A storied program like the Wilmer residency produces more than leaders in the field of ophthalmology — it creates a culture, an approach to ophthalmology, that those who pass through the program carry with them for life.
“Once we’re Wilmer residents, we’re always Wilmer residents,” explains John Payne, M.D., who completed his residency in the mid-1960s and then served as chief resident in 1968. Part of that culture is putting into practice the tenets that Dr. William Holland Wilmer laid out at the founding of the institute — combining research, education and patient care in a way that increases knowledge of the eye and consistently improves upon or creates new treatments.
From his own experience at Wilmer, Payne knows the capacity that research has to ignite a young person’s mind. “When you get into research as a young resident, you never lose that interest in trying to find out how the eye works and how to treat it better,” he says. “It’s the research that really cements your love of ophthalmology and leads to the breakthroughs in treatments and in understanding how disease works.”
Inspired by his Wilmer heritage, Payne has created his own legacy within the Wilmer residency program — the coveted Mitchell Prize, awarded each year to the top three research projects conducted by Wilmer residents and presented at the annual Wilmer Residents Association (WRA) Meeting. Payne funds the prize through the Mitchell Trust. For many decades, he provided eye care for siblings John, Gladys and Al Mitchell. When Al passed away in 2000, Payne and two others, including another doctor who had also treated the family, were charged with using the Mitchell Trust to support ophthalmology and otolaryngology efforts in any way they saw fit. “It’s a challenge and responsibility because one tries to do what the benefactors wanted to do,” says Payne. Yet, it is also a “delight” to distribute the money, he says, “and it has been a wonderful gift over the years for me to do so.”
In 2001 and in consultation with then-Wilmer Director Morton Goldberg, M.D. — who is also a former Wilmer resident and chief resident — Payne arranged for the top research project presented at the annual WRA Meeting to be awarded a $10,000 prize. He was adamant that the winner be allowed to use the funds however desired. “Just like the Nobel Prize, there are no strings attached,” he says. Eventually, the trust was able to fund a $10,000 first place award, a $5,000 second place award and a $2,500 third place award. He hopes to raise the amount of the prizes in the future.
Though the WRA Meeting has existed since 1938, as well as the expectation that residents would present research at the meeting, times had changed by the early 2000s. More ophthalmology research meetings had sprung up, which had the potential to shift residents’ focus away from participating in the WRA Meeting. With the research prize, Payne and Goldberg had hoped to refocus resident attention on the WRA Meeting. And it worked, says Goldberg. Resident participation has held steady.
And there was an additional positive development. Prior to the Mitchell Prize, “the quality of the research was very, very good, but a written manuscript was not required,” explains Goldberg. In order to compete for the prize, though, residents are required both to present their research orally and turn in a publication-ready manuscript one month before the WRA Meeting for the faculty committee to evaluate. This requirement “has increased the number of research publications by the Wilmer residents over what occurred in the ‘good old days,’” says Goldberg.
To see just how much of an effect the Mitchell Prize competition and the WRA presentations have had on the residency, a Wilmer faculty member did some research. Divya Srikumaran, M.D., Wilmer’s vice chair for education (and former Wilmer resident), performed a review of 34 residents who graduated from the Wilmer residency program from 2012 to 2017 and found that presenting at the WRA Meeting was “associated with 1.44 times increased odds of publishing work, and residents who competed for the research prize were 1.76 times more likely to publish.” Since the institution of the contest for the Mitchell Prize, many more residents than before are producing papers, which are then getting published.
Such early publications can have dramatic effects on one’s career, explains Fasika Woreta, M.D., M.P.H., the head of Wilmer’s residency program and a former Wilmer resident — and chief resident — who won a second place in the Mitchell Prize competition. The paper she produced for the Mitchell Prize appeared in a peer-reviewed journal, and she received first-author credit, an important credential in academic medicine. She says such a credit helped her stand out when applying for her fellowship and contributed to her starting as an assistant professor, rather than an instructor, when she joined Wilmer as a faculty member.
Both Woreta and Srikumaran, who also won second place in the Mitchell Prize competition during her residency, emphasize the importance of having a goal when performing research as a resident. “They do the research after hours, weekends, nights. They have a full clinical load and are working on the front lines in the Emergency Department," says Woreta. “Having this generous prize as an incentive is helpful, but so is having a deadline to produce a publication-ready manuscript one month before the oral presentation."
Srikumaran points out that such multitasking is good training for those choosing to go into academic ophthalmology. “This is what you have to do when you’re a faculty member. You’re going to have your clinical work, and then on top of that, you have to dedicate countless hours, evenings and weekends to further your research,” she says. “Wilmer is trying to train future academic leaders. And if that is our mission, then we have to reward, recognize and incentivize research. To honor the incredible amount of work that the residents have to do to get these projects done is truly valuable.”
Since the prize’s inception, David Guyton, M.D., the Zanvyl Krieger Professor of Pediatric Ophthalmology — and a former Wilmer resident and chief resident — has administered annually the competition for the Mitchell Prize.
This task runs a wide gamut, starting with informing residents about the requirements and continues to coordinating the submission of manuscripts, which average seven to eight each year. After the presentations at the WRA Meeting, Guyton convenes the judging committee, composed of eight to 10 Wilmer faculty members, to discuss the totality of the residents’ submissions. They evaluate the papers, presentations and mentors’ confidential assessments of the residents’ contributions. Guyton tabulates the secret rankings from the committee members and stores them securely until he announces the winners at the residents’ graduation ceremony. “Winning this prize involves not just the money, but they get their name inscribed on a treasured plaque in the Patz Lecture Hall. It helps enable them to carry forth Wilmer’s traditions,” he says — whether they return to Wilmer or take the “Wilmer way” to programs around the world.