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Life as a 4th Year Intern!

Lisa Russell Roach, Class of 2017, The Woodlands, TX

Hello again! Now that I'm over halfway through my 4th year intern semester at The Eye Center at SCO I just wanted to check in with an update on what it's like to be seeing patients here as a 4th year. It's a pretty big change from 3rd year clinic so there is a lot to talk about!

For comparison I'll start with a quick recap of what 3rd year clinic is like. As a 3rd year, you have classes in the mornings from about 8:00 until about 10:00. After that, you have clinic for the rest of the day beginning at 10:00 - but only three days per week. Each of these three days is a different clinic assignment: one day in primary care, one day working in the optical, and one day rotating through other more specialized services such as vision therapy, teen clinic, technology, and our external nursing home service. The other 2 afternoons are either free time for studying (which comes in handy when it's time to study for Part 1 of Boards!) or labs, depending on the semester.

As 4th years, we no longer have any classes (which also means no more studying for midterms and finals - yay!). Another change is that only one third of the class is at The Eye Center each semester because the other two thirds are out on their external sites first (each student has to spend one semester in-house at The Eye Center). Also, it's a lot more like working a real full-time job: we are in clinic from about 8:00am until about 6:00pm five days a week. We are divided into groups of 4-5 students and each group is in a different service each day of the week. My group is in pediatrics on Mondays, primary care on Tuesdays, low vision/vision therapy on Wednesdays, contact lens clinic on Thursdays, and ocular disease on Fridays. It's a good system and it makes sure we get adequate exposure to each service so that we are competent in all areas and are able to determine what services we might want to offer when we are out practicing on our own. I also think being in a different clinic each day of the week makes the weeks fly by, and I can't believe the summer term is over halfway over already! It's been a busy summer, but I'm learning a ton every day. I'm excited to begin my external rotations in the fall so that I can apply everything I'm learning here in different settings.  Graduation is in 300 days and I'm making sure to benefit as much as possible from time working with my brilliant attending doctors before I'm out on my own!

Thanks for reading - I'll write again at the end of the summer to wrap up my experience as a student doctor at The Eye Center before I head off to my private practice site in the fall. I hope everyone had a happy 4th of July!

at 7/7/16 | 0 comments

Part 1, externs, and a new last name!

Hello, readers! It has been a while since my last post and a LOT has happened in the time that has passed!

Spring semester of third year was busy with preparing for Part 1 of our National Boards (which my class took in the middle of March this year) while finishing up our last semester of coursework and seeing patients in The Eye Center three days a week. The time between Christmas break and Boards FLEW by, and before we knew it it was time to take the big test! Part 1 is taken over two full days and consists of 500 questions over a LOT of topics. Studying for it was a huge task and could be stressful at times, but the feeling of walking out after the second day of testing was almost worth it. The downside to finally finishing the exam on March 16th was that we had to wait until May 3rd to receive our scores and find out whether or not we passed. My new husband (eek!) and I found out four days before our wedding that we both passed, which definitely added to the happiness and celebration of that week! And just in case we weren't already sure that we are compatible - we actually got the EXACT same score on the test, which has to be pretty unlikely since scores range from 100-900. I guess all of our "study dates" over the past 8 years paid off. Happy day!

Speaking of happy days, Ben and I got married on May 7th in our hometown in Texas and it was just perfect. We had a blast celebrating with our family and friends and dancing the night away at our reception! The morning after the wedding we flew to Canada for our honeymoon. We spent 3 nights in beautiful French Canada (Quebec City) and 3 nights in busy downtown Toronto and we couldn't have asked for a better trip. We were sad to head back to the states on Sunday, but excited to start our 4th year externships the very next day! I am in-house at my SCO rotation this semester and Ben is at his institutional rotation at the Memphis VAMC. We are only on day 3 so far so I will write a more detailed post specifically about externs later on, but so far so good! It's hard to believe my class is already in our 4th year and that we're spread out all over the country at different extern sites. What an adventure it has been!

Thanks for reading, and a huge thanks to the SCO community for going above and beyond in congratulating Ben and I on our marriage! We are so happy and are so thankful for the support. I'll be back soon with a post about externs!

-Lisa Roach :-)

at 5/18/16 | 0 comments

The End of Second Year

Hey everyone!

It’s hard to believe I’m coming to the end of my second year! It seems like we were just sitting through our first-year orientation, and now we’re already getting ready for our clinic orientation in a few weeks.

For me, this semester has been mostly about honing my clinical skills and preparing to enter clinic. We’ve finally learned the last skills that we need to complete a comprehensive exam, which is pretty exciting. Last month, my classmates and I all had to pass a pre-clinic checkout, in which we had to simulate an entire exam in 50 minutes. Now that we’ve passed those, we are officially cleared to start seeing patients in clinic!

While our course load this semester has been as challenging as ever, I feel like we’re starting to see how things come together and are related to one another. It’s been neat to learn about a particular disease in Posterior Segment class, then learn about how to treat it in Ocular Pharmacology. I feel like all of our professors have done a good job correlating and integrating information from our other classes and I’m hoping that will help us in clinic.

When the semester is over in two weeks, I will head home to Pennsylvania for some much needed family time for about ten days, during which I’m hoping to get a few days of shadowing/working in at my local eye clinic. Then I’ll return in mid-May to officially start my 3rd year! I am definitely excited to be done with second year, and to be officially halfway done with optometry school, but I’m also nervous to start applying all of this classroom information to real patients and real exams in clinic.

Stay tuned to hear about my clinic adventures in a few weeks, and I promise to talk about some summertime Memphis activities! It will be my first summer here, so I’m excited to see what the city has in store for me!
at 4/18/16 | 0 comments

Direct Ophthalmoscopy

Direct Ophthalmoscopy is a skill that seemed nearly impossible a couple of weeks ago. Do I see a reflex? Do I need more magnification or less? How close should I get to this patient?  Can I hold my breath that long? Do you even have an optic nerve? Can I go back to retinoscopy? Give me my schematic eye back!!!! These are only a few of the many thoughts running through my mind as I continuously “play” doctor alongside my classmates.

After getting over my mental rant and numerous failed attempts, I was finally able to get my very first view of the optic nerve. It was then that I remembered the analogy a fellow SCO graduate once gave me: think of the cup to disk ratio as a bowl of spaghetti! An idea that once seemed so obscure finally began to take on a whole new meaning. Who would’ve thought that my love for spaghetti would come in handy at optometry school? Not me!

So here is how it goes: Picture a bowl (disk) with a fixed number of spaghetti strands (nerves; lets say 10) arranged diagonally so that the strands all have a common point where they meet, prior to diverting outwards in various directions till they graze the edges of the bowl and ultimately fall outwards. The key point to remember is that the number of spaghetti strands will always remain fixed. However, the bowl of spaghetti may either increase or decrease, meaning the optic disk will be larger or smaller, respectively. You then need to add the spaghetti sauce (cup), which will go in the middle of the bowl. The bigger the bowl, the larger the amount of sauce that can be added, and therefore, the larger the cup will be. Similarly, the smaller the bowl, the smaller the amount of sauce that can be added and therefore, the smaller the cup will be.  Once you can picture this, you can then determine the cup-to-disk ratio. What percentage of the cup does the disk occupy? Or, what percentage of the bowl does the sauce occupy? Good news: you can now predict a C/D ratio!! Bad news: the spaghetti analogy will only get you so far. It will not help with determining the presence of a spontaneous venous pulsation or foveal light reflex, nor will it aid in assessing the vasculature or macula of the eye. You’re on your own there!!

However, I will give you one last piece of advice, when looking at your patient's right eye, use your RIGHT eye, and when looking at their left eye, use your LEFT eye – unless of course, you’re trying to sneak in a peck on the lips! (Seriously, don’t be THAT person in the middle of a practical!)

That’s all for now... until next time! Can’t wait to share some post first year wisdom with you all in just a couple weeks!

at 4/13/16 | 0 comments

A year of many “Firsts”

As our first semester in optometry school came to a close, so did 2015. As one year ends, another begins; and with that, our second semester in optometry school is now in full swing.

So far 2016 has been a year of many firsts; with the month of January, came my first State Day, “Snowmaggedon”, and Eye Ball (no pun intended).

State Day is sponsored by SCO and the AOSA. It allows students to meet with a variety of state representatives and learn more about the individual laws and regulations that legislate the scope of optometric practice individual to each state. It provides students with insight as to what practicing optometry would be like in various states, while simultaneously allowing us to build connections with state representatives and AOA members. As an added bonus to State Day, we had an inspiring presentation by Hunter Chapman ’16 (2015-2016 AOSA President) where I was able to learn more about the AOSA and how to get involved. I should also note that for the second year in a row, an SCO student has been appointed as AOSA President. Congrats are in order for Erick Henderson ’17. #PerksofbeinganSCOstudent

On another note, my first “Snowmaggedon” was quite a tease. I pictured myself singing: “Do you want to build a snowman?” as I pranced around in a blizzard, but all I got was a day off school and an inch of snow. But beggars can’t be choosers, a snowflake is a snowflake, and this Florida girl finally got to experience a “Snow Day” as opposed to a day away from school due to Hurricane Andrew or “El Nino”. Following the flurries, all SCO students were able to mix and mingle with future colleagues at the annual Eye Ball, which took place at the historic Cadre Building and was hosted by SGA. The timing of the ball couldn’t have been more perfect; it allowed us all to engage in some fun before getting ready to buckle down and begin studying for our first set of midterms (taking place next week).

Colleen Fischman '19, Maria Sicco '19 and Betsy Del Valle '19

#EyeBall 2016


Lastly, as an added bonus the month of January granted me with my very first view of the optic nerve via direct ophthalmoscopy. But I should be getting back to studying, so you’ll have to stay tuned till next time!  

at 2/5/16 | 0 comments