Chairs Missing by Joe, resident at the New England College of Optometry


A Blizzard of Options

So remember my last post when I said that winter was already on its way out? Well turns out that estimation was just slightly off. Boston just got hammered by about 2 feet and some change worth of snow, and nearby coastal towns saw catastrophic flooding. Many people have lost power. The Greater Boston area in general has come to a standstill on this weekend as the subway system shut down and there was a government mandated driving ban. My street is presently no longer a two way road and may not be for another few days.  My buddy spent about 6 hours digging out his car after it was buried by a plow, and then another plow almost completely re-buried it later that day. Other friends were either coming from taking or going to take Part 3 in NC and got stuck out there or had their flights from Boston cancelled; really makes me glad I chose to take it so early. In light of the last two winters being so unseasonably mild, I had forgotten what a joy real East Coast winter is like in the city.  Thus I spent the weekend mostly barricaded indoors writing this post and watching the John Adams HBO mini-series with my wife, baking cookies and playing squash with my brother and some friends (my gym is right next door and apparently never closes no matter what).

But life it seems will be quick to continue on. While NECO closed Friday through Sunday for the storm and clinic was cancelled Friday afternoon for many 4th year students in the local area, things are back on as regularly scheduled for Monday. And for myself I have one day to prepare for several residency interviews, all scheduled in one day.  So this begs the question for the potential optometry student, what are residencies in optometry? Are they necessary? While there are many websites out there that answer these questions much better and in more detail than I can (and can be found by Googling the accreditation organization for optometric residencies: the ACOE), I will give my two cents.  Unlike in medicine where they are an essential and obligate part of specialty training and board certification for the MD (and last several years), residencies are optional for the OD.  There are about 10 or so programs supervised by each of the optometry schools. They provide one additional year of training, usually in one of the 11 or so recognized sub-specialties of optometry such as vision therapy, low vision or pediatrics.  The pay is low, much lower than what you could get to start at most private practices. But the tradeoff is three-fold. One is that you get the chance to extend your learning another year and have the chance to manage much more complex or specialty cases, with attending doctors that have years of insight and knowledge to share. By doing a residency, you also are expanding the type of job you can get afterward; most medically based practices, community health centers and Veteran's Hospitals require a residency to be hired. And finally it is all but necessary to do a residency if you want to teach unless you already have another higher degree like a PhD or Masters.  Pretty much if you want to become a leader within the profession, a residency is non-optional.

So with those things in mind, I decided to apply, mainly to VA residencies because ultimately I see myself working at a VA or community health center somewhere down the road and because maybe I will even try to teach one day. Many folks in my class seem to think the same way; it seems a good chunk of my class is also applying to programs all across the country. But it's not for everyone; just as many people can't wait to jump start their careers and to be on their own and start practicing independently, working without a "net" so to speak.  Certainly all of us will be ready to see primary care patients when we graduate. But for me, to keep my options as wide as possible, I feel a VA residency provides the best training in the types of challenging cases I find interesting: complex ocular disease and neuro-ophthalmic disorders. And who knows, the direction optometry is going may one day lead to a residency becoming a more important (and necessary) part of our training. I'd like to try to stay ahead of the curve.

And so that's that from my perspective.  I'll keep you posted on what ends up happening. Hopefully I'll do well enough in my interviews to snag a position and maybe I'll be a blogger as a resident at NECO for another year. Up next, all about my third rotation: clinic in a Boston based community health center.

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