Lessons Learned During Residency

The number of optometric residency programs is continually growing, offering more opportunities for graduates looking for a higher level of training and to specialize themselves. After I graduated from Illinois College of Optometry, I began an ocular disease residency at a multidisciplinary OD/MD private practice. A key factor in deciding to pursue a residency was my concern that I had not yet seen and treated enough patients to be on my own, which is a common worry among new graduates.

Not only have I gained a wealth of knowledge in treating and managing a wide variety of ocular diseases during my residency, but I have also learned many lessons along the way, which may also benefit other new optometrists. Below I share my top four.

A “SAY YES” ATTITUDE

In residency, you quickly learn that the best answer to questions that start with “Would you like to …” or “Do you have some time to …” is “Yes!” Each request is a unique learning opportunity that may not happen again. Saying yes goes beyond patient care. By saying yes to new experiences (eg, publishing papers) and pushing myself outside of my comfort zone (eg, presenting lectures and case reports), I have been able to grow each day academically and as a clinician. As a result, I feel I am better prepared to meet the unique challenges that optometrists face each day.

YOUR INSECURITIES ARE YOURS ALONE

As a newly graduated doctor, I am still seeing certain conditions for the first time. Although residency is a perfectly acceptable time and place to feel uncomfortable while managing these first-time situations, it’s incredibly important to do so with confidence so that patients feel comfortable and trust your management plan. Don’t shy away from difficult patients or new procedures. Refining your skills and treatment plan in a supervised setting is a great way to boost confidence, but it’s also important not to be afraid to ask for a second opinion from your colleagues. This is one of the great aspects of working in a multidisciplinary clinic setting. See one, do one, teach one continues to be a central principle of medical education and the motto of my residency director. If you don’t take the opportunity when it arises, you could very well miss out on an opportunity to gain new confidence and skills.

Source: FAQS about residencies. Association of Schools and Colleges of Optometry. https://optometriceducation.org/students-future-students/residencyprograms/faqs-about-residencies/. Accessed April 29, 2020.

DON’T LET YOUR WORK BECOME ROUTINE

Along with the less common diseases, there are conditions that seem to show up daily. When treating a corneal abrasion or examining a patient for acute flashes and floaters, it’s easy to write up an assessment and plan before you even see the patient. However, this can lead to a somewhat closed-minded exam or even to missing other important clinical details.

My residency program is set up so that the majority of patients I see are triage patients with acute problems. Flashes and floaters may bring in a 65-year-old patient for his or her first exam in 10 years. Along with acute posterior vitreous detachment, I may find that the patient also has borderline high IOP and optic nerve cupping or early signs of macular degeneration that would have gone undiagnosed for many more years if it weren’t for that exam. It is also important to remember that, although this may be the fifth or fifteenth or fiftieth case of a particular diagnosis for you, it is likely the first for the patient and the first time it has been explained to him or her. Compassionate patient care and education allows patients to take part in their health care decisions, leading to better compliance and loyalty.

ALWAYS BE LEARNING

As doctors, we have an obligation to be lifelong learners. Residency is a great way to continue to push yourself academically after graduation and set your career up for success. Each week I dedicate half a day to academic time. This allows time to study the patient cases I have recently seen so that I have more confidence and reasoning behind my treatment the next time I see a patient with the same or similar condition.

While we were in school, evidence-based medicine and clinical studies were something many of us dreaded. At the time, most studies just appeared to be acronyms and intimidating statistics that we memorized but did not understand. It was hard to integrate that level of understanding with conditions that we had yet to see clinically. Staying up-to-date on new studies and brushing up on older ones is now a regular part of my patient care.

I have also been fortunate enough to work alongside great mentors, both optometrists and ophthalmologists, during my residency. I’ve learned that different providers may have different approaches and that’s okay. There isn’t always a right or wrong answer, but there is always an opportunity to learn by asking why someone does what he or she does.

AN OPPORTUNITY NOT TO BE MISSED

So far, my residency has been everything I hoped it would be. I encourage students who are on the fence about completing a residency to apply for one. For me, residency is an essential stepping stone to my future career.