Toyos Clinic

PROGRAM MISSION

The Residency Program in Refractive and Ocular Surgery at Toyos Clinic (TC) provides qualified optometrists with advanced clinical education in the diagnosis and management of eye and vision problems, ocular disease, and co-management of refractive surgery. 

 

PROGRAM GOALS AND OBJECTIVES

 

Goal 1: Strengthen the resident’s expertise in the diagnosis and management of visual disorders and ocular disease. 

Objective 1: The resident will complete a minimum of 2000 patient encounters with patients presenting with vision disorders and ocular disease. The demographics include infants, children, adults and geriatric patients. 

Outcome: The resident will develop advanced expertise in the management of patients with vision disorders, retinal disease, glaucoma, anterior segment disease, and neuro-ophthalmic disease.

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


Objective 2: 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 appropriate level of technical and cognitive ability is being exhibited. 


Objective 3: 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 4: 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 2: Expand the resident’s knowledge of specialized diagnostic procedures and instrumentation.

Objective 1: The resident will develop expertise in performing and interpreting ophthalmic ultrasonography.

Outcome: The resident will perform a minimum of 10 ophthalmic ultrasonography (A and B-scans) and interpret the results.

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


Objective 2: The resident will develop expertise in performing and interpreting corneal topography.

Outcome: The resident will perform a minimum of 250 corneal topographies and interpret the results.

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


Objective 3: The resident will develop expertise in performing retinal imaging.

Outcome: The resident will perform retinal imaging and OCT on at least 100 patients.

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


Objective 4: The resident will develop expertise in performing and interpreting specular microscopy

Outcome: The resident will perform spectra on at least 100 patients and interpret the results.

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


Objective 5: The resident will develop expertise in ordering and interpreting relevant medical laboratory procedures and ophthalmic laboratory fabrication.

Outcome: The resident will order laboratory procedures on at least 15 patients.

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

 

Goal 3: Expand the resident’s knowledge in the care of corneal refractive patients.

Objective 1: The resident will develop expertise in evaluating patients for advanced refractive care including LASIK, Epi-LASIK, and INTACS for keratoconus.

Outcome: The resident will provide advanced refractive care to a minimum of 250 patients.

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


Objective 2: The resident will develop expertise in refractive post-operative care and management of post-operative Lasik complications 

Outcome: The resident will provide post op care to a minimum of 500 patients.

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

 

Goal 4: Expand the resident’s knowledge in the care of refractive cataract patients.

Objective 1: The resident will develop expertise in evaluating patients for advanced refractive cataract surgery including LenSx (laser cataract surgery), Toric intraocular lens, multifocal intraocular lens and clear lens exchange

Outcome: The resident will provide advanced refractive care to a minimum of 250 patients.

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


Objective 2: The resident will develop expertise in post-operative cataract care and management of post-operative complications 

Outcome: The resident will provide post op care to a minimum of 500 patients.

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

 

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 participate in relevant presentations and conferences on systemic disease.

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

 

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 at least one lecture per quarter during the regular Residency Conference, one grand rounds at TC, and when possible will present posters or lectures in other settings such as the American Academy of Optometry and ASCRS.

Measure: The resident will report on these types of activities using the activity log.

 

Goal 7: Instill in the resident an appreciation of the importance of 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 May 1.


Objective 2: Educate the resident in the development and execution of a research project. 

Outcome: The resident will design and execute a publication-quality research project on an approved topic with appropriate statistical analysis. 

Measure: The resident will complete the project by June 30.

 

Goal 8: Provide the resident with the opportunity to become an effective clinical educator.

Objective: The resident will supervise optometry student clinicians in the provision services to patients.

Outcome: The resident will mentor and oversee optometric externs during the final nine months of the residency.

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

 

Goal 9: The resident will acquire a practical understanding of patient coding, billing, and practice management in a primary eye care clinical setting.

Objective: The resident will become familiar with the encounter/billing forms, and clinical chart recording requirements for proper billing.

Outcome: The resident will log accurate diagnosis ICD codes, as well as appropriate office visit billing codes on the patient billing form.

Measure: The results of regular review of the resident's billing/encounter forms by the Supervisor or attending doctor at TC will be reflected in the quarterly resident evaluations.

 

CURRICULUM

The educational objectives of the curriculum are intended to ensure attainment of the mission, goals, and objectives of the program. Consequently, each educational objective reflects a specific program goal. Specifically:


 

Program Goal 1

Objective: The resident will develop a high degree of proficiency in the provision of optometric services to patient with vision disorders and ocular disease.

Learning Activity: The resident will provide optometric services involving a minimum of 2000 patient encounters to patients with vision disorders and ocular disease.

Outcome: The resident will develop advanced skills in the management of patients with vision disorders and ocular disease.


 

Program Goal 2

Objective: The resident will utilize a wide variety of diagnostic procedures and instrumentation while caring for patients.

Learning Activity: The resident will perform and/or interpret ophthalmic ultrasonography, corneal topography, fundus photography, optical coherence tomography, and relevant medical laboratory procedures.

Outcome: The resident will develop advanced knowledge of specialized diagnostic procedures and instrumentation.


 

Program Goal 3

Objective: The resident will provide care to a large number of patients interested in corneal based refractive surgery.

Learning Activity: The resident will evaluate and counsel patients interested in refractive surgery including follow up / post-operative care.

Outcome: The resident will become experienced in providing advanced refractive care.

 

Program Goal 4

Objective: The resident will provide care to a large number of patients interested in cataract based refractive surgery.

Learning Activity: The resident will evaluate and counsel patients interested in refractive surgery including follow up / post-operative care.

Outcome: The resident will become experienced in providing advanced refractive care.

 

Program Goal 5 

Objective: The resident will become familiar with the management of systemic diseases commonly associated with ocular disease.

Learning Activity: The resident will consult with patients’ physicians when appropriate to coordinate the management of related ocular and systemic conditions.

Outcome: The resident will be able to communicate effectively with physicians in the co-management of patients who have systemic disease that impacts their ocular health.

 

Program Goal 6

Objective: The resident will develop and present original presentations to other health care professionals.

Learning Activity: The resident will present at least one lecture per quarter during the regular Residency Conference and when possible will present posters or lectures in other settings such as the American Academy of Optometry and ASCRS.

Outcome: The resident will develop skills in providing effective presentations to health care professionals.

 

Program Goal 7

Objective: The resident will engage in scholarly activity.

Learning Activity: The resident will prepare a publication-quality manuscript and develop a research project on approved topics that will be reviewed and critiqued by the supervisor

Outcome: The resident will develop an appreciation for scholarly activity and its importance to the profession.

 

Program Goal 8

Objective: The resident will supervise optometry student externs in the provision of patient care.

Learning Activity: The resident will mentor and oversee the optometry students during the final nine months of the residency.

Outcome: The resident will develop skills in providing effective clinical education.

 

Program Goal 9

Objective: The resident will be responsible for recording the proper assessment and management plan and indicating the correct diagnostic and procedural codes for each patient.

Learning Activity: The resident will record essential findings and supporting assessments and management plans for each patient encounter in the clinical record and appropriate forms.

Outcome: The resident will gain a thorough understanding of proper coding.


In addition to the specific educational objectives listed, the resident will participate in the weekly residency conferences. These conferences cover a range of optometric topics and are updated each year. Generally, the following areas are covered during multiple presentations every year:

• Contact lens fitting and problem solving
• Office Emergencies
• Anterior and posterior segment ocular disease
• Binocular vision
• Low vision 

Three to four grand rounds presentations, typically emphasizing ocular disease, are also presented each year.

 

CLINICAL ROTATIONS

The Resident will gain clinical experience at Toyos Clinic and associated satellite offices. The resident will meet on a weekly basis with the residency supervisor for discussion of current cases. The exact schedule for these rotations will be determined by the program supervisor.

 

 

DIDACTIC ACTIVITIES OF THE RESIDENT

During the residency a weekly conference is given at SCO which the resident is expected to attend. The resident will be expected to present a talk at a minimum of three of these conferences during the year. A paper of publication quality is expected prior to May 1. The resident will be involved in occasional student supervision if teaching is deemed a career goal.

 

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. 

In order to take part in the Match you must have passed NBEO Part I, Part II (PAM) and TMOD. 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 Tennessee license and furnish official transcripts when available. If accepted, the resident is expected to obtain a Tennessee 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.

 

 

CONTRACT

All applicants selected for admission must sign a standard resident contract.

 

STIPEND AND BENEFITS

The residency program is fifty two weeks in length from July 1 to June 30. The stipend is $38,000 which will be paid on a biweekly basis by Toyos Clinic. Compensation is not contingent upon productivity of the resident. Professional liability insurance is provided by Toyos Clinic. A continuing education allowance in the amount of $500 will be provided to the resident.

 

LEAVE POLICY

One week of educational leave, one week of sick leave, one week of vacation leave are available with prior approval of the Supervisor and the SCO Director of Residency Programs. Additional educational leave may be allowed at the discretion of the above individuals. 

 

SCHOLARLY ACTIVITY

The resident is required to write a paper based upon original research, literature review, or a clinical case suitable for publication in a refereed optometric journal.

 

OTHER EMPLOYMENT

The resident may be allowed to provide patient care services outside of the Toyos Clinic system on a limited basis only with advance written permission by Toyos Clinic’s residency supervisor.

 

CRITERIA FOR COMPLETION OF RESIDENCY

 

A. The resident is required to deliver clinical services at a level which is satisfactory to the Residency Supervisor of TC, the Residency Committee, Director of Residency Programs, and the SCO administration. The office is open from 8:00 A.M. until patient care is completed, usually around 5:00 P.M., Monday through Friday, with some Saturday post op care. On call services are required after one month of training.

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

C. The resident will be required to write a paper based on original research, literature review, or a clinical case for publication in an acceptable professional journal.

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 will be 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 Toyos Clinic.

F. The resident will be expected to assist in the continuing education programs provided at Toyos Clinic.

G. The resident will be required to participate in and complete the requirements set forth in the curriculum.

H. 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.

I. Any resident accepted for training can be dismissed, without receiving a certificate of completion, for infractions of the rules and regulations of Southern College of Optometry, or for any action that 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.

 

ACCREDITATION

The residency program in Refractive and Ocular Surgery at Toyos Clinic is currently in the process of accreditation by the Accreditation Council on Optometric Education, 243 N. Lindbergh Blvd., St. Louis, MO 63142, (314) 991-4100.

 

CERTIFICATE OF COMPLETION

Upon evidence of satisfactory performance in meeting all requirements of the program, the resident will be awarded a Certificate of Completion. 

 

REPORTING STATUS

The resident reports to the Supervisor of the residency program. The Supervisor report directly to the SCO Director of Residency Programs who in turn reports directly to the Vice President for Academic Affairs at Southern College of Optometry. 

 

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