Redirect to Table of Contents

If your browser doesn't automatically redirect to the table of contents, then please click

here.

VINAY A. SHAH, MD

Dr. Shah is currently a fellow in neuro-ophthalmology at The University of Iowa, one of the top ophthalmology departments in the world. He comes from a family of physicians in India, and his parents were trained in the United States. Dr. Shah graduated from medical school and subsequently completed an ophthalmology residency in India. He has completed two fellowships in Vitreo-Retinal diseases and surgery: first at the world-renowned L. V. Prasad Eye Institute in India, and next at the University of Florida. He will continue his American training experience beginning in the summer of 2006 as a resident at the University of Missouri in Kansas City. Dr Shah has over forty-five peer reviewed publications and book chapters in ophthalmology. Through his training experience, Dr. Shah has gained a unique and personal perspective on the topic of international training opportunities. He shares his insights on the challenges and successes for members of the international community of ophthalmologists coming to the United States for further training.

RAHUL BHOLA, MD

Dr. Bhola was raised in a family of physicians in New Delhi, India, where he maintains strong family and professional ties . He received his medical degree from University College of Medical Sciences in Delhi, India and went on to complete an ophthalmology residency at Maulana Azad Medical College in New Delhi, India. Thereafter, he received his initial training in ocular motor disorders at the prestigious All India Institute of Medical Sciences, also in New Delhi. His strong desire to pursue further advanced training and research in pediatric ophthalmology and ocular motor disorders led Dr. Bhola to join the Jules Stein Eye Institute at UCLA as a Visiting Assistant Professor in their Pediatric Ophthalmology division. There, he worked with Dr. Arthur Rosenbaum, Dr. Sherwin Isenberg, and Dr. Joseph Demer and published several research papers under their mentorship. Most recently, he has spent two years as a clinical and surgical fellow of Pediatric Ophthalmology and Strabismus at the University of Iowa Hospitals and Clinics, learning from Dr. Ronald Keech, Dr. Richard Olson, and Dr. Bill Scott. In the summer of 2006, he begins an American residency at the University of Louisville in Kentucky. His experience gives him a unique insight into the topic of Intnernational Ophthalmology.

Clinical Fellowships

Clinical Fellowships

• Introduction
• Fellowship Requirements
• Available Subspecialty
• Application Process
• Responsibility of a Clinical Fellow

Introduction

The main idea for these fellowships are to promote and encourage interaction in research and education with ophthalmology institutions throughout the world, the many major academic institutions offer International Ophthalmology Fellowships consisting of one-year programs of study under the supervision of specific institute faculty. Candidates for these international fellowships are often nominated by institutions outside the United States . Some apply to the program on their own. Fellows participate in the clinical and research activities of ophthalmic subspecialties according to their training needs. When training is completed, the International Fellow is issued a Certificate of Fellowship from the institute

Fellowship Requirements

The fellowship in ophthalmology is a full-time commitment. Fellows are usually appointed to the staff of the University. International fellows are required to have a J-1 visa or a H1 B visa depending on the policy of the institution. A J-1 visa sponsored by the ECFMG program (http://www.ecfmg.org/) may qualify. Fellows who plan to have clinical activity must be qualified to obtain a training or permanent medical license from the state. Medical licenses are issued on a state-by-state basis, and the requirements may vary somewhat from state to state. A physician must obtain a medical license from the medical board of the state where he or she plans to practice after completion of residency training and/or certification. Contact the Federation of State Medical Boards of the U.S. , Inc. (FSMB) at the following address (www.fsmb.org) to obtain general information on medical licensure. The International Fellowship in Ophthalmic Pathology may be an exception in some cases.

Subspecialty Areas

Ophthalmology fellowships are offered in the following subspecialty areas:

• Anterior Segment Surgery
• Cornea and External Diseases
• Glaucoma
• Neuro-Ophthalmology
• Oculoplastics
• Ophthalmic Pathology
• Pediatric Ophthalmology
• Retina-Vitreous
• Uveitis- Immunology
• Miscellaneous Fellowships

More information on the available subspecialties, programs and specific requirements can be found at http://www.sfmatch.org/.

Application Process

Each fellowship program has its own fellowship director. Application materials should be sent to the fellowship director or the program co-coordinator. All correspondence regarding a specific fellowship program should be sent to that program. Programs may have specific deadlines and positions get filled up well in advance (in some cases there is a waiting list). We strongly encourage you to visit http://www.sfmatch.org/ and web sites of individual programs. All ophthalmology fellowships are “non-standard subspecialty discipline”. Further information on the application and sponsorship for training in non-standard subspecialty discipline is available at http://ecfmg.org/evsp/nonstand.html.

Non-Standard Subspecialty Disciplines Recognized for Purpose of J‑1 Sponsorship

Glaucoma

Retina/vitreous

Cornea

Pediatric/strabismus

Oculoplastics

Ophthalmic pathology

Neuro-ophthalmology

Uveitis

Ocular oncology

Websites of interest
http://www.ecfmg.org/

http://www.abop.org/

Clinical Responsibilities

Clinical responsibilities of a fellow are usually under direct supervision of one or more full time faculty. Many programs are supplemented by the valuable participation of part-time faculty members adding a flavor of private practice. Most of the fellowships are geared primarily to a broad clinical experience of the specialty with exposure to techniques of clinical research, laboratory research, or both. Some with a special interest in an academic career who need to be firmly grounded in research techniques have tailor-made fellowships, sometimes extending their time an extra 6 or 12 months.

Research

Each fellowship program encourages the fellow to perform at least one research project in order to understand what goes into research and to learn to evaluate the literature better. Most commonly, fellows undertake a retrospective review of clinical records in an effort to generate new knowledge, but they are also encouraged to perform other types of research, such as exploration of questions of natural history, evaluation of diagnostic tests (e.g., disc or nerve fiber imaging, perimetry, electrophysiology), and therapy being studied in controlled prospective studies, especially for those who intend to include research efforts in their future academic career.

Certain fellowships may have protected research time for the clinical fellows while others may be more clinically oriented with fellows doing research at their own time (weekends/evenings). Usually each fellowship has its individual requirements but generally fellows are required to complete one research project during their training and present their findings at a departmental/university research day. Fellows typically attend at least one international conference. This includes the annual meeting of the Association for Research in Ophthalmology and Vision (ARVO) held each spring in Fort Lauderdale , Florida , American Academy of Ophthalmology or a subspecialty society annual meeting. Certain fellowships may offer a fellow according to his or her academic interest a second optional year for research.

Teaching

Usually fellows are actively involved in teaching both the medical students and residents. Many programs will expect their fellows to present at departmental grand rounds multiple times during the year. Dedicated resident and medical students lectures may also be expected from the fellows.

Research Fellowships

Research Fellowship

• Benefits of Research
• Objectives of Research
• Research Track
• Requirements
  

Benefits of Research

• Clarify career opportunities and choices
• Decide upon a specific subspecialty
• Increase analytical and critical thinking skills
• Develop close relationships with your Mentors
  

The opportunity to work closely with renowned scientists in your chosen field is a strategic and exciting step in launching your research career. Mentored research projects facilitate organizing meaningful questions in a thoughtful manner. Science is advanced by unique insights, supportive collaborations, effective experimentation, adequate funding and timely implementation of ideas. Scholars have long known that the nature of the question is critical in finding the answer. Participation in the research increases understanding how scientists, social scientists, and humanists in their various ways go about creating new knowledge in their respective fields. The research process can therefore be a model for a lifetime of problem solving. Researchers learn to evaluate material critically rather than to accept it without evidence. Research participation also allows interaction with people of different backgrounds, cultures and professional expertise. Moreover one can often publish and/or present their work in professional contexts, and thus have a competitive edge when applying for further advanced training or jobs in their respective fields.

Objectives of Research

The objectives of research in ophthalmology and vision are to encourage and promote basic science and clinical research directed to an increased understanding of the eye and vision, development of procedures for prevention, early diagnosis and treatment of abnormalities and diseases affecting the visual process and scientific studies leading to new treatments for conditions that currently are without effective prevention or treatment.

Research Track

Most Universities in the US have facilities for both basic science research as well as clinical research and offer opportunities depending on the interest and level of prior basic training of the individual. Some universities offer postdoctoral research fellowships which may range from short term (3 months) to long term (3 years). Like clinical and basic science research in general, ophthalmic research is based upon the intuitions and inventiveness of the individual researcher, the level of technological development at any given moment, and the availability of human tissues or animal models with which to conduct in-depth analyses and experiments. Most sophisticated disciplines and tools of basic science research have been productively applied to the study of eye diseases: virology, immunology, morphometry, pharmacology, cell biology, and lately, molecular genetics and transgenic animal models of human diseases.

To promote and encourage interaction in research and education with ophthalmology institutions throughout the world most reputed universities in the US offer International Ophthalmology Fellowships consisting of one-year programs of study under the supervision of specific institute faculty. Candidates for these international fellowships are often nominated by institutions outside the United States . Some apply to the program on their own. Fellows participate in the clinical and research activities of ophthalmic subspecialties according to their training needs.

Most of the Universities offer international research fellowships in the following subspecialties, including:

• Cataract Research
• Cornea-External Ocular Disease
• Glaucoma
• Neuro-Ophthalmology
• Ophthalmic Pathology
• Orbital and Ophthalmic Plastic Surgery
• Pediatric Ophthalmology and Strabismus
• Vitreoretinal Disease and Surgery

Requirements

Although the requirements of applying for research fellowships may vary according to institution policies most of the universities and/or university affiliated hospitals offer institution sponsored J1 or H1B visa for the fellowships. In addition to the paperwork required for the visa application most institutions require additional documents like:

• Most recent curriculum vitae (CV)
• A copy of your medical school diploma in the language of the country of your training, along with a literal word-for-word English translation, if the diploma is not in English.
• A copy of your license to practice medicine issued by your home country, with an English translation.
• A Letter of Good Standing or Certificate of Good Standing, with an English translation, from the Ministry of Health or Medical Council that issued the license to practice medicine.
• A copy of your Residency Training Certificate, and/or medical school diploma.
• Recommendation letters from your previous mentors/faculty
• Personal statement introducing yourself, your character and skills, previous experience and training, and your future goals. What are the most compelling reasons you can give for the committee to be interested in you.

Funding

Research fellowship could be funded by the program or self funded. Various opportunities for sponsorships or grants are available from government or non government agencies.

Short term Fellowship

Short term fellowships

• Objectives
• Application
• Training Opportunities
• Sponsored Funded Opportunities

Objectives

Short term fellowships are designed for education of the international ophthalmologist striving for advanced training in both research as well as clinical ophthalmology. These fellowships are usually established to support promising young ophthalmologists as they improve their practical and research skills and broaden their perspectives in ophthalmology. Fellows will be expected to bring their acquired knowledge and skills back to their own country and participate in programs to prevent blindness in the home country.

Application

Although most short term fellowships are research based, some universities do allow limited patient contact to the fellows. Short term fellowships are offered in most of the subspecialties of ophthalmology and application materials are mostly available on the institutional websites. Individual programs and universities have their own requirements for visa and licensure. States like California offer special license privileges to international fellows for limited patient contact. We strongly encourage the applicant to contact individual programs for further information. To inquire about a particular university policy for Foreign Students we encourage you to contact individual Graduate Medical Education (GME) or institutional international Offices.

Please visit www.sfmatch.org for the complete program listings.

International fellowships may be funded or non-funded. Fellows must bring financial support from their home institution or other sources if non-funded. Many institutions will require the international fellow to document the availability of sufficient funds to cover living expenses for one year including lodging, food, medical and repatriation insurance, and travel. These expenses could be highly variable according to the cost of living of that specific community.

Opportunities

1. Participation in patient care.
2. Observing various aspects of healthcare including management.
3. Participation in Academic and teaching activities.
4. Participation in research.
5. Participation in national and international meetings.
   

Selected - Sponsored Short Term Fellowship

1. International Council of Ophthalmology (ICO)- International Fellowship: Training Young Ophthalmologists from Developing Countries ( http://www.icoph.org/index.html )

IFOS/ICO Fellowship Director Balder Gloor, MD, makes the following suggestions for those interested in applying for Fellowships:

1. Read the Policies for the Fellowships carefully and we encourage you to follow the steps to apply exactly.

2. This includes checking the Directory of Fellowships for a location and institution that would be appropriate for you and contacting the host directly, as described in the instructions.

3. Once you have determined a Fellowship host, submit an application.

4. the best way to communicate with Dr. Gloor by e-mail (bgloor@access.unizh.ch).

March 31 and September 30 are sually the deadlines to apply for each round of the IFOS/ICO Fellowships.

Fellowships generally last three months, but the program is intended to be flexible to meet the needs of different countries and individuals. Under special circumstances, an IFOS/ICO Fellowship can be part of a longer fellowship.

The Fellowship does not cover fees for observors.

http://www.icoph.org/fellow/index.html

http://www.bpei.med.miami.edu/site/info/info.asp

The goal of the Fellowship is as follows:

"The IFOS/ICO Fellowship has been established to support promising young ophthalmologists to improve their practical skills and broaden their perspectives in ophthalmology.

By awarding young ophthalmologists this Fellowship, ICO/IFOS will contribute to VISION 2020 and also enhance collaboration between institutions dedicated to eye care."

2. The Association of Asian Indians in Ophthalmology in the United States of America

Purpose: To provide subspecialty training in ophthalmology at participating and other centers in the United States to suitable ophthalmologists from India. The subspecialty areas will include: External Disease and Cornea, Retina and Vitreous, Glaucoma, Neuro-Ophthalmology, Pediatric Ophthalmology, and Ocular Pathology.

Duration: 3 months

Support: The fellow will receive $1000 a month to cover the cost of lodging and boarding. He or she will be provided funds to support his or her cost for attending the American Academy of Ophthalmology. The candidate is responsible for round-trip transportation from India to their final destination within the United States.

Qualifications: Qualified ophthalmologist of Indian origin who has completed his/her residency and post-graduate studies from an accredited institution in India. He/she is affiliated or has offers for affiliations with a medical institution or hospital involved in patient care, research and/or teaching. The candidate should demonstrate reasonable evidence that upon return to India, he/she will be in a position to utilize his/her training for patient care, research and teaching in India.

Ranking:

1. All the applications received will be reviewed by members of the Fellowship Committee.

2. Each applicant will receive a priority score* on a scale of 1-10, 10 being the highest score.

3. The top 4-5 candidates will be interviewed by the Fellowship Committee or the representative selected by the Committee at the All India Ophthalmological Society Meeting in India and each will receive their interview priority score, also based on 1-10, 10 being the highest score.

4. The best candidate will be chosen on the basis of his/her priority score obtained from #2 and #3.

* The priority score assigned from both the application review and the interview will take into account his/her prior training, current position and future goals and prospects to utilize the training in practice, research and training of future ophthalmologists.

The application and instructions are below. Please print clearly.

http://www.aaio.org/opportunities/

3. ARVO

Short-Term Fellowships are intended for researchers early in their career and provide up to 3 months of support to learn techniques in a new area of research or establish new collaborations in another country. Short-Term Fellowships may be awarded at any stage in a researcher's career though preference is given to independent young scientists early in their career.

For all fellowship programs, researchers from a supporting country can apply to work in any other country, while other nationals can only apply for training in a supporting country (see list below).

Short-Term Fellowships are awarded for visits to foreign laboratories of 2 weeks to 3 months to learn new methods or initiate new collaborations. The fellowship provides a per diem living allowance and the cost of travel to and from the host laboratory.

Applications for Short-Term Fellowships may be submitted at any time of the year.

Supporting countries: Australia, Austria, Belgium, Canada, Cyprus (EU part only), the Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, the Republic of Ireland, the Republic of Korea, Italy, Japan, Latvia, Lithuania, Luxembourg, Malta, the Netherlands, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden, Switzerland, the United Kingdom, and the United States of America.

(www.arvo.org)

Other potential funding sources

http://sciencecareers.sciencemag.org/career_development/previous_issues/articles/1050/funding_ophthalmology_and_plant_biology_research

Introduction

With increase in globalization of technology there is a growing need for global interdependence and integration which is particularly apparent in the field of medical care. Despite the existing misdistribution of health care access, most countries aim at achieving a balanced growth and distribution of health care resources with equal access to both preventive and curative health care measures. One of the major prerequisites for achieving this goal is appropriate medical education and training. Even though more than 1600 medical schools exist worldwide there are no set international standards and guidelines to judge the quality of both basic as well as advanced medical education and curriculum. We feel that increased educational exchange between institutions world-wide will be beneficial to all involved and improve medical education (and consequently medical care) worldwide. This is a symbiotic relationship in that both the academic institution offering training benefits by – both what the trainee brings to the table and what they take back with them in practice (especially academic practice by passing this information and experience along to physicians in training in their home country).

The American Health Care System

There are over 300 major teaching hospitals in the United States of America of which fewer than 1250 participate in graduate medical education (GME). Ophthalmology residency training is offered in over 110 institutions with a total number of residency positions being more than 430 positions per year.

Why Ophthalmology?

In the US, ophthalmologists are among the most professionally satisfied physicians. The broad scope of ophthalmic practice including both the medical and surgical aspect, treatment of pediatric and adult patients, and provision of primary care as well as highly specialized treatment make ophthalmology a desirable specialty. Technological and scientific advances allow both diagnostic and therapeutic precision that are unavailable in many other medical and surgical specialties. Ophthalmology has enjoyed more than its share of scientific and technological breakthroughs in medicine. There are locations throughout the US with relative shortages and others with relative surpluses of comprehensive (general) ophthalmologists and ophthalmologic subspecialists. Overall, from a manpower perspective, ophthalmology continues to be an attractive field of medicine with great opportunities.

With the advances in ophthalmology the need for subspecialty training is ever increasing. From previous decades, American ophthalmology training has attracted both local and international graduates from all parts of the world. It is usually a challenge to procure a desirable training position for foreign medical graduates and post graduates in the United States of America. In these articles, we will give and discuss an overview of graduate medical education (GME) with special emphasis on basic as well as advanced Ophthalmology training for Foreign Medical Graduates (FMG’s) in the USA.

Training Opportunities for Foreign Medical Graduates (FMG)

Basic: The American medical educational system consists of 8 years of primary school, 4 years of high school, 4 years of premedical education at a college or university, and 4 years of medical school (at a Liaison Commission on Medical Education approved institution). The World Health Organization (WHO) tabulates the world directory of medical schools. Additionally, the Foundation for Advancement of International Medical Education and research (FAIMER) publishes an international medical education directory (IMED). This provides an accurate and up-to-date list of medical schools recognized by the government agencies. These agencies are usually represented by the Ministries of health of each country. Some foreign medical schools have developed relationships with several USA states with regards to those US citizens studying abroad in foreign medical schools. They allow for limited exchanges of medical student clerkships in American hospitals.

Related Resources

• American Association of Colleges of Osteopathic Medicine
• Association of Faculties of Medicine of Canada (formerly the Association of Canadian Medical Colleges)
• Educational Commission for Foreign Medical Graduates
• Federation of State Medical Boards
• National Board of Medical Examiners

Specialty: ACGME approved Ophthalmology Residency Program

There are in total over one hundred residency programs with a total of approximately 430 residency positions. The total residency is typically 4 years (one year of internship and three years of ophthalmology training). A few programs require more than the minimum three years of training in ophthalmology or may have staggered start dates. Every residency program is organized differently. Most programs rotate residents among hospitals and services, mixing comprehensive clinical and surgical experience with subspecialty experience. Adequate instruction and clinical experience is available in all subspecialties. Though, there are structural differences among programs the requirements for accreditation are identical. Some programs use hospitals remote from the primary training hospitals for some of the residency experience; other do not. Some programs send their residents to regional basic science courses; others provide the instruction intramurally. In some programs, instruction and surgical staffing are provided almost exclusively by full-time faculty, while other programs rely heavily on volunteer clinical faculty.

For more information and links to individual programs visit: http://www.sfmatch.org/ and http://www.ama-assn.org/ama/pub/category/2997.html

Subspecialty training

Visiting observer: The visiting observerships mostly range from 1-4 weeks in duration. This track is the easiest to get and mostly does not require any stringent documentation . In order to apply for this track applicants need to directly contact the program director/departmental chair with their CV and recommendation letters. This track is extremely beneficial to individuals who have prior postgraduate training in their country and want to, in a short period of time, experience various ways of practice in academic institutions in the US before returning back home to join either private practice or an academic institution. One of the limitation of this track is limited patient contact

Short term fellowship (<6 months): T hese fellowships are usually established to support promising young ophthalmologists to improve their practical and research skills and broaden their perspectives in ophthalmology. This has a flavor of both research and clinical gratification. The prerequisites may vary among states but being ECFMG certified is universal for patient contact and licensure. Getting a clinical fellowship (especially in a good institution) would involve passing all three steps of USMLE with strong letters of recommendations, and existing publications in peer review journals (similar requirements for long term fellowships). F ellows are expected to bring their acquired knowledge and skills back to their own country and participate in clinical, reaseach and teaching programs in their country.

Long term fellowship (>6 months): These fellowships involve formal application to academic programs around the country usually via the official match website (www.sfmatch.org). Fellowships can be of two types: clinical or research. Subspecialty training that includes clinical responsibilities require a license to practice medicine, but research oriented fellowships may be able to take foreign students without a U.S. medical license. We strongly advise contacting each program and state board (http://www.fsmb.org/usmle_eliinitial.html) individually for specific requirements for the application and licensure. Most fellowships require prior completion of a three year ophthalmology residency program.

The various subspecialty programs offered in ophthalmology are:

• Anterior Segment Surgery
• Cornea-External Disease
• Glaucoma
• Neuro-Ophthalmology
• Oculo-Plastic Surgery
• Ophthalmic Pathology
• Pediatric Ophthalmology
• Retina-Vitreous
• Uveitis - Immunology
• Miscellaneous Fellowships
  

For more information and links to individual programs visit: http://www.sfmatch.org/

Note: To provide direct patient care, physicians in the United States are required to complete a three to seven year graduate medical program -- accredited by the Accreditation Council for Graduate Medical Education (ACGME) -- in one of the recognized medical specialties.

Table of Contents

International Ophthalmology:
Perspectives on International Exchange of Training Opportunities and
Challenges for the International Community of Eye Surgeons

Proposed Topics

1. Introduction
2. Training Opportunities for Foreign Medical Graduates (FMGs)
   · Basic
   · Specialty
   · Subspecialty
3. Short term Fellowships
   · Observerships
   · Short term Fellowships: Objectives, Application, Training Opportunities, Sponsored, and Funding Opportunities
4. Long term Programs
   · Research Fellowship : Benefits of Research, Objectives of Research, and Research Track Requirements
   · Clinical Fellowship: Introduction, Fellowship Requirements, Available Subspecialty, Application Process, and Responsiblity of a Clinical Fellow
   · Residency in Ophthalmology