Residency in Ocular Disease

The mission of the optometry residency program in ocular disease at the Greenville VA Healthcare Center (Greenville VA HCC) is to produce optometrists with clinical expertise in the diagnosis and management of ocular disease. The program will build on the Resident's entering clinical skill set and knowledge base through evidence-based, interdisciplinary practice. The Resident will develop expertise in the management of patients with multiple medical problems within a multidisciplinary setting. This program will provide the opportunity for advanced didactic learning and enable Residents to apply this knowledge to clinical care and career-long learning.

Goal 1: Develop, strengthen, and expand the Resident’s capacity to recognize, diagnose, treat, and manage ocular disease and ocular manifestations of systemic disease.

• Objective 1: The Resident will be exposed to various ocular diseases and manifestations of systemic diseases found in our VA patient population.
  • Outcome 1.1.1: The Resident will complete a minimum of 1,350 patient encounters.
• Objective 2: The Resident will achieve competency in diagnosing, treating, and managing patients within specific disease categories encountered routinely within the VA population.
  • Outcome 1.2.1: The Resident will evaluate at least 200 patients with glaucoma, 150 patients with diabetes, and 150 patients with macular degeneration.
• Objective 3: The Resident will demonstrate the ability to select, order, and interpret the appropriate laboratory testing and diagnostic imaging procedures as indicated by findings on clinical exam.
  • Outcome 1.3.1: The Resident will select, order, and interpret appropriate laboratory testing and diagnostic imaging procedures as necessary under the guidance of their assigned Residency Faculty.
• Objective 4: The Resident will gain experience in providing basic low-vision care, including referral to low-vision for services, performing low-vision examinations, and educating patients on how to use low-vision devices effectively.
  • Outcome 1.4.1: The Resident will complete a minimum of 10 low-vision patient encounters.

Goal 2: Strengthen the Resident's ability to appropriately formulate differential diagnoses for patients with ocular manifestations of systemic disease.

• Objective 1: The Resident will be exposed to a wide variety of patients who require the Resident to formulate differential diagnoses for patients with ocular manifestations of systemic disease.
  • Outcome 2.1.1: The Resident will see at least 300 patients in the first three months of the residency.

Goal 3: Develop the Resident's ability to acquire and interpret retinal and NFL images with OCT and fundus photographs.

• Objective 1: The Resident will be required to acquire, interpret, and review OCTs with the attending optometrist.
  • Outcome 3.1.1: A minimum of 20 NFL images with OCT within the first six months of the residency will be obtained.
• Objective 2: The Resident must acquire, interpret, and review fundus photographs with the attending optometrist.
  • Outcome 3.2.1: A minimum of 20 fundus photographs will be obtained within the first six months of the residency.

Goal 4: Develop the Resident's ability to function as a healthcare team member through participation in a multidisciplinary medical center.

• Objective 1: The Resident will interact with various healthcare providers. This can occur in person, by telephone, e-mail, EMR, or a referred consultation.
  • Outcome 4.1.1: The Resident will make referrals for at least 100 patients during the residency.
• Objective 2: The Resident will communicate, as required, with physicians, nurses, nurse practitioners, social workers, laboratory or x-ray personnel, or ward secretaries when managing patients.
  • Outcome 4.2.1: The Resident will write letters for at least 50 patients during the residency.

Goal 5: The Resident will develop skills to communicate with patients effectively, their families/caregivers, and other healthcare providers in a multidisciplinary setting.

• Objective 1: The Resident will be required to communicate with a variety of patients during the residency.
  • Outcome 5.1.1: The Resident will examine and communicate with at least 1,350 patients.

Goal 6: Increase the Resident's knowledge and scholarly development.

• Objective 1: The Resident will present grand rounds cases during Optometry Conference.
  • Outcome 6.1.1: The Resident will present at Optometry Conference grand rounds at least four times during the year.
• Objective 2: The Resident will participate in monthly Journal Club meetings.
  • Outcome 6.2.1: The Resident’s participation in monthly Journal club meetings.
• Objective 3: The Resident will be encouraged to submit a poster to and attend the annual American Academy of Optometry meeting.
  • Outcome 6.3.1: The Resident will present their poster at the American Academy of Optometry Meeting if accepted.
• Objective 4: The Resident will be required to present continuing education lectures.
  • Outcome 6.4.1: The Resident will present two COPE-approved CE lectures to the MCPHS faculty.
  • Outcome 6.4.2: The Resident will present one CE lecture to the NC Optometic Society.

Goal 7: Enhance the Resident's clinical training experience through clinical teaching.

• Objective 1: The Resident will precept optometry student externs.
  • Outcome 7.1.1: The Resident will precept optometry student externs from the Massachusetts College of Pharmacy and Health Sciences, Southern College of Optometry, and Indiana University after six successful months in the residency.
• Objective 2: The Resident will serve as an instructor in clinical education.
  • Outcome 7.2.1: The Resident will teach gonioscopy workshops and grand rounds cases and tutor optometry student externs as needed.

Goal 8: Encourage and supervise the Resident in completing a clinical case report, clinical review, or research project of publishable quality.

• Objective 1: The Resident will develop and complete a written project by the end of the residency.
  • Outcome 8.1.1: The Resident will submit a written manuscript of publishable quality.

Clinical Curriculum – Direct Patient Care

The clinical curriculum will emphasize treating and managing stand-alone ocular disease and ocular disease secondary to systemic medical conditions. The Resident will be in the clinic five days weekly and is assigned 80-90% of their time to direct patient care activities. These assignments are based at the Greenville VA HCC. Direct patient care includes comprehensive ocular examinations of patients with multiple systemic conditions, diagnosis and management of anterior and posterior segment disease, and co-management of cataract and glaucoma surgery. Glaucoma surgery co-management includes trabeculoplasty and stable trabeculectomy, among others.

Optometry Conference

The Resident participates in the Optometry Conference, a weekly meeting where participants discuss peer-reviewed clinical trials on treating and managing conditions such as glaucoma, age-related macular degeneration, retinal vascular disease, and ocular treatment of systemic disease. Optometry Conference includes a member of the Residency Faculty, the Resident, student interns, and interns from other disciplines occasionally. Grand rounds and gonioscopy/scleral depression workshops are performed during the Optometry Conference.

Journal Club

The Resident participates in a monthly journal club with staff optometrists. The Resident is responsible for selecting the discussion topics and performing a literature search of the latest publications on chosen topics. The Resident is responsible for distributing the articles to faculty and student interns for review and discussion.

Optometry Grand Rounds

During the Optometry Conference, the Resident will present a 45-minute formal lecture in a grand rounds format with the Residency Faculty and optometry student externs present. The Resident will be expected to present a case report in a grand rounds format at least four times during the residency.

Meeting Presentation

The resident is strongly encouraged to submit a poster to the American Academy of Optometry's annual meeting.

State Meeting Presentation - Resident 50-minute lecture

Toward the end of their residency year, the Resident will be expected to give a 50-minute COPE-qualified CE lecture for the North Carolina Optometric Society. The topic must be ocular disease. The Residency Coordinator and the CE Champion of the local Optometric Society will coordinate this lecture.

Resident Virtual Presentation to MCPHS Faculty and Students

The Resident is expected to give two virtual continuing education lectures to MCPHS faculty and students during the Resident’s year.

Case Report / Research Paper

Resident must develop, execute, and write an original paper based on a case report or research project. The Residency Coordinator and Residency Faculty will support the Resident in finding appropriate cases for posters, continuing education lectures, and case reports throughout the year.

The Residency is 12 months, beginning in early July and ending on June 30th of the following year.

Benefits

• 40 hours per week.
• No on-call responsibilities.
• Annual salary $45,715
• Vacation Days (AL): 13 days, accrued at a rate of 4 hours per pay period (every two weeks).
• Sick Days (SL): 13 days, accrued at a rate of 4 hours every pay period (every two weeks).
• Professional Days (AA): Academic Leave can be requested to attend professional meetings or to take a state or national licensing exam.
• Health Insurance: Health insurance is provided through the VA.
• Life Insurance: Life insurance is provided through the VA.
• The VA will provide the necessary liability coverage while the Resident only trains within the VA facility.

1. The Resident is required to deliver patient care services at a level satisfactory to those responsible for the supervision of the residency program.
2. 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 the Department of Veterans Affairs and the Massachusetts College of Pharmacy and Health Sciences.
3. The Resident will attend scheduled visits to external sites that specialize in particularareas of Ophthalmology, i.e., Retina, Cornea, Cataract specialists. These visits will occur every Tuesday.
4. The Resident is required to present two, COPE-approved continuing education lectures. One to MCPHS. Faculty and students during the year, and one lecture to the local Optometric Society.
5. The Resident is required to present a 45-minute formal lecture in Grand Rounds at least twice during the year for MCPHS faculty and students.
6. The Resident is required to attend and participate in Optometry Conference.
7. The Resident is required to complete a paper of publishable quality and submit the manuscript by the end of June. It is highly recommended and encouraged that this paper be submitted for publication.
8. The Resident is required to maintain an accurate patient log of all patients seen during the residency year, including ocular diagnosis, treatment and management, and patient race.
9. The Resident is required to maintain an accurate activitiy log that reflects all educational activities they participated in. These include conferences, continuing education, grand rounds, etc.
10. The Resident is required to complete program and preceptor evaluations and questionnaires as required in a timely manner.
11. The Resident is required to participate in monthly journal club.
12. The Resident will participate in weekly resident/student lectures.
13. The Resident will participate in monthly resident/student workshops.

The residency program is a 12-month curriculum that begins on July 1 and runs through June 30 of the following calendar year. The curriculum consists of various activities designed to fulfill the program's mission, goals, and objectives. The primary emphasis at the VA Healthcare Center is patient care, emphasizing diagnosis and management of ocular disease. Other assignments include participation in educational conferences, didactic activities, and clinical supervision and teaching of optometry students.

Clinical Curriculum – Direct Patient Care

The clinical curriculum will emphasize treating and managing stand-alone ocular disease and ocular disease secondary to systemic medical conditions. The Resident will be in the clinic five days weekly and is assigned 80-90% of their time to direct patient care activities. These assignments are based at the Greenville VA HCC. Direct patient care includes comprehensive ocular examinations of patients with multiple systemic conditions, diagnosis and management of anterior and posterior segment disease, and co-management of cataract and glaucoma surgery. Glaucoma surgery co-management includes trabeculoplasty and stable trabeculectomy, among others.

The Resident will be expected to perform ancillary procedures, including anterior and posterior segment photography, optical coherence tomography, corneal foreign body removal, and punctal plug insertion. The Resident can consult with sub-specialists and primary care and urgent care doctors. The Resident will be responsible for ordering, as needed, laboratory testing and radiological imaging, including carotid Doppler, CT, MRI, and X-ray.

The Resident will be able to work with patients who need contact lens fittings. The opportunity to work with patients who need a contact lens fitting varies with need but will be directed to the Resident when possible.

Additional Clinical Activities Outside of Greenville VA HCC:

• The Resident observes/participates in patient care at a retina service.
• The Resident observes/participates in patient care with a cornea specialist.
• The Resident observes/participates in patient care with an oculoplastics specialist.
• The Resident will participate in patient care for low vision services.

Didactic Curriculum

Teaching activities include workshops, lecturing at Optometry Conferences, and supervising students. The Residency Faculty supervises all teaching activities. The Residency Faculty always provides clinical supervision. The Resident gains both teaching and clinical experience through his/her involvement in every patient encounter for clinical sessions. Each activity provides the Resident opportunities to develop and hone instructional skills in various settings.

Didactic activity schedule:

Summer Quarter:

Optometry Conference

The Resident participates in the Optometry Conference, a weekly meeting where participants discuss peer-reviewed clinical trials on treating and managing conditions such as glaucoma, age-related macular degeneration, retinal vascular disease, and ocular treatment of systemic disease. Optometry Conference includes a member of the Residency Faculty, the Resident, student interns, and interns from other disciplines occasionally. Grand rounds and gonioscopy/scleral depression workshops are performed during the Optometry Conference.

Journal Club

The Resident participates in a monthly journal club with staff optometrists. The Resident is responsible for selecting the discussion topics and performing a literature search of the latest publications on chosen topics. The Resident is responsible for distributing the articles to faculty and student interns for review and discussion.

Fall, Winter, and Spring Quarters:

Optometry Conference

Starting in the fall quarter, the Resident will participate in the Optometry Conference as a lecturer. This can occur in one of three formats: workshops, case reports in a grand rounds format, or continuing education style lectures.

• The Resident is expected to lead workshops on gonioscopy and scleral depression for student interns. To prepare for the workshops, the Resident must compile a brief lecture on the topic. The resident presented the lecture, then led the workshop and assisted the student interns as they practiced their clinical techniques on each other. This occurs every quarter as new student externs rotate through the site and is documented in the Resident’s activity log.
• Each quarter the Resident is expected to prepare a 15-minute case report from a case the Resident saw in the clinic. The case report will be given to student externs and must include relevant photos, visual fields, and other images that reflect the latest information available on the topic. Differential diagnoses are expected to be comprehensive, and a discussion on the diagnosis and management plan is emphasized. These are documented in the activity log.

Optometry Grand Rounds

During the Optometry Conference, the Resident will present a 45-minute formal lecture in a grand rounds format with the Residency Faculty and optometry student externs present. The Resident will be expected to present a case report in a grand rounds format at least four times during the residency.

Meeting Presentation

The Resident is strongly encouraged to submit a poster to the American Academy of Optometry's annual meeting.

State Meeting Presentation - Resident 50-minute lecture

Toward the end of their residency year, the Resident will be expected to give a 50-minute COPE-qualified CE lecture for the North Carolina Optometric Society. The topic must be ocular disease.

Resident Virtual Presentation to MCPHS Faculty and Students

The Resident is expected to give two virtual continuing education lectures to MCPHS faculty and students during the Resident’s year.

Attend Continuing Education Courses

The Resident is strongly encouraged to attend continuing education courses at the following:

• American Academy of Optometry annual meeting continuing education courses
• Continuing education offered by the North Carolina Optometry Society
• Virtual continuing education offered by the MCPHS University School of Optometry

Case Report / Research Paper

Resident must develop, execute, and write an original paper based on a case report or research project. The Residency Coordinator and Residency Faculty will support the Resident in finding appropriate cases for posters, continuing education lectures, and case reports throughout the year.

• Application Packet must include the following:
  • Letter of Intent
  • Resume
  • Official copy of NBEO scores
  • Official copy of optometry school transcript
  • Three letters of recommendation: from faculty in a clinical setting
• Before entering the program, applicants must have earned an O.D. degree from an ACOE-accredited school or college of optometry.
• The candidate must be a U.S. Citizen
• A personal interview is strongly recommended but not mandatory.
• Applicants must have taken and passed the TMOD and Basic and Clinical Science portions of the National Board of Examiners in Optometry (NBEO) and furnish official copies of the results before completing the residency.
• All residents must complete the match through the Optometric Residency Matching Service (ORMS). The application deadline for the ORMatch site is January 31.
• Official transcripts from the school or college of optometry are required.

All Department of Veterans Affairs policies concerning discrimination are followed in the selection process. No preference or exclusion will be given to any candidate based on gender, race, color, creed, age, sexual orientation, or national origin.