What You Stand to Gain Through Externships In Corporate Settings

For optometry students approaching their final year externships, there are many things to consider to ensure the experience is as beneficial as possible. When selecting externship sites, students must take into account a myriad of factors that can shape their experience and impact their preparation and confidence in their final year prior to entering the workforce.

Students have historically had to choose an externship site at hospitals, private practices, surgical centers, or academic institutions; however, more recently, opportunities within corporate locations have emerged as an option, providing students with a unique and fulfilling experience.

Four years ago, then-student, now-Doctor Ed Shin, OD, a graduate of Illinois College of Optometry (ICO), was in the process of selecting his externship experiences. However, alongside the usual considerations, such as location and financial impact associated with potential relocation, one of his highest priorities was trying something new and unique. “An important factor for me when deciding on my externship sites was doing different things, whether that was going to the VA or doing a contact lens specialty,” he explained. “I wanted to open up my horizons as much as I could.”

This desire to learn meant Dr. Shin saw the value of a corporate externship at a time when some of his peers did not. “A lot of people weren’t considering corporate settings at the time, as it was something that was a bit new, but my rule is that I don't judge or rule anything out until I try it,” Dr. Shin said.

“My experience of optometry school is that you’re often encouraged to get into a hospital setting, private practice, or even build a practice of your own, but little emphasis is placed on corporate modalities. So, for my personal experience, I wanted to try something unique, something different rather than what was typically recommended to us.” As a result, he selected an externship with the National Vision Doctor of Optometry network and was placed at the site of Dr. Ian Ymalay at an America’s Best.

Interestingly, when approaching the end of his optometry schooling—also at ICO—nearly two decades ago, Dr. Ymalay was not aware that working as a corporate optometrist was a possibility. “Corporate was not on my radar,” he confessed. “I had already been offered a position at a private practice. I just happened to walk into the ICO library and ended up talking to a person from a corporate practice. Back then, not many of my colleagues were really considering corporate practice, and I remember the prevailing sentiment being, ‘Why work at a corporate site where management or the operations department are just going to tell you how to do your job of being a doctor?’ After my discussion with this individual, I realized that was not the way corporate works. It was ultimately this realization that swayed me, and it’s something that I make sure that my externs hear, understand, and experience themselves.”

Dr. Ymalay’s journey into clinical preceptorship was a case of working to provide for students in their time of need. “We’re going on seven years now in my office,” he explained. “It started as an effort to help students from the Inter American University of Puerto Rico School of Optometry who were going to be delayed because of a lack of clinical experience following Hurricane Maria. We were fortunate to receive these students.”

From the word-of-mouth discussions that followed, National Vision reached out to ICO. After establishing the high standards both institutions expected, they formed a partnership. “That first year, we had three students, and we’ve been growing and refining our program ever since,” he said. “So far, my office has taken a little over 40 students—and other offices and Practices in the National Vision Doctor of Optometry network have followed suit in the past few years by joining the preceptor program.”

No two externships with Practices in the National Vision Doctor of Optometry network are quite the same. This is by design, as Dr. Ymalay pointed out: “Everybody is different, so each preceptor factors that into the way we structure the extern experience.” He elaborated saying, “Usually, during the first week, following onboarding and after the extern has shadowed me for one or two patients, I let them settle in and get comfortable with the flow of seeing patients before there are any adjustments or big teaching moments.”

This gentle introduction helped quell some of Dr. Shin’s nerves going into his externship. “Alongside being excited, I was admittedly a little nervous because I didn’t know who my preceptor would be. After meeting Dr. Ymalay, that all went away, he was so welcoming and put me at ease.”

Dr. Shin went on to recall, “I also remember that the flow of the experience helped me come to grips with the routine of seeing more patients—my previous rotation had been at the VA around the time that patients were starting to go back in person after COVID-19 lockdowns. I was coming from a site where I had been averaging one to two patients per day, so the structure at Dr. Ymalay’s office helped to alleviate any nerves I had in that regard. I felt pretty confident within the first couple of weeks.”

Once the extern has had time to settle in and the preceptor has assessed them and their requirements, the experience is further tailored to ensure that students get what they want and need out of the externship. “It’s at this point that we start adjusting and modifying and doing the teaching part of things,” Dr. Ymalay said. “If I see that a particular student needs a little more time with things, then we adjust the schedule to reflect that. For example, if they don’t have a lot of experience with soft or gas-permeable lenses, we'll try to find patients who have those things.”

He further said, “The site itself is primary care, but I make it a point to try to have a well-rounded experience. I set them up to visit with local ophthalmology, so they can observe surgeries. Then they’re more comfortable discussing these surgeries with their patients because they’ve actually seen them firsthand.”

Dr. Shin’s primary goal during his externship experience at America’s Best was increased efficiency and time management when seeing patients—something he feels the experience taught him well.

“The externship with Dr. Ymalay was my second rotation and was really formative for me.” Dr. Shin explained. “Afterwards, I could tell that I used my time far more efficiently - I would be finished seeing my patient within 30 minutes and feel confident about everything I’d done and any additional tests I had performed. Of course, some attendings want you to do extra, but I still had plenty of time to ensure that my charts were complete and that I was comfortable with the way I took care of the patient. I also was able to see an incredible amount of ocular disease and diverse patients that needed medical management.”

If you are thinking of selecting an externship with a Practice in the National Vision Doctor of Optometry network, what should you keep in mind? Here are Dr. Shin and Dr. Ymalay’s top tips:

According to Dr. Ymalay, “For me, the true spirit of externship rotations is seeing what is out there and what you do and don’t like. If you go into fourth year thinking that you’re only going to do a certain modality and all you do is that modality, how do you know if you like anything else? Dr. Shin did a great service to himself by being varied in his choices.”

Even with this mentality, Dr. Shin’s view of corporate optometry expanded. “At first being uninformed and thinking about corporate settings, it’s very easy to think of glasses, contacts, and routine care. But when I was actually there as a student, there was far more medical practice than I expected. I was able to see and manage patients with ocular and systemic disease that you see anywhere else.”

“Don’t be afraid to be forward with requests,” Dr. Shin said. “When I was practicing in Texas working alongside another preceptor within the National Vision Doctor of Optometry network, I know one of his students asked to see more patients because the pace was too slow for her. Whether it’s that, wanting to view a particular surgery, or something else, just ask.”

Preceptors are more than happy to oblige. “I always tell my students, ‘If there’s anything you want to see, let me know because I’ll make it happen.’ It’s really important that students going into their rotations aren’t shy to ask for what they want and need because this is their opportunity to learn,” said Dr. Ymalay.

There are benefits for preceptors who take on externs within their practice. “I’ve been practicing for 20 years and doing anything for that long can get mundane, so it’s really nice to have fresh young minds that are excited about the next step that they’re about to embark on,” Dr. Ymalay explained. “It also forces me to keep up to date with the latest data that the students will be tested on in boards, which keeps my mind healthy and young. Ultimately, I like seeing them grow from where they are on the first day to the point when they leave my site. It gives me the opportunity to somewhat shape my future colleagues, almost like a sculptor chipping away to help them find themselves in this profession that we share.”

Although the externship will last a matter of months, leaving a site doesn’t mean leaving your preceptor behind.

“I stay in touch with more than 90 percent of my former externship students and talk to them at least once every few weeks,” According to Dr. Ymalay, “There are some I talk to every few days, covering both clinical topics and what’s going on in their personal lives.” Maintaining a good relationship with a preceptor—both during and after an externship—may also offer further opportunities, something Dr. Shin experienced firsthand.

“After graduating, Dr. Shin moved to Texas and took on a full time role at a Practice affiliated with the National Vision Doctor of Optometry network, and as luck would have it, one of the other preceptors in the network was in the same Practice,” Dr. Ymalay recalled. “Because we already knew Dr. Shin and what he was capable of, it made the process of him joining the team really easy.” When Dr. Shin’s needs and life changed and he moved back to Chicago, he was able to find another position quickly within the National Vision Doctor of Optometry network, one of the benefits of working in affiliation with a large, nationwide group.

Dr. Shin was quick to add, his preceptor had a hand in his fortune. “It definitely helps knowing Dr. Ymalay. He makes everything a lot easier; everyone loves him. Knowing him means that I’m in good hands both now—as I continue corporate practice—and in the future, no matter the setting.”