I hope everyone is having a wonderful day! I am currently sitting in shorts outside in a little courtyard near the optometry school. I felt it was necessary to supply photo evidence of a beautiful day in Ohio in October! I am super grateful summer has decided to hang on a little longer this year because this summer went so fast, I felt it never really happened!
Summer semester of third year sort of has a reputation for being the hardest. I went into it thinking, I have half days 3 days a week, how bad can it be?! Well, I totally underestimated how much work I would have to consume those free afternoons quickly. My summer was particularly busy because it was my semester to have three clinics. I had two half days of primary vision care (where we do comprehensive eye exams) and one afternoon of Eyewear Gallery. I know everyone has a different opinion of the summer semester, and I think a lot of that depends on how many clinics you had. While summer was incredibly hard, it was probably the semester where I saw the most growth in myself. I started the summer as mostly a technician and finished the summer seeing myself capable of being a doctor. We all went through the transition of knowing how to do the technical skills to knowing how to analyze the data from those skills in real time. I felt this was/is a steep curve still to work through, but I am finally at a point where I know I will become a doctor. Prior to this point in our education, you just had the ambition and dream to be a doctor but very little tangible evidence that you will actually make it to that goal.
At the end of the summer semester, we had a week long course called Keystone 2. Keystone 2 is similar to Keystone 1, which is completed at the end of first year. For Keystone 2, we had 1-2 real patient cases per day that we had to analyze and develop differential diagnoses as a group. Once we developed out tiered list of diagnoses, we had to present the case to a group who had a different case. Our keystone group was fantastic, so we brought snacks and made it fun. I think Keystone really brought to light just how far we have come. I have been with the same 66ish classmates for over 2 years now, and we went from just learning the layers of the retina to debating the nuances between diabetic retinopathy and hypertensive retinopathy. We were all looking at visual fields determining whether the patient had a significant field loss or if it was just artifact. I remember during keystone 1, I was digging through books trying to figure out how to interpret OCT images (optical coherence tomography- images of the layers of the retina), which now come pretty second nature. I also remember Dr. Mutti having to point out to us that we needed to explain why a person has reduced visual acuity (cannot read 20/20 on a Snellen chart). Now we know how to predict what a person’s visual acuity will be based on their spectacle prescription, cataracts, etc. I am always saying this, but time really flies in optometry school.
I remember as a first year hearing our professors say that we needed to be sure to learn everything for the long term for the sake of patient care but also in preparation for boards. At the time I always thought, “Boards?! That is forever away!” Well, forever away has become less than 6 months away. We take our first boards exam in March of 2019. The first part of boards is the basic science component. We take a second exam that is the clinical application component, and the last board exam is actually giving a comprehensive eye exam on a patient in North Carolina. I have decided to start studying for boards this week with the goal of getting through all the information in the matrix by January. Many people wait to start studying in January, but I would rather get a jump start now in case something unexpected happens like illness. I am also eager to start studying to increase my clinical confidence. I am really hoping that studying for boards will bring together all our education to help me elevate my thinking in clinic, which motivates me to do it. My goal is to not see boards studying as a burden but an opportunity to fill in any gaps and ensure I am the absolute best doctor I can be.
In addition to registering for boards this fall, we also had to submit our preferences for our fourth year externships. We are the first class to be on the semester schedule for externship rotations, so there have been some changes. We will do one semester at the Ohio State College of Optometry, where we work in low vision, contact lens, and pediatrics/ binocular vision. We also do a semester at a VA hospital and an advanced practice location (ophthalmology, private practice, etc.). We have so many choices making it really hard to choose just one top choice location. We should find out by the end of this semester where and when we will be going on our externships.
Now to finally update on the current semester! This semester I have one half day of Primary Vision Care clinic (PVC), one half day of vision therapy clinic, and one half day of school screenings. I absolutely love this semester! I am really enjoying vision therapy clinic (VT) a lot. VT is one of the few clinics where we get to work with the same patients consistently. You get the opportunity to watch the patient progress from week to week and cheer them along the way. I absolutely love getting to know my patients and learn their stories. Many of our VT patients have had traumatic brain injuries, and the person may go from working a full time job to being unable to go to the grocery store after a concussion. We also work with people of all ages on binocular vision conditions, which can really improve quality of life. During my short time in VT, I have heard patients exclaiming their excitement for seeing depth for the first time in their life and a patient report this is the first time they could read, look up, and look back with clear vision and not lose their place. There are so many big and small victories to be celebrated in VT, and I just leave inspired and motivated every week by our patients.
I also have very much enjoyed my time in PVC this semester. I have learned a tremendous amount from my attending doctor, Dr. Hopkins, and he has totally transformed how I do exams. I have also had the opportunity to see all sorts of interesting cases in PVC. In my opinion, it is uncommon to have a patient with only refractive codes (only needs glasses).
As far as school screenings, our class is split into four groups and we go to local schools to screen mostly elementary school students. The school screenings are a really great learning experience because we each get assigned a station for the morning, so you may be able to do 40 cover tests in a row (checking eye alignment). It really helps improve our skill levels and learn how to work with kids who may not be interested in looking where you need them to look.
A couple other things about this semester, we do still have classes. We are in a business class right now, where we are learning how to manage an optometry office. I have always enjoyed our business classes with Dr. Wright. This week in class we learned about the optical component of a practice. We learned how to determine how many frames to have in the office, price points, display, and many other things. We had to work in groups to design our perfect optical and present them to the class.
We are also taking binocular vision, advanced contact lens (with corresponding labs), and systemic disease courses. This semester we have several contact lens workshops in the evenings. We have a catered dinner, a guest lecturer, and then get to learn to fit volunteer patients in specialty contact lenses. So far in optometry school we learn to do all our skills on each other, but the advanced contact lenses require particular visual needs, which cannot be simulated on our classmates alone. For example, we did multifocal contact lenses one evening, so we needed patients who need reading glasses in addition to distance correction. I was not sure how I would feel about these workshops because they make for an incredibly long day, but they have been a tremendous experience! As a person who has never worn contact lenses, I have found a passion for them that I did not expect! I knew they would be part of practice, but I love learning about all the specialty lenses that can really make a huge difference in a person’s life beyond just cosmetics.
As far as personal news, I have a kitty! My dad had some kittens at his barn, so now I have a little study buddy (more like study distractor)! Also, my commute has improved in terms of parking this semester due to getting a garage pass. They have a lottery system for garage passes, and I was fortunate to get one. It is incredibly expensive, but if you plan to commute around an hour, it is very worth it. I have been able to sleep in about 30 minutes later, and greatly reduced my stress coming to school.
Have a wonderful day, everyone! Also, good luck to all those still going through the process of applying to optometry school! You will be looking back at this time in your life wondering where the time has gone before you know it! Thanks for reading my blog!