The final year in optometry school is an exciting time for students, as they transition into becoming independent Doctors of Optometry. It is also a time for students to contemplate career paths and consider residency training as means of achieving their professional goals.
In this article series, we are interviewing residency directors from across the spectrum of optometric practice modalities. We will shed additional insight for students contemplating whether or not residency training is right for them.
Today we are interviewing three residency directors from pediatric programs across the country. Jamie Weiser, OD; Christine Allison, OD, FAAO, FCOVD; and Stephanie Jian, OD, FAAO.
Dr. Weiser is an Associate Professor at the Medical College of Wisconsin. She is the Pediatric Residency program director at Children’s Hospital in Wisconsin. This program is affiliated with the University of Missouri at St. Louis, College of Optometry.
Dr. Allison is a Professor of Clinical Optometry at the Illinois College of Optometry. She is the Pediatric Residency program director at ICO.
Dr. Jian is an Assistant Professor of Ophthalmology and Visual Sciences at the Vanderbilt Eye Institute in Nashville, Tennessee. She is the Pediatric Residency Director at Vanderbilt Eye Institute. This program is affiliated with the University of Alabama at Birmingham, School of Optometry.
For students interested in applying to your respective pediatric residency program, what are some characteristics that make a high quality candidate?
Dr. Weiser: A great resident at Children's Wisconsin will be one that is interested in specializing in pediatric optometry, especially in a high-level medical setting. An excellent resident is a self-motivated learner, looking up topics they need refreshing on, and reading outside of the required weekly reading. Finally, a successful resident will be one that expects to make mistakes and learn from them, not be discouraged by them.
Dr. Allison: The candidate should have good grades in the peds/bv courses, they should also be eager to work with peds patients in clinic. They should be creative and eager to learn new techniques. They also should take part 3 of boards early—by beginning of January at the latest—so their scores are in prior to the March match, and all 3 parts of NBEO should be passed.
Dr. Jian: We are looking for candidates who are passionate about pediatric eyecare and want to practice evidence-based pediatric optometry. We want someone who is motivated to take advantage of all the opportunities we can provide at the Vanderbilt Eye Institute. Residents will have diverse clinical experiences and have the opportunity to participate in many academic activities and in clinical research.
What specific advantages will residents take away from their training? What clinical/professional expertise will they be able to carry forward into their careers?
Dr. Weiser: Residents from Children's Wisconsin will be ready to practice pediatric optometry for a wide assortment of complex patients. Residents will get experience working with subspecialists in ophthalmology, and collaborating with other specialists (e.g. neurology, rheumatology, neurosurgery, dermatology, genetics, etc). Upon completion, residents will be experts in managing amblyopia, strabismus, refractive error, many ocular health conditions, and examining various children with genetic and behavioral conditions.
Dr. Allison: They will be very comfortable and confident managing strabismus, amblyopia, high refractive errors in young children, also patients with BV problems of all ages, including managing post head trauma patients.
Dr. Jian: Our residents experience a full and busy year of direct pediatric eyecare. Our resident last year had over 1,700 patient encounters and saw 600+ patients with amblyopia and 500+ patients with strabismus. They will also gain significant experience providing eyecare to pediatric patients with developmental delays and disabilities and with low vision. There are also opportunities to learn about specialty contact lens fitting in adult and pediatric patients.
We want our resident to leave and feel confident in their management of pediatric ocular and visual conditions and also understand how optometry fits into the larger medical system. They will learn how to co-manage patients with pediatric ophthalmologists, sub-specialty ophthalmologists, and other members of a patient’s healthcare team.
What is a typical “day in the life” for residents? This could include details on patient demographics, clinical hours, or after hours call, etc. Also, are there additional opportunities to give CE lectures or participate in other extracurriculars such as journal clubs?
Dr. Weiser: Each of our optometrists (and resident) works 4.5 days per week (with 0.5 day per week for "administrative" activities like working on scholarly work, etc). We see patients from about 7:30/8:00am to 4:30/5:00pm. There are no on call duties. The resident will see patients ranging from 0 to 18 and the patients have a wide variety of ocular and systemic diagnoses. We see a lot of patients with genetic diagnoses, special needs, and complex medical care needs. There is an academic curriculum including weekly article discussions, quarterly doctor-patient relationship book clubs, weekly department-wide conferences, presenting posters and grand rounds, and writing case reports.
Dr. Allison: Our residents see patients in the pediatric clinic, developmental disabilities clinic, and vision therapy clinics. They have weekly sessions in the Urgent Care department managing emergency care walk-in patients of any age. The residents give 3 grand rounds CE presentations as well, as presenting posters at AAO and COVD.
Dr. Jian: Our resident spends the majority of their clinic time providing direct patient care in the pediatric optometry or ophthalmology clinics. They also spend up to 2 half-days a week in the comprehensive optometry/specialty contact lens clinics. They may also spend time in our Low Vision Rehabilitation Clinic or in pediatric ophthalmology subspecialty clinics. There is some flexibility in the clinic schedule, and I work with the resident to develop a schedule that allows them to pursue their clinical interests while prioritizing direct pediatric eyecare.
There are many academic and didactic opportunities for our resident. They will participate in pediatric ophthalmology journal club, pediatric optometry case conference, and weekly Vanderbilt Eye Institute Grand Rounds. We have also started a joint virtual journal club with the pediatric optometry residency programs at Cincinnati Children’s Hospital and Duke Eye Center. The resident is strongly encouraged to attend the annual American Academy of Optometry meeting. They are also allowed to attend the ophthalmology resident lectures at VEI and are able to attend all continuing education events at VEI and at the UAB School of Optometry at no cost. The resident is also given a generous $2,000 academic/travel stipend. They also have the opportunity to learn about clinical research at VEI.
What is one of the biggest challenges residents may face here?
Dr. Weiser: Working with pediatric patients is very fun and rewarding, but presents its own challenges, and requires the resident to utilize a high level of creativity in their examination techniques. The schedules are busy, which provides plenty of patient care practice, and also encourages the resident to become efficient in their work.
Dr. Allison: At first residents often are challenged by the amount of patients we have and the complexity of the patients, but this improves throughout the residency.
Dr. Jian: We have many educational programs at the Vanderbilt Eye Institute, but our pediatric optometry resident is the sole optometry trainee at the Vanderbilt Eye Institute. I know some applicants may be concerned about this, but we have many other students/trainees at VEI, and I know that our residents feel supported by the faculty and staff at VEI. There is a positive optometry-ophthalmology relationship at VEI and a strong culture of support, kindness, and collegiality.
Is there a specific practice setting/modality that pediatric residents commonly pursue after their training here?
Dr. Weiser: The resident would be well-prepared to enter an academic/hospital setting after graduation, specifically at a children's hospital. Graduates would also be prepared to provide high-level pediatric care in a family practice or other setting.
Dr. Allison: Residents may choose to go into academic settings, but also many choose to go into private practices.
Dr. Jian: Our residency program prepares residents for a career in a medical and/or academic setting. Our first optometry resident, Dr. Nicole Roddy, practices as a full-time pediatric optometrist at Knoxville Pediatric Ophthalmology in Knoxville, TN.
While residency training may not be necessary for achieving every new grad’s career goals, it can certainly help facilitate personal and professional growth. Pediatric-based residency programs provide students with an opportunity to gain experience practicing in a multi-disciplinary setting while also seeing a vast array of cases involving complex behavioral and genetic disorders often affecting the binocular vision system.
New grads opting for pediatric residency may also qualify for various loan repayment programs including Public Service Loan Forgiveness. More information on optometric residencies can be found on the American Schools and Colleges of Optometry’s residency directory.
Students interested in a career path practicing in a challenging, multidisciplinary patient setting may find residency the perfect starting point into a successful and fulfilling career in pediatric optometry.