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 University School of Medicine

Subspecialty: Ocular Immunology

Address:
JHU Ocular Immunology
600 North Wolfe Street
Maumenee Building, Room 119
Baltimore, MD 21287-9217

Phone Number: 410-955-1966

Fax: 410-955-0629

E-mail: jthorne@jhmi.edu

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

Alternate Contact:
Mary Breckenridge-Keyes
E-mail: mbrecke1@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) were established in 1989 and is one of 12 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 and is compliant with the Association of University Professors in Ophthalmology (AUPO) Fellowship Compliance Committee (FCC) standards.  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 24 graduates of the Ocular Immunology and Uveitis Fellowship Program, 18 currently hold appointments as faculty in academic departments of ophthalmology.

The clinical fellowship year affords a strong educational experience in the treatment and management of uveitis, scleritis, and 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) includes James P. Dunn, M.D., Nicholas J. Butler, M.D., and Theresa J. Gan, M.D.

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

Faculty

THORNE, JENNIFER E., M.D., Ph.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, Director of the Division of Ocular Immunology and Uveitis Fellowship Director.  She is an expert in the medical and surgical management of patients with uveitis and other autoimmune and infectious eye diseases.  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.  She serves on the Executive Board and Steering Committee for the Standardization of Uveitis Nomenclature (SUN) Working Group and on the Steering Committee for the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD).  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. 

DUNN, JAMES P., M.D.

Dr. Dunn is Associate Professor of Ophthalmology, Director of the Wilmer Residency Program, 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 of 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 Follow-up Study (MUST).  He has an active clinical and surgical practice and is instrumental in the education of residents and medical students rotating through ophthalmology.  His particular clinical interests are surgery in patients with uveitis, intraocular drug delivery, and the ocular complications of bone marrow transplantation.

BUTLER, NICHOLAS J., M.D.

Nicholas Butler, M.D. is Assistant Professor of Ophthalmology at the Wilmer Eye Institute’s Division of Ocular Immunology. Dr. Butler currently sees patient with intraocular inflammation in addition to general ophthalmological disease. His research interests include the pathogenesis and treatment of uveitic cystoids macular edema and infectious causes of uveitis.  Dr. Butler has a continued interest in international ophthalmology as a volunteer clinician and as an educator and researcher.

GAN, THERESA J., M.D.

Theresa J. Gan, M.D. is part-time Clinical Instructor of Ophthalmology at the Wilmer Eye Institute’s Division of Ocular Immunology, where she sees patients with intraocular inflammation in addition to general ophthalmic disease.  She is a co-investigator in several studies utilizing wide angle photography to document disease progression in uveitic conditions such as retinal vasculitis and CMV retinitis.

Educational Program - Basic Curriculum

Clinical Operations and Patient Care Responsibilities

The fellow will spend multiple days each week in clinic diagnosing and treating patients with uveitis, scleritis, mucous membrane pemphigoid and other ocular inflammatory diseases. The uveitis clinics with various faculty will give the fellow a broad field of exposure to patients with anterior, intermediate, posterior and panuveitis, as well as scleritis and orbital inflammatory diseases.  In addition, there are clinics devoted to HIV- infected patients who are followed regularly for ocular complications of AIDS.  Many of these patients are participants in epidemiological studies and clinical trials, in which the fellow will participate.  Fellows will become experienced in the medical and surgical management of ocular inflammatory disease and exposed to all modalities of treatment of ocular inflammation (including topical, periocular and oral corticosteroids, non-steroidal anti-inflammatory drugs, immunosuppressive agents and biologics) and with ocular complications of AIDS, especially CMV retinitis.  The division also sees patients after bone marrow or solid organ transplants that may develop either infectious or inflammatory anterior and posterior segment complications.

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 Studies of Ocular Complications of AIDS (LSOCA):  The LSOCA study is a prospective cohort study following approximately 1,900 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 Follow-up Study (MUST FS):  The MUST Trial was a multicenter randomized controlled clinical trial funded by the NEI and  compared the fluocinolone implant to conventional therapy for the treatment of intermediate, posterior, and panuveitis.  The trial has now been converted to a longitudinal study that will continue to compare the fluocinolone implant to conventional therapy.
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 at JHU, the Department of Ophthalmology at UPENN, the FDA, and the NEI are ongoing or planned.

Procedural Requirements

Patients are seen five days per week under the supervision of Drs. Dunn, Butler, Gan, 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 faculty members from other divisions with an interest in uveitis.  There are daily departmental lectures given each morning for the residents, which fellows also can attend, and these lectures have been found to be very helpful, particularly when studying for 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.  Four fellows have been awarded NIH-funded K-23 training grants, 3 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. Additional documents must be received by September 1, 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 direct all questions and any additional documents to:

Jennifer E. Thorne, MD, PhD
Fellowship Director, Division of Ocular Immunology
The Wilmer Eye Institute
600 North Wolfe Street
Maumenee Building, Room 119
Baltimore, MD 21287

Phone: (410) 955-1966
Fax: (410) 955-0629
E-mail:jthorne@jhmi.edu