[GUIDE] Need Clinical Experience? Optometry or ophthalmology? How to land a Technician Job!

Discussion in 'Pre-Optometry' started by armoman92, 10.29.14.

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  1. armoman92

    armoman92 Banned Banned Account on Hold

    New York, NY
    Hello, before I begin, let me give u some info about myself. [the guide is below]

    I am a JCAHPO certified COMT and ROUB. I went through the hurdles of getting my first job in ophthalmology/optometry. I am going to apply to an MD program in the near future, in hopes of becoming an ophthalmologist. Currently I work in a refractive surgery center, but I have experience in general ophthalmology/optometry, glaucoma, and neuro-ophtalmology.

    As a senior technician, doctors ask me to look at applications for new help quite often. I often conduct interviews for new applicants as well.

    I see a lot of posts in the optometry forum about getting clinical experience. I'm starting a new thread to consolidate a lot of questions I see often. Hopefully, this thread can grow.

    Please read through my guide. Some of it will seem obvious, but try to focus on its relevance to ophthalmology and optometry.

    I have included many links (look for blue underlined text) which are really useful. Please visit them as you read.

    As a disclaimer, there is some bias/opinion here on my part, and this guide is not a definitive way to get a job. I group together ophthalmology and optometry a lot, as you will see. I don't mean to blur the line between the two professions, but for entry level experience, I find the distinction moot.

    Comments and critique are always appreciated.

    [read on below]
    Last edited: 10.29.14
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  3. armoman92

    armoman92 Banned Banned Account on Hold

    New York, NY
    SDN member Celebi recently started a thread about getting work experience. I think his questions really encompass what a lot of people are asking. I'm going to model the guide off his/her post.

    GUIDE, How to Land an Ophthalmic/Optometric Technician Job with Little Experience.

    TRUST, in you, your judgment and (eventually) your measurements is what eye doctors look for in technicians. Having said that, here is how you demonstrate these traits:

    1) First and foremost, broaden your job options. By this, I mean consider ophthalmology practices as well as optometry practices. Know the difference between a optometrist and an ophthalmologist!

    In my career, I've interview at countless offices when between jobs, and I have always had better luck getting jobs at ophthalmology practices. Reader, at your level of experience (which is probably close to none), the distinction is not very significant. Most likely, at an ophthalmology practice, there will be OD's working there, and you will be interact with them A LOT more than with the surgeon(s). I doubt optometry schools will care if you worked in one setting or the other, as long as you had some exposure to licensed optometrists at work.

    You learn the same exact basics in ophthalmology and optometry. As a technician/assistant, you basically take over the minor to moderate optometric responsibility from the doctors.

    I have actually turned down the 3 or 4 optometric assistant potions offered me. Honestly speaking, optometrists prefer to do most testing themselves, and take care of the majority of the face-to-face patient encounter. The optometric jobs were all button pushing for me. My responsibilities, if I took the job, would be to do testing using automated machinery. Trust me, this gets old fast.

    Basically, find a super busy office that most likely needs an extra hand. Consider scouting. I've put on sunglasses and a hat and sat in waiting rooms of potential employers to see what the pace is like :cool:
    2) Know your jargon!!!!!!!!!
    Language is your friend! If you use certain words in your interviews, it can make up a lot for lack of experience. If anything, it will strengthen your desire to work in the field more.

    How do you do this? Its pretty easy. Buy and read this book.

    Read it over multiple times if necessary. It is the best intro book for clinical skills out there that I have found. You might be able to find it online somewhere. 8th to 9th edition, it doesn't matter. I'll post a list of other good reading for technician staff later.

    Examples: Go in knowing what astigmatism is, and how it correlates to the CYLINDER measurement in glasses. Know what a refraction is. Know what tonometry is, and what glaucoma is. Know basic eye anatomy and physiology.

    Basically, using jargon, explain what you want to learn, while demonstrating that you have done some background research at interviews. For younger, eager job seekers, this is invaluable.
    3) Know your machines/instruments, and give off a tech-savy vibe going into an interview.

    This trick has landed me multiple jobs. I could argue that it is the most important, but that's debatable :D
    Eye doctors love their toys, its part of the game:love: When I interview, I always ask about what machines the practice uses. The in-depth knowledge I have about the technology and operation of these machines usually impresses most employers, and lands me the job. As entry level, you won't know much, but you will learn. At an interview, ask the interviewer if the practice has any of the machines I've listed below (the ones with stars *, asking about the unstarred ones would make you look dumb).

    I'll give u a list of machines you should know. Memorize the names, and learn their functions:
    Trust me on this one. Learn these. Reading the book I mentioned before will give you a lot of insight on them. Use the internet too.
    4) Learn some skills on your own, that don't require necessary equipment. Learn how to talk about your knowledge of these skills.

    Most jobs I interview for test me in someway. This happens more so later down the road. Initially it is over the phone as a screener. They ask me about certain clinical skills, and try to fish out whether I am legit or not. At my interview, I'm usually required to work-up a few patients, or a staff member to prove my competency. This usually involves taking the opthalmic vitals: Vision, pressure, pupils, eye drop instillation and refraction. Taking history also plays in, but that you learn as you go with exposure to more pathology. At the interview, demonstrate that you at least know what he ophthalmic vitals are; this will get you bonus points.

    For you, forget about refraction and pressure (tonometry). Those take time to master, and require skill with a phoropter and slit-lamp.
    • Know what OD and OS are.
    • Know what the numbers of a glasses Rx mean.
    • Learn how to check and record vision. ex. 20/20 vs 20/30 vs 20/30+1 vs 20/50-2 The book will tell you how. Explore youtube, there are many videos on this, and other skills.
    • Learn how to put in eyedrops. Practice with artificial tears on a parent or friend (use preservative-free artificial tears). This will get you comfortable touching peoples faces, something you will be doing A LOT of. The book goes into how to do this by creating a lower eyelid cul-de-sac.
    • Learn how to check pupils for PERRL(A) and (R)APD. Book and videos.
    • Learn the basics of history taking. READ THIS GUIDE!!! It is really insightful, and might help you in the jargon department i mentioned before.
    4) Know your schedule and have extremely clear and unequivocal answers to when you are available to work.

    Accept that the doctor's time is WAY WAY WAY more valuable than yours, and that your function will be to save them time. You will notice this as you work more.

    This is more of a general job seeking tip, but it is has a lot of weight in this field.
    5) Learn some basic pathology, common eye drops, and the ophthalmic emergencies.

    If you can talk about this stuff during an interview, it will be a HUGE plus! Know what cataracts are, what myopia is and extera. Ill list some important ones you should memorize. The book goes into these in a lot more detail.
    • flashes and floaters = retinal problems
    • know what "narrow angles" are and why you SHOULD NOT DILATE these patients. Mention that you know this, somehow or some way.
    • Know what an angle closure attack looks like
    6) Show an interest in pursuing certification!

    There is some debate in whether it matters if ophthalmic/optometric technicians are certified, but in my opinion, it makes a world of difference. Some doctors I have met don't even know that there is a certification ladder. On the other hand, most (if not all) hospitals require it.

    To put it simply, certification looks really good later down the road. Do it through JCAHPO (Joint Commission on Allied Health Personnel in Ophthalmology) regardless of if you want to work in optometry or ophthalmology down the road. It is a great credential to have. The first level (COA), certification is not so hard to pass and get. But level 2 (COT) and level 3 (COMT) are difficult exams, and applicants who pass have to know their s@#t, lol.
    7) Polish your resume. Keep it oriented on what you will be doing. Cut out crap like dance team captain and etc....


    That's the name of the game. Everyone deals with this at one point:( Here is some advice on this:

    1) Work for dirt cheap. Don't have to explain this one much. I started off at $10/hour in Manhattan, entry level.:penguin: Now I get close to $30/hour with my skill sets.

    2) Consider volunteering in some capacity of clinical care, even if not related to the eye.

    Nursing homes, rehab centers and hospice are good places to start. At these places, you will get to interact with patients/residents more so than at any other medical places. They always need help. I started off shadowing a CNA (nurses aid) at a rehab center. I would change beds, bedpans, and adult diapers :meh: Not the most glamorous work, but necessary. It at least shows that you know how to work with people. A large portion of the patients you see in ophthalmology are geriatric, so these types of experience help.
    3) {WARINING} This is a good strategy, but is also a very sharp double edged sword. Most offices need a lot more administrative help, than they need clinical. Office managers will ALWAYS try to steal away your time from the clinic to help with admin duties (insurance, phone calls, etc.).

    You could agree to start off agreeing to work those responsibilities, under the assumption that you will move into the clinic. But here is the warning. DONT GET STUCK at the front desk!
    • You will be nervous at first to see patients, because you are clueless. That's normal. You will feel more comfortable doing admin tasks. You have to push to work in the clinic at every opportunity. I have seen, countless times, a (prospect) technician get stuck doing clerical work, and someone else get hired for clinical work in the interim.
    • I'll go as far as to say, get a guarantee that you will work in the clinic if you take this option. Have leverage for later.
    4) Don't give off the vibe that you are only seeking temporary work, and that the job is only an application fluffer, or to get a letter of recommendation.

    You are seeking a job. Treat it like a job. You can mention that you want to be an eyecare professional down the road, but don't make that your main focus during interviews!!

    Put yourselves in the shoes of an employer. Do I want to hire a kid for a few months, spend time (and money) training him, and then just send him off? Or do I want a good employee, who cares about his work and is willing to make a commitment to my business?

    To get your LORs, you need to earn them!​


    In my honest opinion, shadowing is not useful for what you want. Let me put this in perspective:

    :thumbdown: Watching a professional do what they do is note useful without any context. You will just be breathing in the same room.

    I still shadow doctors at my point in my career, but when I do, I have a targeted purpose. I do it to learn how to communicate better with patients, and to learn special skills for specific pathologies. That's it.

    When you land your job, you will be shadowing a technician for at least two weeks. You will see how much more useful shadowing a relatively less skilled working is than showing a doctor. Down the road, consider shadowing the doctor, to learn refraction tips and whatnot.

    If you had a good interview, and didn't land the job, consider asking the employer if you could shadow a technician for a day, in lieu of getting hired. That would be pretty gangster. You just have to be really assertive.

    Just a few notes here at the end, when you do start working:
    • Don't ask dumb questions to doctors. A dumb question is anything 5 to 10 minutes using the internet could solve. Ask fellow technicians first. Ask doctors good questions that you have done some research on.
    • Practice, practice and practice your clinical skills. There are tons of videos online. Tim Root, MD has many great videos.
    • If your practice has an IOL Master calibrate it as many times as you can. This is the best practice for learning to use the slit-lamp.
    • Try to review charts after they have been seen by the MD or OD. You want to see the SOAP notes the doctors have made. This helps you learn about pathology, and helps you develop a protocol (of diagnostic testing that needs to be done at next visit, and history taking questions) for different types of pathologies at the next visit.
    • Speed is very important once you start seeing patients. Being thorough, being fast, and getting good measurements are the trifecta. Patients love to talk, so know how to divert conversation to do your job.


    Feel free to PM me with questions, but ask here for everyones' benefit. Hopefully this thread can get stickied if it gains enough traction.
    Last edited: 01.25.15
    releehw and Celebi like this.
  4. Celebi


    Houston, Texas
    Thank you, this is pretty much what I needed to know!
  5. Optom4018


    This is very helpful!
    Thank You!! :)

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