Goal V.  To develop research projects in the laboratory and/or based on clinicopathologic material available through the David G. Cogan Ophthalmic Pathology Laboratory, MGH Pathology Department, and community-based clinical practices affiliated with the Infirmary and its full-time hospital-based staff.

General Activities:

1)  Participation in daily slide read-out sessions in the David G. Cogan Laboratory of Ophthalmic Pathology.

2)  Participation in monthly tutorials, Pathology Rounds, Grand Rounds, Fellows’ Course, and Pathology Lecture Series.

3)  Supervision and teaching of residents, other clinical fellows, and medical students rotating in the Ophthalmic Pathology Laboratory.

4)  Attendance and presentations of research material at regional and national meetings.

 5) Assistance in the preparation of presentations for attending pathologists, residents, and fellows.

Specific Description and Activities:

Weekday afternoon supervision of a resident who evaluates the 10-15 eye pathology cases generated each day.  Collaborates in the generation of microscopic description and a tentative diagnosis.  After the fellow and resident have interpreted the set of cases, all slides will be reviewed by an attending pathologist (Drs. Jakobiec, Stemmer-Rachamimov, or Dryja) and the fellow’s and resident’s diagnosis will either be confirmed or revised according to the attending’s recommendation. 

After this one-on-one review and discussion of each case, a preliminary diagnosis is reported to the surgeon by telephone, the final results will be entered into the MGH PowerPath reporting system.  Cases of exceptional diagnostic difficulty or of special educational value will be additionally reviewed with appropriate subspecialty pathologists at the Massachusetts General Hospital when requested by the attending eye pathologist, the surgeon, the resident, or the fellow.  The fellow will oversee this activity and order and collate any special stains to finalize the diagnosis.

B. Oculoplastic Service Portion:

The fellow will learn the proper evaluation of patients with conditions of the eyelids, conjunctiva, orbit, and periorbital compartments.  This will include clinical examination, and the evaluation of diagnostic tests such as ultrasonography, CAT scanning, MRI scanning, arteriography, etc.

The fellow will become conversant with normal and surgical anatomy of the various sites that surgery is performed; will do work-ups for the attendings of referrals and follow-up cases; will assist in the operating room for oculoplastic surgery, reconstructive surgery, and exploratory and excisional surgery of the lids, conjunctiva and orbit; will participate in and take care of emergency patients one half-day a week in the Emergency Department of MEEI for one-half a year; will participate as a member of the team comprised of the attending, other fellows, medical students, and residents who rotate through the service; will be expected to prepare reports, make telephone contacts with referring physicians, and attend to the orderly functioning of the day-to-day group practice in oculoplastics surgery.

At all times the fellow will be pleasant, professional, and courteous in dealing with patients, colleagues, secretarial staff, and other support individuals throughout the Infirmary.

SUPERVISION:

While on the oculoplastics portion of the fellowship, he or she will report directly to Dr. Aaron Fay, or on a daily assignment basis to the attending with whom the fellow is working.

While on the eye pathology service, the fellow will function under attending pathologist’s supervision during daily slide-read-out responsibilities, ultimately reporting to the Director of the Cogan Ophthalmic Pathology Laboratory, Dr. Jakobiec.

DUTY HOURS:          

Between the oculoplastic and ophthalmic pathology portions, the position is a 40 hours per week full-time position, without moonlighting.

EVALUATION PROCESS:   

Monthly progress reviews and written evaluations twice a year by the Directors of the two services will be offered.

Page Updated:  October 1, 2009

 

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