1. UW Fox Valley Family Medicine Residency Program
Sponsored by: St. Elizabeth Hospital and Appleton Medical Center
Area of Curriculum/Rotation: ENT/URO/OPTH (8-9 wks) Revision date: March 7, 2007
UW Program Faculty: Mark Thompson e-mail: mark.thompson@fammed.wisc.edu
Primary Rotation sites / Community Faculty:
ENT
URO
OPTH
Approximate hours per week (based on a 4 week schedule – see detail schedule for exact scheduled hours)
Resident UW clinic Hospital / Non-hospital / Inpatient Call hours – Home Call Total ave
Yr hours/week Inpatient outpatient see detail schedule hours hrs per
hours/week hrs/wk week.
R3 12-15 0 8-10 ENT 0 Participate in 45 + call
8-10 URO R3 clinic
8-10 OPTH call
Resident Responsibilities:
Rotation Prep:
1. Read curriculum Policy Manual at least 2 weeks prior to starting the rotation.
2. Contact Faculty at least 1 week prior to start of rotation to confirm reporting times.
3. Read Policy manual entitled “AMC Administrative Procedures and Protocols”, have familiarity with
admission, discharge, daily notes, death summaries, pronouncements, and transfer procedures. Read
Policy Manual entitled “St. Elizabeths Adiminsitrative Procedures and Protocols.
4. Assure that you have appropriate passwords to log into EPIC EMR, Meditech EMR, Digital
Radiography, and Electronic Signature services
Report Times:
1. The ENT/URO/OPTH curriculum is an 8 to 9 week block rotation in which rotation clinics are divided
between these three specialties. A detailed schedule outlining clinics is available in New Innovations.
Actual report times should be discussed with each of your faculty in regards to inpatient work and
outpatient work.
2. Continuity Clinics:
1. R3 Continuity Clinic at Fox Valley Family Medicine is three to four half day sessions per week.
Didactic Report Times
1. Tuesday Didactics—sessions from 12:00 PM to 5:00 PM.
Supervising and Reporting Structure:
1) 3rd Year resident ----
General Responsibilities
1) Reports to assigned community physician in ENT/URO/OPHTH as scheduled per
block schedule.
Clinical Site Responsibilities:
1) Will admit patients from community physician’s office
2) Will see, examine, evaluate, and make recommendations for clinical care with
direction and supervision from community faculty.
Administrative Responsibilities for ENT/URO/OPHTH:
1. Medical records training, transcription training, EMR training, Lab Retrieval training, and passwords
for EPIC and Meditech, Digital Radiography, and ESA (electronic signature) should all be completed prior
to starting the ENT/URO/OPTH.
2. Complete all patient assessments
a. Write or dictate office notes upon direction of supervisor
b. Write and dictate consult notes upon direction of supervisor
c. Dictate Admitting History and Physical
d. Communicate verbally with attending physician immediately after or during patient
encounters
3. Daily Rounds
a. On inpatients per direction of Supervising physician.
4. Complete Electronic Signature of dictated notes
a. Minimum standard is within 30 days, but should sign charts weekly
b. Residents on the teaching service should be electronically signing all dictations on a
weekly basis to assure prompt communication with primary care physicians.
3. 5. Complete daily administrative tasks for Continuity Practice.
a. Call in at least twice a day, or provide daily coverage for you patient messages
6. Complete exposure check lists for all curriculum areas.
Procedural Responsibilities
1. Attending is required to be present for all non-emergent procedures
2. Slit Lamp Examination
3. Foreign body removal from eye
4. Oto-scope examinmation
5. Foreign body removal from ear
6. Nasolaryngoscopy
7. Audiology testing
http://www.aafp.org/afp/20000501/2749.html
8. Tympanograms
http://www.aafp.org/afp/20041101/1713.html
9. Cerumen removal—with loop an or irrigation
10 Rinne and Weber tests
http://www.aafp.org/afp/20000501/2749.html
11. Placement of ear wick
10. Urinary cathatertization
11. Urodynamic studies
http://www.aafp.org/afp/980600ap/weiss.html
12. Vasectomy
http://www.aafp.org/afp/20061215/2069.html
Interpretive Responsibilities
1. Sinus Films/CT
2. Gluacoma indicators/pressure reading
3.Uro-dynamic Studies
http://www.aafp.org/afp/980600ap/weiss.htm
4. Tympanogram
http://www.aafp.org/afp/20041101/1713.html
5.Audiology results
http://www.aafp.org/afp/20000501/2749.htm
6. Bladder Scans
7. PSA results
8 Semen analysis
4. http://www.aafp.org/afp/20020615/practice.html
PATIENT CARE
Specific Objective Measurement Tool Expected Outcome
Gather essential and accurate information Gather essential and Passing Scores on Rotation Evals
using the following clinical skills: medical accurate information
interviewing, physical examination, diagnostic using the following
studies and developmental assessments. clinical skills: medical
interviewing, physical
examination, diagnostic
studies and
developmental
assessments.
Make informed diagnostic and therapeutic *Direct observation Passing Scores on Rotation Evals
decisions based on patient information, *Rotation Eval
current scientific evidence and clinical
judgment, using clinical problem-solving
skills, recognizing the limits of one’s
knowledge and expertise, gathering
appropriate information and using colleagues
and consultants appropriately.
Develop and carry out patient care plans, *Direct observation Passing Scores on Rotation Evals
using principles of evidence-based decision- *Rotation Eval Meeting Institutional Benchmarks
making, appropriate prioritization, and taking * Patient Eval on Patient Evaluations
into account the needs, beliefs and resources
of patient and family.
Effectively use common therapies within the *Direct observation *Direct observation
scope of general adult and pediatric medicine *Rotation Eval * Passing Sore Rotation Eval
practice, including a variety of prescription
and non-prescription medications,. Be
familiar with therapies commonly used by sub
specialists and other professionals who care
for adults.
5. Counsel patients and families in a supportive *Direct Observation Video Tape Review demonstrating
manner so they can understand their illness or *Rotation Eval competency in counseling/decision
injury and its treatment, share in decision- * Video taping making for level of training
making, make informed consent and Passing scores on rotation evals
participate actively in the care plan.
Provide effective preventive health care and *Direct Observation Video Tape Review demonstrating
health care risk factor reduction to patients *Chart Review competency in counseling/decision
and their families. *Video Taping making for level of training
Passing Scores on Rotation Evals
End of Life Care. Planning for end of life *Direct Observation Satisfactory scores on Rotation
decisions. Counseling patients and their *Rotation Eval Evals
families in regards to DPOA, Hospice, and
Comfort Care measures in a thoughtful and
respectful manner.
MEDICAL KNOWLEDGE
Specific Objective Measurement Expected
Tool Outcome
Demonstrate that one knows or can efficiently access the knowledge base *In-Service TE >20% of In-
needed for effective patient care. *USMLE service
*Direct Training exam
Observation Passing Scores
*Rotation Eval on Rotation
Evals
Critically evaluate current medical information and scientific evidence and *Direct Satisfactory
modify one’s knowledge base accordingly. Observation Evaluation for
*Journal Club Grand Rounds
eval and Journal
* Grand Rounds Club
eval
Recognize the limits of one’s knowledge and expertise by seeking * Direct Cost –efficient
information needed to answer clinical questions and using consultants and Observation use of referrals
referrals appropriately. Use this process to guide life-long learning plans. * Referral Passing Scores
Reviews on Rotation
* Rotation Eval Evals
*Direct Satisfactory
Apply current medical information and scientific evidence effectively to Observation Evaluation for
patient care (e.g., use an open-minded, analytical approach, sound clinical *Rotation Eval Journal Club
judgment, and appropriate attention to priorities). *Journal Club Passing Scores
Eval on Rotation
*Peer Eval Evals
Passing Scores
on Peer Evals
ACLS Protocols ACLS training Pass Course
Course Active
members of
ACLS
6. response team
ENT Specific Knowledge Based Competency
Otitis externa diagnosis and management *Direct Satisfactory
http://www.aafp.org/afp/20061101/1510.html Observation Course
Evaluation
Cerumen impacation management of *Direct Satisfactory
Observation Course
Evaluation
AOM, Serous Otitis Media *Direct Satisfactory
http://www.aafp.org/afp/20040601/practice.html Observation Course
http://www.guideline.gov/algorithm/3727/NGC-3727.html Evaluation
http://www.guideline.gov/algorithm/3727/NGC-3727_1.html
http://www.aafp.org/afp/20000401/2051.html
Satisfactory
Chronic Otitis Media *Direct
Course
Observation
Evaluation
Acute Sinusitis/,management of *Direct Satisfactory
http://www.aafp.org/afp/20041101/1685.html Observation Course
http://www.aafp.org/afp/20041101/1697.html Evaluation
Chronic Sinusitis management of *Direct Satisfactory
http://www.aafp.org/afp/20041101/1685.html Observation Course
http://www.aafp.org/afp/20041101/1697.html Evaluation
Epistaxis management *Direct Satisfactory
http://www.aafp.org/afp/20050115/305.html Observation Course
Evaluation
Chronic cough management and work-up *Direct Satisfactory
http://www.aafp.org/afp/20040501/2159.html Observation Course
http://www.aafp.org/afp/20030101/tips/10.html Evaluation
Chronic hoarseness management and work up *Direct Satisfactory
http://www.aafp.org/afp/980600ap/rosen.html Observation Course
Evaluation
Cholesteoma recognition and management
Common Oral Lesions *Direct Satisfactory
http://www.aafp.org/afp/20070215/501.html Observation Course
http://www.aafp.org/afp/20070215/509.html Evaluation
Oral Cancer recognition and work-up *Direct
http://www.aafp.org/afp/20020401/1379.html Observation
Otalgia Management
Hearing loss diagnosis and management *Direct Satisfactory
http://www.aafp.org/afp/20030915/1125.html Observation Course
Evaluation
Vertigo diagnosis and management (BP) *Direct Satisfactory
http://www.aafp.org/afp/20060115/244.html Observation Course
http://www.aafp.org/afp/20050315/1115.html Evaluation
Acute Labrynthitis
7. Acoustic Neuroma/Schwannoma *Direct Satisfactory
Observation Course
Evaluation
Tinnitus *Direct Satisfactory
http://www.aafp.org/afp/20040101/120.html Observation Course
Evaluation
Eustachian tube dysfunction/diagnosis and management *Direct Satisfactory
Observation Course
Evaluation
Allergic Rhinitis. Chronic and Seasonal diagnosis and management *Direct Satisfactory
http://www.aafp.org/afp/20060501/1583.html Observation Course
Evaluation
Head and Neck Symptoms of GERD *Direct Satisfactory
http://www.aafp.org/afp/990901ap/873.html Observation Course
Evaluation
Laryngitis *Direct Satisfactory
Observation Course
Evaluation
URO Specific Knowledge Based Competency
Understands growth and development of male anatomy
Dysuria work up *Direct Satisfactory
http://www.aafp.org/afp/20020415/1589.html Observation Course
Evaluation
Acute Scrotum *Direct Satisfactory
http://www.aafp.org/afp/990215ap/817.html Observation Course
Evaluation
Diagnosis and treatment of STD’s *Direct Satisfactory
http://www.cdc.gov/std/treatment/2006/rr5511.pdf Observation Course
Evaluation
Diagnosis and treatment of Urethritis
Diagnosis and treatment of Epidiiymitis
Diagnosis and treatment of Orchitis *Direct Satisfactory
http://www.aafp.org/afp/980215ap/junnila.html Observation Course
Evaluation
Diagnosis and treatment of Prostatitis *Direct Satisfactory
http://www.aafp.org/afp/20000515/3015.html Observation Course
Evaluation
Penile abnormalities *Direct Satisfactory
Peyronies Observation Course
http://www.aafp.org/afp/990800ap/549.html Evaluation
Phimosis/paraphimosis
http://www.aafp.org/afp/20001215/2623.html
Epispadis/hypospadias
9. Bladder Cancer *Direct Satisfactory
http://www.auanet.org/guidelines/main_reports/bladdercancer.pdf Observation Course
Evaluation
Priapism *Direct Satisfactory
http://www.auanet.org/guidelines/priapism.cfm Observation Course
Evaluation
Vesicouretral Reflux Management *Direct Satisfactory
http://www.auanet.org/guidelines/main_reports/vesi_reflux.pdf Observation Course
Evaluation
Interstitial Cystitis *Direct Satisfactory
http://www.aafp.org/afp/20011001/1199.html Observation Course
Evaluation
Groin Hernia *Direct Satisfactory
http://www.aafp.org/afp/990101ap/143.html Observation Course
Evaluation
testicular Cancer http://www.aafp.org/afp/990501ap/2539.html *Direct Satisfactory
Observation Course
Evaluation
OPHTH Specific Knowledge Based Competency
Amblyopia *Direct Satisfactory
http://www.aafp.org/afp/20070201/361.html Observation Course
Evaluation
Vision Screening Technique in children *Direct Satisfactory
http://www.aafp.org/afp/980901ap/broderic.html Observation Course
Evaluation
Two Minute Eye Exam Video *Direct Satisfactory
http://webeye.ophth.uiowa.edu/eyeforum/Two-Minute-Eye-exam.htm Observation Course
Evaluation
Strabismus
Leukocoria
The Red Eye *Direct Satisfactory
http://taylorandfrancis.metapress.com/content/mdbwaxxjuyvn6e46/ Observation Course
Evaluation
Glaucoma *Direct Satisfactory
Primary Open Angle Observation Course
Secondary Open Angle Evaluation
Primary Angle Closure
Secondary Angle Closure
http://www.aafp.org/afp/990401ap/1871.html
Nystagmus *Direct Satisfactory
Observation Course
Evaluation
Management of non-penetrating trauma of orbit and lid *Direct Satisfactory
Observation Course
Evaluation
Management of chemical burns *Direct Satisfactory
http://www.emedicinehealth.com/chemical_eye_burns/article_em.htm Observation Course
Evaluation
Diagnosis and management of mechanical corneal abrasion *Direct Satisfactory
10. http://www.aafp.org/afp/20040701/123.html Observation Course
Evaluation
Diagnosis and management of traumatic Hyphema *Direct Satisfactory
Observation Course
Evaluation
Diagnosis and management of Bacterial and Viral Conjunctivitis *Direct Satisfactory
http://www.aafp.org/afp/980215ap/morrow.html Observation Course
Evaluation
Diagnosis and management of Allergic Conjunctivitis *Direct Satisfactory
http://www.aafp.org/afp/980215ap/morrow.html Observation Course
Evaluation
Diagnosis and management of Herpes Simplex and Zoster of the eye *Direct Satisfactory
http://www.aafp.org/afp/20021101/1723.html Observation Course
Evaluation
Management of contact lens complications *Direct Satisfactory
Contact Lens types Observation Course
http://www.allaboutvision.com/contacts/ Evaluation
Diagnosis and management of Pterygium and Pinguecula *Direct Satisfactory
Observation Course
Evaluation
Diagnosis and Management of Hordeolum and Chalazion *Direct Satisfactory
http://www.aafp.org/afp/980600ap/carter.html Observation Course
Evaluation
Diagnosis and Management o Dacryostenosis and Dacryocystitis *Direct Satisfactory
http://pediatrics.aappublications.org/cgi/reprint/76/2/172? Observation Course
maxtoshow=&HITS=10&hits&sortspec=relevance&resourcetype=HWCI Evaluation
T
Diagnosis and Management of Blepharitis *Direct Satisfactory
http://www.aafp.org/afp/980600ap/carter.html Observation Course
Evaluation
Diagnosis and Management of Orbital Cellulitis and Peri orbital Cellulitis *Direct Satisfactory
http://www.findarticles.com/p/articles/mi_m3225/is_6_67/ai_98626751 Observation Course
Evaluation
Diagnosis and Management of Acute Visual Loss *Direct Satisfactory
Central Retinal Artery Occlusion Observation Course
Central Retinal Vein Occlusion Evaluation
Retinal Detachment
Posterior Vitreous Detachment
Vitreous Hemorrhage
Macular Disorders
Neuroophthalmologic Visual loss
http://www.aafp.org/afp/20040401/1691.html
Diagnosis and management of abnormal Extraoccular movements and *Direct Satisfactory
pupil abnormality Observation Course
http://cim.ucdavis.edu/EyeRelease/Interface/TopFrame.htm Evaluation
*Direct Satisfactory
11. Cataracts Observation Course
http://archopht.ama-assn.org/cgi/content/full/122/4/487 Evaluation
Diabetic Retinopathy *Direct Satisfactory
http://care.diabetesjournals.org/cgi/content/full/27/suppl_1/s84 Observation Course
Evaluation
Causes of visual impairment *Direct Satisfactory
http://archopht.ama-assn.org/cgi/content/full/122/4/477 Observation Course
Evaluation
Iritis and ocular manifestations of Autoimmune Disease *Direct Satisfactory
http://www.aafp.org/afp/20020915/991.html Observation Course
Evaluation
Eye disease video and web based tutorials *Direct Satisfactory
http://webeye.ophth.uiowa.edu/eyeforum/tutorials.htm Observation Course
Evaluation
PRACTICE-BASED LEARNING AND IMPROVEMENT
Specific Objective Measurement Tool Expected Outcome
Use scientific methods and evidence to *Peer Eval Satisfactory Performance on CQI
investigate, evaluate and improve one’s own *CQI Project project
patient care practice; continually strive to Satisfactory Performance on Peer
integrate best evidence into daily practice. Eval
Systematically assess the health care needs of *Clinical Data Complete Mentor/ Mentee review
one’s practice population, and use this Warehouse of CDW
information to direct population-based Assessment Meeting goals or improving
problem-solving, with special attention to *Grand Rounds Eval performance to meet benchmarks
preventable morbidity and risk. * Chronic Disease for chronic disease management
Management Satisfactory Performance on CQI
Data project
*CQI Project Satisfactory Evaluation for Grand
Rounds
Seek and incorporate feedback and self- *Mentor Sessions Competency for level of training
assessment into a plan for professional growth * Sign off of all noted on Mentor/Mentee summary
and practice improvement (e.g., use evaluations sheets
evaluations provided by patients, peers,
superiors and subordinates to improve patient
care).
Demonstrate willingness and capability to be *Attendance at 80% attendance for lecture series
a life-long learner by pursuing answers to Tuesday Didactics that are required(those which
clinical questions, using literature, texts, residents are not excused as noted
information technology, patients, colleagues in the log)
and formal teaching conferences.
Be prepared to alter one’s practice of *Rotation Evals Satisfactory Performance on all
medicine over time in response to new *Faculty Evals evals/Meeting competency for level
12. discoveries and advances in epidemiology and *360 deg Evals of training
clinical care. * Chronic Disease Meeting goals or improving
Management Data performance to meet benchmarks
for chronic disease management for
level of training
Ability to make appropriate referrals to ENT, Direct Observation Satisfactory performance on
OPTH, and URO specialists Referral Review rotation review
INTERPERSONAL AND COMMUNICATION SKILLS
Specific Objective Measurement Tool Expected Outcome
Communicate effectively in a *Patient Satisfaction Satisfactory Performance on all
developmentally appropriate manner with Surveys evals/ Meeting competency for
patients and families to create and sustain a * Video Taping level of training
therapeutic relationship across the broad range * Direct Observation Video Tape Review demonstrating
of socioeconomic and cultural backgrounds. * Rotation Eval competency in counseling/decision
* Nursing Eval making for level of training
Communicates effectively with peers and *Peer Evals Satisfactory Performance on all
health care team in a way that enhances *360 deg Evals evals/ Meeting competency for
patient safety and work place satisfaction. level of training
Communicates with health care team in a
professional and respectful way.
Develop effective approaches for teaching *Peer Evals Satisfactory Performance on all
students, colleagues, other professionals and * 360 Deg Evals evals/ Meeting competency for
lay groups. * Rotation Evals level of training
Maintain comprehensive, timely and legible * Medical Records/ Dictations Completed within 24
medical records. Transcription hours
Delinquency No more that two delinquent
Reporting notices per year from inpatient
*Chart Review medical records
PROFESSIONALISM
Specific Objective Measurement Tool Expected Outcome
*Peer Eval Satisfactory Performance on all
Demonstrate commitment, responsibility, *360 deg Evals evals/ Meeting competency for
accountability for patient care, including *Patient Evals level of training
continuity of care. *Rotation Evals
*Peer Eval Satisfactory Performance on all
Be honest and use integrity in one’s *Faculty Evals evals/ Meeting competency for
professional duties. *360 deg Evals level of training
*Rotation Evals
Consistently use compassion and empathy in *Patient Evals Satisfactory Performance on all
one’s role as a physician. *Peer Evals evals/ Meeting competency for
*Faculty Evals level of training
*Rotation Evals
Maintain professional boundaries in one’s *Patient Evals Satisfactory Performance on all
dealings with patients, family, staff, and *Faculty Evals evals/ Meeting competency for
13. professional colleagues *Rotation Evals level of training
Place the needs of patients and society over *Rotation Evals Satisfactory Performance on all
one’s own self-interest *Peer Evals evals/ Meeting competency for
level of training
Demonstrate sensitivity and responsiveness to *Video Taping Satisfactory Performance on all
patients’ and colleagues’ gender, age, culture, *Chart Review evals/ Meeting competency for
disabilities, ethnicity, and sexual orientation *Rotation Evals level of training
*Direct Observation
*Peer Evals
Meet high standards of legal and ethical Satisfactory Performance on all
*Rotation Evals
behavior. evals/ Meeting competency for
*Faculty Evals
level of training
*360 Deg Evals
*Sign off on
Professionalism contract
Develop a healthy lifestyle, fostering *Mentor Sessions Signed and completed Mentor
behaviors that help balance personal goals and *Curricular Planning Session documentation twice per
professional responsibilities. Recognize and Documents year. Signed Curricular Planning
respond to personal stress and fatigue that *Completion of the Documents once per year/
might interfere with professional duties. SAFER training Course Signed statement indicating
SAFER training was completed
SYSTEMS – BASED PRACTICE
Overall Goal:
Specific Objective Measurement Tool Expected Outcome
Use scientific methods and evidence to *CQI Project Satisfactory Performance on all
investigate, evaluate and improve one’s own *Journal Club evals/ Meeting competency for
patient care practice; continually strive to Presentation/ level of training
integrate best evidence into daily practice. Evals
*Clinical Data Review of CDW indicating that
Practice cost-effective health care and Warehouse resident is within the normative
resource allocation that does not compromise * Meets ThedaCare range for peer group
quality of care. quality measurement Review ThedaCare Quality
standards standards that resident service is
meeting quality standards within
the hospital setting
*360 Deg Evals Satisfactory Performance on all
Advocate for patients in one’s practice, by evals/ Meeting competency for
helping them with systems complexities and level of training
identifying resources to meet their needs.
360 Deg Evals Satisfactory Performance on all
Work with health care managers and evals/ Meeting competency for
providers to assess, coordinate, and improve level of training
patient care, consistently advocating for high
quality
Advocate for the promotion of health and the *Clinical Data Reaching quality goals
prevention of disease and injury in Warehouse
populations. * HEDIS reports
14. Acknowledge medical errors and develop *Direct Observation Peer Review for residents filed in
practice systems to prevent them *Chart Review portfolio with statement from
*CQI Process/Project resident showing plan for
*360 Deg Evals improvement/lessons learned.
*Peer Review Data Chart review notes placed in
portfolio and reviewed at mentor
session.
Satisfactory Performance on all
evals/ Meeting competency for
level of training
Resource List: (include names / e-mails / web sites / tools / etc……) Include internal as well as external
1. Eye Exam/Disease Web/Sites
http://www.eyeatlas.com/
http://www.nyee.edu/digitalatlas.html?cat=primary_area
2. Eye Tutorials(Including exams)
http://webeye.ophth.uiowa.edu/eyeforum/tutorials.htm
3. Eye Movement and Pupil Simulator
http://cim.ucdavis.edu/EyeRelease/Interface/TopFrame.htm
4. Eye Emergency quiz and tutorial
http://medweb.bham.ac.uk/easdec/emergencyeye2.html
5. Amblyopia
http://www.aafp.org/afp/20070201/361.html
6. Prevention of Eye trauma in sports
http://www.aafp.org/afp/20030401/1481.html
7. Childhood eye exam
http://www.aafp.org/afp/990901ap/907.html
8. Macular degeneration
http://www.aafp.org/afp/20000515/3035.html
9. Conjunctivitis
http://www.aafp.org/afp/980215ap/morrow.html
10. Eyelid Disorders
http://www.aafp.org/afp/980600ap/carter.html
11. Retinal Detachment
http://www.aafp.org/afp/20040401/1691.html
12. Common Causes of Vision Loss in the Edlerly
16. 28. Inforetriever
http://www.infopoems.com/
29. The Cohcrane Library
http://www.cochrane.org/
30. Detailed Video Tutorial on Physical Exams Skills based on System
http://www.conntutorials.com/video.html
31. Palm Programs available for Download Related to HealthCare: Many are Free
http://www.palmsource.com/interests/medicine/#2
/home/pptfactory/temp/enturoophth-1233829770931881-1/enturoophth-1233829770931881-1.doc
