This Is a Program Where Learning Is Valued and the Educational Experience Is Tangible

“This is a program where learning is valued and the educational experience is tangible. You will learn a vocation, but it differs from many other schools in that HMS is a very academic environment. This is a place where a trainee can approach a faculty member and count on getting help. People coming from other institutions are simply struck by the emphasis we place on medical education.” — Simmons Lessell, MD, Director of Ophthalmic Medical Student Education, Harvard Medical School 113 M

Today, about 1 in 6 ophthalmology department EDICAL Innovate. Train. Mentor. Inspire. chairs in academic institutions across the U.S. and

EDUCATION Medical education is integral to the HMS Department of Ophthalmology’s mission, Canada conducted postdoctoral training at HMS. and trainees receive the finest ophthalmic education in the world. The department supports full-time faculty in every ophthalmic subspecialty, giving residents S

a comprehensive grounding in ocular disease and management. Moreover, fellows ETTING have the opportunity to gain further clinical expertise or pursue in-depth research students have the opportunity to •• Visual functions and developing mology is an area of medicine they

evaluate, triage, and manage pa- technologies for visual rehabilita- would like to pursue. Elective rota- S in one or more of nine subspecialty areas. Under the exceptional leadership of John tients, and learn how to use special- tion tions also provide excellent train- TANDARD I. Loewenstein, MD, HMS Ophthalmology Vice Chair for Medical Education and ized ophthalmic equipment, including for students who may choose a ing the slit-lamp biomicroscope, the According to Dr. Lessell, modi- “sister” specialty such as neurology S Director of the HMS Department of Ophthalmology Residency Training Program, tonometer and the ophthalmoscope. fied apprenticeship electives excite or neurosurgery. Program feedback recent program innovations have continued to strengthen the department’s con- Students are also loaned a set of students about the principles of from medical students has been basic ophthalmology textbooks ophthalmology through “real-life” highly positive, with approximately tinuum of medical education. These distinctions culminate in a superb educational and encouraged to attend Grand clinical and research exposure and 30 students choosing an Introduc- experience that offers remarkable depth and breadth to the department’s cadre of Rounds and department lectures one-on-one faculty guidance. Stu- tory Elective each year. to reinforce their training. Faculty dents gain first-hand knowledge of medical students, residents, and fellows. guidance and feedback throughout the field, giving them an opportunity The department’s greatest asset is its dedicated community of educators. the rotation is an important part to decide whether or not ophthal- of the learning process. A pediatric Through their wealth of collective experience, HMS faculty strive to create a sup- ophthalmology elective is also avail- portive and stimulating learning environment at every opportunity: as teachers able at Children’s Hospital Boston for interested students, and directed in the classroom, clinic or lab, and as mentors to students and trainees in their by Ophthalmologist-in-Chief, David day-to-day interactions. Through close teamwork—and by serving as roles models Hunter, MD, PhD. Students who satisfactorily of effective leadership—their goal is to graduate well-rounded academicians and complete the Introductory Elec- outstanding clinician scientists who become tomorrow’s leaders in ophthalmic tive may choose to take a four-week minimum Advanced Ophthalmol- medicine, science and education. ogy course. At this level, more than 30 electives representing a robust, cross-section of ophthalmic subspecialties are open to students Setting Standards for Medical who wish to participate in a focused clinical or laboratory investigation. Students may choose from many ex- Student Education citing areas of study. Some examples include: Within the ophthalmology com- trend, the HMS Department of Oph- students directly engage in clinical •• Pathogenesis of age-related macu- munity, there is general consensus thalmology continues to hone its activity. lar degeneration (wet or dry) of a need to improve the quality of medical student education program. Augmenting these activities, a •• Antibiotic resistant bacterial infec- ophthalmic education for medical In recent years, major innovations revitalized Introductory Elective tion students, residents, and primary care have been implemented, largely due teaches fourth year medical students •• Human and molecular genetics physicians. Even so, statistics show to efforts championed by Simmons the principles of basic ophthal- research with an emphasis on un- that ophthalmic education has fallen Lessell, MD, HMS Director of Oph- mology through hands-on clinical derstanding the role of genes in the victim to tightening budgets and thalmic Medical Student Education, instruction, rather than a traditional development of glaucoma shifting priorities in many academic and Deborah Jacobs, MD, Director lecture-based curriculum. This •• Behavioral and imaging research to medical schools in the United States. of the Core Medicine Clerkship for unique, modified apprenticeship assess visual impairment and moni- According to a 2004 survey by the As- Harvard Medical School students. system pairs each student with tor progression of retinal diseases sociation of University Professors in Today, the program’s revitalized core two active ophthalmic clinicians •• Diseases of the surface of the eye, Ophthalmology, only 30 percent of and elective curriculum emphasizes in different subspecialties, both of including infections and dry eye medical schools nationwide require a dynamic, integrated format that whom provide student supervision diseases a formal ophthalmology rotation1. combines didactics with hands-on and feedback. During the four-week •• Glyobiology – an expanding field Because physicians in many surgical clinical and research training under a rotation, students accompany their at the forefront of the biomedical and medical specialties often need mentor’s watchful eye. Core re- mentors in a busy outpatient set- sciences that studies the structure to perform eye exams—especially if quirements begin in the 2nd year of ting, in the operating room, and at and function of the carbohydrate they are to appropriately manage and medical school, when students learn conferences. Early in their rota- chains (or glycans) present in all triage patients who have ophthalmic to perform the basic eye exam and tions, students work in tandem with living organisms. complaints—this lack of formal oph- use the direct ophthalmoscope in residents in the 24/7 emergency eye •• Ocular immune privilege and the thalmic training is of grave concern. a small-group setting. During their department and trauma center. pathogenesis of autoimmune Diverging from this unsettling 3rd year internal medicine rotation, Closely supervised by faculty, uveitis 115 M EDICAL

“I’m honest. I acknowledge my shortcomings. I’ve EDUCATION also tried to be generous. If you have more pieces of the puzzle than the person you are teaching, the next criterion is generosity. What you are trying to do is to S give to someone else everything you have acquired ETTING and the means of gaining more. You hope that each 1 S one will do even better than you do.” TANDARD — Simmons Lessell, MD S

In 2004, Dr. Lessell retired as Director of the Neuro- Simmons Lessell, MD Ophthalmology Service, and was appointed Director of Ophthalmic Medical Student Education for Harvard Paul A. Chandler Professor of Ophthalmology, Harvard Medical School. During his tenure, he has transformed Medical School the HMS ophthalmic curriculum by radically redesigning Director of Ophthalmic Medical Student Education, the elective program to emphasize faculty mentorship, Harvard Medical School conference participation, and emergency room training. He is a master at leading weekly Grand Rounds, and has Dr. Simmons Lessell is one of the department’s most gained nearly legendary status for his keen insight and respected faculty members, and is well known as a gifted quick wit during his presentations. clinician, teacher, and mentor. Educated at Amherst Dr. Lessell ranks among the top neuro-ophthalmolo- College, he attended Cornell Medical College, where gists in the world, and is frequently sought for consulta- neuro-ophthalmologist Dr. Edward Norton first kindled tion by patients and physicians in the U.S. and abroad. his interest in this specialty. He completed a year of During his career, he received RO1 funding from the residency in neurology at the University of Vermont National Institutes of Health for 13 consecutive years, under Dr. George Schumacher, followed by two years of an objective indicator of his deep intellect and prolific neurology clinical practice and research at the National contributions to his field. His depth of knowledge and Institutes of Health. During this time, he spent a year clinical insight are unmatched, even while he maintains in Guam conducting research on amyotrophic lateral an approachable bedside manner and endearing sense sclerosis, and served as the sole neurologist for 60,000 of humor. He demands the best from his residents and civilians and military personnel. Dr. Lessell then spent fellows, and makes it his personal mission to improve two years doing research in the Howe Laboratory of their analytic and diagnostic skills. In describing Dr. Les- Mass. Eye and Ear/Harvard Medical School, working with sell, one resident stated: “To spend a [clinical session] Dr. Toichiro Kuwabara. Upon completing his research, with Dr. Lessell is to see the rare example of an ophthal- he entered the HMS Ophthalmology Residency Training mologist taking a thorough history and performing a Program, training under noted ophthalmologists David complete exam. In the age of technicians, support staff, Cogan, MD and Paul Chandler, MD. and shortcuts, Dr. Lessell knows only to do things com- After residency, Dr. Lessell joined the new ophthal- pletely and accurately himself.” mology department at Boston University (BU) Medical Dr. Lessell embodies the attributes of his teacher, Dr. Center under Dr. Ephraim Friedman, attaining the rank of Chandler, as a physician who exemplifies the highest Professor of Ophthalmology, Neurology and Anatomy. standards of teaching and patient care. He received the During his 18-year tenure at BU, he maintained a thriving Outstanding Teacher Award in 2004, and in 2006 he was consultative practice at the VA Hospital in Jamaica Plain, honored as a Distinguished Alumnus at the HMS Depart- Carney Hospital, Dorchester, and the New England Medi- ment of Ophthalmology Annual Meeting. In 2006, when cal Center in Boston. Dr. Lessell was a highly regarded the Department of Ophthalmology completed funding teacher at Boston University Medical School, and was for the Paul A. Chandler Professor of Ophthalmology, honored with the 1977 Metcalf Cup and Prize, an annual Dr. Lessell was named the first incumbent, reflecting a award presented to the most Outstanding Teacher at BU. lifetime of major accomplishments and unparalleled ex- In 1983, he was recruited to Mass. Eye and Ear as cellence in academic medicine. Dr. Lessell has authored 1 Trobe, Jonathan D, Director of the Neuro-Ophthalmology Service. Over over 200 publications, chapters and reviews, and serves MD, Simmons Lessell the years, he built an outstanding clinical and teaching on the editorial board of two premier peer-reviewed The Gaon of Neuro- service. His first recruit to the faculty was Mass. Eye journals, Archives of Ophthalmology and Journal of Ophthalmology. Journal of Neuro- and Ear neuro-ophthalmology fellow, Joseph Rizzo III, Neuro-Ophthalmology. At 78 years of age, he remains Opthalmology, 2007. MD. Together, they have trained a premier group of busy with clinical practice, teaching, and educational 27(1): p.61-73 interationally recognized neuro-ophthalmology fellows. administration. 117 M EDICAL

The HMS Residency Program: EDUCATION Training Ophthalmologists, Turning out Leaders RE S The HMS Department of Ophthal- 24/7 Emergency IDENCY mology Residency Training Pro- Department Hands-on learning

gram, directed by John Loewenstein, HMS resident The Mass. Eye and Ear Emergency PROGRA MD, and Associate Director, Carolyn graduate statistics Department (ED) is one of only Numerous program innovations Kloek, MD is ACGME accredited and three dedicated eye facilities in the have created a more effective ranked by Ophthalmology Times as A Five-Year Review: country, and New England’s only learning environment for trainees. M one of the top five programs in the Academic Years 2007–2011 specialized referral center for eye State-of-the art training tools and country. With the program’s stel- trauma. This busy facility handles an technology enable residents to fine- lar reputation, securing one of the 97% seek fellowship training average of 12,000 patient visits each tune their surgical skills outside of department’s eight junior residency 57% choose HMS fellowships year, and provides a tremendously the operating room. slots is highly competitive. Each valuable teaching environment for 60% pursue academic year, the program attracts an aver- residents, complementing their al- Progressive surgical careers after fellowship age of 450 elite physician applicants ready robust clinical exposure. Dur- curriculum from around the globe. ing ED rotations, junior residents Beginning in the first year of Mentored by some of the finest learn to function independently and residency, a progressive surgical educators in ophthalmology, resi- subspecialty programs of our world- manage the medical and surgical curriculum provides a graduated dents receive superb comprehensive class HMS affiliates, including Mass. care of patients with various ocular learning process for trainees, as well and subspecialty training. Many Eye and Ear, Massachusetts General pathologies, conditions, and inju- as greater surgical exposure with a faculty members are renowned Hospital, Children’s Hospital Bos- ries. By year three, senior residents cataract rotation in Year 2. “We’re internationally for their specialized ton, Beth Israel Deaconess Medical perform open-globe repairs on pa- always looking at ways to give our expertise in ocular melanoma, mac- Center, the VA Boston Healthcare tients under the supervision of the residents the best experience pos- ular degeneration, retinal degenera- System, and the Cambridge Health Chief Resident - who also serves as sible,” says Carolyn Kloek, MD, tions, keratoprosthesis, diabetic Alliance. Residents also provide in- Director of the Eye Trauma Service eye disease, ocular surface disease, patient consultations and 24/7 emer- — and supervise junior residents in glaucoma, ocular genetics, amblyo- gency eye care and trauma coverage minor procedures. pia, and ocular pathology. In this to patients at Mass. Eye and Ear, and HMS residency highlights rich and dynamic teaching environ- many Harvard-affiliated hospitals. Aravind Eye Hospital, ment, our gifted academicians and Additional clinical and surgical India Year 1: (PGY-2) clinician scientists nurture, inspire, experience is gained through senior During senior year, most residents •• Ophthalmology fundamentals gained through and challenge residents at every rotations at the Togus VA in Maine choose to do an international elec- daily lectures, core clinical rotations, and “high- turn while carefully balancing the and elective rotations at Aravind Eye tive at the Aravind Eye Hospital in value” exposure in the Emergency Department needs and safety of their patients. Hospital in India. India. This unique opportunity and Eye Trauma Service Residents complete this synergy by With 11 affiliate and partnering allows HMS ophthalmology resi- •• Observe in the operating room and serve as prima- bringing vital contributions, energy, institutions, HMS’s broad-based dents to broaden their clinical and ry surgeon for several operative cases and insight to bear across the de- organizational structure brings surgical experience in an interna- partment. tremendous educational value to tional setting. Year 2: (PGY-3) Residents work closely with our residency program. Diverse At Aravind, residents witness an •• Refine exam, diagnostic, and surgical skills rotating junior and senior faculty to pursue patient populations give residents impressive international health care through subspecialty clinics novel scientific and clinical inves- exposure to a myriad of patholo- system that delivers high-quality eye •• Independently consults for HMS affiliates (w/at- tigations; their efforts often lead to gies and the opportunity to provide care to a large volume of patients in tending supervision) publication of scholarly papers in HMS Department of Broad patient exposure highly specialized care to patients a cost-efficient manner. Residents •• Emphasis on surgical skills (oculoplastics, strabis- peer-reviewed journals. Residents Opthalmology With a strong emphasis on leader- both young and old. Residents di- have the opportunity to participate mus, vitreoretinal, and cataract surgeries) also give presentations at national national rankings ship development, the residency rectly benefit from the international in the cornea, glaucoma, and uveitis •• Perform intravitreal injections, as well as retina meetings and conferences such as program is structured to give train- reputations of our faculty; patients clinics with exposure to end-stage and glaucoma laser procedures Association for Research in Vision ees broad patient exposure and in- come from around the world seeking inflammatory and infectious diseas- U.S. News & World Report and Ophthalmology (ARVO) and creasing responsibility during their specialized care, and residents work es that are uncommon in the United Year 3: (PGY-4) #4 “America’s best hospitals” American Academy of Ophthalmol- three years of training. Residency in tandem with faculty to diagnose States. Residents also spend half of •• Refine knowledge, judgment, technical skills, and (2011–12) ogy. In 2011, 70 percent of HMS oph- training is firmly integrated into all and treat some of the most difficult each day in the operating room, and professional maturity thalmology residents were invited aspects of patient care so that train- and unusual ocular pathologies. serve as primary surgeons for cata- •• Intensive ophthalmologic surgical training in cata- Ophthalmology Times to present at ARVO’s annual spring ees gain expertise in diagnosing and Each affiliate setting is unique, and ract surgeries (both extra-capsular ract, glaucoma, anterior segment, open-globe, and #5 “Overall best program” meeting. treating an extensive array of ocular residents gain valuable insights from and phaco-emulsification). retina surgeries #3 “Best research program” conditions. the varied philosophies of treatment •• Elective surgical rotation at Aravind Eye Hospital, (2010–11) Residents develop finely tuned and surgical techniques of individual India surgical and clinical skills as they ro- institutions and their faculty. tate through the comprehensive and 119 M

“Our goal with the Mass. Eye and Ear Cataract Surgery Mentor is to minimize EDICAL clinical risk while providing residents with the best “real-life” experience

possible for learning cataract surgery. We fully expect this virtual training EDUCATION tool to boost skills and confidence, and to better prepare residents for their experience in the operating room.” —John Loewenstein, MD RE S Associate Director of the Residency numbers in Year 2, and better pre- but also allows users to access a full along with either written teach- IDENCY Program. In collaboration with Dr. pared senior residents for busy cata- reference section. ing materials or training using the

Loewenstein and Lynn Poole Perry, ract rotations at the Togus VA and, if Text options for actions in the Mass. Eye and Ear Cataract Surgery PROGRA PhD, MD, Dr. Kloek has worked over elected, Aravind Eye Hospital. surgery appear during the training Mentor. The residents who utilized the last several years to enhance the session; these actions are then illus- the computer simulation tool scored curriculum. “These enhancements trated on the central video portion. significantly higher on post-training M redistribute the traditional third- If the surgeon-in-training makes a tests, and rated the tool more year ‘blast’ of surgical training so Virtual Success: serious error, the program provides enjoyable to use and more likely that residents get surgical exposure The Mass. Eye and Ear immediate feedback in the form of to be used repetitively. This study, Carolyn E. Kloek, MD much earlier in their careers,” ex- Cataract Surgery Mentor an expert video, explaining how the published in the February 2010 issue plains Dr. Kloek. “Gradual exposure Cataract surgery—one of the most problem occurred, what to do to of the journal Ophthalmology, dem- Associate Director, Residency Program in Ophthalmology, Harvard Medical School allows time to reinforce core surgi- frequently performed eye surgeries fix it, and how to avoid making the onstrates that the Mass. Eye and Ear Instructor in Ophthalmology, Harvard Medical School cal principals and to build key skills in the United States—is notoriously same mistake again. This essentially Cataract Surgery Mentor could be an Editor-in-Chief, Digital Journal of Ophthalmology that trainees can scale up over time. difficult to master. Residents typi- allows new surgeons to master life- effective supplement to traditional It’s a more effective way to learn.” cally train in a “wet lab” scenario be- like surgery without risking injury to teaching. Dr. Carolyn Kloek is a comprehensive ophthalmologist at Mass. Eye and Another program improvement fore moving directly to live patients. a patient. Moreover, the computer “Our goal with the Mass. Eye and Ear who provides consultation and treatment for cataracts, eye injuries, that complements clinic experience Making this leap can potentially simulation tool allows residents to Ear Cataract Surgery Trainer is to and various other ocular disorders. A magna cum laude graduate of is a structured schedule of custom- cause surgeons-in-training and their practice surgery at any time, even minimize clinical risk while provid- Dartmouth College, Dr. Kloek received her MD from Harvard Medical ized wet lab sessions, which are teachers a good dose of anxiety. without a teacher or instructor ing residents with the best “real- School and completed an internship in Internal Medicine at Brigham and formally proctored by faculty and Moreover, finding good teachers present. This promotes more rapid life” experience possible for learning Women’s Hospital. Dr. Kloek completed her ophthalmology residency at fellows. In 2009, the department and patients who will agree to let a learning while drastically reducing a cataract surgery,” says Dr. Loewen- Mass. Eye and Ear, where she served as Chief Resident. also invested in a state-of-the-art resident participate in their surgery host of issues, such as cost, manage- stein. “We fully expect this virtual Dr. Kloek is actively involved in medical student and resident educa- wet lab that is equipped with the so they can gain real-life training ex- ment, and scheduling. “We want to training tool to boost skills and tion. She routinely serves as a lecturer at HMS, and is a preceptor for most advanced teaching tools avail- perience can be challenging. Several make sure that future ophthalmolo- confidence, and to better prepare medical students rotating in ophthalmology at Mass. Eye and Ear. As able. Trainees can now hone their years ago, HMS Residency Program gists can be taught in a safer and residents for their experience in the Associate Director of the HMS Residency Program in Ophthalmology, surgical skills 24/7 using an Eyesi Director John Loewenstein, and more effective manner,” says Dr. operating room.” The developers are Dr. Kloek assists residency program director, Dr. John Loewenstein, in Virtual Reality Simulator and other Bonnie Henderson, MD, FACS, Henderson. now exploring licensing the program the administrative leadership of the program, and serves on several HMS high-tech training tools. former Director of Comprehen- To test the effectiveness of the that would make it accessible to committees, including the Graduate Medical Education Committee and sive Ophthalmology and Cataract Mass. Eye and Ear Cataract Surgery training programs and practitioners Residency Selection Committee. She developed and implemented the Step-wise Consultation Service at Mass. Eye Mentor, Drs. Henderson, Loewen- nationwide. progressive Harvard Ophthalmology Residency surgical curriculum to phacoemulsification and Ear, set out to find a better way stein and colleagues conducted a improve the learning experience for trainees. She also spearheaded a Drs. Loewenstein and Kloek have to ameliorate some of these hurdles prospective, multi-center, single- 360-degree evaluation system for HMS residents. She continues to teach also introduced modular stepwise and better prepare residents for the blind, controlled trial using oph- ophthalmology residents in both the clinic and operating room; in 2008, training of phacoemulsification operating room.” thalmology residents from seven Dr. Kloek was selected by Harvard ophthalmology residents to receive surgery beginning in Year 2. This The “better way” that emerged academic institutions. The residents the HMS Teacher of the Year Award, reflecting her outstanding mentor- has made the intricacies of cataract was the Mass. Eye and Ear Cataract received traditional surgical training ing skills and efforts in medical education. surgery, one of the most difficult Surgery Mentor, a virtual reality Dr. Kloek’s research activities complement her dedication to teaching and complex to master, easier for training tool being developed by and focus on advancing ophthalmology education. She served as co- second-year residents to grasp. In Drs. Henderson and Loewenstein. Principal Investigator for a study assessing residency experience for the lieu of having residents perform the Adam Neaman, PhD was instrumen- progressive surgical curriculum, which was presented at the 2011 annual procedure from start to finish for tal in the conception of the program, Educating the Educators meeting. For Academic Year 2009-10, she re- each surgery, they execute indi- and several other Mass. Eye and ceived the HMS Shore Fellowship to support her contributions to devel- vidual steps (such as lens insertion) Ear cataract surgeons have made op the innovative Mass. Eye and Ear Cataract Surgery Mentor. She is also for every case that day guided by significant contributions. The simu- collaborating with faculty at the Division of Sleep Medicine at Brigham the attending physician. By the end lator contains a screen that shows and Women’s Hospital to investigate the effect of sleep deprivation on of their 7-week cataract rotation, surgical animations and videos of the learning of surgical skills on a simulator. Recently, she was honored residents have mastered every step real surgical examples, complete with a prestigious Harvard Medical School Rabkin Fellowship in Medical of phaco. A recent survey of train- with expert discussions on details Education to develop a standardized online ophthalmology curriculum ees indicates that the new stepwise of the surgery. There is also a help designed to enhance the training of U.S. medical school students, and to model helps them learn more ef- and reference section, and at any prepare graduates to more effectively triage and manage a wide variety ficiently, improves recall of surgical given moment, questions may pop of ophthalmic diseases. The case-based program will feature a series of steps, and creates a more relaxed up that are specific to that step in the guided interactive modules on topics covered in Basic Ophthalmology, a environment for residents and at- surgery. The self-guided, interactive textbook published by the American Academy of Ophthalmology. tendees. The new model has also led program not only anticipates typical to an increase in cataract surgery questions that a beginner would ask, Carolyn E. Kloek, md 121 M

“The retina has long fascinated me. Here, a thin sheet plastered to the back EDICAL of the eye seethes with millions of bustling, firing neurons that translate light spotlight: to information we use to understand and interact with the world around us.” EDUCATION The Experience —Dr. Rajesh Rao, HMS Department of Ophthalmology Resident, class of 2011 of One HMS

Resident Rajesh Rao, MD RE S Determined to improve the lives of patients through garnered him a Retina Research Foundation Award at the department’s firm commitment to providing a leadership- into fellowship training so he can delve more deeply into IDENCY scientific and clinical innovation, Dr. Rajesh Rao was drawn 2011 Association for Research in Vision and Ophthalmology driven education. At least once a month, he typically pre- the nuances of ophthalmic retinal diseases. For the next

to the HMS Department of Ophthalmology’s Residency meeting. Dr. Rao’s research has yielded so much promise sented clinical or research topics at one of several sched- two years, he will be training as a vitreoretinal fellow at PROGRA Training Program for a number of reasons: high-caliber that Dr. Chen has continued this new direction of investiga- uled conferences, rounds or symposia. Despite a brimming Barnes Retina Institute (BRI) at Washington University in programs, broad clinical exposure, and extensive research tion in her laboratory. schedule, Dr. Rao continued to pursue his sophisticated St. Louis. Ultimately, he aims to have an academic career and educational opportunities—all delivered by a world- Dr. Rao considers clinical and surgical mentoring to be and productive investigative work at Schepens. that combines clinical practice, teaching, and research – M class faculty mostly comprised of clinician scientists. Dr. one of the great strengths of the HMS residency program. From the start of residency, he found a supportive and the three-fold mantra of a clinician scientist. In his view, Rao was chosen from an impressive pool of more than 500 As he progressed in his residency, Dr. Rao was entrusted congenial cohort among his fellow HMS trainees. This sup- the possibilities are enticing. “The retinal field is poised to applicants to fill one of eight highly competitive residency with gradually increasing roles in clinical eye care. He also port network created a sense of community for Dr. Rao and benefit from recent pharmacological, regenerative, and slots for the Class of 2011. mastered increasingly complex and delicate surgical proce- other trainees—many of whom are far from home, family, surgical innovations that may soon cure retinal disease, not Dr. Rao graduated this spring, and by his account, the dures through the newly implemented surgical training and friends, and all juggling heavy workloads with rigorous just slow disease progression,” he says. HMS residency program exceeded his expectations—not block for second-year residents, complete with state-of- training demands. He credits the support of his peers as For Dr. Rao, the promise of HMS’s residency program is only in gaining exposure to wide-ranging subspecialty areas the art training equipment, including an Eyesi virtual reality one of the most important factors in his success. all about putting theory into action, working with world- and patient populations, but also in opportunities to pur- simulator. In every facet of training—clinic, classroom, “Dr. Rao enjoyed a stellar career at HMS,” notes resi- class teachers and mentors, pursuing original research, sue novel research. In the laboratory of Dong Feng Chen, lab, OR, and ED—his mentors provided an exceptional dency program director, John Loewenstein, MD. “He has a and utilizing his clinical training to treat a breadth of pa- PhD, an internationally renowned Schepens researcher, Dr. learning environment. deep-seated appreciation for the challenges and complexi- tients and pathologies. “Doctors typically help one patient Rao had a rare opportunity to carry out independent inves- In Dr. Rao’s final year of residency, the line between ties of retinal pathophysiology, and relishes the opportu- at a time,” he notes. “However, as a clinician scientist, you tigations in the burgeoning new field of retinal epigenetics. trainee and ophthalmic professional continued to blur as nity to contribute his energy, expertise, and compassion can potentially help thousands more by deciphering the Dr. Chen underwrote the expense of his experiments and he fine-tuned his clinical, surgical, and leadership skills. Like to improve the lives of his patients. I know he will contrib- critical mechanisms of a disease.” As a fellow at BRI, Dr. Rao provided generously of her time and other resources. Dr. his colleagues, he often began his day with an early meeting ute immensely to his chosen field of retinal medicine will continue to pursue his passion—refining his skills and Rao’s original research yielded several presentations and or Grand Rounds presentation. He gained experience in and science.” knowledge that one day may punctuate a new generation a publication in the December 2010 issue of the journal patient advocacy, ethics in patient practice, and issues with Like nearly all of his residency classmates, Dr. Rao has of discoveries. Investigative Ophthalmology and Visual Science. It also transparency and conflict-of-interest, underscoring the parlayed his exceptional skills and considerable knowledge As a clinician scientist, his journey is just beginning.

A day in the life 122 M EDICAL

EDUCATION Clinical Fellowship Programs Offer Unrivaled Opportunities C linical fellow linical The Ophthalmology Fellowship Pro- Exceptional clinical of the Year Award. Fellows are also al training opportunities to appli- grams of Harvard Medical School are experience encouraged to attend and present at cants from underserved areas of the comprised of nine clinical subspe- During training, fellows will care national and international meet- world. Each program has a compre- cialty programs at several affiliate for patients with a wide variety of ings, and travel reimbursements and hensive orbital and oculoplastic sh hospitals. Together, these individual complex ocular conditions, advanc- awards are available. surgery curriculum that includes ip

s programs pursue a single goal: to ing their clinical skills for a diverse clinical and surgical care, academic train superb specialists in ophthal- array of ophthalmic disorders. research and writing, and cosmetic mology. These programs not only Fellows participate in all aspects surgery. Research is mandatory in prepares fellows to evaluate and of patient care including routine Clinical Fellowship these rigorous training programs, manage the most difficult clinical examinations, patient consultation, Opportunities and there are many opportunities cases, but also provides an atmo- emergency and on-call services, and Chair, Fellowship Committee, for interdepartmental collaboration. sphere that fosters professional surgery. The devotion to teaching Dean M. Cestari, MD development through teaching and and mentoring of our accomplished Glaucoma Fellowship research. This unrivaled breadth of faculty members provides a rich Cornea, Refractive Program Director: Louis R. Dean M. Cestari, MD opportunity serves to mold the next academic and clinical experience Pasquale, MD Surgery, and External Assistant Professor of Ophthalmology, Harvard Medical School generation of educators and leaders for fellows. Disease Fellowship The Glaucoma Fellowship Program in the field of ophthalmology. Program Director: Reza Dana, is an intense one-year training Chair, Fellowship Committee, Massachusetts Eye and Ear Infirmary Unparalleled research MD, MPH, MSc program conducted at the Glau- Organization and opportunities Founded in 1958 by Dr. Claes Dohl- coma Service of Mass. Eye and Ear. Dr. Dean Cestari is one of the few ophthalmologists worldwide who is facilities The HMS Department of Oph- man, the Cornea, Refractive Surgery, In this full-service facility, outfit- board-certified in both neurology and ophthalmology. A graduate of Col- The following clinical fellowship thalmology Fellowship Training and External Disease Fellowship ted with state-of-the-art diagnostic gate University in Hamilton, NY, Dr. Cestari received his MD from the Sack- programs are available within the Program strives to complement is an intensive one-year program and surgical equipment, fellows ler School of Medicine of Tel Aviv University in Israel. He completed an Harvard Medical School Depart- its extensive clinical fellowship that equips fellows with advanced learn the medical management of internship in internal medicine and a residency in neurology at New York ment of Ophthalmology: experience with academic stimula- diagnostic and surgical skills for glaucoma cases, as well as the pre- Presbyterian/Weill Cornell Medical College. After a one-year fellowship in tion and research. Abundant and the entire spectrum of corneal and and postoperative care of surgi- neuro-ophthalmology at Mass. Eye and Ear, Dr. Cestari returned to New •• Cornea, Refractive Surgery, and unparalleled opportunities for clini- external eye disorders. Fellows care cal cases. In addition, fellows can York Presbyterian/Weill Cornell Medical College. There, he completed External Disease Fellowship cal collaborations exist at several for a wide variety of patients with explore career development at Mass. a residency in ophthalmology, serving as Chief Resident in his final year. •• Glaucoma Fellowship HMS affiliate hospitals and other complex disorders in the Cornea Eye and Ear through teaching and Dr. Cestari then rejoined the HMS Department of Ophthalmology and •• Oculoplastic and Reconstructive universities in the Boston area. Service of Mass. Eye and Ear and research. While 80 percent of the Mass. Eye and Ear in 2006 as Instructor of Ophthalmology, and became Surgery Fellowship Ophthalmology clinical fellows who at nearby Mass General Hospital. fellow’s time is dedicated to patient Assistant Professor in 2008. •• Ophthalmic Pathology Fellowship demonstrate strong research poten- Conferences and teaching activities care, many opportunities for clini- Dr. Cestari’s primary clinical interests include optic nerve disorders, •• Neuro-Ophthalmology Fellowship tial are given careful consideration provide forums for ongoing educa- cal, basic science, and translational strabismus, and intracranial hypertension of unknown causes. An integral •• Ocular Immunology and Uveitis for competitive career development tion and collaboration. Numerous research exist in collaboration with member of Mass. Eye and Ear’s Neuro-Ophthalmology Service, he runs Fellowship grants that offer junior faculty status graduates of this fellowship go on investigators of the Howe Labora- an active medical and surgical practice, performing medical and surgical •• Vitreoretinal Fellowship and protected time for research. to serve in positions of clinical and tory of Mass. Eye and Ear. intervention for adult strabismus and evaluating patients with various •• Medical Vitreoretinal Fellowship academic leadership throughout the neuro-ophthalmic disorders. Also an active clinician-scientist, Dr. Cestari •• Pediatric Ophthalmology and Excellence in education world. An optional second year is Ophthalmic Pathology hopes to elucidate the underlying mechanisms of optic nerve disease. His Adult Strabismus Fellowship Historically, HMS Ophthalmology offered in cornea research. Fellowship efforts to develop preclinical models and novel neuro-protective strate- fellows have played an active role in Program Director: Frederick A. gies for optic neuropathies are supported by a Harvard Medical School All eligible fellowship programs are the education of residents and medi- Oculoplastic Fellowships Jakobiec, MD, DSc Catalyst Grant. either currently certified or pending cal students. In addition to serving Program Directors: Suzanne K. The Ophthalmic Pathology Fel- As Assistant Professor of Ophthalmology at HMS, Dr. Cestari is com- certification by the Association of as attending staff in the Emergency Freitag, MD and Aaron M. Fay, MD lowship at Mass. Eye and Ear is mitted to training and mentoring students, residents, and fellows. He has University Professors of Ophthal- Department, fellows help organize The Ophthalmic and Orbital Plastic an interdepartmental curriculum been invited to participate in several training programs, including the Lan- mology. Of the 30 clinical fellows en- conference cases, write didactic Surgery Service at Mass. Eye and Ear coordinated between the David caster Course in Ophthalmology and the Kevin Hill Seminar in Ophthal- rolled in the Ophthalmology Clinical reviews for ophthalmology text- offers three training programs: 1) a G. Cogan Ophthalmic Pathology mology. Dr. Cestari is also recognized for his leadership skills. Since 2007, Fellowship Program for Academic books and journals, and deliver two-year Oculoplastic Fellowship Laboratory, the Ophthalmic and he has served on the Digital Media Committee of the American Academy Year 2011-12, 24 are based at Mass. presentations to residents, students, that is accredited by the Accredita- Orbital Plastic Surgery Service, and of Ophthalmology and on the Curriculum Development Committee of Eye and Ear, three are based at the and other fellows. This tradition of tion Council for Graduate Medical the Mass General Hospital Depart- the North American Neuro-Ophthalmology Society. At Mass. Eye and Ear, Beetham Eye Institute of Joslin Dia- excellence in education not only Education (ACGME) 2) a two-year ment of Pathology. In the Oph- he chairs the Clinical Fellowships Committee and leads the Clinical Fel- betes Center, and three are based at enriches the academic experience Oculoplastic Fellowship that is ac- thalmic Pathology portion of the lowship Program, which spans nine sub-specialties. Children’s Hospital Boston. These of ophthalmology fellows, but is credited by the American Society of curriculum, fellows receive training fully equipped and state-of-the-art also appreciated and recognized by Ophthalmic Plastic and Reconstruc- in eye anatomy and histopathology. institutions enable fellows to master their trainees. Each year, students tive Surgeons (ASOPRS), and 3) a In the Ophthalmic Pathology and innovative diagnostic and surgical and residents honor this tradition of one-year Oculoplastic International Oculoplastics portion, fellows learn techniques. teaching excellence with the Fellow Fellowship that provides exception- to evaluate patients with conditions 125 M EDICAL

EDUCATION C linical fellow linical of the eyelids, conjunctiva, orbit, Ocular Immunology and advanced clinical technology. Here, clinical experience includes broad and periorbital compartments using Uveitis Fellowship fellows receive comprehensive exposure to every aspect of pedi- advanced techniques. This one—to Program Co-Directors: George N. training in the surgical and medi- atric ophthalmology, including two-year program imparts the skills Papaliodis, MD and Lucia Sobrin, cal management of diseases of the innovative procedures for pediatric necessary to rapidly and differen- MD, MPH retina, vitreous and choroid. The oculoplastic surgeries, cataracts, sh ip tially diagnose rare and complex The Ocular Immunology and Uveitis program includes strong compo- strabismus, and glaucoma. This s eye disorders. Alternatively, fellows Fellowship, conducted at multiple nents in ocular tumors and pediatric fellowship also provides compre- may choose to complete a one-year clinics within Mass. Eye and Ear and retina. The two-year fellowship hensive training for the clinical program dedicated exclusively to Mass General Hospital, is an inten- provides a uniquely intense clinical management of complex adult Ophthalmic Pathology. sive one-year program that provides experience that allows ample time strabismus. Fellows have access to advanced diagnostic, therapeutic, for academic pursuits. As a result, advanced diagnostic equipment, as Neuro-Ophthalmology surgical, and research training for this program produces vitreoretinal well as the broad research activity Fellowship ocular inflammatory disorders. specialists with significant experi- and academic stimulation of the Program Director: Joseph F. Rizzo Various assigned clinics provide the ence in basic or applied ophthalmic Longwood Medical Area. Mandatory III, MD necessary skills for delivering high- research. Many graduates go on to research projects are conducted un- The Neuro-Ophthalmology Fellow- quality and comprehensive patient serve as professors of ophthalmol- der the guidance of the diverse and pedram hamrah, md ship at Mass. Eye and Ear provides care. Through collaborations with ogy, private-practice retina special- internationally respected faculty of intense training in both ophthalmol- the Rheumatology Department of ists, retina service directors, and Children’s Hospital Boston. work with a variety of scientists and ogy and neurology. Fellows learn Mass General Hospital, Ocular Im- academic leaders. Research Fellows in clinicians to implement new and in- to evaluate and manage a broad munology and Uveitis fellows may Community-based novative interventions. For example, spectrum of neuro-ophthalmic gain clinical experience in the non- Medical Retina clinical fellowships Ophthalmology research fellow Andrea Cruzat, MD, cases, including optic neuritis, ophthalmic effects of inflammatory Fellowship The Department of Ophthalmology At any given time, the Department worked with Dr. Pedram Hamrah to ischemic optic neuropathy, various disorders. Ample research opportu- Lloyd Paul Aiello, MD, PhD sponsors four additional clinical fel- of Ophthalmology trains approxi- study the use of in vivo confocal mi- other neurological or neuromuscu- nities are also available at Schepens Conducted at the Joslin Diabetes lowship opportunities with several mately 100 research fellows who croscopy in patients with different lar conditions that affect the eye, Eye Research Institute, where ongo- Center, the Medical Retina Fellow- distinguished community oph- represent a new generation of corneal pathologies. Their work has and cases of unexplained vision loss. ing research projects are delineating ship allows exceptional research thalmologists who hold part-time clinician scientists. Integral to the revealed many new applications for Working closely with the neurolo- immunological and inflammatory opportunities along with strong academic appointments at Harvard translational work of the depart- this technology—greatly influencing gists and neurosurgeons of Mass responses within the eye. clinical training in the management Medical School, and practice pri- ment, our research fellows embody ophthalmic research and practice, General Hospital, fellows proviº de of diabetic eye disorders. State-of- vately in the Boston area. As expe- the department’s focus on bench-to- and further strengthening the Ocu- services for inpatients on a regular Vitreoretinal Fellowship the-art diagnostic and therapeutic rienced mentors and teachers, they bedside research. lar Surface Imaging Center of the basis. World-renowned for its strong Program Director: Shizuo Mukai, technology is readily accessible in offer trainees an outstanding clinical Research fellows may be actively Mass. Eye and Ear Cornea Service. translational research, the Neuro- MD this full-service diabetes eye treat- fellowship experience in the follow- involved in both the basic science Research fellows may have Ophthalmology Service of Mass. Eye Established in 1977, the Vitreoreti- ment and research center, which ing subspecialties: and clinical aspects of translational far-reaching impact that extends and Ear also provides cutting-edge nal Fellowship is offered through is located in the heart of Boston’s studies—bridging investigations beyond the department. The thera- research opportunities for fellows in Mass. Eye and Ear’s Retina Service, Longwood Medical Area. Fellows Glaucoma Fellowship: between the laboratory and the peutic regimens designed by Dr. this program. a fully equipped clinical facility with receive excellent training in the his- Preceptor: Mark A. Latina, MD (Read- clinic. As a research fellow work- Dastjerdi are now used throughout tory, diagnosis, and treatment of dia- ing Health Center) ing with Dr. Reza Dana, Moham- the world in clinical testing and betic retinopathy, and interact daily mad Dastjerdi, MD, conducted the practice; similarly, the information with internationally recognized Ocular Immunology and Uveitis initial laboratory investigations gained from Dr. Cruzat’s research experts. In addition to attending Fellowship: of bevacizumab for corneal neo- has been central to the growing use diabetes and ophthalmology clinics Preceptors: C. Stephen Foster, MD vascularization; he then tested the of corneal imaging worldwide in within the local medical community, and David Hinkle, MD (Massachusetts antiangiogenic regimen in prospec- both laboratory and clinical inves- fellows also have ample opportuni- Eye Research and Surgery Institute) tive human studies, and further tigations. Research fellows also ties to participate in national and refined his therapeutic strategies serve as liaisons between multiple international meetings. Retina Fellowships(2): in the laboratory before additional groups—not only working with • Preceptors: John J. Weiter, MD, clinical trials. Research fellows like primary investigators, but also with Pediatric Ophthalmology PhD, and Sheldon M. Buzney, MD Dr. Dastjerdi are key players in each patients, other scientists in differ- and Strabismus (Retina Specialists of Boston) stage of the translational research ent fields, and even pharmaceuti- Fellowship • Preceptors: Arnold J. Kroll, MD process—from experimental design cal companies. Research fellows in Program Director: Deborah K. (Zero Longfellow Place, Charles to clinical evaluation to publication the Department of Ophthalmology Vanderveen, MD River Park), Peter L. Lou, MD and implementation. thus fill a fundamental niche in the The Pediatric Ophthalmology and (Andover Eye Associates), Edward In the Department of Ophthal- concept of translational medicine— Strabismus Fellowship is a one-year A. Ryan, MD (microsurgical eye mology, there are also research within our department and beyond. fellowship program conducted at consultants), and Tatsuo Hirose, fellows who work exclusively on Children’s Hospital Boston. The MD (Boston Eye Group) human studies; as such, fellows may 126 M EDICAL “This meeting was a great platform to engage colleagues from all over the U.S. and abroad, and an opportunity to collaborate with some of the best minds in AMD research. Having

EDUCATION High-Value Education Programs speakers on hand from related disciplines added to the breath of discussion and gave the meeting a very unique flavor.” -Anthony P. Adamis, MD, Vice President and Global Head of Ophthalmology, Genentech, Inc. h ig h

- The Department’s first AMD International Biennial v A robust didactic curriculum comprises ophthalmology Grand Rounds, symposia, alue progra alue Conference, launched in 2010, drew a distinguished and lectures, workshops, conferences, courses, and special events. This structure of- diverse group of clinicians and researchers from around fers exceptional breadth and depth of discussion for residents, fellows, and faculty. the U.S. and abroad to discuss current topics and challenges in AMD research. The interactive format engaged ms Program offerings span enduring educational venues such as the Lancaster Course participants in thought-provoking discussion on numer- in Ophthalmology - now in its 65th year – to the department’s new AMD Interna- ous topics including genetics, inflammation, stem cells and tissue engineering, imaging, animal models, and tional Symposium, which draws faculty from around the world to discuss emerging neurodegenerative disease. Participant feedback spoke trends in AMD research. to the depth of discussion and meaningful dialogue with colleagues. Plans for the 2012 event are in progress. For International symposia Continuing Medical Education more information, visit www.schepens.harvard.edu/ AMD International Symposium NEW Presentation of the Red Eye (HMS on-line) amd_symposium International Cornea Conference Genetics: Macular Degeneration (HMS on-line) NEW The Biennial Cornea Conference, now in its 27th year, Ophthalmology Grand Rounds International explores current basic and laboratory research develop- (CME credit available) Digital Journal of Ophthalmology ments of the cornea and ocular surface, building links between this exciting new information and the numer- Visiting Professors and Invited Department of Ophthalmology Annual ous disease entities that afflict this portion of the eye. Lectures Meeting & Alumni Reunion Two days of lectures typically feature some 30 national Paul A. Chandler Visiting Professorship Frederick A. Jakobiec Lecture in Ophthalmology and international speakers. Session topics include Simmons Lessell, MD Cornea Visiting Professor Lecture Series Mariana D. Mead Lecture Ocular Pain and Sensation, Dry Eye and Ocular Surface, Ephraim Friedman Lecture Distinguished Alumni Awards and Lectures Infection, Inflammation and Angiogenesis, Stem Cells guished Alumni Awards and Lectures. The inaugural Murphy/Chylack Lecture and Regenerative Medicine. Alumni Reunion was dedicated to ten graduating classes Harvard Visiting Professorship & Residents’ Course from 1961 to 2006, and featured the observations and Boston Ophthalmic Pathology Lecture Series The Annual Harvard Intensive Cataract Surgical career achievements of a representative from each five- Pediatric Ophthalmology Visiting Professor Highlights Training Course is the premier cataract surgery train- year anniversary class. Participants were treated to a cel- Lecture Series Ophthalmology Grand Rounds & Visiting Professor ing course for ophthalmology residents in the United ebratory dinner, toured new Mass. Eye and Ear facilities, Schepens Distinguished Lecture Series Lecture Series at Mass. Eye and Ear, Schepens Eye States. Founded in 2005 by Bonnie An Henderson, MD, and capped off their weekend with visits to the Museum Research Institute, and Children’s Hospital Boston FACS the course has been co-directed since 2006 by Dr. of Fine Arts and Fenway Park. Special Courses, Workshops, feature more than two dozen lectures each year, includ- Henderson, Sherleen Chen, MD, and Roberto Pineda Lectures & Seminars ing many named or honorary lectures taught by distin- II, MD. The course attracts distinguished faculty from Macula Conference guished HMS Faculty and lecturers from around the across the country, and offers a complete preparatory Mass. Eye and Ear Resident Lecture Series world. Grand Rounds presentations at Mass. Eye and program covering all aspects of cataract surgery to David G. Cogan Laboratory of Pathology Rounds Ear are moderated by Simmons Lessell, MD, the Paul more than 100 second-year residents each year. The Dr. Pei-Fei Lee Lectureship in Ophthalmology NEW A. Chandler Professor of Ophthalmology. The depart- course is unique in several respects. First, distinguished Ophthalmic Pathology Monthly Cornea Conference ment has also utilized videoconferencing to conduct faculty from around the country are nominated by their The Eye Pathology Service, housed in the David G. Neuro-Ophthalmology Fall Festival international Grand Rounds with colleagues at Aravind respective department chairs as the best representative Cogan Laboratory of Ophthalmic Pathology, serves as a Annual Harvard Vitrectomy Course NEW Eye Hospital, and Shanghai Eye and ENT Hospital at cataract surgeon/teacher of their institution so the level regional and national diagnostic center, and is an inte- Annual Harvard Intensive Cataract Surgical Fudan University. More of these collaborative venues of instruction is unsurpassed. Additionally, the course gral part of training physicians and researchers in ocular Training Course are planned for the future. consists of lectures and a 20-station wet lab so residents pathology. The Cogan Laboratory Lancaster Course in Ophthalmology receive focused instruction on each step of cataract has access to a wide spectrum of Weekly VA Journal Club Annual Mass. Eye and Ear Vitrectomy Course, co- surgery while learning varying techniques from precep- ancillary supports, such as flow cy- Weekly VA Surgical Conferences developed by HMS Ophthalmology Vice Chair for Medi- tors. The course is also foundation-sponsored and free tometry, histochemical and immu- Digital Journal of Molecular Bases of Eye Diseases Course cal Education, John Loewenstein, MD, and HMS Assis- to participating residents. noperoxidase staining, and electron Ophthalmology Cornea Research Seminars and Conferences tant Professor of Ophthalmology, Demetrios Vavvas, MD, microscopy facilities. To provide www.djo.harvard.edu AMD Journal Club PhD, is designed exclusively for first-year vitreoretinal The Department of Ophthalmology launched a rein- the best care possible, the Eye Pa- Glaucoma Focus Group NEW surgical fellows. This unique and comprehensive one-day vigorated and expanded Annual Meeting & Alumni thology Service utilizes a variety of • Original research Surgical Retina Conference (twice monthly) workshop course gives beginning fellows a brief but com- Reunion in 2011. The 3-day weekend features a new clinical ophthalmology services to • Grand Rounds case reports Longwood Medical Area Ophthalmology Conferences prehensive introduction to techniques in vitreoretinal integrated format that combines scientific exchange assist in diagnosis and case manage- • Knowledge review (monthly, September-June) surgery, and prepares them for fellowship OR experience. with networking events and social activities for faculty, ment. The laboratory collaborates • Patient information New Frontiers in Corneal Disease NEW Consisting of lectures, wet labs, and “dry labs” using vir- alumni and newly graduated residents and fellows. The extensively with the Massachusetts • 2,000 registered users from Biennial SportVision Conference tual reality simulators, the course is taught by renowned department’s Annual Meeting - launched in 2004—leads General Hospital Pathology Service 100 countries faculty from the U.S. and abroad and features a 2:1 stu- the festivities with a day of featured speakers, including to evaluate challenging cases, pro- dent/teacher ratio. Dean Eliott, MD, is course director. the traditional Mariana D. Mead Lecture, and Distin- vide enhanced diagnostic services, 129 M EDICAL

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train residents and fellows, and s

Dedicated to every facet of their work, faculty receive first-rate and well-deserved faculty on pursue clinico-pathology research projects. support from Department of Ophthalmology executive leaders. Equally requisite Founded by Benjamin Joy Jeffries support comes from Jeffrey S. Flier, MD, HMS Dean, Faculty of Medicine, and the in 1868 and dedicated to David G. Cogan in 1982, the Cogan Labora- leadership of HMS affiliate institutions. Since taking the helm in 2003, HMS tory is one of the oldest ocular Ophthalmology Chair Joan Miller, MD, has championed a progressive and reward- pathology facilities in the United States. Starting as a simple cabinet ing 21st century workplace environment for HMS faculty While these actions that held pathological specimens require a substantial investment of resources and leadership, Dr. Miller anticipates Frederick A. Jakobiec, MD, DSc and drawings, the Cogan Laboratory Henry Willard Williams Professor of Ophthalmology, Emeritus, Harvard Medical School has grown to include an extensive that future returns—in the form of advances in “personalized” patient care, accel- Professor of Pathology, Emeritus, Harvard Medical School slide collection, an eight-head teach- erated research and discovery, an increasingly collaborative learning environment, Director, David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye and Ear Infirmary ing microscope, digital photography capabilities, and numerous refer- and top-notch faculty recruitment—will be well worth the investment. Some of Frederick Jakobiec, MD, DSc, graduated from Harvard College magna cum laude in 1964. He ence books. Future enhancements these newest efforts have led to: received his MD from Harvard Medical School in 1968 and a DSc from the College of Physicians include acquisition of a twelve- and Surgeons at Columbia University in 1971. He interned at Stanford University Medical Cen- headed microscope, a plasma screen •• New funding & mentoring ter, and completed residencies in both pathology and ophthalmology at Columbia Presbyteri- for viewing slides by large groups, supports an Medical Center. His fellowship in ophthalmic pathology was conducted at the Armed Forces conferencing abilities, and TeleMed •• A streamlined promotion and Institute of Pathology in Washington, D.C. sessions. reappointment track Dr. Jakobiec served as Chief and Chair of Ophthalmology at Harvard Medical School/ Frederick Jakobiec, MD, DSc, •• Expanded programs for profes- Mass. Eye and Ear from 1989 until 2002 when, because of ill health, he stepped down. Upon Director of the Cogan Laboratory, sional development his recovery, he was welcomed back in 2007 as Director of the David G. Cogan Laboratory has been preceded in this role by •• A faculty mentorship program of Ophthalmic Pathology at Mass. Eye and Ear, where he also serves as an attending surgeon a distinguished list of directors •• Establishment of five fully and pathologist. Dr. Jakobiec’s clinical and research interests have centered on inflammation including Drs. Frederick Verhoeff, funded HMS professorships in and tumors of the eye and surrounding tissues. As a clinician he advanced cryotherapy for David Cogan, Taylor Smith, Daniel the last two years conjunctival melanomas and squamous carcinomas as well as concentrated on orbital tumors, Albert, and Thaddeus Dryja. •• Gender-neutral policies that pro- particularly lymphomas, and was responsible for a 450 page chapter on orbital diseases in mote women to leadership roles Spencer’s four volume definitive textbook on Ophthalmic Pathology. •• Numerous venues for profes- Throughout his career, Dr. Jakobiec has focused much of his efforts on ophthalmology sional recognition education. He has served a myriad of visiting lectureships and professorships at over 50 institutions and societies, and has been given numerous awards and medals. For ten years, he was A few of these efforts are highlight- the course director for the Lancaster Course in Ophthalmology, which is the largest and most ed in the following pages. distinguished curriculum for ophthalmology residents. He also participated in the Armed Forces Institute of Pathology Course in Ophthalmic Pathology for two decades. Since 2007, Dr. Jakobiec has served as Program Director for the HMS/Mass. Eye and Ear Clinical Oph- thalmic Pathology Fellowship, and offers daily supervision and teaching of residents, clinical HMS Ophthalmology Today fellows, and medical students, rotating in the Ophthalmic Pathology Laboratory. matthew F. gardiner, md As director, Dr. Jakobiec continues to enhance eye pathology education in the department. Faculty and Trainees by the He developed a pathology-based, visiting professor lecture series covering all aspects of numbers •• 235 Faculty ophthalmic pathology. This popular teaching venue, now in its fourth year, attracts speakers •• Mark B. Abelson IV, MD, CM -- 140 Full-Time who are national leaders in ophthalmic pathology; lectures are open to all HMS and BU Medi- Staying on track •• Lloyd P. Aiello, MD, PhD -- 34 Full Professors cal School residents and fellows in ophthalmology and pathology. Dr. Jakobiec also conducts Guided by HMS Ophthalmology •• Larry I. Benowitz, PhD Ophthalmic Pathology Rounds for trainees and faculty from all HMS affiliate institutions. Held •• 24 Residents Vice Chair for Promotions and (secondary appointment) •• 43 Clinical Fellows monthly, the rounds are comprised of a comprehensive review of cases presented by resi- Reappointments, Dr. David Hunter, •• James Chodosh, MD, MPH •• 100 Research Fellows dents and fellows on all subspecialty services. They are offered as “unknowns” to Dr. Jakobiec the department has made a concert- •• Robert J. D’Amato, MD, PhD •• Postdocs (some overlap with who covers the clinical features, differential diagnosis, pathological features, and management ed effort to streamline the promo- •• Reza Dana, MD, MPH, MSc research fellows) issues of each case. tions and appointment process. •• Anne B. Fulton, MD •• PhD students, Medical In addition to his exceptional clinical and scientific leadership, Dr. Jakobiec has written over Since 2008, 12 faculty members •• David G. Hunter, MD, PhD Students 300 journal articles and book chapters, and has edited more than 20 volumes devoted to eye have been honored with promotions •• Andrius Kazlauskas, PhD 20 percent of full-time HMS tumors and eye pathology. He was Co-Editor of Albert and Jakobiec’s Principles and Practice to Professor of Ophthalmology •• Deborah P. Langston, MD Ophthalmology faculty of Ophthalmology, which is now in its third edition and is considered the gold standard of or Clinical Professor of Ophthal- •• Joseph F. Rizzo III, MD holds the title of Professor ophthalmology reference texts. mology. •• Lois M. Smith, MD 131 M EDICAL

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age-related macular degeneration s (AMD) and other ocular conditions faculty on HMS Ophthalmology Clinician Scientists Meet Our Scholars involving choroidal neovascular- Receive Broad Funding Support On average, researchers receive ization. Her preclinical research their first RO1 or equivalent award utilizes genetic analysis to identify The road of a clinician scientist can be a difficult one at the age of 42, a statistic that un- both risk factors and new pathways Lucia Sobrin, MD, MPH to traverse. On one hand, clinician scientists pos- derscores the critical need for inter- associated with pathological disease Department of Ophthalmology Scholar sess unique skills and perspectives; they help forge mediary funding between mentored processes investigating both mela- multidisciplinary collaborations in translational K awards and independent funding. noma and macular degeneration. K12 Grant Gives HMS Clinician Scientist Time to Grow medicine, and bridge the efforts of academia and Scholar funds are a new funding One area of recent focus explores Dr. Lucia Sobrin is a full-time clinician scientist with the Retina and Uveitis Services. She industry to expedite treatments and cures. On the mechanism designed to address this the use of animal models to study Ula V. Jurkunas, MD completed her ophthalmology residency training at Bascom Palmer Eye Institute in 2003, fol- other hand, they face the challenge of fluctuating need and maintain momentum in the pathophysiology and progres- Department of Ophthalmology lowed by a medical and surgical retina fellowship at the Mass. Eye and Ear in 2005 and a uveitis government and industry funding, which is often our overall research efforts. sion of dry AMD to geographic Scholar and ocular immunology fellowship at the Massachusetts Eye research and Surgery Institute compounded by increasing financial pressures to In 2011, six exceptional faculty atrophy and blindness. She is also Dr. Jurkunas is a full-time member (MERSI) in 2006. That year, she joined the Department’s Retina and Uveitis Services as one of boost clinical productivity in many U.S. academic members were named to funded working with colleagues to test the of Mass. Eye and Ear’s Cornea and the Department’s first Harvard Vision Clinical Scientist Research Program (K12) recipients, re- medical institutions. These added demands can scholar positions in retina, cornea safety and efficacy of antiangiogenic Refractive Surgery Service and As- ceiving a four-year grant to study the genetics of macular degeneration and diabetic retinopa- make it difficult for rising young investigators to find and glaucoma. The program is sup- therapies for various other ocular sistant Scientist at Schepens Eye Re- thy under the mentorship of David Altshuler, MD, PhD, Joan Miller, MD, and Johanna Seddon, the time and resources to pursue investigative work. ported primarily through the award diseases. search Institute. Her studies focus MD, ScM. Not surprisingly, the ophthalmology community and continuing royalties to Mass. on translational research related to One of Dr. Sobrin’s primary research interests is elucidating the genetics of diabetic retinop- has questioned the viability of this career path, even Eye and Ear from the department’s corneal dystrophies and stem cell- athy in African Americans. She was the first ophthalmologist to be awarded funding under the though its rewards often prove rich in scientific successful QLT judgment – itself based therapies for other diseases of HMS Catalyst Grant Program, and is principal investigator for a study entitled, “Epidemiology discovery and patient care. the outcome of successful transla- the cornea. In 2006, she was one of and Genetics of Diabetic Retinopathy in the Jackson Heart Study.” In 2011, she was honored The HMS Department of Ophthalmology has a tional research in the field of wet the first HMS junior clinician scien- with the ARVO/Alcon Early Career Clinician Scientist Research Award. long history of successfully sustaining the efforts age-related macular degeneration. tists to receive a K12 Harvard-Vision Here, Dr. Sobrin describes her experience as a K12 recipient. of its clinician scientists. Examples include: the Additional multi-purpose funding Clinical Scientist Development Pro- introduction of cataract surgery to New England helps support individual research gram award, monies that supported Has the K12 program enabled you to advance your career as a clinician scientist? by Mass. Eye and Ear co-founder, Dr. John Jeffries; programs throughout the depart- her award-winning research into the Yes, it gave me protected time so I could learn the field of complex disease genetics. I didn’t development of the cornea subspecialty and a cor- ment, including stem cell studies pathophysiology of Fuchs’ Endothe- have a background in genetics apart from what I learned in medical school. With salary support neal prosthesis (Kpro, Dr. Claes Dohlman); and the and other translational research lial Corneal Dystrophy (FECD). In and protected time to attend seminars and courses in genetics and biostatistics, I was able to development of photodynamic therapy and anti- projects in the cornea, glaucoma, Demetrios G. Vavvas, MD, addition, her translational research gain the skills I needed to do research effectively in this field. It also provided me with time for VEGF therapies to treat AMD (HMS Angiogenesis and retina services. PhD to bring corneal stem cell therapy on-the-job learning of statistical genetics, which is very time consuming. Finally, it provided me Research Group). This commitment has remained Joan W. Miller Scholar in Retina into clinical practice has been ac- with the funds to start the study of diabetic retinopathy in African Americans that I have initi- rock solid and, since 2004, the department has Research cepted by the Production Assistance ated in the Jackson Heart Study. made substantial headway to broaden funding sup- Dr. Vavvas is on the full-time faculty in Cellular Therapies program of ports so that junior faculty members are encour- of Mass. Eye and Ear’s Retina Ser- the National Heart Lung and Blood How has K12 support directly benefitted your research efforts? aged to pursue research careers. HMS clinician vice. His laboratory research spans Program. The K12 funded a study coordinator and fundus photography for the initial year of our diabetic scientists now receive support through a number of neuroprotection, ocular cancer, retinopathy study. It also supported my tuition for a Masters in Public Health at the Harvard sources, including the K12 program, Scholar funds, angiogenesis, and retinopathies School of Public Health. In a nutshell, the K12 funded my education so I could pursue the re- endowed chairs, as well as multi-purpose funding to of prematurity and diabetes. He is search and then funded the essentials of getting the study started. boost salaries, create programs and fund individual participating in ongoing studies to academic pursuits. Some of these efforts are de- find safer and less toxic therapies for Did the K12 award influence your decision to join the MEE retina and uveitis ser- scribed here. treating retinoblastoma in infants, vices in 2006? Ivana K. Kim, MD and aims to develop therapies that It did. I wanted a position that would support me in my initial years of trying to become a clini- Evangelos S. Gragoudas prevent the growth of primary and cian scientist. I still needed training in research techniques, specifically biostatistics and genet- Distinguished Scholar in Retina metastatic tumors in uveal mela- ics, in order to become an effective clinician scientist. The K12 gave me the time and resources Research noma. In collaboration with Dr. Joan to complete this training while allowing me to continue my clinical work. Director, AMD Unit, Mass. Eye and Ear Miller, he is also pursuing neuropro- Dr. Kim joined the full-time faculty tection strategies that can prevent Pedram Hamrah, MD Has the K12 program met your expectations? of Mass. Eye and Ear’s Retina Ser- photoreceptor death, and poten- Henry Allen Cornea Scholar Definitely. It’s given me the protected time necessary to train in biostatistics and genetics, and vice in 2003. As a key member of the tially preserve vision in many retinal Dr. Hamrah is a full-time faculty under the mentorship of some of the best minds in science – Drs. David Altshuler, Joan Miller, HMS angiogenesis research group diseases. Together with Drs. Miller member of Mass. Eye and Ear’s Cor- and Johanna Seddon. It has also supported my early stage research and subsequent scientific (HMSARG), she has been involved and Kim, he is also developing the nea and Refractive Surgery Service. work that has been the basis for applications for independent funding. I’ve been able to train in numerous clinical and transla- first dry AMD primate model. He directs the newly formed Ocular to become an independent investigator while also continuing to see and treat patients in one tional studies directed toward the Surface Imaging Center in the Cor- of the largest and most prestigious academic medical school environments in the world. development of new therapies for nea Service, where he is interested in 132 M EDICAL

EDUCATION focu

s developing live imaging techniques institutions. Funded through the Ocular Genomics Institute on faculty on and using in vivo confocal micros- National Human Genome Research -- Associate Director of the HMS Endowed Chairs in Ophthalmology Incumbent 2011 Completed copy for image-guided therapy. Institute, this work has generated Ophthalmology Residency Henry Willard Williams Professorship Joan W. Miller, MD 1893 Dr. Hamrah’s research focuses on the largest known group of POAG Training Program immune cell trafficking in immune cases, and seeks to eventually identi- -- Chief Quality Officer in Oph- David Glendenning Cogan Professorship** Richard H. Masland, PhD 1969 and infectious diseases of the cor- fy the full complement of gene-gene thalmology for Mass. Eye and nea, including viral and microbial and gene-environment interactions Ear. William Frederick Chatlos Professorship Eliot L. Berson, MD* 1978 keratitis, corneal transplant toler- associated with POAG. •• Promoted two women physicians ance and rejection, neurotrophic to full Professor with a third in the Paul Austin Chandler Professorship Simmons Lessell, MD* 1986 keratopathy, and ocular surface pipeline disease. From 2008 through May •• Created the first HMS Profes- Charles L. Schepens Professorship Vacant 2008 2010, his research was supported by Shattering the glass sorship that will be named for a a K12 Harvard-Vision Clinical Scien- woman: The Joan Whitten Miller Sir William Osler Professorship Michael S. Gilmore, PhD* 2003 tist Development Program award. ceiling Chair (to be named upon Dr. Mill- Recent research funding includes a More than at any other time in the er’s retirement; currently named Claes Henry Dohlman Professorship Reza Dana, MD, MPH* MSc 2008 Grant-in-Aid award from Fight for department’s history, HMS women in honor of her father, Charles Sight, two grant awards from Alcon faculty are achieving an unprece- Edward Whitten). David Glendenning Cogan Professorship (2) In process 2010 Research, LTD, and a Research to dented array of leadership positions David Glendenning Cogan Professorship (3) In process 2011 Prevent Blindness Career Develop- in patient-care, teaching, research, ment Award. and administration. Guided by Charles Edward Whitten Professorship Evangelos S. Gragoudas, MD* 2011 the vigorous support and gender- HMS Endowed chairs neutral policies of department In part through the establishment of Stelios Evangelos Gragoudas Professorship In process 2011 chair, Joan Miller, MD, significant endowed chairs, the HMS Depart- resources have been directed to ment of Ophthalmology attracts Solman and Libe Friedman Professorship In process 2011 ensure academic and professional and supports the endeavors of advancement of women faculty, and world-class clinician scientists and *signifies inaugural incumbent to redress the inherent balancing act investigators. Endowed chairs offer **The David Glendenning Cogan Professorship was divided into three chairs in 2010 and 2011. of career and family. This support research and training support to has come in many forms - admin- incumbents while giving them the istrative policy changes, financial freedom to pursue independent mology at Mass. Eye and Ear. The au- field of ophthalmology and AMD. On support and scholarship awards, and research without the burden of thor of 36 scholarly articles focusing the occasion of his 80th birthday in Louis R. Pasquale, MD encouragement and mentorship - to financial risk. These endowments Gifts Pay Tribute to on circulation in the eye, Dr. Fried- 2011, another family legacy gift was Distinguished Scholar in enrich the careers and lives of many are a wonderful tribute to the past Ephraim Friedman, MD man developed the vascular model established: the Solman and Libe Ophthalmology outstanding HMS women faculty. success of their namesakes, and for the pathogenesis of age-related Friedman Professorship in Ophthal- Dr. Pasquale is the director and a Since 2009, the department reached serve as a building block for future (1930-2011) macular degeneration (AMD), the mology at Harvard Medical School. full-time faculty member of Mass. several milestones: endeavors. They are also powerful Dr. Ephraim Friedman, ophthal- leading cause of blindness in the Named for Dr. Friedman’s parents, Eye and Ear’s Glaucoma Service. Dr. recruiting tools, attracting vision- mologist and past President of the developed world. He served as Dean the professorship was made possible Pasquale’s research focuses on pri- •• Established the first short-term ary leaders whose contributions Massachusetts Eye and Ear Infirma- of the Boston University Medical through a very generous gift from mary open-angle glaucoma (POAG), disability program for medical historically have forged many paths ry, passed away on June 18, 2011. He School (1970-1974) and Dean of the the Friedman Family Foundation and seeks to improve early detection leave for professional staff at in medicine and science. Prior to was a friend to many within the HMS Albert Einstein College of Medicine with contributions from additional of the disease and improve the un- Mass. Eye and Ear 2008, just four chairs had been com- Ophthalmology community, a loving (1974-1983) before returning to donors and the Foundation of Mass. derstanding of its pathogenesis. He •• Awarded three of six Mass. Eye pleted; today, that number has shot family man, skilled clinician and the Mass. Eye and Ear as President Eye and Ear Infirmary. is principal investigator of several and Ear Scholar Funds to women to 12 thanks to generous department retinal surgeon, sculptor, educator, (1983-1990). A life-long sculptor, Dr. “Generations of HMS ophthal- NIH-funded studies that examine faculty and institutional support, private researcher, and administrator. Friedman retired from administra- mology faculty and trainees will gene-environment interactions re- •• First women appointed to the foundations, and the philanthropy Dr. Friedman was drawn to oph- tion in 1990 to spend more time with benefit from these gifts as they lated to POAG. Together with Janey following positions at Mass. Eye of HMS ophthalmology friends and thalmology while serving as a cap- his art, family, research, and the log endure through the 21st century and Wiggs, MD, PhD, Dr. Pasquale is and Ear: alumni. These gifts will help ensure tain in the Air Force, and completed home he built in Maine. beyond,” said Dr. Miller. “They com- co-leading the NEIGHBOR Consor- -- Vice Chair for Basic Research that generations of outstanding his residency at Harvard Medical In 2006, a gift from Friedman memorate dedication to learning tium—a multi-center cohort study -- Associate Chief for Clinical HMS ophthalmology faculty thrive School/Mass. Eye and Ear under Dr. Family Foundation initiated the that is a Friedman family hallmark, that includes 8,000 glaucoma cases Research in perpetuity. David Cogan in 1961. For the next Ephraim Friedman Lecture in honor and create a lasting tribute to a man and controls gathered from Mass. -- Associate Director of the Howe four years, he was a research fellow of Dr. Friedman’s extraordinary who gave so much to our institution, Eye and Ear, the Nurses’ Health Lab at the Howe Laboratory of Ophthal- teaching, research, and service to the our profession and our patients.” Study (NHS), the Health Profession- -- Director of the Genetics als Follow-up Study, and eight other Diagnostics section of the new