Student Experience

The Fear of Finding Something

It’s spring semester of your second year of optometry school; you’ve finally made it to the most exciting and important step in your optometric journey: clinic. On your first day, you gather all of your things— your lens set, retinoscopy handles, prism set, BIO and your trusty tonometer tip—and head into the University Eye Center. You find your room and clean your machines. Your classmate opens the EHR and, by the luck of the draw, you have a patient. A 30-year-old, white female walks into your room, sits in your exam chair and is ready for the fun to begin. Upon a gross anterior segment examination, you find a resounding case of corneal neovascularization—and you panic. The fear sets in. You’ve only had two weeks of ant seg classes. Are you supposed to know what’s causing this? Does she abuse her contact lenses? Does she have limbal stem cell deficiency? Or could she have a severe case of Fuchs endothelial cell dystrophy? Your head is filling with possibilities. Your hands are sweaty; you’re visibly shaking— what do you do next?

I’ve found that this is a common fear among second years and newbie student clinicians, but with a little less of the drama. We practice on young, healthy, relatively normal eyes in all of our labs. Except for the few cases of strabismus or corneal scarring, most of my classmates are only battling varying amounts of ametropia and astigmatism. I so desperately want to learn how to be a good clinician, how to identify diseases and oddities on my first day in clinic, but the only way to succeed in achieving this is by seeing abnormalities in person. Pictures can only be so helpful. The eyes in them aren’t blinking or photophobic or constantly moving to find something to fixate on. It’s scary to find something even slightly different than normal on a real, paying patient. As much as I was hoping to see something cool in clinic my first day, I also found myself hoping that I didn’t see anything at all. What if I misdiagnose them? What if I find something vision-threatening and they need emergency treatment? What if I see something so bizarre that I can’t even begin to explain it to my scribe? The fear can be all-consuming, but it’s comforting to know that everyone has been there, even the most well-renowned doctors saw corneal arcus for the first time and started shaking. The most important thing to remember is that we’re not alone in the clinic. We have so many resources and minds to help us make the correct diagnosis and treatment plan for our patients. And when in doubt, don’t be afraid to ask for help— that’s literally what all the precepting doctors are getting paid to do. In the end, the fear will make us all incredibly knowledgeable and competent doctors of optometry someday very, very soon.

Student Success & Residency

Advice for Optometry School Hopefuls

What is the key to getting into optometry school? Networking! Not what you thought I’d say, right? When applying to schools, I was in frequent communication with my top choice program’s admissions teams. I would pick up the phone, ask for informational interviews and use them as an opportunity not only to learn more about the program, but to build rapport with the admissions teams and help them put a face to my name. Doing this made me feel comfortable on interview day because I already knew some of the people that were there, as well as navigate the application process with better guidance to have the best chances of acceptance.

Another thing that I found useful was utilizing email communication. During the

COVID-19 pandemic, when it was difficult to shadow in person in hospitals or clinics, I still made it a priority to network. I would get in touch with local practices and schedule informational interviews with doctors of optometry to learn more about the care that they specialize in.

Eventually, when it was safe to do so, I was able to go in and shadow when other applicants may have still been having a difficult time. This also broke down geographic barriers and allowed me to connect with optometrists all over the country whose specialties I took interest in. Highlighting these experiences in my application showed that I was a resourceful and outside thinker, and these were qualities that often stood out on interview day.

While it is important to network with the schools themselves, I also found it beneficial to network with other optometry students. Just before my AZCOPT interview, I received an email from the program with the breakdown of how the virtual interview day would go. Included in this email were the names of the three student panel members and their emails in case us interviewees wanted to reach out to them beforehand. Being quick to seize this opportunity, I looked up the student panel members on LinkedIn to see if I had anything in common with them, and I found out that one of them actually went to the same undergraduate institution as I did. I emailed her to introduce myself and on interview day, I had the advantage of already being connected to a student panel member.

Being quick to create and seize opportunities gave me greater advantages as an applicant; however, these skills have carried over into my career as a whole. I am still connected with the student panel member and she is currently in my top choice residency program which has further benefited me by allowing me to ask questions, get in touch with the right people and set myself up for the best chance of being matched with them in the future. About a month after receiving the news of my acceptance, I toured AZCOPT and there was a first-year student ambassador who stayed with me for the entirety of the tour. I made sure to stay in touch with her all throughout the summer. She helped me in my decision-making process, and when I began school, she became my anatomy and physiology tutor. Furthermore, at the start of school, the assistant dean sent out an “AZCOPT Survival Guide” and provided the email of the student who had written it. Again, I was quick to take the opportunity to connect with her, and now she too has become a close friend of mine as well as an amazing resource. These skills advanced my application and educational experiences, setting me up for success and excellence.

 

Overall, my advice for optometry school hopefuls would be to make your own opportunities instead of waiting for them to come to you! A quick phone call, a short meeting and staying connected goes a long way and you never know when those connections will come in handy.

Student Success & Residency

When the Student Becomes the Doctor: Maintaining Knowledge and Skill After Graduation 

As a new graduate, keeping up with the ever-changing world of optometry can be a daunting experience. After years of seemingly non-stop lectures in school, I personally was tempted by the idea of coasting by with online continuing education that required minimal effort. It quickly became clear to me, however, just how fast things change in healthcare. There is a lot more value to staying up to date than just getting enough credit to maintain a license. Keeping up with new available drops, surgeries, and research has helped me offer quality care to my patients far beyond the basics I learned in optometry school and externships. I have come to learn that there are many ways to expand clinical knowledge outside of direct clinical experience. 

For me, continuing education was the most obvious method of keeping up to date with new developments in the field of optometry. This comes in many forms including in-person vs. online, local vs. national level, and OD-only vs. combined OD/MD. I found local meetings to be particularly enjoyable. These are often offered through state associations as well as local clinics. They are a great way not only to get some credits but also to socialize with optometrists in the area. I also really enjoy getting to know local ophthalmologists who often lecture or attend these local meetings themselves.

Another great source of continuing education is national meetings. American Academy of Optometry (AAO) and American Optometric Association (AOA), for example, host annual meetings in different locations each year. One perk of this is the opportunity to visit another part of the country – I personally will take any excuse to travel. It can also be a great way to meet up with classmates following graduation. Online continuing education is a convenient method to stay up to date without having to leave home – this has become more prevalent in the times of COVID. Some meetings may even offer the option for an in-person or online course, which allows you to have some flexibility when case rates are high. 

One way to build more hands-on clinical experience is completing a residency. Truth be told, I was initially reluctant to consider residency. The idea of taking a reduced salary for a year was especially painful after seeing the final total of my student loans. However, I found the experience to be invaluable and would recommend it to every student I meet. The opportunity to see a high patient volume while under the supervision of experts in the field increased my clinical decision-making skills tenfold. I completed my training in corneal and refractive surgery and was amazed by the type of cases I was exposed to. Conditions I now see maybe once a year in private practice became routine for me during residency. At many sites, you also have the opportunity to participate in clinical trials – I was involved in nine different studies just by being at a research-heavy clinic! Plus, with only 26% of optometry students pursuing a residency, it is a great way to set yourself apart from other applicants when it comes time to look for a job.  

Board certification through the American Board of Optometry (ABO) is an excellent avenue to keep current with best practices and guidelines once you are out of school and in practice. This not only serves to differentiate yourself from other new graduates in the field but also to expand clinical knowledge. The first step to becoming board certified involves completing an application to ensure eligibility. In order to sit for the exam, three years of clinical experience or a residency are required. If residency has not been completed, additional activities such as fellowship, AAO diplomacy, and continuing education can be used to meet the requirements. The test is very similar to part two of national boards – it tests on clinical knowledge and skills, not didactic details. Upon passing the exam, you are awarded the title of Diplomate of the American Board of Optometry.

To maintain certification, ABO members complete maintenance of certification activities throughout the year. This includes self-study assessments, self-assessment modules, and continuing education. Personally, I have found the mini-assessments, given three times per year, to be even more helpful than traditional continuing education. They involve reading a provided set of articles on a particular subject (i.e. anterior segment disease) and completing an online 25-question quiz. The subject changes every time and ranges from binocular vision to contact lenses. The knowledge is all very clinically relevant and a great refresher on current standards of practice. Another big perk of ABO certification includes quarterly, top-notch online continuing education courses offered for free. 

Whatever your mode of practice, I think we can all agree that lifelong education is crucial to providing quality care for our patients. Whether you are one year out of practice or fifty, there is always more to learn as medical providers. Fortunately, there is no shortage of excellent opportunities to keep growing as clinicians and provide top-tier care for our patients. 

  

Lauren Bruehl, OD
Diplomate, American Board of Optometry