Fellowship

Dr. Chynn has the most Refractive Fellows working for him of any surgeon in NYC. In fact, Park Avenue LASEK is the largest Refractive Fellowship Program in NYC! We have 4 Refractive Fellows at all times, 2 Senior Fellows and 2 Junior Fellows. All are full MDs! They have chosen to spend 1-2 years learning the intricacies of Refractive Surgery from Dr. Chynn, since he was at Columbia when the excimer laser was invented, and at Harvard when LASEK was invented. So they can learn from a true pioneer!

Dr. Chynn is recognized as a National Expert in Refractive Surgery
In this article, 3 national “thought leaders” including Dr. Chynn were asked their opinion on how to treat a complicated case. Dr. Chynn advocates using the VISX WaveScan CustomVue to create a PreVue lens. Using the PreVue lens, Dr. Chynn can show complicated patients (e.g., LASIK patients with flap complications) how they would see after he fixes their problem by performing a totally non-invasive, surface LASEK over their prior (failed) LASIK.

We have MDs contacting us every week from Around the World applying for a Refractive Fellowship. And flying in from abroad for LASEK. Read why.
Nobody flys to the US from abroad for a fellowship in LASIK, or to have LASIK. Why is this? They would just study LASIK or have LASIK in their home countries.

In contrast, Dr. Chynn and Park Avenue LASEK are recognized throughout the world as the #1 LASEK center in NYC and one of the top LASEK centers in the USA.

Why is it important to the patients and fellows that Park Avenue LASEK is the largest refractive fellowship in NYC?
Park Avenue LASEK is authorized by the official San Francisco National Residency & Fellowship Match Program to accept 2 Refractive Fellows per year for a 1-2 year Fellowship, for a total of 4 Refractive Fellows at any given time (2 Senior Fellows and 2 Junior Fellows). We thus have more Refractive Fellows (4) than any other academic center, hospital, or private practice in New York State!

We wouldn’t be even allowed to accept any fellows, much less 2 per year, if we didn’t have the surgical volume for training future refractive surgeons, or if Dr. Chynn hadn’t trained at top institutions like Columbia, Harvard, and Emory. Even huge academic centers like the combined program of Columbia and Cornell only have 1 Refractive Fellow to cover both institutions. Some huge centers like Albert Einstein and NYU don’t even have a single Refractive Fellow (because they don’t have a large, active program in Refractive Surgery). Park Avenue LASEk actually has an equal number of Refractive Fellows as all the other institutions in NYC–combined!

Why is this important to our patients and fellows? Because this objectively demonstrates that we have more surgical volume, and hence more clinical experience in refractive surgery (particularly Advanced Surface Ablations: LASEK and epi-LASEK) than any other center in New York State.

What is a Refractive Fellow?
A Refractive Fellow is an eye surgeon, or ophthalmologist, who has already graduated from Medical School and received his or her MD. They have already completed a 3-year Residency in Ophthalmology, where they learned all about the medical and surgical treatment of common eye diseases, such as cataracts, glaucoma, and age-related macular degeneration. Once they finish residency, they are considered qualified to practice ophthalmology. Legally, they can also perform LASIK, and many have done some supervised cases while a resident.

After all of this training, which lasts 8 years (including a 1-year internship in general medicine before specializing in eye surgery), these MDs choose to do another 1-2 years of sub-specialty training in Refractive Surgery under Dr. Chynn. Only 1% of all eye surgeons performing LASIK have actually completed a Refractive Fellowship, because they would have to voluntarily extend their training for 1-2 more years. Few doctors have the commitment to further optional training to study for a decade.

What do the Refractive Fellows do at Park Avenue LASEK?
As fully trained MDs and eye surgeons, the Refractive Fellows at PAL help Dr. Chynn with your preoperative testing before your Advanced Surface Ablation, and with your post-operative testing. They also assist Dr. Chynn in the OR, or laser suite during your LASEK or epi-LASEK procedure. All testing is done under Dr. Chynn’s supervision, and all tests are thoroughly reviewed by both the Refractive Fellow(s) and Dr. Chynn. It’s like having another set of MD eyes reviewing your data, for added care and safety.

How do the other laser centers in NYC function, if they don’t have any MD Fellows?
Other private centers use technicians, who aren’t doctors, don’t go to medical school, and may not know the full pathophysiology or mechanism behind the tests they are performing. In some cases, they may not even know how to properly interpret the test results, as the increasingly sophisticated, computerized tests now being performed to see if you’re a good candidate for refractive surgery (like an OrbScan, Pentacam, and/or WaveScan) are very difficult to interpret.

Other centers also usually rely primarily (or even exclusively) on optometrists, or ODs, to assist with preoperative or postoperative testing. An optometrist doesn’t go to medical school, so is not a MD. Their entire training is exactly half of that of an ophthalmologist, or MD who specializes in eye surgery. Optometrists are not trained in the surgical treatment of eye disease, because they are by law not allowed to practice surgery or medicine, because they never went to medical school. Optometrists are the people you find in white coats at a Lenscrafters or similar retail eyeglass store. While they are excellent at working with glasses and contacts (and in some cases may be even better at that than eye surgeons, because that’s what they were primarily taught in school and do every day), they are not trained surgically.

Optometrists in some states, including New York State, can also prescribe eye drops for the treatment of common eye conditions such as glaucoma. They can also evaluate the retina, but if there is any serious pathology requiring surgery, they must refer to an ophthalmologist for that treatment, as they are not physicians.

If the testing is computerized, do I really need a MD performing my tests, or can a “tech” or OD go as good a job?
Although the tests are computerized, the more the person performing the test knows about how to interpret the results, the better the accuracy of the tests. For example, we had a patient come in recently with a diagnosis from another laser center as having keratoconus, which is the #1 reason why it would be unsafe to laser a person, and the #1 disease refractive surgeons are trying to pick up and screen out before clearing a patient as a “good candidate” for refractive surgery.

That patient wound up not having KC, but that was a misdiagnosis based on a poorly-performed test (the patient’s head was angled in the OrbScan, leading to a topography that looked like “inferior steepening.” Dr. Almeida, one of our Senior Refractive Fellows, picked this up in 10 minutes, because he has so many years of experience here with OrbScans (he has now been with us for 5 years!). So we were able to perform our SafeSight procedure and make this patient 20/20!

Does Park Avenue LASEK engage in any active research in refractive surgery, and if so, how does this benefit patients?
Park Avenue LASEK is the leading private center in terms of conducting and publishing research in refractive surgery in NYC. Objectively, we attend more national and international meetings, present posters and give lectures at them, and publish papers in peer-reviewed journals than any other private laser vision correction center in NYC. For example, every year Dr. Chynn and his fellows attend the ASCRS, AAO, and ESCRS meetings, which are the top 3 meetings of this kind in the world.

We feel that conducting clinical research is very important, as it keeps us on the cutting edge of refractive surgery (or in our case, on the non-cutting edge!). We were the first center to introduce epi-LASEK as standard of care in NYC. We were chosen by VISX, the market leader in excimer laser manufacturers to launch Hi-Def WaveFront CustomVue ReadingVizion to correct presbyopia and eliminate reading glasses in NYC. We are the only center in NYC comfortable treating extreme prescriptions that cannot be treated safely with a cutting procedure like LASIK or IntraLase, because we have by far the most experience treating extreme myopia, hyperopia, astigmatism, and thin corneas.

Our patients benefit immediately from not only our own advances, but the advances of other top refractive centers and surgeons throughout the world. Dr. Chynn and his fellows are active on Kera-Net, which is a users group of leading refractive surgeons around the world–so specialized that it is even closed to general ophthalmologists (the kind who take a 1-day course and perform LASIK, rather than committing to a 1-2 year cornea or refractive fellowship). This means that one of Dr. Chynn’s former colleagues at Harvard who is now running a large center in Greece can advise us on the state-of-the-art in corneal crosslinking (CXL), even ahead of FDA approval, since this procedure to treat or prevent progression of KC, possibly in conjunction with LASEK, has been approved in Europe for 10 years.

Do the Refractive Fellows perform surgery on any patients?
Dr. Chynn is the only surgeon who performs surgery on patients at our center. In rare circumstances, the fellows may assist with surgery on certain non-paid patients so they gain more experience (i.e. Dr. Chynn will let them assist him when performing surgery on their own relatives, which we do at cost).

For example, Dr. Almeida had the older non-cutting procedure PRK performed in 2006 in Venezuela, where he is from. This older PRK is very painful, takes a long time to recover, and can result in scarring. His father owns the largest private hospital in Venezuela, so his family could also have had PRK themselves for free in Venezuela. Instead, after working at PAL for a year, Dr. Almeida had his entire family fly up to NYC to get our Advanced Surface Ablation procedures, which he assisted on. Clearly, this family of MDs are convinced that LASEK is so much better than PRK it’s worth paying several thousand dollars more for and flying out of the country!

His entire family (and his fiancee) is now seeing better than 20/20 after their SafeSight procedures at PAL!:)

As a Refractive Fellow, would I get experience in just Refractive Surgery, or in Cornea as well?
Dr. Chynn completed a full Cornea and Refractive Fellowship at Emory University in Atlanta in 1996-1997 under the world famous refractive surgeon George Waring, MD, who headed the ground-breaking FDA-sponsored PERK study. He also trained in cornea under the equally famous Doyle Stulting, MD, PhD, and learned how to perform corneal transplants and manage other complicated corneal pathologies.

He even learned how to perform corneal tattoos for people missing their iris or with a cosmetic pupil defect, which is much safer than inserting titanium plates into the eye for cosmesis, and performed a corneal tattoo on Ralph Lauren’s private limo driverin NYC in 2009. So he can teach the fellows about the cornea, as well, although this is a primary Refractive Fellowship.

As a fellow, you will assist Dr. Chynn in the diagnosis and management of very complicated refractive cases and procedures, as people are flying to our center from all over the world to have prior refractive surgery complications treated.Such cases include fixing LASIK flap complications, including flap striae, epithelial ingrowth, incomplete flaps, and old RK, AK, and PK by performing CustomVue LASEKs over the prior aborted or complicated primary procedure.

I’m interested in applying for a Refractive Fellowship at Park Avenue LASEK under Dr. Emil Chynn. What’s the process?
If you are interested in starting on the regular academic year, which begins on July 1, then you should apply through the San Francisco Match. The terms and process of how to apply though the official national fellowship match site are on their site, www.SFMatch.org. If you have further questions or are confused about this process, please contact the SF Match directly. Dr. Chynn sponsors the only pure refractive fellowship program in the country, so the head of the SF Match Program (Dennis Thomatos) and the administrator (Dina Wong) both know him personally, and will be willing to help you out, either by email or even on the phone.

If you are interested in starting at a date other than July 1, then you should apply directly with us, off-match. Please email us all of the following:

  1. resume
  2. cover letter stating why you want to do a Refractive Fellowship, what experience you have in refractive surgery, and if you want LASEK yourself or have had refractive surgery yourself already (PAL is the only center in NYC that encourages all employees from the surgeons to the secretaries to have LASEK themselves, which we provide at cost, so they can speak to patients from personal experience).
  3. 3 letters of recommendation
  4. Board scores (USMLE) if you are a US graduate; ECFMG scores in you are a FMG (Foreign Medical Graduate). You don’t have to have finished your USMLE or ECFMG process, or be fully licensed yet. We will help you complete this process while you’re a fellow. We will also assist you in obtaining your license and malpractice insurance, where appropriate. So please apply even you haven’t completed these processes, but also clearly state where you are in this process so we can properly assess your candidacy.
  5. visa and work status in the US (we can and are sponsoring a H1B visa for one of our fellows, so can sponsor this for you, too, if necessary)

We will email you if we think you are a qualified candidate, and then ask you to call us and further discuss your candidacy and career goals. If we then feel that you are a good fit and can help our practice and patients, we will schedule you for a 1-2 day, in-person, working interview, where Dr. Chynn will assess your medical knowledge and refractive surgery background, as well as your ability to work comfortably with our high-end, New York patient population, and staff members.

If you are a well-qualified US graduate (meaning you trained at a top medical school and residency), Dr. Chynn will consider taking you on after completing our Refractive Fellowship as a full equity partner, as he has performed 20,000 procedures to date, and is looking forward to letting junior partners take over more clinical responsibilities, so he can devote more time to research, including bringing 1 of his 3 US patents to product (and guiding 1 through US FDA trials).

Please note that you must have completed a full, 3-year residency in ophthalmology to be considered for this Refractive Surgery Fellowship.