Ophthalmology
Vitreoretinal Surgery
Distinguished Service Director Emeritus Dr. Evangelos Gragoudas established this fellowship in 1977 with the goal of creating the premier surgical fellowship in retina. Four decades later, we firmly believe that we offer the most comprehensive retina training in the country. When fellows graduate, they are confident in both the surgical and medical management of all diseases of the retina, vitreous, and choroid.
The team of retina faculty at Mass Eye and Ear is unmatched across the country and offers an excellent environment to grow professionally. Our diverse and talented faculty members are role models in every retina subspecialty and clinical practice model while also providing career mentorship.
Our alumni include numerous professors of ophthalmology, retina service directors, academic chairs, and a dean of a medical school as well as physicians in many of the most sought after private practice groups around the country.
AUPO Compliant
This fellowship is Association of University Professors of Ophthalmology Fellowship Compliance Committee (AUPO FCC) compliant.
Highlights
- Fellowship Director: Dean Eliott, MD
- Associate Fellowship Directors: John B. Miller, MD, and Nimesh (Nemo) Patel, MD
- Program length: 2 years (beginning in July)
- Number of positions available: 4
- SF Match number: 4067
- Additional Surgical Retina Faculty: Jason Comander, MD, PhD; Mohammad Dahrouj, MD, PhD; Jose Davila, MD; Dan A. Gong, MD; Ivana Kim, MD; Leo A. Kim, MD, PhD; Ines Lains, MD, PhD; K. Matthew McKay, MD; Shizuo Mukai, MD; Elizabeth J. Rossin, MD, PhD; Demetrios Vavvas, MD, PhD; Frances Wu, MD and David M. Wu, MD, PhD
- Additional Medical Retina and Oncology Faculty: Joan W. Miller, MD (Chief of Ophthalmology); Evangelos S. Gragoudas, MD (Distinguished Director, Retina Service); Lucia Sobrin, MD, MPH (Posterior Uveitis); Lucy H. Young, MD, PhD
- Affiliated Surgical Retinal Faculty: Christopher Andreoli, MD (Atrius Chair of Surgical Specialties and Chief Transformation Officer); Miin (Irene) Roh, MD (Atrius and Joslin Diabetes Center); Archana Seethala, MD (Atrius); Mehnaz Khan MD (Atrius)
Program Details
Objectives
Clinically, the fellow will demonstrate competency in the diagnosis of diseases of the retina, vitreous and choroid. At Mass Eye and Ear, patients from all over the world come with unusual diagnostic dilemmas or as complex surgical referrals, and there is no shortage of presentation- and publication-worthy clinical cases.
Surgically, the fellow will become comfortable in any surgical retina scenario. They will master skills in both basic and complex retinal maneuvers and managing a variety of diseases including:
- Rhegmatogenous retinal detachment
- Diabetic tractional retinal detachment
- Proliferative vitreoretinopathy
- Macular surgery
- Traumatic retinal detachment after ruptured globe
- Intraocular foreign body
- Dislocated lenses and scleral fixated IOLs
- KPro-related vitreoretinal surgery
- Ocular oncology surgery
- Diagnostic vitrectomy in uveitis and oncology
- Pediatric retina surgery
As investigators, fellows will carry out meaningful research projects that can be presented at national and international meetings and published in high-impact peer-reviewed journals. The fellows work very closely with an excellent cohort of ophthalmology residents and medical students on a constant basis, both clinically and from a research standpoint.
Surgery
We are a high-volume surgical retina practice, with multiple cases occurring at any time. Our fellows use state-of-the-art instrumentation and techniques with:
- 25, 23, and 27 gauge vitrectomy systems
- Standard and Advanced scleral buckling
- Zeiss and Leica microscopes
- Ngenuity 3D Heads Up viewing
- Resight, BIOM, and AVI wide angle viewing systems
- Alcon Constellation and DORC EVA vitrectomy systems
- Endoscopic vitrectomy
- Intraoperative OCT
Fellows take a primary and active role in the preoperative, intraoperative, and postoperative management of all surgical patients managed on the Retina Service. Additional surgical training is completed in all scheduled ORs with the community.
Medical Retina
There is a weekly Macula Conference when particularly interesting retina cases are prepared and presented by the residents to the first year fellows. Macula Conference is a cornerstone in the teaching of fellows and aims to create a systematic approach toward the diagnosis and treatment of retinal disease. The second-year fellows serve in a teaching capacity to assist the residents as they prepare the cases.
In addition, medical retina patients are seen in every clinic, and the fellows gain extensive experience in the diagnosis and management of macular diseases from all faculty, including leaders in the field like Joan W. Miller, MD, Deeba Husain, MD, and Demetrios G. Vavvas, MD, PhD. The fellow also has an opportunity to treat patients with a variety of posterior segment inflammatory disorders with our posterior uveitis faculty member, Lucia Sobrin, MD, MPH, including learning how to manage patients with immunomodulatory therapy. We also have pediatric retina surgeons who focus on a wide variety of pediatric vitreoretinal diseases. Furthermore, a unique aspect to the fellowship is the extensive exposure to the diagnosis and management of intraocular tumors, with Evangelos Gragoudas, MD, Ivana Kim, MD, and Mary E. Aronow, MD. All aspects of subspecialty retina care are therefore represented in our fellowship.
On-Call Schedule
Fellows take call a half week at a time divided across the six surgical fellows. Call is very busy and high yield with multiple surgical cases that come through our emergency room. Second years cover the bulk of the call over the first three months.
As the only ocular emergency center in New England, the Emergency Department at Mass Eye and Ear draws patients from a large geographical area with significant vitreoretinal disease. This allows for the fellow to be involved in the surgical and medical management of interesting and often complex cases. The call duties also include coverage of established Retina Service patients. Call is taken one-on-one with a retina faculty member in two half week blocks, Monday 8AM to Thursday 5pm and Thursday night until Monday morning. We have dedicated Retina Service call block time on Monday and Thursdays in the operating room to complete call cases.
Facilities
The Retina Service at Mass Eye and Ear is a multi-site service offering top level retina care throughout Eastern New England. Despite its large size, the fellow experience is centrally located all within downtown Boston. The majority of the fellows’ time is spent on the 12th floor of the downtown office at 243 Charles Street in Boston, MA. There is also a busy and thriving clinical practice at the Longwood office at 800 Huntington Avenue by Brigham Women’s Hospital and Harvard Medical School. All facilities are fully equipped with examination lanes, procedure rooms, and state-of-the-art diagnostic equipment. We routinely perform Heidelberg, Optovue, and Zeiss spectral domain OCT. We have five different OCT-Angiography platforms for fellows to use. All sites have Optos wide field photography, fluorescein and indocyanine green angiography, and B-scan with full time dedicated certified retinal photographers.
A fully equipped Laser Suite is also located at both 243 Charles Street and Longwood with dedicated nursing staff for the administration of intravitreal injections and laser therapies. The lasers include argon, diode, YAG, Pascal, and PDT systems.
A fully equipped Laser Suite is also located at both 243 Charles and Longwood with dedicated nursing staff for the administration of intravitreal injections and laser therapies. The lasers include argon, diode, YAG, Pascal, and PDT systems.
Eligibility
All applicants must be Eligible to obtain a full medical license per the Massachusetts Board of Registration in Medicine. International medical graduates must also be eligible for an H1B visa.
Requirements
Interested vitreoretina fellows can apply through the San Francisco Match Program: #4067
At least one letter should be from a retina specialist in your residency program.
Only completed applications will be considered for an interview at Mass Eye and Ear (typically in September or October).
Questions?
If you have questions, please contact David Tosatti or Liz Portante.
The fellowship provides many opportunities for the pursuit of basic, clinical, or translational research. The Retina Service will help fellows prepare applications for support from private sources (e.g. The Heed Foundation, Fight for Sight, Inc., etc.) and public sources (e.g. NIH National Research Service Awards). The Retina Service fellows have been extremely successful in getting external funding, such as the Heed Fellowship.
Research opportunities are currently available in many areas. The Retina Service faculty members are involved in a wide variety of projects encompassing a full spectrum of investigation from clinical trials and epidemiology to basic science bench research. Many examples can be viewed on each faculty’s research profile:
The fellow can also tap into the extensive research community in the Boston area. Even within ophthalmology and eye research, this community is quite extensive, and includes the Schepens Eye Research Institute of Mass Eye and Ear and Joslin Diabetes Center to name two.
Many Retina Service fellows have been successful in conducting multiple research projects that resulted in publication in high impact peer-reviewed journals, such as Ophthalmology, JAMA Ophthalmology, the American Journal of Ophthalmology, and RETINA. In addition, they have been very successful in winning awards, which have included:
- Heed Fellowship
- Retina and Macula Society Fellow Research Awards
- Michels Award
- ARVO Travel Grants
Fellows who would like to pursue academic careers should be aware that Mass Eye and Ear holds a career development grant allowing the institution to extend a K12 award to a fellowship-trained ophthalmologist. K12 awards provide a graduating fellow junior faculty status with 80% protected time for research. While this is a competitive award, Mass Eye and Ear fellows who demonstrate strong research potential will be given careful consideration.
Fellows have traditionally played an integral role in the education of residents. During the first year, fellows serve as attending staff to the residents in the Emergency Department one half day per week.
Although fellows are not responsible for giving didactic lectures to the residents, they are involved in helping organize Retina Conference cases (see: Clinical Responsibilities), and in addition, the fellows are responsible for presenting a case at Grand Rounds approximately once per year. Each year there is a Fellows Course at Mass Eye and Ear. Once during the fellowship, the fellow is expected to write a review paper that will be published as in an ophthalmic journal, undertaken with faculty mentorship. There is a tradition of excellent teaching by the Retina Service fellows, and this has been well appreciated and recognized by the residents. Many of the annual Fellow of the Year Awards given by the residents for the best teacher among the fellows have been given to a Retina Service fellow.
Salary
Competitive annual salary. This can be supplemented by a Heed Fellowship (100% of stipend to the fellow) and other extramural and intramural fellowships or grants (50% of stipend to the fellow, 50% to the Retina Service). Internally, Harvard also offers several educational grants for our current vitreoretinal fellows. The Thomas J. Madden Fellowship provides salary support to one second year fellow annually. The Robert Brockhurst Academic Development provides additional funding support for meeting attendance.
Malpractice
Malpractice premiums are fully paid by Mass Eye and Ear.
Health Insurance
Mass Eye and Ear offers competitive benefits, including health insurance for fellows and their families.
Vacation/Sick Leave
Each fellow is allotted multiple weeks of vacation time and conference time each year. Maternity/Paternity leave is also offered through the institution.
Professional Meetings
Attendance and participation at meetings is encouraged. First-year fellows usually attend the Atlantic Coast Retina Meeting, Duke AVS, ARVO, and the Mass Eye and Ear Vitrectomy Course. Second-year fellows usually attend ASRS, AAO, Macula Society, Retina Society, and VBS. Vacation time and travel reimbursement are available.
