The Mass. Eye and Ear Glaucoma Fellowship Program
The Glaucoma Fellowship at the Massachusetts Eye and Ear Infirmary began under the tutelage of Drs. Chandler and Grant in the mid-1960s. 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.
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 fellowship is one year in length and is clinically 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.
Clinical Facilities and Organization
Facilities
The Glaucoma Service is located on the first floor of the Massachusetts Eye and Ear Infirmary. The current facility is fully equipped with examination lanes, procedure rooms, and diagnostic services. Diagnostic tools include Humphrey visual field machines that run SITA and Glaucoma Progression Analysis software, a Goldmann visual field machine, a Frequency Doubling Perimetry instrument, a Pascal dynamic contour tonometer, an ultrasound biomicroscope (housed on the 12th floor), A scan and B scan units (the B scan unit is also on the 12th floor), an OCT3, and a GDx (an HRT is available on the Comprehensive Ophthalmology Service, and spectral domain OCT is available on the Retina Service). A full range of photographic services is available, including slit photography, goniophotography and digital photography for optic nerve documentation. We use an electronic medical record system linked with an image management software tool called ANKA.
Personnel
Teresa Chen, MD
Cynthia Grosskreutz, MD, PhD
Mark Latina, MD
Louis R. Pasquale, MD
Douglas Rhee, MD
Lucy Q. Shen, 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 Infirmary. Dr. Chen’s research focuses on developing novel optic nerve imaging technology and clinical issues related to pediatric glaucoma.
Cynthia Grosskreutz, MD, PhD completed her residency and fellowship in glaucoma at the Massachusetts Eye and Ear Infirmary. 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.
Mark Latina, MD completed his residency and fellowship in glaucoma at the Massachusetts Eye and Ear Infirmary. He is in private practice in Reading, Massachusetts. He is the inventor of selective laser trabeculoplasty and has over 32 years clinical experience.
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 at Massachusetts Eye and Ear Infirmary and Director of the Glaucoma Fellowship. 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.
Douglas Rhee, MD completed his residency at Wills Eye Hospital and fellowship in glaucoma at Bascom Palmer Eye Institute. After his fellowship he served as an attending ophthalmologist at Wills Eye Hospital. He joined the Glaucoma Service at Massachusetts Eye and Ear Infirmary in September 2005. Dr. Rhee is funded by the NIH to study the role that matrix metalloproteinases play in trabecular meshwork function. Clinically, Dr. Rhee maintains a strong interest in pediatric 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.
Angela Turalba, MD completed her residency and served as Chief Resident at Massachusetts Eye and Ear Infirmary. 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 the Massachusetts Eye and Ear Infirmary. 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
Approximately 80% 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 a management plan. Fellows do not have to attend any external clinics, but they 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 long before the attending and 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 third 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 MEEI 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 MEEI holds a career development grant allowing the institution to extend a K-12 award to a fellowship-trained ophthalmologist. While competition for this award is typically fierce, MEEI fellows who demonstrate strong research potential will be given careful consideration for this award. K-12 awards give a graduating fellow junior faculty status with 80% protected time for research.
Please click here to 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
SALARY: Currently $50,000/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 2013-14
In the merged Harvard Glaucoma Fellowship, fellows would participate in three 4-month blocks.
July through October:
Fellow 1 – Latina
Fellow 2 – Chen
Fellow 3 - Rhee/Pasquale/ Grosskreutz/Wiggs
November through February:
Fellow 1 – Chen
Fellow 2 - Rhee/Pasquale/ Grosskreutz/Wiggs
Fellow 3 – Latina
March through June/July:
Fellow 1 - Rhee/Pasquale/ Grosskreutz/Wiggs
Fellow 2 – Latina
Fellow 3 - Chen
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Dr. Chen block:
Monday: Dr. Teresa Chen clinic all day
Tuesday: OR with Dr. Chen
Wednesday: Dr. Chen clinic in the AM.
Thursday: Dr. Chen OR; ER in PM
Friday: free for research
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Drs. Rhee, Pasquale, Wiggs and Grosskreutz block:
Monday: Dr. Rhee’s clinic in the AM; PM work with Drs. Wiggs and Grosskreutz
Tuesday: Emergency Room in AM; 2nd Tuesday PM when the fellow works with Dr. Brauner; otherwise the fellow is free
Wednesday: OR / lasers with either Dr. Pasquale or Rhee.
Thursday: Clinic with Dr. Rhee in AM (but see LRP postops when appropriate) and LRP in PM
Friday: Dr. Rhee clinic in AM and free in the PM.
Saturday: Clinic with Dr. Pasquale 1st Saturday of the month from September through June
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Latina block:
Monday ER in AM; PM free
Tuesday Dr. Latina clinic
Wednesday Dr. Latina clinic
Thursday - research
Friday OR Latina
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*Emergency Room is only required one half-day session for 6 months out of the year.
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.
Page updated November 21, 2012
