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Residency in Primary Care Optometry

Hampton VA Medical Center, Hampton, Virginia

affiliated with

SOUTHERN COLLEGE OF OPTOMETRY

MEMPHIS, TENNESSEE

 

Program Mission

The mission of the Hampton VAMC residency program is to provide residents with post-graduate clinical experience beyond that provided in the Doctor of Optometry program.  The program will prepare optometrists for the provision of comprehensive primary optometric care for adults in a multidisciplinary environment by enhancing their diagnostic and management skills, collaborating in the management of systemic disease, and participating in clinical and academic education.   

 

Residency Program Goals, Objectives, Outcomes, and Measures

 

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 on the number of patient encounters of this type using the resident 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 daily by clinic faculty. The resident will be evaluated quarterly by the supervisor and/or other clinical staff 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: All resident charts will be reviewed daily by clinic faculty.  The resident will be evaluated quarterly by the supervisor and/or other clinical staff 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 to best address the patient’s needs.

Measure: All resident charts will be reviewed daily by clinic faculty.  The resident will be evaluated quarterly by the supervisor and/or other clinical staff to assess the appropriateness of the resident’s management skills.

 

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

Objective 1: Ensure the resident gains adequate experience with advanced diagnostic ocular procedures.

Outcome: The resident will perform advanced diagnostic procedures (including, but not limited to, gonioscopy, ophthalmic ultrasonography, fundus photography, and retinal and optic nerve diagnostic imaging to include optical coherence tomography, and potentially fluorescein angiography) when clinically indicated and interpret the results. 

Measure: The resident will report on the number of patient encounters of this type using the resident activity log.


Objective 2: The resident will gain experience in ordering and interpreting relevant laboratory and radiological procedures.

Outcome: The resident will order relevant laboratory and radiological procedures.

Measure: The resident will report on the number of patient encounters of this type using the resident activity log. 

 

Objective 3: Provide the resident with adequate experience and training in the management of complex ocular disease

Outcome: The resident will manage and treat an adequate number of patients with complex ocular disease presentations.

Measure: The resident will report on the number of patient encounters of this type using the resident activity log (as defined as those patients with three or more ICD-10 diagnoses relating to the eye).

 

Objective 4: Provide the resident with experience in the triage and management of urgent ocular conditions

Outcome: The resident will see urgent eye care consultations requested of the Eye Clinic.

Measure: The resident will report on the number of patient encounters of this type in the resident activity log.

 

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

Objective 1: 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 the management of patients with systemic disease. 

Measure: The resident will report on the number of patient encounters of this type using the activity log. 

 

Objective 2: The resident will work within an interdisciplinary system with other medical subspecialties. 

Outcome: The resident will have the opportunity to rotate through other medical subspecialties both in and outside the hospital setting (such as, but not limited to: endocrinology, neurology, primary care, infectious disease, ophthalmology, etc). 

Measure: The resident will evaluate and be evaluated on medical subspecialty rotations and will log these activities. 

 

Goal 5: Provide the resident with the experience and opportunity to become an effective educator and develop the resident’s skills in presenting topics to fellow professionals.

Objective 1: 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 weekly conferences and other meetings held at the Hampton.  The resident will present and participate in Resident’s Day at the Southern College of Optometry.  When possible, the resident will present posters or lectures in other settings, such as the American Academy of Optometry, American Optometric Association, and/or other local, regional, state, or national meetings/conferences. 

Measure: A copy of the resident’s handouts for lectures/posters presented, including a bibliography for each presentation, will be collected.  The resident will report these activities on the resident log.

 

Objective 2: Develop the resident’s instructional and clinical teaching skills.

Outcome: The resident will participate in weekly optometric educational conferences with staff and optometry externs.  The resident may participate in the clinical supervision of optometric externs when appropriate.

Measure: A record will be kept of the topics covered during teaching conferences and the resident will report quarterly on the number of patients precepted with the externs.

 

Curriculum

The residency program has a strong clinical emphasis, with a diverse patient base and clinical experience.  The resident manages patients with ongoing and chronic ocular diseases, systemic diseases, as well as seeing emergency patients and coordinating care within an interdisciplinary hospital setting.  The resident will utilize a wide variety of diagnostic procedures and instrumentation while caring for patients. Academic and didactic activities include weekly conferences as well as presenting a lecture for the SCO Resident’s Day. 

With its emphasis on direct patient care, the residency curriculum is designed to develop enhanced skills in the management of primary eye care patients.  In the clinic, the resident is given priority regarding number of patient encounters, urgent or emergency consultations, and complex or challenging cases. The resident will be expected to have a minimum of 1000 patient encounters.  Approximately 85% of the resident’s time is spent in direct patient care, and the remaining 15% in observation, didactic, or academic activities.

The resident will gain experience in managing patients with complex ocular disease at both the main hospital in Hampton and at the community based outpatient clinic (CBOC) in Virginia Beach. Established and new patients requiring ongoing care for chronic and/or acute ocular diseases are scheduled in the resident designated clinic, thus ensuring that the resident can establish ongoing follow care for his/her own patients. Ocular disorders managed by the resident include but are not limited to diabetic retinopathy, glaucoma, macular degeneration, uveitis, anterior segment disease, peripheral retinal disease, and neurologic disorders. The resident is also given priority for evaluating patients with acute or emergent eye conditions.

When clinically indicated, the resident will be able to and become proficient in ordering diagnostic tests from the laboratory (serology, blood chemistry, etc.), imaging (X-rays, computed tomography, MRI, etc), nurse injection clinic (ppd and anergy panel), peripheral vascular lab (carotid doppler studies), and cardiology (echocardiograms). Within the Eye Clinic, advanced diagnostic procedures, such as ultrasound scanning, are performed independently by the resident after a period of supervised training by the Program Coordinator. When necessary, consultative services outside the Eye Clinic can be obtained through other specialties and subspecialties within and outside the Hampton VAMC and its clinics.

The vast majority of patients are examined on an outpatient or ambulatory basis. However, the resident also evaluates patients undergoing long-term intermediate (domiciliary) care, short term inpatient care, and long-term inpatient care (e.g. Nursing Home or Spinal Cord Injury patients) when requested by their providers. Inpatient bedside examinations on the hospital wards are also performed when indicated.

Academic and didactic activities include the following:

 

Journal Review

Throughout the year, the resident is assigned journal articles to read which are reviewed and discussed with the Program Director, optometry staff, and optometry externs.

 

Friday Conference

Each Friday afternoon an academic conference is held in which case presentations and lecture topics are presented. The presentations are given by the optometry student, resident, and/or staff.
 

Other rotations

The resident is scheduled to rotate through other clinics in and outside the hospital, such as, but not limited to: endocrinology, neurology, primary care, infectious disease, ophthalmology, etc. These rotations designed to give the resident experience with and exposure to Primary Care and other supportive disciplines.

 

Resident’s manuscript

One of the requirements for the awarding of a residency certificate is the completion of a manuscript of publishable quality. This paper may be a case report with literature review or a research project.

 

APPLICATION PROCEDURES

A.  All applicants must complete the SCO application and return by January 30. Supporting documents should be submitted to the Director of Residency Programs of Southern College of Optometry no later than January 30. This program uses Optometry Residency Match (ORMatch). Applicants must complete the ORMatch application by the SCO deadline of January 30, to be considered. Applicants are responsible for ensuring that all supporting documentation is submitted to each entity involved, e.g., the College, ORMatch, and the residency site supervisor. 

You must have passed NBEO Part I, II and TMOD in order to apply to one of our programs through ORMatch.

2.    You must have passed NBEO Part III and ISE (if applicable) in order to begin an SCO affiliated residency program. 

Those applying to a VA hospital or a state that does not require TMOD to obtain licensure are an exception if TMOD is not passed on first attempt.

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 required for state licensure and furnish official transcripts when available. If accepted, the resident is expected to obtain a state optometry license.

E.  Three letters of recommendation are required.

The College affirms that no person shall be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity at or affiliated with Southern College of Optometry on the basis of race, color, creed, religion, gender, age, disability, or national origin.
 

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.
 

STATUS OF THE RESIDENT

A. The residents are defined as employees of the Hampton VAMC and the residency stipend is paid by the VAMC. No tuition or fees are applicable.

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

C.  Professional liability protection for residents for professional activity performed at the Hampton VAMC.

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

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

F.  Residents privileges will be determined by Hampton VAMC policy.

 

LEAVE POLICY

All residents are eligible for sick and annual leave.

 

CRITERIA FOR COMPLETION OF RESIDENCY

A.  The resident is required to deliver clinical services at a level which is satisfactory to the Residency Supervisor, Director of Residency Programs, and the SCO and Hampton VAMC administrations.  Normal clinic hours are from 7:15AM until 4pm or later if necessary as patient care indicates, Monday through Friday at the Hampton VAMC or Virginia Beach outpatient clinic. 

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

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

D.  The resident will be required to deliver an oral presentation at the annual Resident Weekend, held on the campus at SCO.

E.  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 Hampton VAMC.

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

G.  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 Hampton VAMC or those set forth by Southern College of Optometry, or for any action which jeopardizes the safety of patients, personnel, or physical facilities.


A resident rotating through a hospital based (or similar) residency program must adhere to all facility policies and procedures, including but not limited to, receiving all required immunizations or showing appropriate medical documentation that he/she is in full medical compliance with required immunizations.  In addition, if a resident cannot receive a flu or similar immunization due to potential allergic reaction, medical documentation must be made available to the Program Supervisor prior to the program's start date.  A resident should receive the required immunizations provided by the facility when appropriate.  Otherwise, any costs incurred will be the resident's responsibility.  Any grievances should be submitted in writing to SCO's Director for Residency Programs utilizing the procedures found in the Residency Handbook.
 

STIPEND

The residency stipend will be provided for the year of training by the Hampton VAMC.  The current stipend is $##,###. Compensation is not contingent upon productivity of the resident.


HEALTH INSURANCE

Health insurance is available through the VA at decreased group rates. Part of the premium is also paid by the Department of Veterans Affairs.
 

OTHER EMPLOYMENT

Other employment (moonlighting) is permissible during the residency year provided it does NOT interfere with any program responsibilities including the completion of educational assignments and should only occur outside of normal duty hours.  Government resources, including email, computers and printers should not be used in the establishment of outside employment.  Also, the VA malpractice insurance does NOT cover work performed outside the VA facility to non-veterans. 
 

ACCREDITATION

The residency program at Hampton VAMC is fully accredited by the ACOE, 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. Lerma, O.D.

Director of Residencies

Southern College of Optometry

1245 Madison Avenue

Memphis, TN 38104

(901) 722-3201

email: [email protected]