MOYES EYE CENTER RESIDENCY PROGRAM SUPERVISION POLICY
Supervision of the resident at Moyes Eye Center, similar to Southern College of Optometry, is divided into separate phases that reflect increasing levels of responsibility for the resident based on demonstrated clinical competency. To move from one level to the next, the expected levels of technical and cognitive clinical proficiency and professionalism must be demonstrated by the resident in the prior phase. The residency supervisor determines when the resident advances to the next level, based solely on demonstrated performance, not on the amount of time spent in the residency program. However, the resident is expected to progress at an acceptable rate. The phases are described below:
Initial Phase: This phase is intended as an acclimation period for the resident into the Moyes Eye Center program. This begins during the first full week of training. In this phase, the new resident shadows the resident getting ready to graduate from the program. There is an overlap of 7 days for the outgoing and incoming resident to spend ample time together both in and outside of clinic. The resident will focus on becoming oriented to both the Lee’s Summit and North MEC locations layout,and electronic health records, in addition to understanding coding & billing and proper chart documentation. The resident will also become acquainted with the administrative and professional staff at MEC, its medical physicians, and will begin to learn its referral network. The resident will begin direct patient care and will discuss each case, including case management, with the resident finishing the program, current faculty or residency supervisor. The residency supervisor or another designated faculty member is always physically accessible to the resident at any clinical location in which patient care is provided. Additionally, the resident is expected to learn to independently and accurately operate all relevant (as designated by the program supervisor) ophthalmic instruments at MEC.
In addition to providing direct patient care, the resident will begin to serve in MECs on-call rotation with the residency supervisor present at each on-call encounter. At no time during Phase I will a resident examine an on-call patient or take part in patient care outside of MEC without the physical presence of a residency supervisor or the supervisor’s designee, who must be an MEC doctor.
To advance to the next Phase the resident must complete the initial orientation at MEC and demonstrate to the supervisor’s satisfaction that he/she is functioning at professional entry-level competence and is becoming familiar with MEC operations.
In addition, the resident will begin training in advanced procedures pertinent to the residency program emphasis (e.g. foreign body removal). The residency supervisor or another designated MEC doctor will be physically accessible to the resident at all clinical locations. It is anticipated that this Initial Phase will last approximately 1 to 3 months for most residents, but as noted the length of time in any phase is solely dependent on demonstrated competence. To advance to the next Phase the resident must demonstrate acceptable progress in the supervisor’s judgment toward mastering procedures and cognitive tasks that will enable the resident to attain advanced clinical competency. Should the resident’s progression through the Initial Phase be slower than anticipated, remediation will be considered at or around the third month.
Intermediate Phase: The resident will be given increased autonomy in patient care. With regard to the on-call service, the resident may examine patients as necessary but must telephone the residency supervisor (or their designee) regarding any out-of-the ordinary clinical cases in order to ensure standard of care has been met. The residency supervisor (or their designee) must be physically available to the resident for consultation. Feedback will be provided to the resident as necessary. The residency supervisor or designated faculty member will be physically or remotely accessible at all of the resident’s clinical assignments during this phase. The accessibility level will be determined by the Residency Supervisor and based upon the clinical competency of the Resident. Competence will be expected in advanced procedures learned in the prior Phase. To advance to the next Phase the resident must demonstrate to the supervisor’s satisfaction the ability to successfully manage advanced clinical cases. Residents are expected to complete this phase by or before the midpoint of the program. Should the resident not be ready to transition to the Final Phase by the midpoint of the program, remediation (see below) will be considered.
Final Phase: This phase will typically be instituted midway into each program. The resident will be given full autonomy with regard to patient care for patients specifically given to the resident. The resident will still assist specialists in their own clinics. When appropriate, the resident will also be given opportunities to precept student interns. The resident will be fully autonomous with respect to the on-call service for MEC but will have remote accessibility to the residency supervisor as needed or requested. With regard to student intern precepting at MEC, the resident will work alongside the residency supervisor (or their designee) until which time they are deemed competent to independently oversee and educate students. The goal of MEC’s Residency Program is that all residents will successfully complete this Final Phase, being fully independent and autonomous in all aspects of patient care, by the completion of the Residency Program.
Remediation
In the event that the Resident is unable to progress through the Initial Phase or the Intermediate Phase in the expected time period, or if the resident is unable to perform at the level expected when reaching the Final Phase, there will be a discussion between the MEC Residency Supervisor and the SCO Director of Residencies and game plan written out and a remediation program will be implemented. This remediation program document will be signed by both the resident and the residency supervisor. Regular updates will be provided to the SCO Director of Residencies either by phone or email or both. A timeline will be created for such remediation not to exceed the length of the end date of the residency cycle.