ratio of normal to pathology in opt. school?

[Tony.]

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im about to start optometry school this year,

can anyone give me an estimated ratio of normal patients to pathology patients that i'll be seeing in the next 4 years?

 

[Andrew_Doan]

Moved to the optometry forum where I think you'll get a more honest answer.

 

[jholtod]

Beyond refractive, binocular, the occasional cataract and some mild BDR. . . you'll see some type of pathology in maybe 1 for every ten. At least that was my "in school" experience. You could possibly see far more depending where you choose to do your externship rotations and if you decide to do a residency.

 

[christie]

Here at The Eye Institute, we see a lot of glaucoma patients, also diabetic retinopathy, hypertensive retinopathy, the occasional RD, AMD, etc...There are only a few "normal" patients at The Eye Institute.🙂

 

[Andrew_Doan]

Originally posted by christie
Here at The Eye Institute, we see a lot of glaucoma patients, also diabetic retinopathy, hypertensive retinopathy, the occasional RD, AMD, etc...There are only a few "normal" patients at The Eye Institute.🙂

Christie,

How many patients do you all workup as optometry students by the end of your training in your program?

 

[christie]

Andrew,

With this new curriculum implemented at PCO, by the time we graduate, we will have seen approx 3,000 patients. PCO started this new Clinical Tracking System..after every patient we see, we put in the computer system, the patient's age, sex, race, diagnosis, procedure code, and additional comments about the patients, so when we graduate and go look for a job, we will know exactly how many POAG patients we have seen, for example. This can also be beneficial to the prospective employer to see how much experience we have in different areas of optometry, i. e disease, contact lens, etc...🙂

 

[Andrew_Doan]

That's great! So you all see patients on your own, and then staff the patient with a staff optometrist?

 

[christie]

Yes, we report to the doctor right before we want to dilate, they give us the A-ok, the doctor comes in at the end to double-check our DFE, and at this point (since we're only 2nd years) the doctor is the one who educates the patient on the findings.🙂

 

[acurael]

wow...sounds like a great program...too bad i didnt apply there

 

[TomOD]

Hi Christie,

I currently host a student extern from PCO. They have recently changed their curriculum so the students begin external rotations in the middle of their 3rd year (am I right) ...as opposed to at the end of their 3rd year.

The guy I have now is seeing a wide variety of patients---about 75% medical. He's here with me for 4-5 months, then to a VA hospital for 6 months or so, then to a comanagement center for 4-6 months and then back to school for the exciting pediatric tour before graduating 🙂.

I think this is great. I can't say how many patients he will see in all but I know he will see around 1,400 pts in my office and will range from routine to cataract post-ops, glaucoma, diabetics, ARMD, contact lenses and some low vision. He's done a few corneal/conj. foreign body removals and inserted a few punctal plugs. Had a case of Duane's Syndrome and commotio retinae recently for him to see. I know he will see many at the VA and the comangement center in addition to those seen in school. How many total he will see, I don't know.
but I guess it to be 4,000-7,000 (?) by the time he graduates.

In my office, the extern is built up gradually to doing their own exam with me checking afterwards. He gets to shadow a cataract, retinal, glaucoma and corneal Ophthalmologist for general knowledge and to view some surgeries.

It hasn't always been like this. An OD that recently retired that graduated in 1958 told me he saw 30 patients in school before graduating. Of course, these were all refractive because that's all they could do back then.

I agree with Dr. Doan. We need to see more patients and I'm glad the schools of Optometry have provided more of an opportunity for students to do this.

By the way, many of the OD schools are located in the inner cities. I went to Memphis where the location provided us with a steady supply of diabetic and glaucoma patients (in addition to alcoholics and addicts..........and not all of them were students 🙂 ). The only problem there is that we had 120 students all trying to see them. 😉

 

[cpw]

UHCO is inner city too... in the fourth largest city in the country. I've seen my fair share of HTN retinopathy, diabetic retinopathy, glaucoma glaucoma glaucoma and some more glaucoma, cat scratch fever, AION, Duane's Retraction, optic neuritis, uveitis... and probably a few others I can't think of off the top of my head.

I leave in two weeks for externship at the VA in Palo Alto where I'll see even more path.

My Tuesday contact lens patient had an operculated retinal hole, my peds patient two weeks ago had a small inferior detachment, and neither of them knew it when they came in.

The only time the attending comes in to check on my is to re-do my DFE. I counsel my patients myself (now that I'm third year) the attending just listens in to make sure I don't forget anything.

I believe the statistic UHCO uses is we'll see about 1500 to 2000 patients by the time we graduate. I know at the site I'm going to in the fall I'll be seeing about 50 a day... so my number will be higher.

UHCO is going to start computer patient tracking some time in the next year. They're starting testing on it now... our clinical evaluations for every patient are currently online.

 

[HighlyFanatic]

christie, and cpw....that sounds really 😎

 

[Tony.]

cpw,

do you personally think seeing 2000 patients is enough?
would it matter if you saw 3-4000 pts. for example....

I guess what im getting at is when will you be comfortable enough to say "i've seen it all" and be able to diagnose everything without the need of an attending....

 

[cpw]

you're never going to be able to diagnose everything.... I think seeing 2000 patients is fabulous. Students coming out of our program are excellent clinicians and score very highly on boards.

the doctor who wakes up and says "i've seen it all" is fooling himself/herself.

but, I have seen enough to know when something's not right, I know enough to know when to go look something up, and I know enough to know if it's over my head and i need to refer it the heck out of my chair.

 

[Andrew_Doan]

Originally posted by cpw
you're never going to be able to diagnose everything.... I think seeing 2000 patients is fabulous. Students coming out of our program are excellent clinicians and score very highly on boards.

I agree. I think 2000 patients in an inner city clinic is awesome. This sounds like a solid clinical experience.

Your quote of 50 patients a day, however, at the VA seems high. It's hard to see 50 patients with pathology. Few people can get through these many patients, unless the majority are quick normal follow-ups.

 

[cpw]

Originally posted by Andrew_Doan
I agree. I think 2000 patients in an inner city clinic is awesome. This sounds like a solid clinical experience.

Your quote of 50 patients a day, however, at the VA seems high. It's hard to see 50 patients with pathology. Few people can get through these many patients, unless the majority are quick normal follow-ups.

the 50 patients a day isn't the VA. I'm going to be at an ophthalmology clinic working up patients for the docs. (who see 50-70 patients a day) But, I'll be the only OD there. 🙂

 

[Andrew_Doan]

Originally posted by cpw
the 50 patients a day isn't the VA. I'm going to be at an ophthalmology clinic working up patients for the docs. (who see 50-70 patients a day) But, I'll be the only OD there. 🙂

I see. You won't be working up 50 patients by yourself then.

 

[cpw]

Originally posted by Andrew_Doan
I see. You won't be working up 50 patients by yourself then.

good god no, but I'll be in contact with all of them 🙂

I think they told me I'll see 10-12 patients a day at the VA. (alone) which is much more than the four or five a day I see now. 😎

 

[Andrew_Doan]

good god no, but I'll be in contact with all of them 🙂

I think they told me I'll see 10-12 patients a day at the VA. (alone) which is much more than the four or five a day I see now. 😎

I understand. I was thinking... that woman is fast. 😉

Good luck CPW!