Uveitis Fellowship Program

Uveitis Fellowship Program
The Division of Ocular Immunology
The Wilmer Eye Institute
The Johns Hopkins University School of Medicine
Ophthalmology Fellowship Match No. 851.51

Program Demographics

Name: The Wilmer Eye Institute, The Johns Hopkins Universty School of Medicine

Subspecialty: Ocular Immunology

Address: (Mailing): JHU-Ocular Immunology  550 N. Broadway, Suite 700, Baltimore, MD 21205

Address: (Physical): 600 North Wolfe Street, Maumenee Building, Room 119, Baltimore, MD  21287-9217

Phone Number: 410-955-1966

Fax: 410-955-0629

Email: jthorne@jhmi.edu

Program Director: Jennifer Thorne, M.D., Ph.D.

Alternate Contact: James P. Dunn, M.D. email: jpdunn@jhmi.edu phone:410-955-1966

Fellowship History and Structure

The Ocular Immunology and Uveitis Fellowship Program at The Wilmer Eye Institute (www.wilmer.jhu.edu) was established in 1989 and is one of only eight such fellowships offered through the Ophthalmology Fellowship Match Program. This Fellowship program offers one year of clinical training devoted to the medical and surgical management of uveitis and related ocular inflammatory diseases. An optional second year devoted to research pursuits is available. In addition, there is an option for extensive training in clinical research leading to an advanced degree, which can be funded through a K award from the National Eye Institute (NEI). The flexibility of this fellowship has been viewed favorably by former fellows and has allowed for successful transition into academic or private practice. Of the 21 graduates of the Ocular Immunology and Uveitis Fellowship Program, 18 currently hold appointments as faculty in academic departments of ophthalmology, and four currently are principal investigators on NEI-funded grants.

The clinical fellowship year affords a strong educational experience in the treatment and management of uveitis, scleritis, immune-mediated ocular surface disease such as mucous membrane pemphigoid, infectious uveitides, and the ocular complications of AIDS. Surgical experience includes placement of fluocinolone and ganciclovir implants, and cataract surgery in patients with uveitis. Training focuses on the effective pre-operative and post-operative management of patients with uveitis. Additional experience in trabeculectomy, secondary intraocular lens (IOL) placement, and penetrating keratoplasty is provided. Training is conducted at The Johns Hopkins Wilmer Eye Institute located at 600 North Wolfe Street, Baltimore MD, 21287-9217. The qualified applicant should have satisfactorily completed an accredited residency program, preferably within the United States, prior to starting this fellowship.

Resources

The program is directed by Jennifer E. Thorne, M.D., Ph.D., Associate Professor of Ophthalmology and Epidemiology.  Other faculty in the Division of Ocular Immunology (DOI) include: James P. Dunn, M.D., Richard D. Semba, M.D., M.P.H., and Michelle Tarver-Carr, M.D., Ph.D.  All the faculty are acknowledged experts in their fields.

The weekly schedule for the clinical year for the fellow typically is as follows:

FACULTY (in alphabetical order):

DUNN, JAMES P., M.D.

Dr. Dunn is Associate Professor of Ophthalmology, Director of the Division of Ocular Immunology and holds the Eugene de Juan Professorship in Ophthalmology.  He is the principal investigator of The Johns Hopkins Medical Institutions Clinical Center for the Longitudinal Studies of Ocular Complications of AIDS (LSOCA). This study is a multicenter, longitudinal study that is monitoring the incidence of ocular complications in AIDS as well as visual outcomes and quality of life. Dr. Dunn also is the division’s principal investigator for the Multicenter Uveitis Steroid Treatment (MUST) trial.  He has an active clinical and surgical practice and is instrumental in the education of residents and medical students rotating through ophthalmology. Dr. Dunn serves as the Director of the Residency Program at The Wilmer Eye Institute. His particular clinical interests are surgery in patients with uveitis, intraocular drug delivery, and the ocular complications of bone marrow transplantation.

SEMBA, RICHARD D., M.D., M.P.H.

Dr. Semba is Professor of Ophthalmology at The Wilmer Eye Institute and of Molecular Microbiology and Immunology and International Health at The Johns Hopkins University Bloomberg School of Public Health (JHSPH).  Dr. Semba is interested in the role of nutrition and the eye. His nutritional research focuses on vitamin A, carotenoids, and zinc and their role in human health. He has served as a mentor for medical students, public health students, and doctoral students on various projects related to nutrition and infectious diseases. Dr. Semba’s research team was the recipient of the 2002 John M. Kinney-Nestle Pediatric Nutrition Award for his work on vitamin A and carotenoids.

TARVER-CARR, MICHELLE, M.D., Ph.D.

Dr. Tarver-Carr is Assistant Professor of Ophthalmology at The Wilmer Eye Institute and is also a PhD level epidemiologist.  She is an expert in the medical and surgical management of patients with uveitis and other autoimmune and infectious eye diseases.  She is a treating ophthalmologist for LSOCA and MUST.  Her current research focuses on the prevalence and incidence of toxic maculopathy due to hydroxychloroquine use.

THORNE, JENNIFER E., M.D.

Dr. Thorne is Associate Professor of Ophthalmology at The Wilmer Eye Institute and of Epidemiology in the Center for Clinical Trials, the Department of Epidemiology, JHSPH.  She is an expert in the medical and surgical management of patients with uveitis and other autoimmune and infectious eye diseases.  She performs cataract and pharmacological implant surgeries in these patients.  Dr. Thorne directs the Mucous Membrane Pemphigold Clinic, a multidisciplinary clinic evaluating and treating patients with cicatrizing conjunctivitis.  Her research interests lie in clinical trials and epidemiologic studies in uveitis, ocular inflammatory diseases, and the ocular complications of AIDS.  She is the Deputy Director of the Coordinating Center (CC) for LSOCA and Medical Safety Officer for the CCs of MUST and LSOCA.  Current research projects include analyses of clinical and treatment outcomes of patients with mucous membrane pemphigoid, juvenile idiopathic arthritis-related uveitis, and multifocal choroidopathies, such as birdshot chorioretinopathy.

Educational Program - Basic Curriculum

Clinical Operations and Patient Care Responsibilities

Research

A second year in the fellowship may be devoted to either clinical or laboratory research. Fellows pursing clinical research will be taught approaches to epidemiologic studies and/or clinical trials, including the use of appropriate statistical techniques. Fellows are encouraged to identify a preceptor and begin planning the project in their first year so that applications for financial support can be submitted well in advance of the start of the actual project. Projects in other divisions, such as the Dana Center for Preventive Ophthalmology, in other Departments or in the School of Public Health may be developed as well.

Current clinical research studies within the Division of Ocular Immunology:

1. Longitudinal Study Of Ocular Complications Of AIDS (LSOCA): The LSOCA study is a prospective cohort study following approximately 1,500 patients with AIDS with and without major ocular complications. The study is conducted by the Study of Ocular Complications in AIDS (SOCA) Research Group, a research group funded by the NEI and that investigates ocular complications of AIDS, of which the most frequent complication is CMV retinitis. Further information can be found on the study’s website (www.lsoca.com).
   
2. Multicenter Uveitis Steroid Treatment (MUST) Trial: The MUST Trial is a multcenter randomized controlled clinical trial funded by the NEI and compares the fluocinolone implant to conventional therapy for the treatment of intermediate, posterior, and panuveitis.
   
3. Retrospective studies in uveitis, scleritis, other autoimmune ocular diseases, and the ocular complications of AIDS are ongoing and supervised by members of the faculty.
4. Industry-sponsored trials and collaborations with the Department of Infectious Disease are also ongoing

Procedural Requirements

Patients are seen five days per week under the supervision of Drs. Dunn, Tarver-Carr, and Thorne.  Fellows will perform the initial evaluation for new patients as well as evaluating appropriate follow-up patients.  Treatment  for these immune-mediated disorders is largely medical.  A small amount of anterior segment surgery, including cataract surgery and glaucoma surgery, as well as placement of pharmacological implants is performed, in which the fellow will be expected to assist when available.
 

Didactic Components - Conferences/CME

There is a monthly uveitis case management conference with Division faculty, as well as other faculty members from other divisions with interest in uveitis. There are daily departmental lectures each morning for the residents, which fellows can attend and have found very helpful, particularly when studying for a boards or medical exams. There is a weekly "grand rounds" on Thursdays, entitled "Thursday Morning Conference" and a monthly Uveitis Journal Club with faculty, fellows, and second year residents participating. The clinical schedule allows the fellow to attend these lectures and conferences.

Evaluation

Fellows are evaluated by the program director quarterly.  Each faculty member will submit an evaluation of the fellow commenting on and rating the fellow's clinical and administrative capabilities (e.g., history taking, patient examination, surgical skills and timeliness of returning patient calls and dictating notes), teaching and presentation skills, and interactions with patients and colleagues.  The program director will summarize these evaluations and discuss them with the fellow identifying strengths and areas for improvement.

Past Fellows

Fellows graduating from the Division of Ocular Immunology's Fellowship program have been extremely successful in securing academic positions or other employment they desire. Three fellows have been awarded NIH-funded K-23 training grants, 2 have been awarded R-01 grants, and 6 have been on faculty at The Wilmer Eye Institute. A list of former fellows since 1990 is provided below including their current positions.

Requirements for Applicants

The Uveitis Fellowship sponsored by the Division of Ophthalmology (851.51) is part of the formal Ophthalmology Fellowship Match Program (OFMP) sponsored by the Association of University Professors of Ophthalmology (AUPO). The website for the match program is www.sfmatch.org. The website contains pertinent information concerning application procedures and notification dates, including the new Central Application Service (CAS).

If you have fulfilled 3 years of ophthalmology residency, please register for the match at www.sfmatch.org and complete the CAS form, which requires three letters of recommendation (we prefer one from your current program director), and a personal statement explaining your interest in the program.  Please include any research interests that you may have in your CAS personal statement.  Additional information (if deemed essential to the candidate's application) may be forwarded to Dr. Thorne at the address below with a cover letter that includes the applicant's match number and the dates of the fellowship for which the applicant is applying.  Applications (including any additional documents) must be received by September 2, 2008 in order to be considered.

A personal interview at Johns Hopkins is required and typically takes place between late September and November for the fellowship year beginning in July of the following year. Only the applicants with complete files will be invited for an interview. Accepted fellows who have trained in the United States may be eligible for a faculty appointment through the Advanced Subspecialty Training Program (ASTP). This more prestigious appointment includes faculty status in the hospital as well as a faculty benefits package. Please forward all documents to:

Jennifer E. Thorne, MD, PhD
Fellowship Director, Division of
The Wilmer Eye Institute
550 North Broadway, Suite 700
Baltimore, MD 21205
Phone: 410-955-1966, Fax: 410-955-0629
jthorne@jhmi.edu