Glaucoma and Advanced Anterior Segment Surgery Fellowship at WashU in St. Louis

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GAASS

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In the last several years, glaucoma fellowships have become much more popular. Much of this attributable to the rapid pace of innovation of surgical procedures and devices (MIGS/etc) in the management of glaucoma. Traditional glaucoma fellowships were tube/trab heavy +/- phaco. Today there is a big range when it comes to the surgical experience you will get in fellowship. These fellowships are fragmenting into what I’ll call Traditional Glaucoma (tubes/trabs/revisions) and Glaucoma+ (tubes/trabs/revisions, MIGS, complex cataract, iris repair, IOL repositioning/exchange).

I am the current Glaucoma and Advanced Anterior Segment Surgery (GAASS) Fellow at Washington University in St. Louis, MO. While WashU holds a lot of historical relevance in glaucoma, it has not been discussed on SDN best fellowships list, so I wanted to bring attention to it for people that may be looking for some direction as I was as an applicant.

After interviewing at the top programs across the country last year, I realized there was a huge range in the type of surgical experience you get as a fellow. Some places merely pay lip service to MIGS while others have shifted too heavily to MIGS and away from foundational tubes/trabs/revisions. Sadly, there are even some programs that refer to themselves as “not phaco programs”.

I was looking for a strong academic program that would not only give me a strong foundation in traditional glaucoma surgery (tubes/trabs/revisions) but also give me tons of experience with all approved and experimental MIGS and novel devices as well as an even deeper complex cataract experience. I wanted longitudinal mentorship and apprenticeship from a core of dedicated faculty. I wanted research support/opportunities as well as industry collaboration. Suffice to say, I got it all and I want to spread the good word about this fantastic fellowship as application cycle approaches.

My PRIMARY surgical numbers after 1 month in fellowship:

TRADITIONAL GLAUCOMA:
Trab - 5
Trab revision - 2
Tube - 6
dCPC - 6

CATARACT + ADVANCED ANTERIOR SEGMENT:
Routine Phaco - 14
Complex Phaco - 8
IOL Exchange - 1
IOL Reposition w/ iris-fixation - 1

MIGS+:
ECP - 2
GATT - 3
KDB - 5
iStent - 5
Cypass - 2

PRIMARY surgical numbers from last years fellow:

TRADITIONAL GLAUCOMA:
Trab - 28
Trab Revision - 7
STAFFED Resident Trab - 7
Tube - 30
Tube Revision - 8
STAFFED Resident Tube - 28

CATARACT + ADVANCED ANTERIOR SEGMENT:
Routine phaco - 145
Complex phaco - 70
STAFFED resident phaco - 90
IOL Exchange - 8
IOL Repositioning - 14
Planned Vitrectomy - 12
Pupiloplasty - 8

MIGS+:
ABiC - 2
Cypass - 11
GATT - 19
Trab360 - 4
iStent - 34
KDB - 37
Trabectome - 7
XEN - 48
ECP - 20
STAFFED Resident MIGS - 70

This is an ideal fellowship for someone interested in becoming a truly bullet-proof glaucoma and anterior segment surgeon. You have ample opportunities to get involved with NIH-funded research as well as industry collaboration with exposure to new products/platforms.

Faculty Mentors:
Anjali Bhorade (NIH R01 funded)
Michael Kass (NIH R01 funded)
John Lind
Arsham Sheybani
Carla Seigfried (NIH R01 funded)

This fellowship is truly a hybrid of Traditional Glaucoma and Glaucoma+. The surgical diversity provided by Dr. Arsham Sheybani follows a long respected GAASS lineage; Allan Crandall at University of Utah and Ike Ahmed at University of Toronto. I have never encountered a surgeon educator who is more committed to teaching/mentoring/coaching than Dr. Sheybani. He pushes you to excel, gain confidence, and become independent very quickly. He has high expectations but also what seems like never-ending support and patience to make you better. Most importantly, you are able to have your own independent OR days once deemed reliable and capable. This fellowship is for individuals that want structured autonomy but also want to be pushed to develop their own clinical decision making and surgical abilities.

Insider info: A lot of fellowships expect you to take on a great degree of scut, call, and other such duties for the privilege of being a fellow that earns a meager NOT-PGY scale stipend. This fellowship is a lot of work (3 OR days per week) but you are not overwhelmed by scut/admin duties. More importantly, you get paid on PGY scale at the University and hourly as a staff physician at the VA. While this shouldn’t be a deciding point for a fellowship, the respectable salary and modest cost of living in St. Louis was a huge plus.

Please send me a private message with any questions.

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What is a good balance between MIGS and traditional Trab/Tube shunt cases?
 
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