View Full Version : Ophthalmology (Medicine) at Nassau University Medical Center

06-15-2011, 02:37 PM
Hi again! Figured while I'm on a roll, I'd get this one out of the way too. Enjoy!

Facilities, locale: Can't add much to what others have no doubt said of the general Nassau locale, but it seemed fairly safe from the short experience I had. The ophthalmology clinic itself is set back in a trailer add-on to the main hospital on the 1st floor, and it sure feels like a trailer add-on! However, while I was there a new wing was being renovated and should open within the next few months, and it will be a beautiful new addition to the hospital. The old clinic area is stocked with quite old equipment, some of it balky, but most of it serviceable and actually pretty fun to use. I didn't get to scrub into any surgical cases in the OR, so I can't speak to that portion of the hospital. Also, the old ER was... well, glad it's now an old ER, as the new ER should have opened by now. :D

Transportation: This was one rotation where I actually felt disadvantaged by not having a car, since I was still commuting from Manhattan to get there. There is a free parking lot (7/7A) for students at the end of the hospital campus, and that part of Long Island is eminently friendlier for driving than, say, Queens or Brooklyn. The LIRR does run out to both Hempstead and Hicksville (Hempstead connects at Jamaica and then on to Atlantic Terminal in Brooklyn, while Hicksville runs through Jamaica to Penn Station), and buses are available from the train stations to the hospital, but that was a looong commute. Better off driving, I think. Taxis were also available at the train stations, much cheaper than in the city.

Rotation setup: This is a four-week elective rotation scheduled through MEAS; I was with another AUC student for the duration of the elective, and we also overlapped one week with two students from NYCOM. There is no call schedule, naturally! :hail: You spend the entire time in the clinic; I'm not aware that the director allows students into the OR, and in any case you wouldn't be able to see anything since the teaching scopes in the OR permit the attending plus a resident to see what's going on.

Teaching: Teaching is almost exclusively done by residents, since the director is usually in the OR supervising cases, and the specialty faculty are there once a week (or even once a month). The first year residents were really great at working with us, and a couple of the second year residents were likewise more than happy to have us around and learning. One of the chiefs was super-cool and actually made lectures specifically for medical students (although he rarely had time to give them); the other chiefs were often in the OR and were busy trying to figure out where they wanted to work when they graduated. The specialty attendings, when present, did a great job of teaching as well and were well worth following around. Much of the learning came from self-reading, starting from a website they gave us and also from a small text from the AAO they made available.

Workday: Clinic began at 9:00 am each morning and took an hour lunch break at noon. On non-specialty days, in theory that meant that all the patients were typically seen by 1:30 or 2:00 pm each day, after which I was free to go. (For some reason, the NYCOM students and the other AUC student left at lunch. I think the residents knew they weren't interested in ophthalmology as a specialty so they didn't care if the students got anything out of the rotation or not. Who knows?) On Monday afternoons we had retina clinic, and a specialist from Columbia would join us and go through those patients. That was a busier service and we typically left after 4:00 pm; the retina specialist is a very, very good teacher and has teaching prisms on his indirect ophthalmoscope so you can see what he's looking at. Pediatric clinic is every Thursday morning and is actually quite light. Every Friday the clinic sees prisoners from the nearby facility (literally across the street from the hospital). One Thursday every month the strabismus specialist comes in, and one Wednesday each month the glaucoma specialist comes in. Both are excellent teachers and spend a lot of time instructing the residents and students.

Student responsibilities: In a nutshell... none! We weren't asked to do anything we didn't want to do, but naturally I stepped up and the residents were more than happy to let me do as much as I wanted. With a couple of the residents I did end up writing portions of notes for them, but mainly I kept to performing the ophthalmologic exam: visual acuity (with Snellen charts, autorefractor, and phoropter for manifesting), tonometry (both with the applanator and the handheld Tonopen), external slit lamp exam, and dilated funduscopic exam. Absolutely none of that was required, and I have no hesitation in saying the other three students I saw rarely did anything.

Student evaluation: There is a written quiz at the end based on reading material and basic, common components of the ophthalmologic exam and ocular diseases. Also, you'll be asked to prepare a ten-minute presentation to give to the residents at the end of the rotation, picking any ocular disease topic you like.

Impression: A great rotation if you're looking to learn something about ocular disease and treatment in the clinic setting, and it doesn't hurt that the hours are so relaxed! This is definitely a rotation where you'll get out what you put in, so if you show the initiative you'll find the residents more than happy to coach you along.

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