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One To Watch | Sept/Oct '16

One To Watch: Gene Kim, MD

Gene Kim, MD

Gene Kim, MD

Dr. Kim is a Clinical Assistant Professor and Residency Program Director, Department of Ophthalmology; Visual Science at McGovern Medical School at The University of Texas Health Science Center at Houston.

Please share with us your background.

I moved around a lot as a child because my dad is a physician, and, at that time, we followed his path to obtaining and finishing a residency and fellowship. I spent time in Philadelphia and New York City (Queens and Staten Island) and eventually settled down in Irvine, California. Even though I have lived in a lot of places, I still consider myself a Californian.

I fell in love with science as a high school student and never looked back. I pursued a degree in bioengineering as an undergraduate at the University of California, San Diego, because I had always hoped that I could use that knowledge to invent something new in medicine. I completed medical school at the University of Pittsburgh. Afterward—like earlier in my life—I continued to move around and completed an ophthalmology residency at Emory University and a fellowship in cornea, external disease, and refractive surgery at the University of Utah. I have now been part of the ophthalmology department at the University of Texas in Houston for the past 4 years.

What drew you to ophthalmology and, specifically, to your field of interest?

My first introduction to the field of ophthalmology was as a third-year medical student. The University of Pittsburgh has a unique curriculum, in which every medical student has a 1-week mandatory rotation in ophthalmology during his or her clerkship year. I had always wanted to do internal medicine prior to this week but ending up loving ophthalmology in just that short time. I always knew that I wanted to be a specialist where I—at least try to—know absolutely everything about my field, so doing a fellowship was as natural path. I chose cornea as my subspecialty because the goal is to restore vision and, in many cases, to try to get patients seeing perfectly. There is a beautiful combination of science and art with lasers and optics calculations on one end and the task of trying to equalize every tension of my stitch by feel in a corneal transplant on the other end that fits my personality well.

Please describe your current position.

I am in a tertiary care academic institution at the McGovern Medical School at The University of Texas at Houston. I am one of three cornea specialists and deal primarily with ocular trauma, corneal transplants, and corneal infections—basically everything that nobody else wants to do. I have my own practice at the university and have a large role in staffing residents at the Lyndon Baines Johnson county hospital. I now also serve as the Residency Program Director at our institution. I have always been an idealist and love academic medicine. I spend my time treating the sickest patients, teaching our future ophthalmologists, and working on research to advance our field. I am always excited to go to work and feel fortunate that I can say that my work is both my profession and my hobby.

Who are/were your mentors?

I have had many mentors along the way and cannot mention them all, but I will name a few. My first mentor has to be Mike Nakaue, who was the head of the science department at Woodbridge High School in Irvine, California. He spent much of his after-hours time organizing science teams and activities for us, and he is really the one who got me interested in science. As a teacher now, I appreciate all the time he took to help us grow, and I will be forever grateful for his fostering my love of science. Anyone who has gone through residency at Emory cannot acknowledge his or her teachers without mentioning Geoffrey Broocker, MD, who served as Chief of Ophthalmology at Grady Hospital. He had an amazing passion for teaching, and you could feel that he loved his residents and had a vested interest in our future success. I think I can speak for all who were mentored by Dr. Broocker and say that he was the person that set the tone of making education a priority in our residency program. Maria Aaron, MD, who was my program director during residency, continues to be a sounding board for me, as I am now in the same position. Bradley Randleman, MD, helped guide me into the field of cornea. Both of my fellowship mentors—Mark Mifflin, MD, and Majid Moshirfar, MD—were amazing, and I would not be where I am today without them. Drs. Mifflin and Morshirfar were incredible teachers and are now great friends. They continue to be mentors for me, and I always feel fortunate that I can give either of them a call at any time for guidance. I am lucky to have been taught by people who are great at what they do and love what they do, and I try my best to make them proud every day.

What has been the most memorable experience of your career thus far?

Dealing with ocular trauma has been interesting and challenging. It has pushed the limits of my medical knowledge, my surgical ability, and my creativity to try and fix problems where really there are no good answers—believe me, I have looked in the literature. At the same time, the difficulty of these cases has helped me to become a better doctor and surgeon, and reconstructing eyes from being open and ruptured to eventually restoring their vision has been special. Also, seeing residents learn and grow over the years has also been memorable. It has been humbling to watch residents go from knowing nothing to later becoming colleagues who I can turn to for advice. Guiding and mentoring their growth and seeing them go out and help others with what I have taught them is truly rewarding and the main reason why I put in my time and efforts now as Residency Program Director.

What are some new technological advances that you have found particularly exciting? Which advances in the pipeline are you most enthusiastic or curious about?

Cornea has so many technologies that are exciting for the future. The new IOLs that operate on the principle of extended depth of focus are supposed to be game changers in helping cataract patients regain the vision of their youth. Corneal collagen crosslinking has finally been approved by the FDA and will prevent many children from requiring full-thickness corneal transplants in the future; this is a big deal because this surgery commits a patient to a lifetime of maintenance and risk. I am excited to see what customizable topography-guided LASIK can do for patients with traumatic scars and irregular corneas. Although this platform is not currently FDA-approved for eyes that have suffered trauma, I hope that I can be involved in the research to apply this technology toward helping this population of patients.

What is the focus of some of your research?

One aspect of my research centers on resident surgery, from how to better teach surgery safely and, unfortunately, to dealing with the aftermath of surgery that does not go well. We do not have many fellows at our institution, so our residents get to do a lot of subspecialty surgery as the primary surgeon. In letting novice surgeons tackle complicated cases, I have adjusted a lot of surgical techniques and have been able to publish papers on easier and more effective ways to perform difficult surgery. My own personal research focuses on the pathophysiology of dealing with corneal inflammation. We have a confocal microscope at our institution, which allows us to look at microscopic data that could only be analyzed in a laboratory with tissue samples. Confocal microscopy allows us to get this same information in real time and in the clinic without a tissue sample. Because there is no universal atlas or guide, presenting a confocal microscope photo is like showing a Rorschach inkblot test, with many physicians observing different reads for the same picture. I have spent a lot of time characterizing my findings and correlating the photos with laboratory and tissue data, and I hope to publish an atlas with these findings soon so that we can standardize the image reads.

What is a typical day in your life? What keeps you busy, fulfilled, and passionate?

I am fortunate in that every day of my work life is different. One day I can be in my own clinic, and the next day I am at the county hospital staffing resident clinic and surgery. Another day I will be in administrative meetings for the residency program, and, on a different day, I get protected time to read and conduct research. My work life is varied, and I wear multiple hats, which keeps me engaged and challenged and makes work enjoyable. Outside of work, I try to stay busy as well. I am an avid sports fan and love to watch and play basketball. In preparation of my future retirement from basketball, I am also trying (trying being the operative word) to play golf. Music was a large part of my life in the past. I played piano for 12 years and played trumpet for years as well. Relearning how to play piano has been more of a recent hobby. When I am not doing something productive, it is always nice to spend time with both my family and friends, who are great at keeping me grounded and sane.

What advice can you offer to individuals who are just now choosing their career paths after finishing residency or fellowship?

The most important thing is to do what you love. It may sound cliché, but you will always be successful at doing anything that you love. Many times, young physicians are practical, conservative, and sometimes scared to do what they really love, and they end up choosing a path that makes their work more of a job that they do for money, rather than a passion and a career that allows them to grow. Another piece of advice that we do not heed often in medicine is to step back and work smarter and not always harder. It is great to be open-minded and recognize that there is not only one way to live or one way of doing something. None of us knows everything, and so truly listening to what others have to say and being open to other ideas and approaches will save you a lot of trouble in work and in life. So be open-minded, do not be scared, and do what you love.

Tell us about an innovative procedure you are performing or a new imaging/diagnostic tool that has improved your practice.

As mentioned above, confocal microscopy has been a great clinical tool that helps guide my management of difficult cases and has opened up a new way for me to look at the cornea in terms of research. There are a limited number of ways that a cornea knows how to react to inflammation, so many different disease processes can look the same. Most of the time, we take educated guesses to try and work our way to a diagnosis. By using the confocal microscope, we can see what is going on at the cellular level and treat the actual pathology without obtaining tissue samples. Unlike tissue data, however, we do not know exactly what we are looking at, and I have spent a lot of time trying to catalogue and correlate these images with tissue samples. I have been lucky to be recognized at the American Society of Cataract and Refractive Surgery Film Festival for a tutorial I created on how to read confocal microscopy images, and I hope to continue advancing what we can do with this technology in the future.