For the inaugural global ophthalmology spotlight, we spoke with Jacquelyn Jetton, this year’s current – and first – global ophthalmology fellow at the University of Oklahoma’s Dean McGee Eye Institute. She completed medical school at the University of Texas at San Antonio and her residency at Dean McGee. She talked to us about …
1. Which came first, your interest in global health or in ophthalmology? My interest in global health predated my interest in ophthalmology. I’ve always wanted to be a doctor. I actually had my first “global health” experience growing up in Dallas. I learned Spanish in elementary school and became an interpreter at a free clinic in my teen years. That early exposure to the disparities in healthcare inspired me to want to make a difference, and my ability to speak Spanish allowed me to work both in the US and abroad.
2. Why did you then decide to become an ophthalmologist? At the beginning of medical school, I was interested in infectious disease. During the course of my medical education, however, I really fell in love with ophthalmology. I love the fact that you can fix something. There are still barriers to bringing those cures, but at the root of it that’s what keeps me going: helping to give people their sight back.
3. How did you begin to connect your passion for global health with your career in ophthalmology? I chose to train at Dean McGee in large part because of their formalized residency curriculum in global health. Residents are able to rotate in either China or Swaziland. In China, Dean McGee residents help educate Chinese ophthalmology residents. In Swaziland residents learn surgical techniques such as manual small incision cataract surgery (MSICS) that are often used in developing settings.
4. What are your current career goals? I would like to work in academia. I have had incredible mentors at Dean McGee. They have a vision for improving eye care both in the states and around the world, and I have come to share that vision. I want to continue to improve both patients’ access to care and the quality of that care. I also really enjoy teaching and have begun to take on more teaching responsibilities as a fellow. I hope to bring a unique perspective to residency education by teaching skills such as manual small incision cataract surgery and by heightening awareness of needs both around the corner and across the globe. I also really want to work in ophthalmology at a “public health” level, connecting people and improving systems of care delivery. My fellowship has given me an excellent footing on which to develop these goals.
5. What training and opportunities have you had through your global eye care fellowship? My time is split 50/50 between sites in the US and sites abroad. I actually worked with the faculty and Dean McGee to develop the curriculum for the global eye care fellowship, and we all felt it really important to address needs both in Oklahoma and globally. In Oklahoma I work with charitable clinics, tribal health (which has a large presence in Oklahoma), and federally qualified health centers. I am doing a research project right now that will determine the prevalence of blindness in Oklahoma City’s uninsured and underinsured population. Globally, I am working in Swaziland, China, and Peru. In Swaziland I do a lot of clinical work and am working with the Swazi government to develop a Vision 2020 program in conjunction with the World Health Organization. In China I am assisting with Dean McGee’s educational efforts, which have culminated in the development of an eye institute in southwestern China’s Sichuan province. In Peru I am helping a Catholic group increase the capacity of their eye clinic. Finally, the fellowship at Dean McGee offers an optional second year at the London School of Hygiene and Tropical Medicine. I’ll be spending a year in London obtaining a Master’s in Public Health for Eye Care. Understanding healthcare delivery systems is crucial in global health, and I feel very fortunate have this opportunity.
6. What is most rewarding aspect of providing eye care in underdeveloped areas? It’s truly making an impact on someone’s day-to-day life. You certainly make a difference here in the US doing cataract surgery. The severity of vision loss that you see in underdeveloped countries, however, can be profound. Helping a person see well so that they can once again provide for themselves and their family is incredibly rewarding.
7. What’s the most difficult part? Right now, it’s the situations that stretch me surgically and clinically. When you are in a place without much eye care, you are by default one of the only ophthalmologists there. I have certainly found myself in situations where I am the only person available to care for a patient, and either the diagnosis of their disease or the ensuing management is really challenging. I’ve had to push my clinical and surgical abilities, and that can be a challenge.
8. Is there anything else that you have learned over the past year that you’d like to share? As much as I love working abroad, it’s really important to remember that there are huge needs here at home in the United States. While the international work is wonderful, you definitely do not need to leave the country to find underserved populations. There are parts of the US with a disproportionate burden of blindness, and we need to do a better job of taking care of these patients. Dean McGee, for example, has partnered with a local diabetes clinic to provide diabetic eye exams and subsequent treatment at no cost to low-income patients. Whether it’s through a residency program, the US Vision 2020 agency, or another nonprofit, there are a number of ways to get involved. The US has excellent eye care; however, there are patients that, for a variety of reasons, don’t get to take advantage of that care. We can’t forget about them. There’s work to be done here too.