Graduation, 2015: My Last Blog Post

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Last Sunday, four amazing and challenging years of optometry school culminated in the graduation ceremony for the class of 2015. It’s surreal and strangely unexpected—even after all of the testing, preparation, and clinical rotations, it doesn’t feel like it could possibly be time to graduate. Even through all the struggles of optometry school—the late nights studying, the need to adapt quickly to new clinical rotations, struggling to master new techniques in the lab—it still feels like it’s gone by too fast. It’s bittersweet, also, to be writing my last blog post for NECO after four years.

I’m extremely grateful for the experiences I’ve had at NECO. Over the past four years, I’ve been taught by a wonderful faculty and also by an extremely dedicated and inspirational team of clinical educators. My clinical experiences have been diverse, and I’ve learned from every single one about different aspects of optometry—not just about low vision, or contact lenses, or pediatrics, but about seeing patients as people in need of our help rather than sets of eyes, and about how to understand the needs of the community we are working in. I’ve been given advice that I will continue to use throughout my career—particularly the need to stay current on optometric news and new areas of research in eye care without neglecting the knowledge base that I have built during my time in school.

What will I miss most about NECO? The answer is, unquestionably, the friends that I have made here. In addition to a stellar education, NECO has a way of connecting you with other people. I’ve made friends here who I know will be my friends for life—and I’m proud to know that the friends that I have made are dedicated and passionate and will make incredible doctors. I’ll miss them so much, but I’m comforted by the fact that we’ll stay in touch and be able to visit each other, in addition to seeing each other at optometry conferences and events.

Although finishing optometry school and leaving Boston is difficult, I’m extremely excited about what’s coming next. I will be joining a private eye care practice in my hometown of Buffalo, New York and am grateful for the opportunity to serve my community. I’ll have the chance to work with pediatrics, primary care, urgent care, geriatrics, contact lenses, and all of the components of a private eye care practice, in addition to performing pre- and post-operative exams for refractive surgery patients.

I’d like to congratulate the class of 2015 on our graduation from NECO, and wish everyone the best of luck. We’ve all worked hard, and I know that we’ll continue to do so in our careers as doctors. I’ll miss you guys, and congratulations—we did it!

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Low Vision Learning Experiences

It’s a little over a month until graduation, and the reality of progressing from student to practicing optometrist is imminent. It’s a reality that encroaches on my clinical demeanor and decision-making process. When discussing cases with my preceptors, I’m constantly questioning myself and drawing from classroom knowledge and past clinical experiences to develop an optimal treatment strategy. I question my own decisions so that I know what studies and data support them, and ask my preceptors how they arrive at their own clinical decisions to learn what I should take away from each case. Being so close to graduation also makes me extremely grateful that I have been exposed to such diverse clinical experiences this year. Currently, my experiences in the Low Vision Clinic at the Buffalo VA Medical Center are introducing me to a patient base that I would not otherwise encounter in such depth. The VA, or Veteran’s Health Administration, is an extensive health care system in the U.S. that provides medical care and other services, including eye care, to former members of the military.

Low vision is an interesting branch of optometry, and one that most primary care optometrists encounter seldom in practice. A low vision exam differs greatly from a typical eye exam, and the philosophy of low vision optometry is directed toward rehabilitation and functionality rather than diagnosis and treatment. Of course, different low vision optometrists may utilize individualized techniques and structure their exams differently than the methods I have been introduced to through the VA. However, low vision’s uniqueness, in and of itself, is a reason for optometry students to familiarize themselves with its practice as much as possible; if we are able to become comfortable giving low vision exams as students, it will mean fewer referrals once we are practicing clinicians.

Low vision exams differ from comprehensive eye exams in several ways. Interestingly, a low vision exam typically takes place after a patient has already received a comprehensive eye exam by an eye care provider and a diagnosis and treatment plan for their specific needs has already been formulated. That way, the entirety of the exam can be devoted to assessing the patient’s visual needs and determining various methods of compensating for their vision loss. Unlike most comprehensive eye exams, taking a patient’s case history, rather than performing testing and examining the patient with various optometric devices, comprises the majority of the exam. I’m used to talking with a patient about their problems and history, which typically gives me a good idea of what I will be encountering in the exam and dictates my differential diagnoses, but after taking a thorough case history I rely primarily on objective testing and examination methods to rule out certain potential diagnoses and finalize a diagnosis and treatment plan. With low vision, it’s completely different—almost 100% of your information is gathered exclusively through talking to the patient.

This crucial difference between low vision exams and comprehensive eye exams can be jarring for students, but it’s also extremely advantageous. By talking to patients about their vision loss, you’re able to connect with them and better understand the issues they face in a way that simply isn’t possible from reading about it in a textbook. It’s one thing to read that patients with macular degeneration develop blind spots or distortion in their central vision, and another thing to have a patient describe to you the frustration he feels when he tries to read the mystery novels he loves. Low vision exams teach aspiring clinicians that the problems faced by patients aren’t always the ones that you would anticipate, and that solutions can vary with a patient’s abilities and motivation.

While I am learning at the VA to administer low vision exams as an optometrist, I have also been impressed by low vision’s focus on a team approach. To give a patient a successful low vision exam, you first need thorough examination and treatment by another optometrist or ophthalmologist at the VA. Then, after you, as the low vision optometrist, assess the patient’s visual functionality and needs, you rely on the rest of your low vision team to execute a specific rehabilitation treatment plan for the patient. At the VA, we work closely with a team of occupational therapists who specialize in vision and blind rehabilitation specialists to demonstrate various low vision devices to patients, and patients are able to receive home assessments and care catered to their daily lives. Low vision is a unique branch of optometry that allows a clinician to have a profound impact on a patient’s quality of life, and it is an excellent learning experience for both clinicians and patients alike.

On Migrations and Milestones

Last week, I moved to my hometown of Buffalo, New York, for my fourth and final clinical rotation of optometry school. This will be my second rotation at a VA hospital, and I will be working in both a primary care environment and also a low vision clinic. While in the primary care setting, I will be giving comprehensive eye exams to veterans as well as urgent care and follow-up visits for red eyes, foreign bodies, and glaucoma management. In the low vision clinic, I will be specifically working with veterans who have lost a good portion of their sight to disorders such as glaucoma, age-related macular degeneration, retinitis pigmentosa, and traumatic brain injuries. Rather than focusing on the treatment of these conditions, which is handled by a separate team of optometrists and/or opthalmologists within or outside the VA system, the low vision exams I will be performing are focused on analyzing the degree of vision loss the patient has experienced, maximizing the patient’s remaining vision and teaching them tools and techniques to help them function better in their environment.

I was extremely impressed with and touched by my last VA rotation in New England, as I discussed in a previous blog, and am very glad to again be working within the VA system. It’s also great to get the opportunity to rediscover my hometown, where I haven’t lived for more than a summer since high school, and spend time with my family here. Returning to my hometown, as well as beginning my final clinical rotation of optometry school, has induced me to more carefully consider where I stand with regard to my optometric education. As of today, there are a little over two months left until graduation; as of last week, I found out that I have officially passed all three parts of my National Board Exams.

I can type those words, I can reread them and stare at them until my eyes glaze, but it’s extremely hard for me to internalize them. After four years, nine clinical sites, three separate parts of Boards, and countless midterms, final exams, and projects, I’m almost finished. It’s difficult as a consummate student to accept this fact, this reality of “almost.” At times it feels as though I am fighting against this, this idea of transitioning from student to doctor, the word that my classmates and I whispered in the library as we frantically highlighted our notes, and toasted together at the pub crawl we did after completing Part I of Boards. It’s difficult, I realize, because of the dedication to learning that has been instilled in us not only during the past four years, but all the years that came before. And I’ve realized that the difficulty of comprehending an end to optometry school, instead of being problematic, is actually an asset.

Even after we graduate, we, the Class of 2015, need to embrace the concept of being students. Health care in general, and optometry in particular, is a dynamic, nuanced field, with new innovations in its various aspects continually being researched and explored. Graduating shouldn’t denote an end to studenthood, but the beginning of a new phase of it. Optometrists should remain students all their lives, and dedicate themselves to remaining up to date on new treatments, tools, and studies in the field, as well as reviewing current literature on the diagnosis and treatment of both common and rare conditions. Learning should be a career-long, even lifelong purpose that drives us to give our patients the best possible care and to hold ourselves to the highest possible standards as clinicians. We’ve accomplished a great deal through hard work and a passion for optometry and should be proud of the progress we have made, but as optometrists we also need to be sure to remain inspired and conscientious throughout our careers.

Winter Brings Snowstorms and Board Exams

This week, courtesy of Winter Storm Juno, I had two days off from clinic. I’ve been enjoying being back in Boston with my NECO friends, taking advantage of all of the amazing things the city has to offer. It looks particularly nice covered in snow, as I observed on a winter walk today–the city looks welcoming and cozy under a snowy blanket, although the need to shovel out my car is less than ideal. From the perspective of a Buffalonian, it’s strange not having snow until January, but I’ve heard that we’ll be getting more than enough in the next few weeks to make up for lost time.

As I mentioned in my last blog post, my third and current rotation is taking place at a community health center in the city. After being the sole student at my previous rotation sites, it’s been great having other NECO students to work with in clinic—I think that clinical education benefits significantly from patient analysis and discussions with colleagues. Working as a team compels you to utilize collaborative thinking on the diagnosis and treatment of ocular conditions, and at the clinic we see a number of urgent care visits in addition to contact lens fittings, pediatrics, dry eye disease, and diabetic patients. We also work with an ophthalmologist twice per month, at which time we see patients who have been referred for glaucoma management as well as evaluations for potential cataract extraction and laser procedures. It’s great working with a diverse patient population, and I have been able to hone my existing skills while working with several different supervising doctors.

This winter also brings, for the majority of fourth years, Part 3 of the National Board Exams. Unlike Part 1, which you take during the spring of your third year of optometry school, and Part 2, which is taken in December of fourth year, students can schedule Part 3 at any point during their fourth year of optometry school. However, the majority of students tend to schedule the exam during the winter, after we have already been exposed to a substantial amount of full-time clinical work. Another aspect that sets Part 3 apart from previous Board exams is that it is not taken at a testing site in Boston with the rest of your classmates; instead, students must travel to Charlotte, North Caroline, to a national testing site.

Although exams in general, and board exams in particular, tend to evoke feelings of stress in optometry students, Part 3, also known as the Clinical Skills Examination, is the test that students seem to find the most intimidating. The majority of the exams that we take during high school, college, and optometry school are written, and the idea of a two-hour-long practical exam that is videorecorded can be extremely daunting to students. It’s not as though this is our first practical exam, however; we take proficiency exams periodically during first and second year at NECO to assess our clinical skill set. These exams are observed and graded by preceptors and encapsulate the various skills we will practice every day as optometrists–not to mention that those same skills are tested later on Part 3 of Boards.

I’ve found over and over again in optometry school that the key to stress management, especially where exams are concerned, is preparation. NECO provides a room for fourth year students to practice in that contains the same equipment used at the testing center in North Carolina, and preclinic laboratory rooms are also available for Part 3 practice. What helps most of all is being surrounded by a supportive community, however, and this is where I have found that NECO truly excels. By fourth year you know your classmates well, and intrinsic to the bond you share with them is the knowledge that your fellow students are colleagues, not competition. When preparing for Part 3, I found that my classmates were very generous with their time–we sit as patients for one another and grade each other based on the Boards guidelines. Like studying, like all exams, Boards are something that NECO students get through together–even if we take them separately.

Fourth Year Lessons

It’s winter again in Boston, although the lack of snow makes it hard for me, a native of Buffalo, New York, to feel that fall has really ended. First, second, and third years are busy studying for and taking their final exams, while we fourth years are able to reminisce with the fondness of distance about days spent in the school library. In a little over a week I’ll be heading home to celebrate the holidays with my family, and in the meantime I’m beginning my third rotation of the year at a community health center in Boston. However, as I start my third rotation, I find myself thinking often about my second rotation and the lasting impact it had on my clinical perspectives.

My fall rotation was the first time I’ve had clinic in a VA hospital. Based on what I had heard from my fellow students, I expected to gain a great deal of clinical knowledge, but what I did not expect was how moved I would be by the experience.

The majority of the patients that I saw at my VA rotation were men aged sixty to ninety, although of course there were always exceptions. I was able to gain a great deal of familiarity with identifying and staging glaucoma, age-related macular degeneration, and diabetic retinopathy, and received invaluable advice from my preceptors regarding their protocol for monitoring and treating those conditions. I was also able to learn more about optometry from an interdisciplinary perspective, a viewpoint that the VA hospital emphasizes. I had the opportunity to shadow several different departments in the hospital to understand better how optometric patients are treated for systemic disease, such as audiology, the vascular clinic, and the low vision services department. I also came to appreciate the symbiotic relationship between the optometry and opthalmology departments in the hospital, and was able to observe both cataract surgeries and minor outpatient procedures performed by the opthalmologists. I learned how it is extremely beneficial for both parties to work so closely with one another; we were able to immediately refer visually significant cataracts and suspicious eyelid lesions to opthalmology, and they in turn referred postoperative cases to us for follow-up.

Before I began my rotation at the VA, I had only thought about the experience in terms of the clinical skills and knowledge that I would gain. From the very first day, however, I began to realize that the most significant aspect of the rotation for me was being able to work with our country’s veterans: to hear their stories, thank them for their service, and provide them with the best health care possible.

I have no personal experience with the military, but both of my grandfathers are veterans. One served in the Merchant Marines during World War II as an engineer, and the other served in Germany during the Korean War. I thought about my grandfathers and their stories as I listened to my patients tell me their own. I remember speaking to one patient, a Vietnam veteran, and telling him that I was impressed that he was able to see 20/20 without glasses. He told me that when he was drafted at age eighteen, he didn’t see his clear vision as much of a blessing—it was why he became a sniper and was immediately sent overseas. One female Air Force veteran with glaucoma told me, smiling, about how she had met her best friends in the world in the service, as well as her husband of over fifty years. I met a World War II veteran who, having lost a great deal of vision due to macular degeneration, has found a way to enjoy reading the war memoirs he loves on an e-reader with large print capabilities. However, he only reads the “happy stories,” the inspirational tales of sacrifice, courage, and brotherhood, because, he told me, war is a terrible thing, and he would rather spend his time reading about the good in people instead of the darkness.

Meeting these incredible men and women, who sacrificed so much on behalf of people they had never met, is an experience that I will never forget. I can’t begin to imagine the degree of selflessness it takes to enter the service. I wanted to become an optometrist, in the simplest of terms, to help people. I wanted to know, when I went to work every day, that in some small way I was giving back. I’ve been told that this is a naive notion, that it is a simplistic rendering of a multifaceted career decision. And I’m sure that, in a way, that’s true. But during my VA rotation, I was confronted with the importance of my initial motivation, and inspired all over again by the incredible people I met; not only the veterans, but the dedicated VA doctors who dedicate their time and compassion to providing veterans with the absolute best care possible. I want to extend my thanks to the veterans I was fortunate enough to work with for their inspiration, and to thank all of our country’s veterans for their service.

Happy holidays to everyone, and I’ll continue with my thoughts on my clinical experiences in the New Year.

Six Months

I’m six months away from becoming an optometrist.

It’s not that I didn’t think that I would make it this far, it’s that I can’t believe that I’m here already. Optometry school is an immersive experience: once you enter the NECO family, you’re consumed by classes, friends, and clinic. You quickly realize that your dedication to the field and desire to learn and help others will be what inspires all the hard work. But while you’re working, while you’re striving, it never quite strikes you to stop, take a moment, and think: I’m three years away from becoming an optometrist. Two years. One year. These are vague, abstract stretches of time, which can seem insurmountable the night before an exam or the moment you register to take your first part of Boards.

So, here I am. I have one week left at my current rotation site, and I’m six months away from becoming an optometrist.

Fourth year is a completely different experience from the rest of optometry school. It’s why I can finally take the time to see the end of school in months, not years. The reason for this is that fourth year forces you to consistently evaluate yourself as a clinician and a prospective optometrist. What are you good at? What do you need to work on? What areas of optometry are you most interested in? What could you bring to the table at a practice? Where do you want to live? Where do you want to work? Who do you want to be?

Unlike previous years, fourth year is spent entirely in clinic at four three-month-long rotations that can be located within Boston or at sites around the country. There is even a rotation site offered in China. It’s an opportunity for you to explore different career options and work environments, and to learn from preceptors with different teaching styles and unique opinions on practicing optometry.

I spent my first rotation at a private practice in Virginia. I chose the site because when I was applying to optometry school, I was set on the idea of one day opening my own practice, and this idea has followed me throughout my time at NECO. I wanted to see what the running of a practice was like from the inside, and see how the flow and patient population differed from the clinic settings I was accustomed to working at in Boston.

I worked initially with three doctors at the practice, although a fourth started soon before I left for my next rotation. Although one doctor focused on contact lens patients, another on pediatrics and vision therapy, and the last on ocular disease, I was impressed with the way the practice functioned as a cohesive patient management team. The doctors at the practice specialized according to their strengths and interests, but worked together and with technicians, opticians, and front desk staff to provide effective and efficient patient care. Teamwork was consistently emphasized, as well as the importance of setting and meeting individual goals geared toward improving the practice as a whole.

In addition to a significant amount of contact lens experience, in Virginia I was exposed to a lot of what we call “problem focused urgent care visits,” which are when a patient presents with an urgent issue. I saw several different types of red eyes, including an ulcer from contact lens overwear and an extremely large recurrent corneal erosion–and my first retinal detachment. When a patient presents to you saying “half of the vision in my right eye is gone,” it can be a very scary moment for you as well as the person sitting in your exam chair; I was lucky to be working in a facility where my preceptor and I could immediately obtain imaging, diagnose the problem, and send the patient to a nearby surgical center.

I was also able to improve my pediatric exam techniques at this rotation by working with children from age three to teenagers. If you’ve ever attempted to dilate the eyes of a sobbing five-year-old, you’ll know that pediatrics isn’t always the easiest modality, but it can be one of the most fun and rewarding—especially when you get that rare child who, when you ask, “What do you want to be when you grow up?” replies, “An eye doctor!”

My second rotation has been at a VA hospital in New England. All NECO students are required to have at least one VA rotation site during their fourth year; I’ll also be at a VA hospital for my final rotation this spring. I can’t begin to tell you here how inspirational and impactful this rotation has been to me, but I will in my next post. In the meantime, I’ll be moving back to Boston for my third rotation, located at a community health center in the city, and celebrating Thanksgiving with my family in Buffalo.

Firsts and Lasts

Elementary school, middle school, high school. Four years of college and three at NECO; all told, I’ve been in school for twenty of the nearly twenty-five years of my life. I’ve survived what feels like an infinite number of quizzes, tests, and exams and the stress inherent in pursuing a challenging academic path. Whether you count it in years or in blood, sweat, and tears, I have taken a very long journey that has recently come to an end.

Last month, I took the last final exams of my life. It may sound like a small measure of progress, but it is something that I am still finding difficult to grasp. Finals week, more so than any other measure of academic achievement, has been a constant in my life. There’s the ritual of studying: rewriting notes, underlining, highlighting; making flashcards; studying with friends and quizzing each other when we find something we don’t know; making lists and study schedules and covering them with satisfying checkmarks. There’s the places that become transitory homes: libraries, coffee shops, hidden nooks at school. There are the emotions: stress, relief, concentration, and that magical combination of hilarity and exhaustion that occurs around midnight when you realize that you’re getting nowhere with studying and need to resort to dancing it out. For all the difficulty inherent in finals week, I have some strangely wonderful memories of studying at NECO, and the ways we coped with stress as a NECO family: an aforementioned midnight Gangnam style dance party in the Clausen room; a twilit jog through newly fallen snow with my roommate; repeated trips to Starbucks with a few of us gathering coffee orders from everyone in the library. It’s all over now; after the completion of several projects and three exams, I have, hopefully, utilized my last mechanical pencil and Scantron sheet. I should feel a sense of accomplishment; truthfully, it’s surreal. I think I still half-expect to receive a schedule for midterms soon.

Of course, being finished with the formal classroom aspect of my education in no way necessitates an end to studying. In addition to the remaining parts of Boards that I need to take, studying for clinic will be a constant force in my life. Moving forward with my career, I want to refresh my knowledge about different aspects of optometry while I continue to research new frontiers in the field and stay current with optometric news and treatment modalities. It’s a different kind of studying, one that seeks to build confidence and grow a knowledge base rather than to accomplish a specific goal or bypass a particular academic landmark, and it’s crucial, in this sense, that I never stop studying.

In my next blog post, I’ll tell you all about the first of my fourth-year rotations and the myriad of differences I’m noticing between private practices and community health centers, but for now, I’ll just say this–being in clinic full time is challenging, intriguing, and inspiring. I’m here to learn, and I’m absolutely learning–about my strengths and weaknesses as a clinician, about eye conditions I haven’t encountered previously, and about what kind of optometrist I want to be.

VisionExpo, Eye Ball, and Saying Goodbye to Third Year

In three weeks, I will be leaving Boston and starting my first rotation of fourth year at a small private practice in Virginia. It’s simultaneously frightening and exhilarating to think that I am not only three-quarters of the way done with optometry school, but also that I am about to transition into full-time clinical care. Thinking about leaving Boston is bittersweet: I’ve loved living here so much, and I hate the thought that I won’t be returning for six months. The city has so much to offer, and leaving my NECO friends will be extremely difficult, but it will also be extremely beneficial for me to explore different modes of practice in environments outside of the city. In the past few weeks I’ve had some amazing times with my NECO family, making the most of what Boston and NECO have to offer before I begin my fourth year externships.

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A few weeks ago, I, along with many of my classmates and first year students, travelled to New York for Vision Expo East. I had never attended the Expo before, and I was interested to learn more about the different products being displayed there, and also to network with students from other optometry schools. Vision Expo offered a formal student program that included presentations about different types of optometry practice as well as different optometric companies. My favorite part of the student program was that we were initially divided into random groups, forcing us to meet students from other schools, and then given a project to complete. My group consisted of myself and three first-year students from MCPHS in Worcester, and we were assigned to gather information from the Expo about developing an electronic medical records program for a hypothetical practice. In order to complete the project, we needed to explore the Expo and speak with representatives from different companies. In the process, we also visited many different vendors’ booths and tried to absorb as much information as we could.

On Saturday, NECO students and faculty celebrated at the traditional 84th annual Eye Ball at the Hyatt Hotel in Boston Harbor. Despite being a rainy day, it was a gorgeous night with delicious food, dancing, and great times with friends. The Eye Ball included a cocktail hour with gorgeous views of Boston Harbor at sunset and a photo booth with fun props, many of which were glasses-related. It was great to see my classmates dressed up and enjoying themselves before many of us leave the city for rotations.

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Now that spring has finally arrived, I’ve also enjoyed spending time outside in the city, particularly enjoying the Esplanade and Public Gardens. Last week was the Boston Marathon, which I was able to watch from Newbury Street, a few blocks from the finish line on Boylston. It was inspirational to see the athletes who have worked so hard to attain their goals, and to also see many members of the National Guard running as well. Perhaps the most heartwarming part of watching the marathon was seeing and participating in the incredibly warm and encouraging reception that the crowds give to each runner, clapping and shouting encouragement for hours to people they have never met. The most incredible thing I witnessed, however, was the athletes who ran while pushing a child or family member with a developmental disorder along with them; the amount of strength and love that this takes is an inspiration to anyone striving towards a goal and an example of the indomitable nature of the human spirit. The reception that these runners and their family members received was thunderous, and well-deserved.

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In conclusion, I’d like to wish my fellow almost-fourth year students good luck on their rotations. I’ll miss everyone and I hope that during this year we all learn a lot about optometry and the direction our careers will take next year.

Boards Are Over and Spring Is Here!

Congratulations, NECO third years! We survived Part I of our National Board Exams and made it through to the traditional post-Boards pub crawl on the other side. We spent months stressing and studying, carrying our Boards books from coffee shop to coffee shop, quizzing each other and preparing ourselves as best as we could. The air of relief around us is tangible; we won’t find out our scores until May, which is both unfortunate and a welcome relief from the Boards anxiety that has been permeating our lives for months.

With the end of Boards comes the end of winter in Boston as well, which I ironically celebrated this week by going to a new frozen bar that opened downtown near Faneuil Hall which features walls, couches, and even glasses made of ice, all enjoyed in 20-degree weather inside mandatory blueberry-colored (and blueberry-shaped) parkas. It feels wonderful to be able to celebrate by enjoying the city, and as it gets warmer Boston becomes more walkable and welcoming, ready to be explored.

The fact that spring semester, and third year with it, will soon draw to a close is bittersweet, especially for someone who has grown to love Boston as much as I have. I’ll be leaving in May for my first summer rotation site in Virginia, and after that my fall site in Maine, meaning that I’ll be away from Boston–and my NECO family–for six months. As excited as I am to be exposed to new practice modes and new areas of the country, I’m also sad to be leaving the city and the people I’ve grown so close to. I’ve decided to spend my last month and a half here taking advantage of the city, as well as working to complete my various third year projects. To ensure that I don’t miss out on any opportunities to enjoy the city in my last full year here, I compiled a post-Boards, pre-rotations bucket list that includes the annual NECO Eye Ball, a formal end-of-the-year dance at a fancy location downtown; running on the Esplanade; finding gems of used books at the city’s many secondhand bookstores and the Boston Public Library’s book sale; and exploring the historical side of Boston on the Freedom Trail.

This weekend, however, I’ll be leaving Boston for New York, where the 2014 International Vision Expo and Conference is being held. I’ll be traveling by bus with many other NECO first, second, and third years to attend the event where we can network with other students, optometrists, and vendors; learn through student education events; and discover new brands and vision-related products. I’m looking forward to learning about the field in a different way than I’m used to by attending my first optometry-related conference, and hopefully enjoy a little of New York City while I’m at it.

Once I’m back from Vision Expo, it’s project time: as I’ve mentioned previously, our class has projects to complete this spring for our Business, Clinical Reasoning, and Refractive Issues classes, parts of two of which are due next week. In the fictional world of my Ophthalmic Business and Management Policy class computer simulation, things are looking up: my group’s hypothetical practice jumped this week from second-to-last in profit to second as a result of our newfound “go big or go home” practice management mentality. My group was glad to see that our strategies paid off, and as we enter the simulation’s final weeks, we hope to increase our lead and improve upon our fictional business success.

I’d like to reiterate my congratulations to the class of 2015 for completing Boards Part 1, and I hope that everyone at NECO is able to enjoy Boston in the upcoming spring weather!

Winter Study Weather

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It’s been cold and snowy here in Boston the past few weeks, which makes me, hailing from Buffalo, feel right at home. It’s also February, a little over a month away from Part 1 of our Board exams, which means that the stress of the class of 2015 is at an all-time high. We have all become very good friends with our Boards review books and will continue to spend a lot of time with them until the exam on March 18. The winter weather provides more motivation to stay inside with our books and a cup of coffee or hot chocolate, and it’s important to stay motivated with the exam rapidly approaching. Variety in studying is key, as is keeping in mind study goals and a timeline for review. Studying will definitely be more of a challenge during midterms week; although our course load is much lighter than usual this semester, it’s always difficult to balance studying several different things simultaneously.

Of course, we can’t study all the time–we still manage to have fun at school events like casino-themed Alcon Night, which helps raise money for VOSH (Volunteering Optometric Services to Humanity), and work on coursework like our Business computer simulations and Clinical Reasoning presentations.

I gave my patient presentation to my Clinical Reasoning class last week, the presentation being the first of two projects we will be doing this semester for that course. The presentations are structured as learning experiences; we present the steps of an eye exam as we performed them and the information as we learned it, and the class discusses what they think the differential diagnoses are for the patient; what conditions can be ruled out as the exam progresses; and what they think the treatment plan for the patient should be. We then discuss our patient’s condition in general: risk factors, signs, symptoms, and treatment, and compare our patient experience to the expected.

jan 2014The patient I discussed had multiple sclerosis and presented at the clinic with a variety of symptoms that lead me to believe that her MS was causing optic neuritis, a very important warning sign we as optometrists will need to be on the lookout for. Since many patients with MS first present with vision problems at the optometrist, it’s crucial that we understand the disease as students. Although my patient’s vision problems thankfully did not mean that her MS had progressed to affect her eyes, it was a good learning experience for me because it showed the importance of identifying probable differential diagnoses, but also being open to the fact that a patient’s diagnosis isn’t always what you expect it to be. It also gave me an opportunity to research and learn more about multiple sclerosis so that in the future I will be able to better understand the symptoms and signs to watch for in my patients. Other students in my class presented patients with conditions like amblyopia and blepharitis, and their presentations gave us a chance to review key topics related to those conditions and learn more about patient diagnosis and care.