Looking Forward and Looking Back

I cannot believe it, but it is time to write my last blog. I remember reading the student blogs before starting optometry school anxiously wondering what it would be like. It is hard to believe that it is over already. So now what? That is the most exciting part, the opportunities for life after optometry school are endless– private practice, corporate optometry, research and development, graduate school, fellowships, and residencies! I am actually just coming to the realization today that I am in the driver’s seat and get to decide what I do from here. During optometry school, our schedules were made for us, our clinic rotations assigned to us, and there was a four year plan. There is no more plan!

As for me, I am fortunate enough to have obtained exactly the job I had wanted in private practice. I am really excited to start working! I have always loved all aspects of optometry, and I would like to utilize the full range of skills I have learned. I have to admit, I was a bit nervous about how the current economic situation would impact all of our job prospects, but fortunately, most of my classmates’ jobs have been unaffected. The majority of my classmates are pursuing jobs in private practice and about a third are doing residencies. Most of the people doing residencies are looking to specialize, particularly in ocular disease at the VA.  We also have a couple of people in our class who are going to serve as optometrists in the military!

Reflecting back on my time at OSU, I realized that every difficult time was followed by a joyous time. Optometry school is definitely not a walk in the park, but with each trial comes a victory, and it is so worth it. It is an amazing feeling to go through each struggle and slowly see yourself becoming a doctor. It is worth your while to believe in yourself and go completely out of your comfort zone to see what you are made of. I really was not sure if I was going to be capable of becoming an optometrist, but with one day at a time, one test at a time, and one patient at a time, I eventually got there. I am so incredibly thankful to the OSUCO for believing in me and supporting me through this journey. The college truly is a family including students, faculty, staff, and patients. I am so thankful to have had the opportunity to spend the past four years with the most brilliant, caring, and supportive Buckeye family. I am also thankful the Buckeye family is forever, and I look forward to being part of the alumni community!

I sincerely hope this blog has been helpful to someone who has been considering going to optometry school. I appreciate you all taking this journey with me, and I am so thankful for the opportunity to share it with you. I wish you all the best if you are an undergraduate considering applying to optometry school, a “non-trad” who is considering a major life change, or someone who is curious what this wild ride looks like. I hope you all stay healthy and never settle for less than the best in life! Thank you to the OSU College of Optometry for changing my life forever! Let’s save vision!

P. S. Every person’s time at OSU looks different, but my advice is to take every opportunity that comes your way! Below are some of my favorite memories.

My attempt to recreate the picture from my first day.
White coat ceremony
White Coat ceremony
AOAPAC lobby day in Washington D.C.
A mandatory stop on the way back from the OOA’s East West Conference in Cleveland
Our class had a theme for every Friday during first year.
RAM is my favorite!
Ashtabula, OH on a RAM trip.
Our last EyeBall and last time most of us were together.

Optometry Day at the State House was a highlight every year
Friendsgiving with the class of 2020 every year
Many Bad Habits- The Official Eye Docs of Rock concerts

Graduation Part 1

It is official, the Ohio State University College of Optometry Class of 20/20 has graduated! We are optometrists and alumni rather than students! May 3 we had our virtual graduation ceremony, which exceeded my expectations. I must admit that when I first heard about the virtual graduation, I was upset because I thought it would mean it was less likely we would have an in-person graduation. Fortunately, Dean Zadnik and President Drake are still committed to their promises to host in-person graduation festivities in the future. So the way I see it, this weekend was graduation part 1.

Just like a wedding, when nothing goes according to plan, it is important to remember that the only thing that really matters is actually getting married. Well, nothing went according to plan for our graduation but the important thing is, we still graduated. The moment President Drake officially granted us our degrees was still the moment we all became doctors. I spent that moment with my husband in our living room, and I am thankful for the memory. I feel like we earned that degree together, and he deserved to share in that moment by my side rather than far away on the bleachers as it would have been. He packed many meals, talked me through many emotions, took care of literally everything around our house, financially supported me, and was my constant source of support all the way through this journey. It seems like just yesterday we both decided to change careers, and we finally made it! We went from -ers to -ists (teacher and police officer to optometrist and chemist)!

Graduation from my living room.

So how did we celebrate graduation? Creatively! I have so much enjoyed seeing all the creative graduation celebrations for my classmates via social media. Some people had ordered their regalia, while others donned regalia from previous graduations to at least look the part. Graduation celebrations took the form of drive-by parties, driveway parties, social distancing selfies, virtual gatherings, and lots of pictures.

My brother and I. He is representing my undergrad!

I decided last minute to celebrate with my family, and I am so glad I did. I gave my mom only a few hours’ notice, and she managed to throw together some decorations and have a wonderful patio party! I pulled up to my parents’ house, and my mom had tied balloons to the mailbox, put up class of 2020 signs and was dancing to Hang on Sloopy as I pulled in. I absolutely loved it! I also received some incredible gifts like a beautiful bracelet shaped like glasses, an optometrist Barbie, and many heart-felt notes. One of my favorite gifts, though, was a buckeye sapling my dad pulled out of the woods as I was leaving their house. I know tree analogies are cliché, but I could not help but realize the symbolism. So forgive me for the next cliché’ paragraph….

My dad handing me the buckeye tree made me realize the transition we are all experiencing right now. This weekend we went from student to doctor. I am only just beginning the next 30+ years of my career.

My little buckeye tree!

I planted it first thing and have been watering it diligently ever since. I hope to watch that buckeye tree grow just as my career grows. It is of course up to me now to ensure that both succeed. Just like the tree, I am ready to start putting down roots in a community and watch families grow up through a private practice. I can already imagine the day I stand beside that tree and look back thinking, “Where did the time go?” These past four years have been the fastest four years of my life and this is only just the beginning of this exciting career. I am so ready for this journey! I am also looking forward to graduation part 2 someday!

 

Melvin was able to attend the virtual ceremony.

The Elephant in the Room

Hello, all!

I have been debating about writing this blog post for a long time because I could never quite decide how to write it. I considered writing a post that made no mention of COVID-19 in my own desperate attempt to ignore the elephant in the room for just a few minutes. I considered writing a post entirely about how COVID-19 has impacted the college, but then that felt like accepting the reality that I am still having trouble accepting. While the battle in my mind continues, I decided to just write something.

As you all are probably aware, OSU has transitioned to all online learning, which includes clinical rotations. The last day fourth years were all at the college was Friday, March 13, and at that time, none of us knew if we were going to return. Initially only classes were moving online and clinics were going to remain open. Several days later we learned that all of our clinic rotations as optometry students were suspended until further notice. Again, shortly after that, we got the news that clinics were suspended for the remainder of the semester. As a fourth year student, that meant we would never return to the OSUCO as students. At that point, we were all clinging to the idea of still having our graduation festivities. As you probably already know, those festivities are now postponed.

As you can imagine, each email we received during that time of uncertainty triggered all sorts of emotions. I honestly have felt this experience has been similar to a grieving process. I know every person has responded differently during this time, but for me, it has been grief. I was initially very shocked and had a hard time accepting the news. I actually would reflexively go to set my alarm for my usual time and then be reminded I had nowhere to be the next day. Every day I would just think about my patients, my attendings, my classmates, and I just wanted life to go back to normal. It was also very unsettling initially wondering if we had met the requirements to graduate.

Fortunately, all of the uncertainty regarding graduation is behind us. Dean Zadnik made a promise to us that we would have our class celebrations at some point, and she has stayed very committed to that. I have felt so fortunate to be an OSU student during these times because the president of the university has done his best to protect us while also recognizing the importance of graduation. President Drake is hosting a virtual graduation while still promising to host an in-person graduation in the future, as well.

So what did they do with us when clinic was shut down? Well, to finish out our semester as fourth year students, we transitioned to online clinic in place of seeing patients. From what I understand, our class was the first class to do fourth year rotations on the semester system rather than the quarter system. Thanks to that change, we were set to see more patients than the previous classes, so that allowed us to miss the remaining weeks of the semester and still have adequate patient encounter numbers. Even though I had seen “enough” patients to graduate, it still felt like having the rug pulled out from under me. When I learned clinic was cancelled for the remainder of the semester, the reality set it that the next patient I would see would be as a doctor rather than a student intern. I think we all had our own reaction to this thought, but ultimately we are ready. There are many doctors who graduated in the 1980s or earlier, and they graduated having never dilated a pupil! I have come to realize that graduating does not mean I am an expert and know everything there is to know about the practice of optometry for all of time. It really just means I know enough to get started, and I know how to get the information to continue learning. Optometry is a profession that continues to grow and change as medicine changes, new research comes out, state laws change, and the vision demands of society change. While this realization is intimidating, it is also exciting. It is so exciting to know there is always something new to learn.

Let me tell you, I did a lot of learning during these past few weeks of online learning. While I would have much rather been in clinic seeing patients, I found the online materials our clinic attendings developed to be very valuable. For those of us who were on our in-house rotation at the college, we had a weekly session with an attending from each clinic service, so I had a 1.5-3 hour session for binocular vision and pediatrics, low vision rehabilitation, student health center, and contact lens. We also had various assignments sprinkled throughout. The sessions consisted of literature reviews, many patient cases, and new trends or topics in the field. I actually felt it was enough material to keep me busy most days, and I enjoyed seeing my clinic attendings and classmates on zoom every day. In addition to the material presented through the college, there were a lot of additional lectures available to students and doctors free of charge given the circumstances. The American Academy of Optometry presented lectures hourly all day every day for the past month for students, which I have found to be a nice addition to the materials offered by the college. Basically, if there was a topic I wanted to learn more about, there was a lecture somewhere about it online.

While I hate that I had to write this blog about how COVID-19 impacted our time at the college, I am glad to say that the transition from clinic to online turned out better than I could have imagined. I feel I was able to fill gaps in my education and expand on areas that I had been meaning to explore more. Up next,  virtual graduation!

Back at the College!

Hi, all!

I have so much to share with you and so little time to do it (as always)! I finished my Cincinnati VA rotation the first week of January, so I am back at the College of Optometry for the remainder of this semester. I cannot even believe we are quickly sliding into graduation! I have never been one to count down or wish for anything in the future because I firmly believe in enjoying every day and every experience for exactly what it is in that moment. So while I have to be planning for and considering my future right now, I am also soaking up every minute of my last few months of being a student.

In all honesty, I was extremely nervous to come back to the college after being out on externs for the past eight months. When you ask people about their experiences at different sites, you have to always take each person’s opinion with a grain of salt because just as classes and professors, every person has their own opinion. I heard a lot of people say they prefer the VA over the college or private practice over the college because it is a much faster pace. I personally have loved every one of my rotations this year. I am also loving being at the college. I feel like I had the opportunity to get good at primary care the last eight months, and now I am getting to focus on specialties with some primary care mixed in, as well. I have seen a lot of really interesting cases in just three weeks! One of my favorite rotations right now is low vision. I am with Dr. Hopkins again, which if you have read my earlier blogs, I have always enjoyed working with him. In the low vision clinic we do a lot in relation to driving. Some patients are unable to pass the vision component of the driver’s exam in the BMV, so they can come to the college for a driving exam. We see patient’s who participate in the bioptic driving program (drive with telescope glasses after extensive training) or people who have vision that meets the standards but requires different testing conditions. For example, I did a driving exam for a patient with oculocutaneous albinism. She has the acuity (20/40) necessary to pass a normal driver’s test, but her nystagmus (eyes moving back and forth) makes it difficult for her to demonstrate her true visual acuity in the BMV.

I also had the opportunity to do a low vision exam for a patient who was completely new to low vision, and she was in tears by the end of the exam because she was so excited to hear she has the potential to start driving with the bioptic program and  learn about the wonderful world of low vision devices to assist her at work. That afternoon I was in contact lens clinic, and I had a patient with a history of a penetrating keratoplasty (corneal transplant) in one eye and severe scarring from keratoconus (abnormal cornea) in the other eye. He was walking around with 20/400 vision, which is not correctable in glasses because his cornea is so irregular (not smooth and round), and I had the opportunity to dispense his scleral contact lenses which allowed him to see 20/30! He was so excited to get his lenses!

Another interesting case I had was a patient who has been struggling with double vision for a couple of months. He had a full stroke and brain tumor work up, so he came to us completely frustrated by his double vision with seemingly no explanation. After just a few tests in the binocular vision clinic Dr. McDaniel knew exactly what was wrong, and we were able to prescribe glasses with prism to help him comfortably read and walk again without seeing double!

Being in these specialty clinics, is awesome for me because I am a “fixer.” I am a person who wants to find a solution to a problem, and I will obsess over the problem until I have found a solution. I never knew this about myself until I started doing optometry because I am most excited about cases where I can solve a problem for a patient and improve their quality of life.

I exceeded my 15 minute allotment of time to write this blog, but I just love sharing how amazing optometry is! I sincerely hope to carve out some more time between now and graduation to write about various highlights over this past year a bit more, so stay tuned! Have a wonderful Friday, all!

VA Clinic

Hello! This week is the American Academy of Optometry meeting in Orlando, FL, so our clinic is essentially a ghost town. The residents and most of the doctors are at the conference, so today it was just my classmate and I seeing a super packed schedule including over-booked emergency patients. While days like today are a bit intimidating, I find them to be an exciting challenge because it is a chance to see how prepared you are for real practice. I typically see about seven patients at the Cincinnati VA Eye Clinic, but today I saw twelve! Many of my classmates see this many patients, I am sure, but for us this was a chance to try out a more realistic doctor schedule. Most optometrists see fifteen or more patients per day, so I still did not see a true doctor-level schedule, but it feels good to know I can manage the load. In reality, I could see more patients, but the preceptor also does an exam on the patient. I also had the opportunity to see a lot of variety today including proliferative diabetic retinopathy, non-arteritic anterior ischemic optic neuropathy, mild to mature cataracts, severe epithelial basement membrane dystrophy, ocular hypertension, various levels of glaucoma from suspect to end stage with palliative care only and an eye pressure of 46 mmHg (normal is under 22mmHg), posterior vitreous detachment, lots of dry eye, and lots of allergic conjunctivitis. I am actually really excited to have this increased patient load all week to have the opportunity to see more and learn more.

Last week I went to the Ohio Optometric Association’s annual East West Eye conference in Cleveland. I always enjoy this conference. I have been to this conference before, and I remember walking around not knowing anyone there, and this time I felt every time I turned around I saw someone I knew! It is exciting to know that I will see classmates and professors at annual conferences for many years to come. I was so excited to see people from the class that graduated this past spring! I also enjoyed going to the lectures. As I have said before, lectures are much more meaningful now that I am out in clinic. I also remember when I went to this conference in the past I would just pick random classes to go to based on hypothetical interests, and now I chose classes in areas I know I could use in my current clinic or areas of interest for my future practice.

While I had a busy day, there is no time to waste. We all take our NBEO part 2 exam the first week of December, so it is time to start studying again. Many of us started October 1, but there is no real rule about it. I prefer to start studying early to prevent panic as the exam gets closer and allows for wiggle room in case a life event pops up. My goal is to be completely done with boards in 2019. I took part 3 in August, part 1 in March, and just one more to go.

My VA preceptor requires us to write a bi-weekly paper on a topic of our choice, so my long day is going to end with writing my paper, which also is useful for part 2 studying. Tomorrow morning we start at 7:15 with an ophthalmology grand rounds lecture at the University of Cincinnati Hospital, then another busy clinic day! After tomorrow, my classmate is leaving for the conference, so it will just be me and my preceptor!

Have a wonderful week! Thanks for reading about the mundane details of my life! 🙂

Fourth Year Life

Hi, all!

I have so many things I want to share with you about the wonderful life of fourth year! Time is just flying by like always, and it is hard to believe we are already one month into our second rotation of fourth year. My class is the first to do three rotations rather than four. I personally like having three because I feel I have the opportunity to really get comfortable in the setting rather than spending time orienting. Fourth year is such a unique time in optometry school because you are applying all your knowledge in the clinical setting, taking board exams, moving every four months, learning new electronic health record (EHR) systems, learning different office/hospital/clinic styles, and pursuing plans for after optometry school. Just like everything in optometry school, once you start feeling comfortable, it is time to move on to something more challenging.

Amidst all of the chaos of fourth year, I am trying to savor every moment. I am trying to soak up every piece of knowledge and advice I can get from my preceptors (doctors who oversee your work while on rotation). I remember very vividly what it felt like my first year of teaching to close the door to my first period physics students knowing that I was the captain of the ship and had no one else to lean on at that point. I know very soon I will close the door to my exam room and will be signing my own charts, my own prescriptions, and have to make medical decisions all on my own. Obviously you are truly never alone, but I know the day is coming where I can’t just step out of the room and get a second opinion. As uncomfortable as it is to have your preceptor ask you how you want to manage a condition you may have never seen or only saw in a book, it is better to go through that uneasiness with an experienced clinician by your side rather than without, in my opinion.

So where am I now? I am currently at the Cincinnati VA along with a classmate. A lot of the VA sites have two students, so you are not alone, but that is not always the case. We also have VA residents at our site, which I find to be a great learning opportunity. We all share an office space, and I enjoy hearing their discussions of patient cases. Typically the residents get more of the challenging cases and do more of the acute care, but truthfully, the VA is full of interesting cases. I am finally at the point of feeling like I can just enjoy my time here. I remember Dr. Goedde telling us that students would call or email her hysterically the first few weeks they were at the VA because it was such a difficult learning curve and then they would suddenly be okay. I have not been hysterical, but I would say I was certainly uncomfortable the past few weeks. It is difficult to adjust from a private practice setting to a government clinic. It is always the little things that get you all sorts of flustered when you first start out in a new clinic. For instance, at the VA, all of your exam room supplies are stored in a locked room, in password protected cases. I ran out of tissues in my room, so I needed to find the right key, then figure out my username and password, then figure out how to operate the case, just to get a box of tissues. I find those little things to be more stressful than the patient care! I am excited to finally be past the orienting phase and really just focusing on learning how to treat and manage ocular disease, which is the focus of this rotation. I felt really well prepared to treat and manage glaucoma when I was taking our glaucoma class last summer, but in reality, it is so much more nuanced. I am thankful that in a typical day I see 3-7 glaucoma patients, so I will hopefully graduate fully prepared to manage glaucoma.

The Cincinnati VA is probably a little unique in that I have a variety of clinics within the VA. I have a half day of contact lens clinic where we only fit contact lenses including specialty fits for things like keratoconus. I have a half day of low vision where we assess various aspects of a person’s visual system with a focus on making a person’s activities of daily life and hobbies more accessible. It is a really impactful experience to be in a low vision clinic where I see patients who are light perception only in an eye from glaucoma. It helps me to realize how critical our decision making is in preventing and treating sight-threatening diseases. I also have a half day of traumatic brain injury (TBI) clinic, which is focused primarily on treating things like double vision and light sensitivity. The rest of my days are primary care where we do full exams either from start to finish or a tech gets the patient worked up to dilation, and then we do the refraction and health exam. One fairly universal thing about VA care is that you typically rotate between patients. At the college, you see the same patient from start to finish and stick with their care the whole time. At the VA you do the exam up to dilation, then while the patient dilates, you get another patient and work them up to dilation before doing the dilated fundus (retina) exam on the first patient. The switching between patients is a common practice in private practice, but it takes some getting used to. I also have the opportunity to go to the ophthalmology grand rounds at the University of Cincinnati every week and we have our own lecture series once a week. I very much enjoy these extra experiences because I find lectures to be more impactful now that I am in clinic. It is nice to get a refresher on a familiar topic or learn something new that you can apply right away.

I have so much more I want to tell you, but I need to go in early to do some chart edits tomorrow. At this VA, we print all of our charts, the doctors edit them, and then you fix the chart. It is a hassle, but I like learning what needs to be in the chart and learning to write things in a more sophisticated way. I can say the extra time has been worth it to learn how to document more like a doctor than a student.

Just in case you are curious, my first rotation this summer was at OSU’s Upper Arlington Outpatient Care facility, which runs like a private practice. I could write for days about how much I loved that site. I truly woke up excited every single day to be there. Unfortunately, I need to go to sleep, but stay tuned for more fourth year updates!

 

Time to Look Up!

Good morning, all! So you know how certain things just trigger your memory and put you back in a certain time of your life? This past week has been a whole lot of those triggers for me as we finish out the end of third year, and I thought I would let you in on my inner thoughts a bit.

This morning I woke up pretty early, which always puts me in a nostalgic mood. I feel like odd hours can be super meaningful experiences where everything just seems different. I feel like I take time to pay attention to things I would not normally, and this morning I caught a glimpse of a hummingbird at my back door. In case you are unfamiliar with hummingbirds, they migrate thousands of miles every year, so this little lady at my back door had probably just returned from Mexico and remembered I had a feeder. I had not put my feeder out yet, so I had to hurry up and get it out there. When this tiny creature travels all the way from Mexico to come to your back yard, you better provide! Anyways, these little hummingbirds reminded me that summer is coming. I was reflecting back to last summer when I would study outside on my patio with the hummingbirds until the only light I had left was my laptop and a citronella candle. I was determined to still enjoy summer even though it was probably the most challenging semester of optometry school. That little hummingbird reminded me where I was and where I am now. Last summer I was struggling with so much insecurity. Being in clinic the first time was a hard transition for me. It is overwhelming at first to be in an exam room by yourself with a stranger, who is counting on you to figure out why they are not seeing well, and fix the problem before the meter runs out on their car parked out front. Learning to sift through all the information the patient provides quickly, start developing differential diagnoses and their corresponding treatment plans, all while maintaining casual conversation is a real challenge. I deeply questioned whether or not I could be an optometrist last summer, and now here I am one week away from starting fourth year. I feel it is important to be transparent about my personal struggles with transitioning to clinic, so when or if you feel you are the only one struggling with insecurity, you know you are not alone. It is important for clinicians to be confident and project confidence to their patients, so while I was interiorly very insecure last summer, I had to keep my composure with the patient. I wish I could tell you there is a magic way to speed up the discomfort with the learning curve, but there really is not. The only way to get through those times is to just keep believing that someday you will get it. You have to set realistic expectations for yourself and know that you are not going to be perfect and that there is a reason we have one whole year of just patient care as part of our education.  It takes a long time to build up the trust and confidence in yourself that you can handle whatever situation comes up in the exam room. Experience is the greatest teacher.

I had a similar reflection this past week as we finished out our last week of exams. We still have one more exam on Monday for our business class, but that is obviously less stressful than something like our lasers and injections final. The only things standing between me and fourth year right now are finishing up our business plans and our business final. As I took finals this week, I could not help but recognize that I was not really stressed. Finals used to be a grueling experience. I have always studied in the practice exam rooms before taking finals because I typically leave early for the test in case there is a traffic situation. This week I was sitting in the practice exam rooms, and I realized I was just calmly reviewing my notes, mostly just looking forward to the test being over. I was still sleep deprived, but I did not feel the pressure I used to feel because I have proven to myself that I will make it. I also think boards part 1 teaches you perspective. Taking a midterm or final is literally a drop in the bucket compared to the experience of taking a test of all your knowledge of optometry school. Another advantage to finals this time around is we only had three that required a lot of studying compared to the six you have in first year.

As I mentioned in my last blog, we have been finishing up our series of lasts. This past Monday was our last day of lecture ever. You would think that this would be a day of pure bliss, but it was honestly bittersweet. I am so anxious and ready to start seeing patients and really ramping up my clinic skills in fourth year, but I am going to miss learning from brilliant people directly every day. From now on, I am largely responsible for seeking out knowledge. It will be up to me to study topics of interest or areas I need to review after clinic. It will be up to me to be sure I am asking my preceptors (doctors overseeing my work) questions. OSU is really fortunate to have such incredible professors who are our mentors, educators, and friends in some ways. Just to prove the point, this week Dr. Flom gave her send off message wishing us luck for next year, and some of my classmates began to cry. We are so fortunate to have such a close community that we are sad to leave our last lecture! We took the traditional last day of class photo, of course. It is so hard to understand that after we take our final Monday, we will never all be in one room again until graduation.

In the spirit of looking back, I thought I would give a quick rundown on some of the amazing things we have learned this semester. Despite boards dominating our minds and lives for the majority of the semester, we also learned to do some pretty awesome things in our lasers and injections course! We learned how to do laser refractive surgery such as LASIK and PRK. We also learned how to do laser peripheral iridotomies (LPI) and selective laser trabeculoplasty (SLT). When I say learned, I mean we learned about it in class and actually performed the procedures. We had a couple of days in March where a full laser surgery facility set-up takes over our pre-clinic, and we performed LASIK and PRK on pig eyes. We also learned how to do sutures and injections. These are currently procedures that are not within our scope of practice in Ohio, but they are in Kentucky and a few other states. We are always taught to be prepared for the highest scope of practice and to be prepared for changes in our scope in the future potentially. In our low vision course we had the opportunity to get a crash course on mobility from the instructors at the Ohio State School for the Blind. We experienced walking with a long white cane down stairs and around the college. We also had an assignment to wear goggles simulating low vision during our daily life, which required us to do a community activity while wearing the goggles to better understand what can be challenging about the social, emotional, and visual aspects of low vision. Lastly, in our business class, we learned how to decide whether or not to be a provider for different insurance programs, how to determine the value of a practice, and many other valuable things. It has been a really great semester.

I titled this blog, “Time to look up!” because I feel spring is a good reminder to lift your head up every once in awhile. I have always lived in Ohio, and I have always enjoyed the four seasons because each season reminds you to stop and think about where you were, are, and where you are going. I find the seasons to be landmarks for reflection. This past week, I walked out of clinic, and I looked up and realized there were baby leaves on the trees! I asked my classmate, “How long have the leaves been out?!” I seriously questioned my sanity given that I had not even noticed the leaves had started, but on my drive home I realized that the leaves had not actually started coming out at my house. Yes, I live far enough away from the college that the leaves are on a different schedule…Anyways, it was good reality check for me to make sure to lift my head up every once in awhile. Sometimes optometry school is so busy you just forget to pick your head up and take in the moment. I feel like I have spent the past three years living for the next test, practical, or proficiency on the horizon, and I suddenly lifted my head to realize that is all behind me. I actually cleaned my locker out last night after my last day in the primary vision care clinic. The next time I pull out my equipment will be on my first day of my summer externship. I have absolutely no idea what the next year of life will really be like, and I am completely fine with that. I am so excited to see what the next year brings knowing full well I may have moments like last summer where I question myself and feel overwhelmed. I know in the end, I will make it through. Next year when I lift my head up to see the first leaves on the trees, I will be trading in my short white student coat for the real doctor coat. And on that note, a little early congratulations to the first years on finishing your first year, and you will have your white coat soon! Congratulations second years on passing your final proficiency and taking probably some of the hardest classes of optometry school! Congratulations third years on finishing part 1 of boards and getting through classes! Huge congratulations to the fourth years for graduating optometry school (in a week)!

P.S. If you want to see photos of these various things I talked about and all these upcoming exciting events, check out the OSU College of Optometry’s social media accounts. Here is a link to their Instagram. https://www.instagram.com/ohiostateoptometry/

 

 

Just Press Pause

Good morning!

I finally can take a few minutes to write a blog! Derek and I both said, “No blogging until after boards!” because every single minute is precious leading up to the test. I took my part I national board exam on March 19. I talked about that day so frequently that when I would type the word boards, my phone would auto populate March 19! So what exactly does life look like leading up to that test? I will give you a glimpse into my world during that time, but truthfully, it all feels like ancient history already.

So for our class, the boards frenzy started in October. Our class has always been a bit extreme in terms of grades in that we tend to have ridiculously high class averages for exams. We are also known for practicing insane amounts, so they always had to order us a lot of supplies for labs. This same attitude seemed to translate to boards, so many of us started at least somewhat studying for the test six months before we took it. I had the intention to do that, but I truthfully did very little prior to December. Over Christmas break, I really started focusing my time on boards. I tend to be someone who likes to dig deep in one thing at a time, so I just focused on one subject at a time. Starting the semester, I pretty much studied for boards every day at least a little bit unless we had midterms for our classes. Thankfully, a lot of the material we covered in class was still boards material, so no matter what I was studying, it was good preparation for the test.

I studied using a variety of resources, but I mostly used the KMK package. The college and the national board of examiners (NBEO) do not encourage or endorse any particular study program, so this is just what I chose to do. KMK has live lecture courses, so for three weekends in January and February we had class from 9-5 on Saturday and Sunday. I initially thought I would hate these because I would be driving to school 7 days a week, but I honestly loved it. It was actually really fun to be with my classmates all weekend and go home feeling like I learned a lot. We still have a full course load and regular clinic rotations during this semester, so there was a lot of juggling we had to do. The last month leading up to the test, I ramped up my study routine from studying most of the time to studying literally all the time. I had taped pages of notes all over my bathroom walls, so that while I got ready in the morning I was studying. I would listen to the KMK lectures pretty much constantly (while folding laundry, cooking, driving, etc.). The week before the test was spring break, so I was all day every day studying. I actually loved that week because there was nothing competing for my attention. I had a daily routine of studying and exercising that was sort of refreshing. I actually never left my house except to go to church and exercise for 10 days straight. While this sounds miserable, I never minded studying for boards. To me, it was an opportunity to build confidence and fill in all the gaps in my knowledge, so I am prepared to be a doctor.

In addition to KMK, our professors provided us with a variety of practice questions and review sessions over their courses. I found the review sessions and review material provided by our professors to be super helpful. I also utilized a lot of Quizlet flashcards and the Daily Dose of Optoprep (free daily questions) for additional preparation. There is no one way to prepare for the test, which is probably the hardest part. You have to really make a decision to study the way you believe you need to and tune out everything else. You will hear other people talking and it will always make you start thinking you are doing it all wrong, but you have to stick to what you know about yourself. I would hear people say things like, “Well if you don’t know it by now, you are not going to.” For me, that is never true. I studied all the way up until I went to bed the night before, while others took the whole day off before the test. While the test is intense, I walked out feeling that Ohio State really prepared me well. You really do not have to buy any expensive study package to prepare, but if you prefer having everything in one place, you may like the study packages. We are still waiting on scores, so stay tuned!

Life after boards has been fantastic! The day after I took the test I went to the Optometry Day at the Statehouse (ODASH) with the Ohio Optometric Association (OOA), which was an invaluable experience! I met about eight different legislators that day. Since we are not currently advocating for any particular optometry related bill, we just educated them about optometry. We met with each legislator one on one or their staff and explained what optometry is, how we fit into the healthcare system, and all the possibilities of how we fit into the healthcare system in the future. I also had the opportunity to learn from incredible optometrists throughout the state of Ohio. Most of the doctors I met recommended I start shadowing practices to see all of the different modalities before I start working. I have started doing some shadowing, and it really is a valuable experience. I have not shadowed since I was applying to school, and it is a whole different perspective now. I am so grateful to the OOA for all that they do. All of the OOA events I have been involved in have been some of my favorite experiences in optometry school. I look forward to being involved as a doctor!

This past weekend a group of my classmates and I did another Remote Area Medical trip in Ashtabula, Ohio. I am super passionate about RAM, and I highly recommend everyone get involved from general volunteers to doctors. I have found these trips to always impact me in a profound way and the patients are so grateful for what we do. While there are many ways for people to get healthcare in Ohio, there are also lots of gaps in coverage that people can fall into and RAM fills those gaps. Ohio passed legislation last year to allow RAM to operate in Ohio, so this is new for our state. This past weekend the optometry clinic saw about 600 patients for full dilated eye exams! The housing and food is free, so the only cost you have to do a RAM trip is travel. My classmates and I caravanned up to Ashtabula Friday night after clinic and made a mandatory dinner stop at Der Dutchman. We saw patients Saturday from 6am until about 5pm. We did an escape room that night and literally ran to watch the sun go down on Lake Erie. Sunday we were in the clinic from 6am to about 1pm; it was an exhausting but rewarding weekend. I had two moments that will probably stick with me. My first patient on Sunday morning, I saw papilledema (both optic nerves swollen) for the first time. He was a young man with good vision, so I went into it expecting to find nothing remarkable and was quickly reminded that no exam is routine and that 20/20 vision does not mean there is nothing else going on. Thankfully, RAM provides follow up care with local doctors, so he was referred out. Another memorable moment was a four year old who had pretty decent hyperopia (farsightedness) and astigmatism (light focuses in two places rather than one). She would not leave the phoropter because she was seeing a clear image for the first time. She was also referred for follow up amblyopia care (“lazy eye”). RAM makes each patient glasses on site, so we got the little girl started in glasses.

So I titled this blog, “Just Press Pause” because that is how I feel right now. Optometry school is such a roller coaster, and I realize the ride is about to come to an end. While graduation is still a year away, we have begun our series of lasts. Yesterday was our last midterm ever. We are headed toward our last week of class and labs. We will be taking our last finals soon. We are on our last few weeks of Primary Vision Care clinic (PVC). We are all very ready and excited to go out on externships for fourth year, but it is hard to understand that the people we have spent nearly every day with for three years will be scattered across the country in a few weeks. We are such a close group and have been through a lot together. We have seen each other through academic and personal triumphs and challenges, and I just cannot imagine what it will be like to not see each other for a whole year.

As for me, I am sort of partially going away this summer. I will be at the OSU owned family practice in Upper Arlington, so I am not technically leaving, but I will not be on main campus. I have two other classmates with me, and I know the attending doctors who will be at the clinic, so there is a lot of continuity for me. I have heard it is a big adjustment initially transitioning to full time patient care, but I am definitely ready. This past weekend was a taste of full time patient care, and I loved every minute of it.

It is a beautiful spring weekend as the flowers are all blooming on the trees and we finally have some nice weather! Have a nice weekend! Below are some pictures of this past weekend and ODASH.

Kevin, Julia, and Derek refracting.
The clinic was in an abandoned department store in a mall. (RAM photos courtesy of Taylor)
We escaped in 37 mins!
Back row L to R: Taylor, Nate, Kayla, Kevin, Amy, Julia. Front: Derek and Jacob. We narrowly escaped the geese to take this photo.
Sunset on Lake Erie
Left to right: OSU alum and former blogger Elizabeth (Dr. Bower), Derek’s head, Nate, Jacob, Gentry, Kevin, Zack, Amy, Kayla, Julia, Dr. Nerderman, and Taylor
Bridget and I at ODASH. (Photo courtesy of Bridget)

Last Semester of Classes

 

Me, Julia, Sarah, and Taylor in front of the Alamo!

Hello! I have been wanting to blog forever, but I have to be pretty strict in how I use my time now that it is “boards season” and the end of last semester was a whirlwind. The turn of the new year sort of is a big mental shift for us third year students as we begin to prepare for the National Board (NBEO) part I exam in March. I started casually working through review material back in October with the intention of getting through the first pass of the material before January 1st, but life did not pan out that way. Now I am reorganizing for new goals and a new schedule to be sure I get through all the material twice before the exam. 

Since my last post, many new and exciting things have happened! We have received our fourth year externship assignments. I actually got my first and second choices with regards to our Advanced Practice site and Ocular Disease site. I feel super fortunate because all three of my semesters are at locations I can commute to from my home, so I can stay with my husband. My VA site is going to be a really long drive (about 1.5 hours), but I do a little over an hour now. Last fall was full of excitement starting with a Remote Area Medical (RAM) trip to Charleston, West Virginia where about 20 optometry and pre-optometry students helped provide at least 450 free comprehensive eye exams and about 600 pairs of free glasses to anyone in need. I did a RAM trip as a first year, but I was only able to help with the entrance testing, which is important, but I learned an incredible amount from being able to actually perform the exams. I think the first day I did 21 refractions, which really improved my skills. We also took turns doing dilated slit lamp exams and binocular indirect ophthalmoscopy, which allowed us to see some interesting pathology. We were fortunate to have Dr. Nerderman go with us from the college, and there were three other doctors from around the country who all went out of their way to show us anything they saw they thought we should see or help us identify things were had not seen before. It was an amazing learning experience!

A few weeks after that trip I went to San Antonio, Texas for the American Academy of Optometry Meeting. I highly recommend making a trip to San Antonio if you get the chance. It was a really neat city with so much to offer. I could write a ton about it, but the short of it is, that is the location of the Alamo and the whole downtown is built around a beautiful river walk. On top of getting to explore an incredible city, we also learned a ton at the conference. There were optometrists and professors from around the world at the conference presenting and participating, and I really learned a lot. It is also neat to be at a point in my education where I know what talks I am interested in, areas I would like to learn more about, etc. I participated in the Student Fellowship Program, which has a set of required activities to attend. Some other highlights included the first ever academic challenge, which was a quiz bowl for the different colleges to participate in and OSU won! I highly recommend going to the meeting at least once. It seems particularly popular to go third year because our schedules just allow for more flexibility to travel as long as you get the clinic leave. It was also fun because both of our flights had many of our professors and classmates on them. They did the whole, “O-H… I-O” thing over the intercom because there were so many of us on the plane. On our way back, many of us had some travel complications, so we ended up getting a free night in a hotel to take a flight out the next day and a $250 voucher for airfare in the future. Thanks to that little hiccup, I get to take a trip to Georgia this spring for only $50! 

This week was my first week in my spring clinics, and I think I am going to love these rotations! I am in Primary Vision Care (PVC) and Advanced Ocular Care (AOC) clinics this semester with a four-week rotation through contact lens in April (contact lens clinic is a fourth year clinic, primarily). I am super sad to be done with my fall clinics because I just adored vision therapy, and I got really attached to my patients. It was awesome to spend an hour with a person every week, and sometimes you saw the same person for six or more weeks! It was great getting to be a part of the care team for so many people with traumatic brain injuries, too. I learned a lot about the extent to which a concussion can impact a person, and now I just cringe when people talk about them casually. During my time in vision therapy, the majority of the patients would say things like, “Thanks to vision therapy, I can read again!” I had one patient who said he felt uncomfortable navigating stairs because he could never quite focus his eyes on each step, and now he does it without even thinking about it. Vision therapy is really impactful! I also had a lot of really interesting cases in PVC, and I just adored working with Dr. Hopkins. He transformed every part of my exam and helped me really think about writing a good spectacle prescription, and I look forward to continuing to improve on those skills. 

Just a quick lifestyle note for all the prospective students, we do have all of our clinics as third year students through the holiday break. I had six days of clinic during the three week break from classes. I actually really enjoyed these times in clinic the most because it felt like being a doctor where you just see patients and don’t have to worry about juggling classes. I am fortunate in that I live at home year round, and my immediate family is about 40 minutes away, so I did not mind going into clinic on Dec. 26. Some people who are from other states have a lot harder time with the holidays. I highly recommend that during your third year you plan as best as you can what days you want off according to the school leave policy, so you can request them as soon as the email goes out saying it is time for requests. Leave requests are granted on a first come, first serve basis, so you have to be ready to act fast. 

I cannot believe that tomorrow is my last first day of classes! I just made my last semester schedule, and went through all my beginning of the semester routines (putting midterms/ finals, deadlines on my calendar, etc.). We start first thing tomorrow morning with our class about injections and lasers! I am excited for our classes this semester! Have a wonderful week, all! Below are some pictures from RAM and Texas.

About 18 of us third year students refracting in a church on the RAM trip.
The San Antonio River Walk!
I did not get the memo to do an eyewear theme, so I went Texas!
There was a booth at the conference recreating this commercial, so we got to pretend! Thankfully we are not presbyopes (need reading glasses) yet!

 

Halfway Through 3rd Year

Hello, all!

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!

It is a beautiful fall day at the college!

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.

My cat, Melvin, likes to study with me.

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!