Teaching Biomedical Photographic Communications into the Next Century
Michael R Peres, MSc, RBP, FBPA
Biomedical Photographic Communications
College of Imaging Arts & Sciences
Rochester Institute of Technology
Rochester, New York

The Biomedical Photographic Communications department of the Rochester Institute of Technology, offers the only Bachelor’s Degree in this field in the United States. With over 80 students, the curriculum and its delivery have been continually challenged by the “New World” of imaging and the demands from the industry where the graduates will work. This paper will examine the program’s recent strategic decisions about curriculum and the future directions for educating tomorrow’s professionals. The paper specifically will asses aspects of what is taught, how it is taught, and other relevant issues specific to equipment, networks, ethics, expansion, as well as extracurricular activities that have been put in place.

It goes without saying that a University’s purpose in 1999 maybe defined in several ways and would be based upon whose perspective is queried. Parents might describe the University as a place to send one’s “kids” to get them away from home, while students might describe it as a place to experience both personal and intellectual growth. Industry might describe the University as "a resource of community knowledge or a source to find consultants or a provider of its work force. Because of the variety of perspectives, characterizing the Rochester Institute of Technology(RIT) and the Biomedical Photographic Communications program is also equally complex.

The Biomedical Photographic Communications program was initiated in 1969 and a received an external funding grant designed specifically to enhance health care related fields from the United States government. Over the course of its brief history, it has graduated over 450 students who have received Bachelor of Science degrees( a typical 4 year experience at U.S. universities). Many of these alumni work in human and veterinary medicine environments, in ophthalmology, in forensic science laboratories or other life sciences related organizations such as pharmaceutical companies or life science multi media companies.
RIT is located in Rochester, New York. By car, it is approximately 4 hours from Toronto, Canada or 7 hours from New York City. Rochester is world renown for certain industry giants such as the Eastman Kodak Company, the Xerox Corporation as well as the Bausch & Lomb Corporation. These imaging and optical companies, although mutually exclusive from one another as well as RIT, share a healthy relationship in our community to one another. One interesting characteristic of Rochester is its average snowfall of 2625mm per year. Clearly this feature of our winter weather is a strong deterrent to study here, so the students who do enroll really want to be at RIT.

Although this article will share much about approaches that have been recently adopted in the BPC, it should be pointed out that the heart of the BPC experience, is its faculty and curriculum. Over the years, this dedicated group has included Nicholas Graver, RBP, FBPA, H. Lou Gibson, RBP, FBPA, Nile Root, RBP, FBPA, and William DuBois, FBPA. There are currently 3 full time faculty members as well as 3 adjunct appointments(part time). Together with the author, this group influences every aspect of how the department conducts its business. The School uses primarily full time faculty to deliver the majority of the curriculum.
Each faculty member has a unique area of expertise which is useful in broadening what can be taught in the program. Current specialties include ophthalmic photography, medical photography, photomicrography, electronic imaging, desktop & web publishing as well as many other areas of imaging. Beyond the faculty's expertise, it is expected that the faculty is professionally active. Each of the faculty is expected to stay current through professional development activities. This might include taking or leading relevant workshops, participating in the BioCommunications Association or Ophthalmic Photographer's Society, or similar such activities. Publishing is also considered to be important. Additionally consulting activities are supported because of their validation of one's skill set in appropriate areas. This might include writing a grant application, testing products or other similar activities,

The College
The BPC program is situated within the College of Imaging Arts & Sciences. This unique college has many distinctive programs including the Imaging Permanence Institute which received an award from the
OSCAR foundation for its work in the preservation and study of the
storage of motion picture film. The college also has many other diverse
programs including Graphic Arts & Electronic Publishing, the School of American Crafts as well as the School of Photographic Arts & Sciences where the BPC is aligned.

The School
The School of Photographic Arts & Sciences(SPAS) is a very large organization with over 850 students and 32 full time faculty. It has a portfolio of programs including: The Imaging Systems Management program, the Imaging & Photographic Technology program, the Biomedical Photographic Communications program, the Fine Art Photography program which also administers the #1 rated Masters of Fine Art program in USA, and the Applied program: Advertising & Journalism program. Without developing too much detail, the shear size and complexity of the school influences all facets of daily operations as well as its long term planning.

School Facilities
It is important to add a bit of perspective here so one can develop a complete picture of how the BPC achieves its mission integrated into a very large organization. The facilities for SPAS are housed in an enormous physical plant that encompasses over of 65,000 square feet in a 4 story building. Within the school are 151 fully equipped darkrooms, 35 fully equipped large format studios, a gallery, 100 computer workstations complete with all sorts of input and output devices, as well as a complete automated processing lab and related equipment. The learning environment is very rich and diverse to support courses and homework. To compliment the equipment side of the organization is a very capable support staff of 8 which coordinates access to these facilities . Students have access to work in the building Monday through Saturday, from 8:30am - 10:00pm

Beyond the general usage facilities listed above, the school is filled with specialized laboratories for other more specialized activities. Although it is not practical to list all labs, listing a few might be useful. There are laboratories designated for the study of holography, high speed and instrumentation photography, scanning electron microscopy, non-silver processes, color measurement & management, as well as optics and photographic chemistry. These areas of specialization are available to all SPAS as well as BPC students to supplement the curriculum requirements of their degree and are taken as free elective courses.

Previous Curriculum
The original curriculum was written in 1969 and was delivered over a two year period. It resulted in an A.A.S. degree or a two year degree. In 1973, the upper division was written with the first Bachelor's of Science(BS) degree being awarded in 1974. These degrees were created using traditional techniques which were common in the 1970's. These original courses included the study of the materials & processes of photography, courses to develop proficiencies in the studio and the darkroom, as well as the use of specialized photographic materials and methods. Additionally, clinical photography & other specialized photographic methods such as photomicrography were taught. It was exactly what would be expected at that time. There was a strong general studies component which included writing, literature, sociology and related courses . The degree also required three courses in the biological sciences. This approach was quite complete for many years and the field people worked in was mature and stable.
Going into the 80’s however, the biomedical photography worldin the States started to change very quickly. Much of this was predicated by economic factors associated with the business side of the healthcare industry but additionally the availability of desktop computing begun. As a consequence of these factors, there was a huge impact on the industry the BPC graduates went to work for.

In 1985, the Career trends of a hypothetical RIT class of 12 graduates might have looked like this:
10 medical photographers
1 ophthalmic photographer
1 other
Contrast the class of 1999 career trends of 12 graduates to the 1985 situation:
1 medical photographer
7 ophthalmic photographers
3 electronic media
1 other

The 3 students who received positions in electronic media found positions as a consequence of their strong technical imaging education and communication design. One of the students works for Ziff-Davis, a large American Printing Company who specializes in scientific publications. Her position is in the Inter-Net publishing & training area where she is a part time tutor as well as web designer. The second position in the electronic media arena was located in Chicago for a large pathology department as the manager of the digital imaging services. Her responsibilities include managing the digitizing of the hospital's film image library for integration into a large image data base. The final student to secure a position was in an electronic imaging sales company specializing in photomicrography equipment and software. This person's job responsibilities include providing technical sales support as well as part time web master.

As a society, we really are still truly in the beginning phases of the Info age. People are demanding more information than ever and receive this "info" via the web, magazines, television and other media. The world also has more access to a variety of technologies than ever before. We live in a society which is cost conscientious and where insurance companies influence how medical services are provided as well as at what cost they will be reimbursed. Additionally, medical professionals advertise their services and their organizations as routine practice. As a result of the new digital technologies, physicians and researchers are creating many of their own images independent of the photographer. As a consequence, the role of the "biomedical photographer has been changed forever into the "media generalist/expert". We at RIT have found there is an new increasing demand for imaging experts for both the traditional and new markets. Additionally we have found a significant market for interdisciplinary "media literate" people. These discoveries have significantly influenced the future directions the Biomedical Photographic Communications has chosen to pursue.

Because of the variety of factors that influence the job market, the department initiated its strategic plan to design an adequate response to the many new opportunities that were being identified. This planning session was undertaken in the Spring of 1998. As a result of the strategic analysis which included input from an advisory board, faculty, alumni, as well as other colleagues in the field, the program set out to initiate:
- an aggressive curriculum revision
- a plan to update much equipment of its inventory
- a method to expand the educational opportunities for the students
- ways to use new technology for more effective delivery methods
- create non-credit experiences for adult learners
- an enhanced work study program for the students
- revitalize the alumni relations

The curriculum changes were quite simple in concept. The goal was to create a more inter disciplinary experience for the student. Also, the plan was to increase the electronic imaging activities while not significantly diluting the silver based skills which we believe have value. While the curriculum has been continually revised over the past few years, the new approach needed to be more aggressive.

The terminal objective for our curriculum is, "to develop an attitude as well as the skills required to be an effective visual information specialist in the life sciences industry". For this objective to be realistic, students would need to be exposed to classes and assignments that establish:
- a respect for diversity and different opinions that will be found in media teams in the work place
- a rigorous experience that instills confidence and develops problem solving skills using visual communications
- a technology independent learning experience that focuses on message delivery, not media used
- a life long applied learning approach
- the enhancement of self directed methods

Prior to these changes, students took a courses in a variety of areas but there it had become a "band-aid" approach. Courses over the years had just sort of been fit in and integration factor had been not optimized. It is functioned but with the new media driving decisions, we chose to revise 25% of the curriculum at once.

One interesting challenge the faculty has had to address is keeping current. With the speed of the digital revolution accelerating, the learning curve is quite scary. We are fortunate in an Institute of technology that some faculty member is always experimenting with something new in a peripheral area. The era of constant learning is quite stressful at times and in many instances faculty learn the new applications side by side with the students. When performing research projects, this has actually served to be quite useful. In addition to the three full time instructors, we employ several part time tutors from the field. Using this approach, we feel confident that the students are receiving a very practical foundation from a variety of resources. One very powerful approach that is often used invites experts to campus for one week blocks of time to augment the course.

Students are required to complete the following course requirements which total 188 credit hours. RIT uses a trimester system and so these credits may seem large upon first inspection however are delivered using 3 ten week blocks.
54 credits of general studies (not changed)
e.g. English comp, psychology, etc.
8 credits of math to include algebra & calculus(not changed)
12 credits human biology and medical terminology(not changed)
4 credits of computer science(eliminated)
8 credits of business electives(not changed)
8 credits of misc. science electives(not changed)
92 credits of a variety of imaging required and electives
curricula including:
9 credits in the Material & Processes of Photography(not changed)

12 credits in Biomedical Photography I(reduced from 15)
1st year photography coursework explores all camera formats,
the use of artificial lighting applied to some medical imaging applications
as well as aspects of b & w" manual" photo finishing
Presentation strategies are also investigated. Additionally experiences are built in to invite professionals from the field to campus to interact with students.

6 credits in Preparation of Biomed Visuals(not changed)
Students take courses that explore 2 -d design as well as courses in basic photo lab methods which include, copy work, slide duplication as well as scanning and basic computer graphics.

20 credits in the second year experience(assignment changes)
2nd year coursework explores, close-up photography,
specimen management, small object lighting, photomicrography, electronic flash, including studio, intra-oral and ophthalmic photography. Also color printing using both RA-4 and Digital methods are experienced.

12 credits in electronic photography(brand new)
Students take digital photography I & II ; desktop publishing, web graphics, and basic multi- media as required classes.

12 credits 3rd year courses investigate(assignment changes)
A-V Production, Multi-Media and Advanced BioMedical Photography including marketing photography, media campaigns, invisible spectrum, and data bases as examples of content.

12 credits self directed senior project( new approach) Students are also allowed to produce their own self proposed and directed project. In this fashion, they are further enhancing their skills in the directions that will be pursued as the career path.

Up to 24 credits of professional electives
There are also many professional electives that can be taken
during the third and fourth years. Students can take up to 24 credits of electives as well as a series of courses in a area of specialization. With this approach, students can explore specialized areas of imaging such as ophthalmic photography, photomicrography, or additional courses in electronic imaging. The flexibility this method provides is a powerful mechanism for students to develop a solid body of marketable skills as well as developing a strong that fits with their personalities as well as interests.

RIT currently offers the only, for-credit, college courses in ophthalmic photography in the United States. As a matter of fact, the job market in this specialty in the states, provides more opportunities than students interested in this field. Our ophthalmic course work is designed to provide the students with a solid foundation in ophthalmic imaging skills. There are currently three courses offered, Basic, Intermediate, and Advanced Applications in Ophthalmic Photography. Basic Ophthalmic photography encompasses anatomy & physiology of the eye, pharmacology, fundus photography, stereo photography, and an introduction to fluorescein angiography as well as some disease processes. Intermediate Ophthalmic photography explores further posterior segment imaging including fluorescein angiography, descriptive interpretation, and disease processes. Imaging of the anterior segment is also explored, including slitlamp biomicrography and its various lighting techniques, specular biomicrography and external imaging.
The Advanced Applications in Ophthalmic Photography class puts students int0 the clinical setting. Working one on one with University of Rochester faculty member, students perform fundus photography, fluorescein angiography, digital angiography, and slitlamp biomicrography. The faculty member assess on a case-by-case basis when each student is ready to 'solo' on various photographic assignments with real patients. The students gain valuable clinical experience related to photography and patient management that can not be taught in the classroom. In this fashion, education and experience are balanced so as to not compromise patient care.

Work Study
To satisfactorily complete the BS degree requirement, all students must complete a 10 weeks COOP Study block. As was mentioned, students pursuing this degree are exposed to the field through a variety of channels including the Co-op. One co-op is required to matriculate while two are suggested. The Institute typically will send out over 400 letters seeking sponsors for approximately 25 students per summer. Past sponsors of students have included, Eastman Kodak Company, Leaf, Sinar Bron, Johns Hopkins Hospital, Scheie Eye Institute, Henry Ford Hospital, Dade County Medical Examiners Office, Wake Forest University Eye Center, Bowman Gray School of Medicine, Medical College of Georgia, Duke University and the Moran Eye Center in Salt Lake City Utah to name a few. Internationally, we have placed students in Hydrobad, India as well as at the Royal Children's Hospital in Melbourne, Australia.

It is too premature to assess the outcome of these changes. The class of 2003, will be the first to fully experience all the changes going from start to finish. Typically students are "grandfathered" into new courses or allowed to complete the old curriculum. From all relevant feedback to date, the response seems quite favorable.

Teaching Labs
The department's curriculum is heavily dependent on equipment . The teaching labs are estimated to house over $850,000 in various equipment which includes: 15 Trinocular photomicroscopes and accessories, twenty - Nikon 35mm cameras with various accessories & lenses, Mamiya medium format equipment, Polaroid and Bencher Vertical Copy Stands as well as Optical Cameras for slide creation and duplication. There is a variety of tungsten and electronic flash lighting equipment, as well as specialized equipment for photomacrography and intra-oral photography. This list only begins to share the diversity of the film side of the program's labs.

The students experiences in the electronic photography
is reinforced through their lab assignments. At present the department is sharing computers with the Imaging and Photographic Technology(IPT) department which brings the total number of workstations available to the students to 15, each with peripherals. 11 Macintosh computers are networked with 4 PC' s and connected through an ethernet system. Three film scanners, three flat bed scanners, one film recorder, a thermal printer, two laser writers, and various imaging software applications are available to support the 73 BPC students as well as the approximately 80 IPT students in the two programs. Some of the software applications include: Photoshop, Quark, Illustrator, Free hand, PowerPoint, Macro Mind Director, Premier, Netscape, IDL Image processing software.
The departments ophthalmic imaging resources are equally impresive. Through equipment purchases, vendor support from Topcon and Zeiss, and private donations, the department has acquired a considerable amount of equipment for student use. The department's Fundus Cameras include: two Zeiss FF–4, Zeiss FK–30, Zeiss FF–2, Topcon 50X, Topcon TRC-W, Topcon JE, two Kowa RCXV2, and an Olympus handheld camera. SlitLamp cameras include: Zeiss 40SLP, Zeiss SL-2, and a Topcon SL–7E. Additional resources include a Topcon SP-1000 non-contact specular biomicroscope, and video capabilities allowing the teaching and illustration of imaging techniques.

A Research University
RIT as a whole also underwent a strategic planning process. One of the goals was to establish itself more as a research organization. Historically, the mission of RIT was primarily undergraduate teaching so getting involved in this area of activity is new for many faculty. As a consequence, the program's faculty have aggressively tried to become an Applied Research “resource ’’ for hire to specific industries. Some of the noteworthy projects have included: developing a protocol for the New York Botanical Gardens to use for digitizing their herbarium collection; beta- testing Kodak cameras for application on the light microscopes before market release; creating over 1000 digital photomicrographs for use as interactive teaching CD-ROMs for a biological supply company; as well as others smaller projects. These projects have realized over $25,000 in discretionary income that has been used to hire students for research projects, purchase new equipment and travel funds. This summer(1999) one of the department's faculty members is on loan to NASA for the design and creation of an instructional media project designed for children that visit the center.

In the context of this article, it is not possible to fully develop all aspects of the department, however one of our key initiatives is to develop Non-Credit Curricula. Some of these activities are beginning to establish themselves as workshops for adult learners. Some of these activities have included digital imaging courses for scientists, hosting the CRA exams for the Ophthalmic Photographer's Society as well as distance learning initiatives teaching digital photography to the general photographic community. With a faculty of only three, we find ourselves having often to prioritize how we will apply ourselves during each of the three quarters to maximize our output but still promoting personal initiatives.

Core to our achieving the terminal goal, extra-curricular activities
play a significant role. These include a student organization, the Biomedical Photographic Student Association, BPSA; a very active BPC WEB site(www.rit.edu/~Biomed), and a 16 page student publication produced 3 time annually, entitled the BPC Bulletin as well as the now ell known Big Shot projects. Students are encouraged to play active roles in any aspects of these activities. There is much to learn by joining and developing the leadership skills required to be successful as a professional.

In conclusion, the BPC is a very unique educational program both in our college as well in the United States. It draws students from all over the country and the faculty work very hard to create a rich academic experience for the students, preparing them for the dynamic job market. In the largest sense, we expect our graduates to contribute to an organization so that it might better achieve its mission. This might be through aiding in research and the publication potentials, or to bring prestige to “the” organizations through excellent visuals or through contributing to patient care that is enhanced. There are many ways this happens. In this very dynamic world of electronic imaging BPC students still will serve customers, and we all must continue to evolve. Digital imaging, the world wide web as well as telemedicine are realities in the new world that we provide graduates to. What is clearly different are the tools that we use.

Several years ago I was working on an article investigating nudity and clinical photography with Devid Teplica, MD, MFA and Stanley Burns, MD. In doing some research I learned of an interesting story that has some relevance here. In the mid 1880's, Mr. Moishe Friedner was a citizen from Krakow, Poland and he was quite a sick man. His physician was perplexed and did not know how to help him, however he knew of a glandular expert who lived in Vienna, Austria. The Doctor convinced Mr Friedner, an orthodox Jew to allow him to be photographed in the nude so to reveal the full extent of his condition. The pictures were successfully made and delivered to Vienna through a courier service, probably a pony express type service. The Vienna doctor made the diagnosis and sent his interpretation via courier back to Krakow where Mr. Friedner was treated. It is ironic that in 1880, there existed the exact same problems of 1999, with the exception that technology then was completely different. Obviously the world is a profoundly different than in 1880, but still there exists the important need for visuals. As we approach the millennium, the only thing for sure is that powerful new forces will continue to shape the industry. For BPC graduates to be successful, they must strive to adapt as well.

Nudity in Clinical Photography: A literature review and the quest for Standardization, Journal of Biological Photography
Volume 64, Number 1, January 1996; Peres, Michael R, MS, RBP, FBPA; Teplica, David, MD, MFA ; Burns, Stanley, MD, FACS

The Advanced Biomedical Photography Class at RIT
Journal of Biological Photography Volume 58, Number 1, January 1990Peres Michael R , MS, RBP, FBPA

The Biomedical Photographic Communication Program at Rochester Institute of Technology, Rochester, New York
Peres, Michael R, MS, RBP, FBPA; Fischer, William S, CRA
The Journal of Ophthalmic Photography
Volume 18, Number 1, 1996 , pages 14-16

In Search of Excellence: The Imaging Systems Management Program at RIT, ;Peres Michael R , MS, RBP, FBPA
Photo Lab Management Magazine December 1994