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Residency in Pediatric Optometry, with Emphasis in Cornea and Contact Lenses and Ocular Disease
AT DUKE UNIVERSITY
DURHAM, NORTH CAROLINA
SOUTHERN COLLEGE OF OPTOMETRY
The Residency in Pediatric Optometry, with Emphasis in Cornea and Contact Lenses and Ocular Disease at the Duke University Eye Center offers a multi-specialty, high volume, progressive learning environment involving pediatric care. Residents will become proficient in all aspects of pediatric optometry including primary care, contact lens, binocular vision and diagnosis and medical treatment of ocular pathology. Due to the nature of the setting of this residency, training includes working with pediatric ophthalmologists, pediatric retina specialists, and pediatric neuro-ophthalmologists.
Goal 1: Enhance the resident’s skills in the provision of pediatric optometric eye and vision care.
Objective 1: The resident will develop a high degree of competency in the provision of pediatric optometric services.
Outcome: The resident will provide optometric service involving a minimum of 1500 direct patient encounters on patients’ ages 18 years and younger.
Measure: The resident will report the number of patient encounters of this type using the activity log.
Objective 2: The resident will develop advanced competency in providing visual care to a diverse patient population.
Outcome: The resident will perform a minimum of 800 refractive evaluations on patients’ ages 18 years and younger.
Measure: The resident will report the number and age of patient encounters using the activity log.
Objective 3: The resident will gain experience in the treatment of ocular disease in pediatric patients.
Outcome: The resident will experience a minimum of 100 ocular disease-related patient encounters involving patients age 18 years and younger.
Goal 2: Strengthen the resident’s expertise in the diagnosis and management of vision problems in pediatric patients.
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 for each patient.
Outcome: The resident will consistently devise an appropriate management plan for each patient in order to best address the patient’s needs.
Goal 3: Expand the resident’s knowledge of binocular, developmental vision problems and contact lens.
Objective 1: The resident will gain experience in managing patients with strabismus, accommodative, vergence and motility disorders.
Outcome: The resident will evaluate and manage a minimum of 300 patients with strabismus, accommodative, vergence and motility disorders.
Measures: The resident will report the number of patient encounters of this type using the activity log.
Objective 2: The resident will gain experience in managing patients with amblyopia.
Outcome: The resident will evaluate and manage a minimum of 150 patients with amblyopia.
Objective 3: The resident will gain experience in managing pediatric patients in contact lenses.
Outcome: The resident will evaluate and manage a minimum of 150 patients with contact lenses.
Goal 4: Develop the resident’s skill in presenting topics to resident 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 one lecture during the annual residency conference and one lecture at a Community Education CE dinner. When possible, the resident will present posters or lectures in other settings such as the American Academy of Optometry.
Measure: The resident will report these types of activities using the activity summary.
Goal 5: Instill in the resident an appreciation of the importance of education.
Objective: The resident will attempt to attend all pediatric lectures, grand rounds and symposiums hosted by the Duke Eye Center.
Outcome: The resident will attend all pediatric lectures, grand rounds and symposiums hosted by the Duke Eye Center.
Once the resident is licensed in the state of North Carolina, completes his/her onboarding process with Duke and becomes fully credentialed, he/she (or the resident) will have one day per week or two half days per week in our comprehensive ophthalmology service to maintain and hone their primary care optometry skills.
Additional employment (moonlighting) during the tenure of this residency is not permitted without prior consent of the Duke University optometry residency director.
The residency program is one calendar year in length from August 1st to July 31st. The stipend is $30,000 and will be paid out on a monthly basis. Compensation is not contingent upon productivity of the resident. Benefits associated with this appointment are defined in the policies of Duke University. The resident will be given the opportunity to purchase health insurance through the Payroll and Benefits Service Center. If the resident should choose to decline, proof of health insurance coverage must be provided.
Seventeen days of vacation and ten sick days are provided to the resident. These vacation days include those on which the involved clinics are normally closed: New Year’s Holiday, Martin Luther King Day, Memorial Day, Independence Day, Labor Day, Thanksgiving and Christmas Day. If the clinic is closed, provision of these vacations days is automatic and does not require approval or submission of a leave request form. The additional ten vacation days can be used at the resident’s discretion, but they must be requested sixty (60) days in advance so that scheduling changes can be accommodated. In addition to the aforementioned vacation days, the resident will be expected to see patients if/when the residency director is not in clinic.
Six days of educational leave are provided. These days are intended to allow the resident to attend meetings pertaining to his/her residency training. The resident must submit a request in advance to attend educational/professional meetings. The director will then approve or disapprove the request. If the director approves the request, the leave request is then forwarded to the Director of Residency Programs (DRP), who is responsible for tracking the resident’s leave balance. If the resident has a leave balance sufficient to cover the request, the DRP will approve the request and forward the appropriate copies of the form to the resident and director. The resident and director are responsible for notifying the Director of clinical operations of the days that the resident will not be available to provide clinical services.
Duke University does not provide funding for meeting registration, housing or transportation costs for the resident. Therefore, it is encouraged that travel grants/scholarships provided by the specific meetings (AOA, AAO, etc) be applied for in advance.
There are no on-call duties for this resident.
The resident will be encouraged to assist or to participate in any on-going laboratory and/or clinical investigation(s) initiated by Duke University faculty members. The resident will also be encouraged to generate their own studies/seminal work, but it will not be required for successful completion of their residency program.
The Duke University Pediatric Optometry Residency Program is pending accreditation by the Accreditation Council on Optometric Education of the American Optometric Association, 243 N. Lindbergh Blvd., St. Louis, MO 63141, 314-991-4100.
Upon evidence of satisfactory performance in meeting all requirements of the program, the resident will be awarded a Certificate of Completion from the Southern College of Optometry and Duke University.
The resident reports to the Director of the pediatric residency program at Duke University. The Director at Duke 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:
Nathan L. Cheung, OD, FAAO
Pediatric Optometric Residency Director
2351 Erwin Road
Durham, North Carolina 27710
Email: [email protected]
Cheryl Mengelt, OD
Director, Residency Programs
Southern College of Optometry
1245 Madison Avenue
Memphis, TN 38104
The Duke University Pediatric Optometry Residency is a full-time, 52-week residency program, beginning on August 1st and ending on July 31st of each residency year. The focus of the program is threefold: Clinical care, didactic education and scholarly activity. The resident is involved in patient care approximately 80-85% of the time. The resident is expected to have a minimum of 1,500 direct patient encounters by the end of the residency year. The remainder of the resident's time is devoted to didactic activities that take place either on the Duke campus or off-site. Clinical, didactic and scholarly activities specific to our program are listed below.
Some mornings, from 7:00 am to 8:00 am, the resident attends lectures given by the Ophthalmology Faculty to the ophthalmology residents at the Duke main eye center. The optometry resident is expected to attend all pediatric lectures. After lecture ends, the resident is expected to attend clinic.
A typical weekly schedule for the resident includes clinic from 8:00am until approximately 4:30pm (including a lunch break) Monday through Friday.
1) Direct out-patient patient care in the various primary care optometry clinics – (includes regular outpatient OD clinics and pediatric contact lens clinic) involves performing routine and problem-directed eye exams on pediatric patients from start to finish, accurately charting findings in our electronic medical record system, developing appropriate treatment and management plans, and actively participating in patient/parent education. The resident will be required to present all findings/decisions to the staff optometrist who will be required to sign off on all charting and documentation after appropriate discussion of each case.
2) Limited indirect/observational out-patient care in the various primary care ophthalmology clinics- (includes regular outpatient MD clinics, pediatric low vision, pediatric retina, and pediatric neuro-ophthalmology clinics) involves shadowing our ophthalmologists and their staff of technicians and residents/fellows during out-patient care sessions. The resident will be given opportunity to discuss interesting cases, examine interesting conditions, and time-permitting, discuss findings and treatment plans with the attending surgeon, all at the discretion of the attending surgeon.
Observation of surgical procedures will not be a formal part of the resident’s training. Any opportunity to do so will be at the complete discretion of the managing ophthalmologist with verbal approval to do so by the division director.
3) Adult Direct out-patient care in a primary care optometry clinic. The resident will be assigned their own clinic and set of patients once a week. They will have the ability to bill for services independently. This clinic will only commence once he/she has obtained their North Carolina Optometric license. The resident will be fully autonomous.
The residency must maintain a record of the resident’s patient encounters that includes diagnoses, the level of case complexity, and the level of the resident’s involvement (direct care or observational).
The resident will provide comprehensive and acute care exams to infants, toddlers, adolescents, and those with strabismus 4 days a week. Under the guidance of an optometrist and ophthalmologist specializing in pediatrics the resident will develop advanced clinical competency in:
To enhance the resident's skills in the diagnosis and management, the resident will rotate through, and provide care in ophthalmology subspecialty clinics one day a week.
Under supervision of the clinical faculty, the resident will become proficient in advanced clinical skills.
Under supervision of the clinical faculty, the resident will learn how to perform and/or interpret results from specialized diagnostic instrumentation used in primary eye care:
The resident will observe techniques of examining children for the first two weeks of the program. After the first two weeks, the resident is expected take the initiative of working up patients and should be eager to practice techniques.
The resident will see patients under the direct supervision of any of the faculty members that he/she has been assigned to on a given day.
Regular outpatient OD clinics (and contact lens clinic): the resident will be assigned patients off the attending’s schedule for that day (to be determined together, at the start of each session). The resident will not have their own patient schedule per se. The attending and resident will see different patients at the same time. The resident will stop to discuss all findings with the attending, and the attending will confirm results by further examination of the patient in the presence of the resident if need be. The resident will be responsible for entering the history, all pertinent exam findings, and documenting a formal Impression and Plan in the electronic medical record system. This will all be reviewed by the attending and remedied whenever indicated after the attending has self-examined the patient. The attending will then enter his/her own formal documentation in the electronic medical record system. This pattern of supervision will continue throughout the duration of the residency, with increasing independence provided to the resident as their skills and proficiency develop, and increasing staff support for technical assistance. The amount of independence offered will ultimately be at the discretion of each individual attending. The quality and quantity of resident effort will impact the attending’s evaluation of the resident.
Ophthalmology clinics- (includes regular outpatient MD clinics and specialty MD clinics): the resident will not be assigned patients for these clinics initially. At the beginning of the residency program, the resident role in the MD clinics will be purely observational. They will be invited into the exam room with the ophthalmology resident, fellow, and/or attending to view an interesting finding, or findings that have significant educational value. The optometrists will together decide if and when the resident is ready to self pre-examine patients in the MD clinics. Only then, and at the discretion and permission of the attending MD, will the resident be able to examine patients in the same manner as described above for “Regular outpatient OD clinics”. The optometric resident should understand that this opportunity may not be afforded throughout the entirety of the residency due to the fact that the teaching ophthalmologists have a primary obligation to the ophthalmology fellows and residents. The quality of resident effort will impact the attending’s evaluation of the resident.