The PGY-3 year is a time when residents continue to refine their clinical and surgical skills while solidifying their independent clinical decision-making. PGY-3 residents have two, two-month rotations at the main pavilions, Ben Taub Hospital and the Michael E. DeBakey Veteran Affairs Medical Center. The PGY-3 residents also have two-month subspecialty rotations in cornea/anterior segment, glaucoma, retina, and pediatrics.
At BT and the VA, the PGY-3 resident manages inpatient and emergent consultations while helping optimize clinic flow. In addition to this, we are primary surgeons for cataracts cases, laser procedures, and in-clinic minor procedures. At these pavilions, PGY-3s master their clinical skills, improve their surgical abilities, and learn vital leadership skills as they handle consults, communicate with consulting services, and help to facilitate clinic.
In the PGY-3 pediatrics rotation at Texas Children's Hospital, residents pick up where they left off during their PGY-2 year but with a focus on primary strab cases. At the Texas Children's main campus, residents see interesting and rare cases in the clinic and help to manage inpatient and emergent consultations with the faculty. At the satellite locations, residents get a significant amount of personal one-on-one time seeing patients with faculty, which is a great opportunity to improve and refine clinical skills such as streak retinoscopy, strabismus measurements, and detecting and eliciting nystagmus.
For the cornea/anterior segment, glaucoma, and retina rotations, residents spend time at the private-academic clinic (Alkek Eye Center) and the pavilions (BT and VA) both in the clinic and the operating room. The true strength of these rotations is being able to spend a significant amount of time with renowned faculty members. We have independence in seeing new patients, follow-up patients, and both routine and complicated post-operative patients. These clinical experiences challenge us to create treatment plans, which we then discuss with our faculty. These interaction with our attendings help strengthen our ability to think critically about how to manage complicated clinical and post-operative cases and strengthens our clinical competence. These rotations also allow residents to form strong mentor-mentee relationships with faculty members who are all very enthusiastic about teaching and making us better physicians/surgeons.
By the end of this immersive year, PGY-3s have performed 20-30 primary cataract extractions, 20-30 primary strabismus surgeries, at least one primary glaucoma surgery (and many as assistant), 10+ anterior segment lasers, and 10-20 retina lasers. They’ve also assisted in 10-20 endothelial and penetrating keratoplasties and 10-20 vitreoretinal cases. We finish this penultimate year with an excellent understanding of general ophthalmology and each subspecialty, which helps us to decide if we want to pursue a fellowship or stay comprehensive. We also gain a good foundation in the operating room, which gives us a head start for a productive, surgery-intensive PGY-4 year. As PGY-3s, residents take primary call every six days at Texas Children's, St. Luke's Hospital, and the Alkek Eye Center where we have fellows and attending faculty as back-up.