RESIDENCY IN HOSPITAL BASED PRIMARY EYE CARE

SALEM VETERANS AFFAIRS MEDICAL CENTER

affiliated with

SOUTHERN COLLEGE OF OPTOMETRY

MEMPHIS, TENNESSEE

PROGRAM MISSION

The mission of Salem VAMC Primary Care Optometry Residency is to prepare optometrists for the provision of comprehensive primary optometric care for the adult patient by providing post-graduate clinical experience and facilitating clinical acumen beyond that attained in the Doctor of Optometry program via the enhancement of diagnostic and management skills, experience in collaborative management of systemic disease in a multidisciplinary setting, and the provision of a post-graduate didactic and scholarly education program.

Goal 1: Enhance the resident’s examination skills in optometric primary care

Objective:	The resident will develop a high degree of efficiency in the provision of primary eye care services.
Outcome:	The resident will provide primary eye care services involving a minimum of 1500 patient encounters, 50% of which will include obtaining a case history, visual acuity, refraction, tonometry, and external and internal ocular health assessment.
Measure:	The resident will report on the number of patient encounters of this type using the activity log.

Goal 2: Strengthen the resident’s expertise in the diagnosis and management of refractive, physiological and pathological conditions of the eye and adnexa.

Objective 1:	The resident will perform the appropriate diagnostic procedures.
Outcome:	The resident will consistently select and successfully perform the proper diagnostic procedures for each patient.
Measure:	All resident charts will be reviewed and co-signed on a daily basis by clinic faculty. Quarterly audits of 5% of the resident's charts will be conducted by the program supervisor or other faculty. The resident's skills will be assessed based on these chart reviews and by direct observation and the results reported by the supervisor each quarter.
Objective 2:	The resident will determine the correct diagnoses for each patient.
Outcome:	The resident will consistently select the correct diagnosis for each patient with increasing independence as the residency program progresses.
Measure:	All resident charts will be reviewed and co-signed on a daily basis by clinic faculty. Quarterly audits of 5% of the resident's charts will be conducted by the program supervisor or other faculty. The resident's skills will be assessed based on these chart reviews and by direct observation and the results reported by the supervisor each quarter.
Objective 3:	The resident will determine the best management based on the diagnoses.
Outcome:	The resident will consistently devise an appropriate management plan for each patient in order to best address the patient’s needs.
Measure:	All resident charts will be reviewed and co-signed on a daily basis by clinic faculty. Quarterly audits of 5% of the resident's charts will be conducted by the program supervisor or other faculty. The resident's skills will be assessed based on these chart reviews and by direct observation and the results reported by the supervisor each quarter.

Goal 3: Expand the resident’s knowledge of specialized diagnostic instrumentation.

Objective 1:	The resident will develop expertise in performing and interpreting ophthalmic ultrasonography.
Outcome:	The resident will perform ophthalmic ultrasonography (A or B-scans) and interpret the results on at least 6 patients.
Measure:	The resident will report on the number of patient encounters of this type using the activity log.
Objective 2:	The resident will develop expertise in performing ophthalmic (fundus and/or anterior segment) photography.
Outcome:	The resident will perform ophthalmic photography on at least 10 patients.
Measure:	The resident will report on the number of patient encounters of this type using the activity log.
Objective 3:	The resident will develop expertise in ordering and interpreting relevant laboratory and radiological procedures.
Outcome:	The resident will order laboratory and radiological procedures on at least 10 patients.
Measure:	The resident will report on the number of patient encounters of this type using the activity log.
Objective 4:	The resident will gain experience in prescribing low vision devices for patients with visual impairment.
Outcome:	The resident will evaluate at least 10 patients with visual impairment, determine appropriate low vision aids or other assistive devices, and educate patients regarding their use.
Measure:	The resident will report on the number of patient encounters of this type using the activity log.
Objective 5:	The resident will gain experience in performing or assisting in the performance of fluorescein angiography.
Outcome:	The resident will participate in performing fluorescein angiography on 5 patients.
Measure:	The resident will report on the number of patient encounters of this type using the activity log.

Goal 4: Increase the resident’s knowledge of systemic diseases and their treatment.

Objective:	The resident will acquire additional knowledge of systemic disease and treatment, particularly those systemic diseases with significant ocular manifestations.
Outcome:	The resident will coordinate care with non-optometric providers in management of patients with systemic disease. The resident will participate in relevant presentations and conferences on systemic disease.
Measure:	The resident will report on the number of patient encounters and participation in conferences of this type using the activity log.

Goal 5: Develop the resident’s skills in presenting topics to fellow professionals.

Objective:	The resident will acquire and practice skills needed to effectively present information to other professionals in group settings.
Outcome:	The resident will present lectures during meetings of the Eye Clinic Staff or other health care providers. The resident will, when possible, also present posters or lectures in other settings such as the American Academy of Optometry or SECO.
Measure:	The resident will report on these types of activities using the activity log.

Goal 6: Instill in the resident an appreciation of the importance of scholarly activity.

Objective:	Educate the resident in the preparation of a professional manuscript.
Outcome:	The resident will prepare a publication-quality manuscript on an approved topic.
Measure:	The resident will complete the manuscript by the designated completion date.

CURRICULUM

The educational objectives of the curriculum are intended to ensure attainment of the mission, goals, and objectives of the program. Consequently, each educational objective reflects a specific program goal. Specifically:

Program Goal 1
Objective:	The resident will develop a high degree of efficiency in the provision of primary eye care services.
Learning Activity:	The resident will provide primary eye care services involving a minimum of 1500 patient encounters, 50% of which will include obtaining a case history, visual acuity, refraction, tonometry, and external and internal ocular health assessment during the encounter.
Outcome:	The resident will develop enhanced skills in the management of primary eye care patients.

Program Goal 2
Objective:	The resident’s expertise in the diagnosis and management of refractive, physiologic and pathologic conditions of the eye and adnexa will be enhanced.
Learning Activity:	The resident will provide services to a significant number of patients with refractive, physiologic and pathologic conditions of the eye, and will formulate a diagnosis based on the results of the procedures performed.
Outcome:	The resident will become highly proficient in the performance and interpretation of basic and advanced ocular examination techniques on patients with complex ocular anomalies and disease, and will attain advanced skills in the management of these patients.

Program Goal 3
Objective:	The resident will utilize a wide variety of diagnostic procedures and instrumentation while caring for patients.
Learning Activity:	The resident will perform and/or interpret ophthalmic ultrasonography, ophthalmic photography, and relevant laboratory and radiological procedures.
Outcome:	The resident will develop advanced knowledge of specialized diagnostic procedures and instrumentation.

Program Goal 4
Objective:	The resident will acquire additional knowledge of systemic disease and treatment, particularly those systemic diseases with significant ocular manifestations.
Learning Activity:	The resident will provide eye care to a large number of patients with systemic disease and will consult with non-optometric providers in the total care of these patients. The resident will also attend at least 5 didactic lectures on systemic disease.
Outcome:	The resident will be able to communicate effectively with physicians in the comanagement of patients who have systemic disease that impacts their ocular health.

Program Goal 5
Objective:	The resident will develop and present original presentations to other health care professionals.
Learning Activity:	The resident will present at least one lecture per quarter to Eye Clinic or Primary Care staff and will be encouraged to present posters or lectures in other settings such as the American Academy of Optometry and SECO.
Outcome:	The resident will develop skills in providing effective presentations to health care professionals.

Program Goal 6
Objective:	The resident will engage in scholarly activity.
Learning Activity:	The resident will prepare a publication-quality manuscript on an approved topic that will be reviewed and critiqued by the supervisor.
Outcome:	The resident will develop an appreciation for scholarly activity and its importance to the profession.

APPLICATION PROCEDURES

A. All applicants must complete and return the Southern College of Optometry application forms by January 15. Supporting documents should be submitted to the Director of Residency Programs of Southern College of Optometry no later than January 31. This program uses the Optometric Residency Matching Service. Applicants must complete the ORMS application and forward it to the ORMS as directed in the application. Applicants are responsible for ensuring that all supporting documentation is submitted to each entity involved, e.g., the College, ORMS, and the residency site if required.

B. Applicant must have earned an O.D. degree, or will have earned such a degree by the time of matriculation from a school/college of optometry accredited by the Accreditation Council on Optometric Education.

C. Applicant will furnish an official transcript from his/her school/college of optometry. An applicant should have a cumulative grade point average greater than 3.0 on a 4.0 scale in the professional optometric curriculum.

D. Applicant must pass all parts of the National Board of Examiners in Optometry examinations and furnish official transcripts when available.

E. Three letters of recommendation are required.

F. A brief essay stating reasons for applying to this program.

G. A personal interview is required. The program supervisor or other designee at the residency site may elect to conduct an additional interview by telephone and the Southern College of Optometry Residency Committee will conduct at least a telephone interview with the applicant.

H. Applicants must be United States citizens, as required by the Department of Veterans Affairs.

H. Southern College of Optometry affirms that all residency candidates will be evaluated without regard to sex, race, color, creed, national origin or disabilities.

LETTER OF INTENT

All applicants selected for admission must sign a standard letter of intent.

LENGTH OF RESIDENCY

Each residency is one calendar year in length, commencing July first.

LEAVE POLICY

The resident is eligible for thirteen days annual leave and thirteen days sick leave. The resident is also eligible for educational leave to attend approved professional meetings. Annual and educational leave is granted with prior approval of the Supervisor in conjunction with the SCO Director of Residency Programs.

STATUS OF THE RESIDENT

A. The resident is defined as an employee of the Salem VAMC and the residency stipend is paid by the VAMC. No tuition or fees are applicable.

B. The resident should apply for optometric license in at least one of the fifty states prior to the beginning of the residency.

C. Professional liability protection for residents for professional activity performed at the Salem VAMC is provided under the Federal Tort claims act. Professional activity at other Southern College of Optometry affiliated clinics is covered under the College policy.

D. Residents will be required to present credentials according to the Salem VAMC policy for credentialing of residents.

E. Residents privileges will be determined by Salem VA policy.

CRITERIA FOR COMPLETION OF RESIDENCY

A. The resident is required to deliver clinical services at a level that is satisfactory to the Residency Supervisor, the Residency Committee, Director of Residency Programs, and the SCO and Salem VAMC administrations. The resident’s on-duty hours are from 7:15am until 5:00pm Monday through Friday, with the resident off-duty every other Friday. The resident is expected to be present in the clinic during all scheduled working hours, except when attending or delivering lectures or doing study or research. The resident may be required to be on-call for the clinic on evenings or weekends when ophthalmology staff are unavailable or at the discretion of the program supervisor.

B. The resident is required to keep a record of patient contacts. The Supervisor of the Residency Program, the Director of Residency Programs, and the Residency Committee will review cases periodically.

C. The resident is required to write a publication quality paper based on original research, literature review, or a clinical case.

D. The resident is expected to perform in a professional manner in the delivery of patient care services and to observe those proprieties of conduct and courtesies that are consistent with the rules and regulations governing Salem VAMC.

E. The resident is required to participate in and complete the requirements set forth in the curriculum.

F. Upon successful completion of the Residency Program, the Residency Supervisor and the Director of Residency Programs will recommend the granting of certification to the Vice President of Academic Affairs.

H. Any resident accepted for training can be dismissed, without receiving a certificate of completion, for infractions of the rules and regulations of the Salem VAMC or those set forth by Southern College of Optometry, or for any action which jeopardizes the safety of patients, personnel, or physical facilities.

STIPEND

A residency stipend will be provided for the year of training paid by Salem VAMC. The stipend is currently $31,965. Additional benefits such as FICA and insurance are also funded.

HEALTH INSURANCE

The resident will have the opportunity to purchase health insurance at a nominal cost through the College’s group insurance plan, or through the VA. The resident may also purchase life insurance through the VA.

OTHER EMPLOYMENT

Other employment (moonlighting) is permitted under the condition that it does not interfere with any program responsibilities including completion of written assignments. Any hours of moonlighting must in no way conflict with the hours of duty assigned to the resident. Moonlighting is not allowed during periods when the resident is assigned to be on call.

ACCREDITATION

The residency program at Salem VAMC is accredited by the Accreditation Council on Optometric Education, 243 N. Lindbergh Blvd., St. Louis, MO 63141, 314-991-4100.

CERTIFICATE OF COMPLETION

Upon satisfying all the requirements for completion of the program as determined by the Supervisor of the Residency Program and the Director of the Residency Programs, a Certificate of Completion will be awarded to the resident by Southern College of Optometry.

REPORTING STATUS

The resident reports to the Supervisor of the residency program. The Supervisor reports directly to the SCO Director of Residency Programs who in turn reports directly to the Vice President of Academic Affairs at Southern College of Optometry.

FOR FURTHER INFORMATION, PLEASE CONTACT:

Cheryl E. Ervin, O.D.

Director of Residencies

Southern College of Optometry

1245 Madison Avenue Memphis, TN 38104

Office: (901) 722-3201

Fax: (901) 722-3325

email: cervin@sco.edu