How Optometry Students Are Adjusting to COVID-19

2020, the year of the optometrist, is certainly not the year that anyone expected. Students nationwide are fearful over what this lost time might mean for the clinical education they’ve worked so hard for. Optometry schools and students are facing this challenge by converting their curriculums to online meetings that still allow for interaction—virtual interaction, that is. In addition to losing clinic and classroom time, one of the biggest challenges optometry students face in this COVID-19 era is uncertainty surrounding NBEO exams. Speaking with Dr. Lewis Reich, President of the NBEO, he says that NBEO is doing everything they can to get optometry students back on track.

As meeting in person is no longer possible, schools are forced to get creative in delivering high-quality didactic and clinical instruction. Optometry school is unique in that the educational process evolves from almost purely didactic to purely clinical over four years. This means that each class has unique challenges in the conversion from in-person to online instruction.

Each school has taken a different approach to providing online learning in an effective way. Apps like Microsoft Teams, Zoom, and Google Hangouts have all become an integral part of students’ daily lives. Some of the Learning Management Software (LMS) already employed by schools have virtual capabilities. The LMS Blackboard has a feature called Collaborate to host virtual courses, which is being used by Salus University. Nova Southeastern University is using Zoom and Southern College of Optometry is using Microsoft Teams. Other schools are using the same or similar programs to end the semester. Each of these platforms has its own quirks, but optometric educators nationwide have risen to the challenge of learning how to use these platforms effectively.

The first and second year of optometry school comprises the largest amount of in-classroom learning, which can be more easily transitioned to an online format. These students are, however, losing the ability to practice newly acquired skills. This is causing anxiety for many, as rising second year students will be expected to start seeing patients immediately after reopening as the rising third year students will be headed for externships. Depending on when schools reopen, students will have gone without practicing clinical skills in a clinical setting for three or more months.

Didactic courses have not been impacted nearly as negatively as clinical education. It has become common for schools to provide case presentations to their third and fourth year students to supplement for lost clinic time; however, students and faculty alike lament that case presentations are not adequate replacements for real-life clinical experiences.

Third year students face the most uncertainty as externships are postponed. Externships pose unique challenges to school leadership as the pace of returning to life as normal will vary between the different states and different externship sites. Students at Salus University lost their first rotation which was scheduled from March 23-May 9th. Students like Madison Dunning, c/o 2021, are hopeful that their summer rotation (which is scheduled to begin May 19th) will proceed as planned. Southern College of Optometry is facing delays as well, and does not plan to reopen until June 15th, cutting summer externships short. At this time, optometry schools are hopeful that COVID-19 will not cause delays in graduation for the classes of 2021. Lost time may be made up by changes in holiday time off, but that remains to be seen.

Fourth year students’ externships have ended early. All classes are expected to graduate on time, but sadly without graduation ceremonies or celebrations. Some schools have opted to host virtual ceremonies, while others, like New England College of Optometry, have decided to postpone graduation ceremonies in order to afford them the grandeur they deserve.

Fourth year students who were affected by NBEO cancellations will be facing a delay in eligibility for licensure, inevitably delaying starting jobs. It is too soon to tell how this will affect the job market for new graduates.

Students were shocked to learn that the Part 1 ABS exam scheduled for March 17-20 had been cancelled. Pearson VUE made the abrupt decision on Monday 3/16/2020 to close all testing sites starting the following day. Thus, students scheduled to take their exam on the 17th were given less than 8 hours of notice that the exam they had been studying for over the last 6 months was cancelled.

Candidates expecting to take the Part II PAM/TMOD examination on April 7th received the same shock, coupled with uncertainty over graduation as many schools require passage of both Part I and II for graduation. The National Center of Clinical Testing in Optometry (NCCTO) in North Carolina also closed its doors, delaying the licensure eligibility of graduating optometry students who had yet to sit for the NBEO Part III clinical skills examination.

For the last several years, NBEO has had a contractual agreement with Pearson VUE testing centers for the proctoring of Part I (ABS) and Part II (PAM/TMOD) examinations with relatively few hiccups. According to the Pearson VUE website, all centers are closed until May 17, and this reopening date is subject to change based on recommendations from the CDC.

As it stands, for optometry students to move forward in taking their examinations, Pearson VUE must reopen and both parties must agree on new testing dates. It is unknown at this time when these new dates might be released. Rescheduling will be no small feat: Pearson VUE claims that they administer an exam every 2 seconds. This means that from March 17th to May 1st more than 1 million exams will need to be rescheduled. In the shadow of exam giants like the NCLEX and MCAT, NBEO exams are a relatively small fraction of these exams to be rescheduled,

In a conversation with the President of the NBEO Board of Directors, Dr. Lewis Reich OD, PhD empathized with students over the frustration and disappointment felt in this uncertain and unprecedented time. He assured me that NBEO is doing everything they can to reschedule all cancelled examinations in a timely fashion and to that end, the executive director of the NBEO is calling Pearson VUE daily in an attempt to schedule new dates for NBEO examinations. Dr. Reich also reported that for Part I (ABS), candidates will still have three opportunities prior to graduation in 2021 to take the examination. He encourages students to refer to the NBEO page to stay informed of this evolving situation.

On March 27th, President Donald Trump signed the CARES Act, which provides relief to federal student loan borrowers, into law. The act applies to certain loans owned by the Department of Education. Loans owned by commercial banks or by another institution do not qualify. For graduates who are currently paying back loans, their loans were automatically put into academic forbearance.

This means that from March 13, 2020 through September 30, 2020 borrowers can but are not required to make payments on their loans. For current students and graduates alike, federal student loan interest rates have been set to 0% for the same time period.

While the CARES Act does provide relief during this time, students, especially in the C/O 2021, may still incur additional debt if schools are forced to delay their graduation. While some schools have promised no additional tuition should an additional semester be required, a delay in graduation means additional living expenses and potential lost wages. C/O 2020 may similarly experience lost wages if they were impacted by the NBEO closure and are unable to obtain licensure.

Virtual graduations, exams with no dates, cancelled externships… When the optometric community looked to the year of 2020, a global shutdown was definitely not in the plans. Despite the anxiety, fear, and uncertainty that has clouded the beginning of this year, the optometry students, educators, and graduates alike look ahead, driven to reclaim 2020 as the year of optometry.