RESIDENCY IN HOSPITAL-BASED PRIMARY EYE CARE

MOUNTAIN HOME VETERANS AFFAIRS MEDICAL CENTER

JOHNSON CITY, TENNESSEE

affiliated with

SOUTHERN COLLEGE OF OPTOMETRY

MEMPHIS, TENNESSEE

 

PROGRAM MISSION

The mission of the residency is to prepare optometrists to provide full-scope primary care optometry by providing post-graduate clinical experience beyond that provided in the Doctor of Optometry program.

 

Goal 1: Enhance the resident’s 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 1000 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.
Measure:	The resident will report monthly on the number of patient encounters of this type using the patient encounter logs and summary sheets.

 

Goal 2: Strengthen the resident’s expertise in the diagnosis and management of ocular disease.

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:	The resident will be evaluated quarterly by the supervisor to determine if the desired level of technical and cognitive ability is being exhibited.
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:	The resident will be evaluated quarterly by the supervisor to assess the appropriateness of the resident’s diagnostic ability.
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:	The resident will be evaluated quarterly by the supervisor to assess the resident’s management skills.

 

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 and B-scans) and interpret the results.
Measure:	The resident will report monthly on the number of patient encounters of this type using the patient encounter logs and summary sheets.
Objective 2:	The resident will develop expertise in interpreting ophthalmic fluorescein angiography.
Outcome:	The resident will observe ophthalmic fluorescein angiography and interpret the results.
Measure:	The resident will report monthly on the number of patient encounters of this type using the patient encounter logs and summary sheets.
Objective 3:	The resident will develop expertise in performing ophthalmic photography
Outcome:	The resident will perform ophthalmic photography on at least 50 patients
Measure:	The resident will report monthly on the number of patient encounters of this type using the patient encounter logs and summary sheets
Objective 4:	The resident will develop expertise in ordering and interpreting relevant laboratory procedures.
Outcome:	The resident will order laboratory procedures on at least 30 patients.
Measure:	The resident will report monthly on the number of patient encounters of this type using the patient encounter logs and summary sheets.

 

Goal 4: Enhance the resident’s knowledge of low vision care.

Objective:	The resident will gain experience in managing patients with limited sight.
Outcome:	The resident will evaluate and manage at least 30 patients with limited sight.
Measure:	The resident will report monthly on the number of patient encounters of this type using the patient encounter logs and summary sheets.

 

Goal 5: 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 participate with non-optometric providers in management of patients with systemic disease.  The resident will observe clinics with other medical providers.
Measure:	The resident will report monthly on the number of patient encounters of this type using the patient encounter logs and summary sheets.

 

Goal 6: Develop the resident’s skill 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 conferences and other meetings held at the Mountain Home VAMC and when possible will present posters or lectures in other settings such as the American Academy of Optometry and SECO.
Measure:	The resident will report monthly on these types of activities using the activity summary.

 

Goal 7: Instill in the resident an appreciation of the importance or 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

I.          Educational objectives

A. During the course of a residency at this facility, the optometrist will gather extensive experience in several specific areas, including:

1.    Primary eye care procedures, including routine examination, diagnosis, and treatment of vision disorders.

2.    Diagnosis and treatment of ocular disease, using full scope of diagnostic testing and pharmaceutical intervention available at this medical center.

3.    Systemic associations with ocular disease, and the procedures for diagnosis and treatment of these systemic conditions.

4.    Utilizing optometrists as gatekeepers into the health care system by appropriate interaction with a referral to other health care providers as needed for the total management of the patient.

5.    Performing and interpreting specialized ophthalmic testing procedures including:

                        a. automated and manual visual fields

                        b. fluorescein angiography

                        c. ultrasonography (A- and B- scans)

                        d. anterior and posterior segment photography

                        e. retinal nerve fiber analysis (GDx)

6.    Procedures involved in ordering and interpreting other specialty tests pertinent to ophthalmic diagnosis and management, including:

                        a. radiology

                        b. laboratory (including microbiological and hematological studies)

                        c. vascular laboratory (including carotid studies)

7.    Areas unique to hospital-based optometric practices, including:

                      a. familiarity with ophthalmic surgical procedures, including    comanagement of surgical patients with ophthalmology

                      b. ophthalmic consultation and management of hospital inpatients

                      c. management of ophthalmic disorders in extended care and            nursing home care units

8.    The residency program will encourage the residents to enhance the existing optometric literature by requiring at least one paper of publication quality to be written during the residency.

 

B.  The resident will gain experience in presenting optometric topics to peers in written and oral form

II.         Learning activities

A. The resident will provide direct care to patients in the Optometry and Ophthalmology Clinics of the Mountain Home Veterans Affairs Medical Center

B. The resident will actively participate in weekly Optometry Journal Club meetings

1. Attendance at weekly presentations

2. Resident will give scheduled presentations to the Optometry Journal Club

C. The resident will author a paper of publication quality

 

III.  Expected outcomes

A. The resident will, at the completion of the residency, have directly provided eye care to a substantial number of patients, a significant percentage of which presented with ocular and / or systemic disease. This experience will enable the resident to independently provide full-scope primary eye care at the highest level.

B. The resident will, at the completion of the residency, have directly provided eye care to a substantial number of patients requiring low vision services. This experience will enable the resident to independently provide intermediate level low vision services.

C. The resident will, at the completion of the residency, have coordinated the care of a significant number of patients with the VAMC ophthalmology service. This experience will enable the resident to effectively assume a significant role in the co-management of patients with ophthalmologists.

D. The resident will develop skills in presentation of optometric topics to peers to a level suitable to provide sanctioned continuing education to optometric practitioners and to author articles suitable for publication in the professional literature

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 OD 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 required for Tennessee license and furnish official transcripts when available.

E.  Three letters of recommendation are required.  One letter must be from the chief academic officer or clinical director of the institution.  Two letters must be from full-time faculty members who have been most responsible for the clinical education of the applicant.

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

G.  A personal interview is required.

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

I.    Department of Veterans Affairs policy requires that applicants must be United States citizens.

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 in July.

LEAVE POLICY

The resident is eligible for thirteen days annual 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 and the Associate Chief of Staff for Ambulatory Care, in conjunction with the SCO Director of Residency Programs.  Residents are also eligible for 13 days per year of sick leave.

STATUS OF THE RESIDENT

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

B.  The resident should for 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 work done at the Mountain Home VAMC is provided under the Federal Tort claims act.

D.  Residents will have access to Southern College of Optometry facilities such as the library.

E.  Residents will be required to present credentials according to the Mountain Home VAMC policy for credentialing of residents.

F.   Residents privileges will be determined by Mountain Home VAMC 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 Mountain Home VAMC administrations.  Normal clinic hours are from 8:00 A.M. until patient care is completed, usually around 4:30 P.M., Monday through Friday.  The resident is expected to be present during all working hours, except attending conferences and doing study or research.  Since the Optometry Section is not responsible for on-call services the resident will not be required to be on call.

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

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 Mountain Home 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 Mountain Home 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 AND BENEFITS

A residency stipend will be provided for the year of training paid by Mountain Home VAMC.  The stipend is currently $30,099.  Additional benefits such as FICA and insurance are also funded.  Optional health and life insurance benefits are also available through the VAMC.

ACCREDITATION

The residency program at Mountain Home VAMC is fully accredited by the 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 Clinical Programs at Southern College of Optometry.

FOR FURTHER INFORMATION, PLEASE CONTACT:

 

J. Bart Campbell, O.D.

Director, Residency Programs

Southern College of Optometry

1245 Madison Avenue

Memphis, TN  38104

(901) 722-3201

email: jbartc@sco.edu