let's wake up!

[cpw]

Hey guys... lets wake up around here! Is everybody on vacation???

I almost miss the incessant bickering with the OMD-wannabes. (oh wait, what am I thinking)

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[Richard_Hom]

Dear cpw,

What will your concentration, emphasis on specialty in optometry school will you take? Or would you prefer to be a generalist?

Will take a residency?

Regards,
Richard

 

[cpw]

I haven't really decided since I haven't been exposed to all the clinics yet. I am leaning towards low vision and contact lens. But, I have a long way to go before I make anything official. Any words of wisdom as to where there's a need for specialities? I know my school does do a very good glaucoma speciality.

I don't believe I will do a residency. At this point in my life (since I'm older) i'm ready to be settled, living my life, back with my fiance and looking into buying a house.

Thanks for your interest, Dr Hom. I actually used to work for two doctors (Berkeley grads) out in San Ramon, CA. (Dr Fletcher Thames and Dr David Moline) Do you happen to know them?

 

[Richard_Hom]

Dear cpw,

1. I was a faculty member when they both were still in school. Dr. Thames won top honors for his class and was awarded the "Gold Retinoscope".

2. The notion of the best emphasis should probably be based upon your own like and dislike. So what follows is my own personal opinion:

a. Low Vision - Significant need but hard to make a living if just doing that. A Low Vision Rehabilitation residency or 1 year experience will significantly improve your salability to those institutions who are seeking such a provider. I remembered that Johns Hopkins Wilmer Eye Institute has a low vision O.D. on staff and other ophthalmology-oriented institutes and large eye practices might also entertain a specialist. The population isn't getting younger and there will certainly be more low vision from AMD and DR.

b. Contact lens. This isn't necessary if you practice general optometry. Very few practices can benefit from a CL speciailist that also include either a CL residency, Diplomate of AAO, etc. If you want to work at an educational institution or an HMO, it might be helpful. Most large institutions (HMO or medical schools) really like official credentials.

c. Binocular Vision - If you're COVD or Diplomate of AAO, you can probably skip the residency. There is a significant need but again, you have to work in a BV-friendly private practice. They are out there. I consider this one of the hardest specialities to learn and can go into so many different directions. Many O.D.'s have gone further to get masters degrees in education to work in "developmental" or "behavorial" optometry. With a MA ED, educators will more likely speak to you.

d. Primary care. A residency here helps a lot because it's one of the best places to get exposure to a lot of different cases. There aren't a lot of O.D. practices that will see the variety of cases necessary to feel comfortable. A first job in a hospital or an ophthalmology practice might help, but only if you're given more than "refractionist" and contact lens fitter duties. I'm not sure how the Diplomate in AAO helps here. But I'm open on how this helps.

That's the big 4. There are other less well know specialities such as industrial vision and public health. With public health, you'll need an MPH if you want to get any credibility. That's my biased opinion.

HTH,
Richard

 

[Eyegirl2k7]

Wow, Thanks Mr. Horn. I'm a low vision hopeful.

CPW--I'm sorry I've been absent. I've been having horrible troubles with my marriage---it looks like I'm going to ICO by myself. It's put me off being on the board lately.

Eyegirl

 

[J.opt]

Dr. Hom, what about eye disease residencies?

 

[Richard_Hom]

Dear J.opt,

Eye disease residencies are useful if you will pracitce in OK, NC, WV and other states where the scope of practice is wide open.

Take my case, I'm in a community health agency at a 200-bed county hospital and at a community clinic. There's a lot of management involved but very little in the way of equipment, formulary, etc. to definitively manage the eye cases. Most of the time, it's managing the patients in partnership with a team of providers.

I think the value you can gain from an eye disease residency are the following:

1. How to work with primary care physicians, physician assistants, and nurse practitioners

2. Understanding systemic disease and their relevance to the eye.

3. Learning to function where the best, the greatest and the latest isn't available to you and you do your best anyway.

4. And lastly working with ophthalmologists.

If you don't see this in a residency, then you'll be narrowing your experience. Some people confuse LASIK preop and post op residencies/fellowships as an eye disease experience. It will not. The residency must be tied to working with the primary care guys. If you're residency is an "eye-only" institution, you'll only learn to work in a similar environment but not in conjunction with other players.

Tell me what you have heard about eye disese residencies.


Regards,

Originally posted by J.opt
Dr. Hom, what about eye disease residencies?

 

[J.opt]

Originally posted by Richard_Hom
Tell me what you have heard about eye disese residencies.

I really haven?t heard much about them, but I guess it would be a good idea to do it if I see that I am going to practice by myself right after graduation, just to get some exposure/experience in eye disease. I just was wondering, I still have long ways to go before I get there

By the way, is it common to find an optometrist working in a hospital?

 

[Richard_Hom]

In reply to your question regarding hospitals, no. There are however, many optometrists who work in outpatient departments of a hospital but do no have staff privileges of any kind.


I think I'm I'm fortuante to be in my position.

Regards,
Richard Hom, OD,FAAO

 

[rpames]

What are considered staff privileges? Is that like a private bathroom, just joking, I just don't know what they are.

Thanks

 

[Richard_Hom]

Staff privlieges are as follows:

1. Member of the voting medical staff of the hospital.
2. Do emergency room coverage and call
3. Serve on medical staff committees
4. Order imaging and lab studies
5. Admit patients (which I don't have)

Etc,

HTH,

 

[Richard_Hom]

Dear CPW,

What did UHCO do in that first year to help you get over cognitive dissonance (e.g. "I'm not sure I made the right decision coming here")?

Regards,
Richard

 

[cpw]

wel, I never really thought about making the wrong decision. For me it was the only decision I had to make. I was not admitted to Berkeley, SCCO was way too expensive and going to UHCO I could live at home and still get in state tuition. My only real reason for wanting to stay in CA was my fiance (and chances are I will not be returning to CA when I graduate). I'm not sure though.

UHCO is great in that you get clinical experience so early. I took my clinical competency exam in my third semester and started seeing patients once a week fourth semester. It really helps you see where your lecture knowledge is going.

In the first year I was too busy to think about where I was (or where I'd "rather" be). Talking to friends who went to Berkeley I wouldn't have fit into that class as well as I've fit into my class at UHCO. I've made GREAT friends I can't see getting through school without. They made being far from home (even though I was living with my parents) much much easier.

 

[cpw]

ps-- eyegirl.. I am SO sorry to hear about you and your husband. PM me if you need to talk about anything.... I'm there if you need a friend.

 

[Richard_Hom]

Dear cpw,

What about Berkeley would make you feel that you wouldn't fit in?

Originally posted by cpw
Talking to friends who went to Berkeley I wouldn't have fit into that class as well as I've fit into my class at UHCO.

Regards,
Richard

 

[cpw]

Originally posted by Richard_Hom
Dear cpw,

What about Berkeley would make you feel that you wouldn't fit in?

Regards,
Richard

From what my friend said the class is extremely competitive. (the average being a 93 or higher on every test) She also said it's very clique-ish.

My class at UHCO has its cliques don't get me wrong, but for the most part the class is pretty laid back. Yes there are a few classmates that get WAY too into competing with each other, but I try to stay out of that. (even though I can hold my own with the class)

I was also told Berkeley's class isn't as diverse as my class at UHCO. (this is just what my friend said) I enjoy the diversity of my school and interacting with people I never would have met before. I think it ads something special to my education.

 

[Richard_Hom]

Dear cpw,

From my personal experience with these 3rd and 4th year students in clinic, in externship and in grand rounds, I wouldn't get too worked up at how "smart" they are?

It still takes maturity, common sense and "caring" to make a good practitioner and no amount of "smarts" or "competitiveness" can beat that. It's amazing, but the it's been widely known that the best private practice doctors are those that aren't the smartest.

I also know that every so often the freshman or sophmore class will lose one student to medical school. That's another reason they're so competitive.

When I finished my second year, I was accepted into several top notch MBA schools, but decided to stay after much inner turmoil. And I'm just an average student.

Regards,
Richard

 

[r_salis]

Originally posted by Richard_Hom
When I finished my second year, I was accepted into several top notch MBA schools, but decided to stay after much inner turmoil.

Richard -- what made you decide to apply to MBA programs while you were in optometry school?

 

[Richard_Hom]

Dear r_salis,

My undergraduate major was in business adminsitration. After optometry school I went back to business graduate school but couldn't get back into the top schools so I went to a local state college. I did management consulting for a few years before starting practice.

Richard

 

[r_salis]

How did you decide to go to optometry school, then? (Hope I'm not being too nosy -- I just like to hear how people choose the paths they've chosen!)

Originally posted by Richard_Hom
Dear r_salis,

My undergraduate major was in business adminsitration. After optometry school I went back to business graduate school but couldn't get back into the top schools so I went to a local state college. I did management consulting for a few years before starting practice.

Richard

 

[Richard_Hom]

Dear r_salis,

I had originally decided to combine a pharmacy and business approach and actually been accepted to pharmacy school before optometry school.

At the time, pharmacy school started one month before optometry school. After 1 week at pharmacy, I dropped out and was accepted off of the wait list to UC Berkeley. If I had not been accepted to UC Berkeley, I would have still graduated with a BS in Business from UC Berkeley.

I still like the business aspects of healthcare and high technology and continue to participate in those venues. In addition, I teach these subjects at an adult evening college.

Regards,
Richard

 

[simplyanny]

Allo our all-knowing cpw!
not a stalker, and just want to drop a line saying hi!
finding info on optometry school, I stumbled upon this forum, and as I said in my 1st new post, I'm thrilled by all the valuable resources! hail to our respected moderator and many others, ya'll did a fantastic job!

I'm currently a longhorn like you, gonna be my third year, and I plan to go to UHCO in fall 2006. so if you don't mind, I will have questions now and then, and I'm sure I'll learn A LOT from you! and if I'm bothering you too much, pls let me know too!
I know you must be busy studying hard towards your career path, and I wish you all the best and not stressing out. Hope to hear from you soon when you're free!

*there seems to be a problem on your private msgs. I treid msging you twice and my sent item won't show any of them...so now I can remember the content of this e-mail now..hahaha*

anny