Thoughts on How to Survive Midterms at NECO

Midterm week at NECO is always a challenge. In college, my professors gave several exams throughout the semester with each course culminating in a final exam taken in one difficult week. At NECO, because our coursework is so intensive, we have structured exam weeks for both midterms and finals that are alike in difficulty, although in a few courses the final exams are cumulative for the midterm material as well. I took my midterm for Neural Basis of Vision this morning, a week ahead of time, so during midterm week we will have five exams instead of six.

In my first year, I found it challenging to adjust to the structure of the courses at NECO until I discovered that the key to handling exam weeks here is to develop your own strategy and stick to it consistently. Find a place where you study most effectively; determine whether you like to study alone, with classmates, or a combination of the two; figure out whether you concentrate best in absolute silence or with mellow background noise. Make a to-do list or a studying calendar to remind yourself not to spend all your time on one subject. Set goals and make sure that you accomplish them, because your study time can be limited by classes, labs, and other obligations like practicing techniques in clinic. Reward yourself when you accomplish your study goals, and make sure you take breaks to rest both your brain and your eyes.

I developed study strategies for myself previously in high school and modified them for studying in college, but I found that I needed to rework my tactics yet again when I started at NECO. I learned that despite being an honor student throughout my academic career, unfamiliar and difficult coursework can still pose a challenge, and it’s important not to underestimate how much you need to study for each class. Perhaps most importantly, I learned that it is impossible to leave all of your studying to the weeks leading up to exams. It is important when you are learning such challenging material that you will need to be able to retain for the rest of your career that you study consistently and reinforce what you learn in lecture with time studying on your own.

I think it’s also crucial to take advantage of the different resources NECO has to offer when it comes time to prepare for exams. There are a variety of different study spaces in NECO’s gorgeous Beacon Street building, and our NECO ID cards also give us access to different campus libraries around Boston if we need a change of scenery. Professors are always willing to answer questions about course material, and between recordings of lectures, PowerPoint notes, and notes from the school notetakers, course material is presented in a variety of different formats so that you can study for one subject in several different ways. The most important resource, I’ve found, is your classmates—not only to study with, but as a support system. Since NECO is a small school, there is a sense of community that follows you from your first day as a first year student throughout your time here. Although exam weeks are when I am the most stressed, they are also when I have been able to really get to know my classmates by studying together, encouraging each other and supporting each other. It’s important to remind each other that all of your hard work studying for exams is an investment in your future, and that your motivation stems from a passion for becoming an optometrist.

Good luck to everyone on midterms and have a wonderful spring break!

Reflections on a Snow Day

IMG_0192This week NECO had its first snow day of the year due to the arrival of winter storm Nemo in Boston. This was the first time I’ve been able to see the city completely covered in snow since I moved here, due to our mild winter last year and the small amount of snowfall we’ve received prior to Nemo. Since I am originally from Buffalo and spent my undergraduate winters in Ithaca, New York, I’m used to several feet of snow being present for most of the winter. This snowstorm reminded me of the snow days I used to experience as a child, although to a lesser extent; once in Buffalo we lost power for ten days due to an October snowstorm, and in high school we had school cancelled for a week when we had seven feet of snowfall. I was glad for the chance today to take a study break and explore the snow-covered streets of Boston in my snow boots. I wasn’t the only one; I was reminded of Boston’s immense student population as I saw gaggles of students like myself walking the snowy streets this morning to throw snowballs at each other and admire how gorgeous the brownstones look covered in snow.

Because we work so hard at NECO, a snow day was extremely welcome; for the entire weekend, the school is closed, and we are unable to practice procedures in the labs or work on our biweekly homework assignments for PPO lab. A weekend away from NECO gave me the opportunity to not only catch up on my studying, but reflect on my progress from a clinical standpoint. This semester is proving to be a challenge in more ways than one. In addition to a larger amount of coursework, we have also been learning more complex procedures in PPO lab that we are starting to integrate into our clerkship experiences as we become more adept at practicing on each other. In particular, this semester, we are focusing on four different procedures, each requiring a great deal of practice: tonometry, gonioscopy, and the examination of the posterior segment of the eye using 90D/78D lenses and binocular indirect ophthalmoscopy, or BIO. These techniques can be difficult for beginners, and as I am practicing them I have also been learning about how to communicate reassurance to patients who may be more nervous about procedures that require contact with their eyes or bright lights.

Tonometry, a method of measuring intraocular pressure, is a crucial aspect of evaluating a patient’s risk for glaucoma and ocular hypertension. It can be challenging because it requires a very light touch and a great deal of patient reassurance, since many patients tend to flinch or blink frequently when the tonometer tip approaches their eye. We learned last semester that gonioscopy allows us to evaluate the structures of the anterior chamber angle of the eye and determine whether it is open or potentially occludable, and this semester we are learning to use our gonioscopy lenses to examine the eye’s posterior pole, equatorial region, and peripheral retina as well. Gonioscopy is used more rarely in clinic, but allows us to evaluate a patient’s risk of angle closure without dilation. It comes with its own set of patient challenges; despite being completely painless, gonioscopy can make patients nervous due to the fact that a large lens is being applied directly to their eye. Many of my classmates were apprehensive about having the procedure performed on them during lab. We soon discovered that since our eyes are numb during the procedure and the lens cushioned with solution, the only real associated discomfort is a feeling of dryness in the eye not being examined. In addition to being good practice, learning by performing procedures on each other allows us to understand the procedures from a patient’s perspective so that we are better able to empathize with them in clinic.

More recently, we have learned how to use our 90D/78D lenses with the slit lamp to examine the optic nerve and macular region; I was able to perform the procedure in clinic on a patient for the first time this week. Previously,
IMG_0194we had been using our direct ophthalmoscopes to examine the optic nerve, but the 90/78D lenses give a more detailed and stereoscopic view that aids in diagnosis of macular and optic nerve head abnormalities. We are also beginning to practice with the BIO, which is challenging to use at first due to the necessity of very specific positioning of both the patient and lens in order to obtain a clear view of the retina. As opposed to the other procedures we have learned, which have patients in an upright and seated position, we are practicing BIO on patients who are lying down. We also need to learn to perform this quickly and efficiently, because the light from the BIO lamp can be very bright and irritating for patients.

As I practice more advanced procedures, I try to remind myself to think about them not only from an optometrist’s perspective but also from a patient’s. It is important to remember that we as students need to develop our communication skills alongside our technical skills, and to integrate both of these when working with patients in clinic.