Clinical Spotlight: Enhancing the “Winn”ing Residency Program at Columbia Ophthalmology

Left to Right: G.A. Cioffi, M.D. and Bryan Winn, M.D.

When Bryan Winn, M.D. became Director of the Residency Program in the Department of Ophthalmology, he had two objectives. First, he wanted to enlarge the program, expanding its clinical outreach and enabling the residents to gain experience beyond Columbia Ophthalmology’s tertiary care centers. Second, he wanted to modernize the curriculum, ensuring the program’s approach to resident education remained rigorous and innovative.

He recently achieved his first goal, increasing the cohort size for the three-year residency program. Receiving authorization from the Accreditation Council for Graduate Medical Education (ACGME) involved several years of planning, due to strict national guidelines regulating the expansion of residency programs. In November 2014, the ACGME approved the change, and beginning July 1, 2015, Columbia Ophthalmology will support four residents in each incoming cohort instead of three, eventually increasing the total number of residents to 12.

With a larger cohort, the residency program will provide greater clinical outreach within the community. Each of the four incoming  residents will serve a three-month rotation at Harlem Hospital, treating patients from the disadvantaged communities of Central Harlem, East Harlem, Inwood, and Washington Heights. Since Harlem Hospital’s patient base is largely underinsured or uninsured, Dr. Winn believes the rotation will offer residents the opportunity “to serve the underserved” and care for some of New York City’s more vulnerable patients within a public, inner-city hospital environment.

Harlem Hospital also offers numerous advantages to the residency training program, as it is both a teaching hospital and a trauma center. By exposing the residents to a wider range of ophthalmic diseases and traumatic ocular injuries, this residency rotation will help to broaden their clinical horizons. In conjunction with Harlem Hospital, Columbia Ophthalmology is currently conducting a national search for a candidate who will serve as Chief of Ophthalmology at Harlem Hospital as well as a faculty member at Columbia Ophthalmology. The search committee is seeking a dedicated leader who shares Columbia’s vision for the future of its residency program and the overall health of the greater Harlem community.

The residency program also provides a rotating residency in pediatric ophthalmology to the Stephen Ross Pediatric Ophthalmology and Otolaryngology Center at the Morgan Stanley Children’s Hospital. The residents perform these rotations with Steven Brooks, M.D., the Anne S. Cohen Professor and Chief of Pediatric Ophthalmology, and Lauren Yeager, M.D.,

Assistant Professor and the Peter J. Sharp Pediatric Ophthalmology Scholar. Drs. Brooks and Yeager enjoy working with the residents and providing them with an immersive experience in pediatric ophthalmology. The pediatric rotation aims to enhance the interpersonal skills and empathy of the residents, allowing them the opportunity to develop their bedside manner among very different age populations, from adults to young children.

In collaboration with Royce Chen, M.D., the residency program’s Associate Director, Dr. Winn has also introduced a more modernized curriculum. Three years ago, the Department initiated a two-day, off-site weekend retreat as an annual event. The aim of the retreat is to cultivate a sense of respect for patients and the medical profession, as well as to develop well-rounded and skilled individuals. At the retreat, the residents participate in leadership workshops, communication seminars, professional development programs, and exercises that highlight mindfulness and meditation. At this year’s Resident Retreat, one of the focuses was revising the Department’s approach to the resident curriculum. The residents were able to provide feedback about various aspects of the program, taking a more active and engaged role in shaping the substance of the program. This feedback helps guide faculty members as they consider the program’s curriculum and philosophy.

Jason Horowitz, M.D., the Medical Director of the Resident Clinic, and G.A. Cioffi, M.D., the Department Chair, along with many other faculty members, have also helped guarantee the program’s continual improvement. Dr. Horowitz spends a considerable amount of time with the residents, teaching them clinical skills. Dr. Winn characterizes his teaching style as accessible, supportive, and constructive. “He has the ability to teach the residents without ever making them feel belittled or underappreciated,” Dr. Winn comments. Jokingly, he adds, the residents can often be heard repeating the acronym “WWJD,” or “What Would Jason Do.”

Dr. Winn credits Dr. Cioffi’s willingness to support a more modernized and resident-specific approach as a key factor in the program’s success. “Dr. Cioffi granted us the latitude to implement important modifications to the residency program. In doing so, he has ensured our residents will continue to receive the best possible clinical training at Columbia,” he says.

With the modernized curriculum and the program’s broadened clinical outreach, Columbia Ophthalmology’s residency program will continue to rank among the best programs in the nation. These programmatic enhancements will guarantee that Columbia continues to attract and train the next generation of leaders in ophthalmology.