Monthly Archives: May 2010

Optometry students, test-taking, and the self-serving bias

In psychology there is something called the self-serving bias. To quote from Wikipedia:

“A self-serving bias occurs when people attribute their successes to internal or personal factors but attribute their failures to situational factors beyond their control.” (wikipedia)

Not my fault, the DOG ate my homework!

This is prevalent in optometry school and no doubt with many other professional/graduate  schools. When it comes to test-taking, it seems to happen on every other test that there is a question that students miss yet inevitably blame the instructor for writing a poor test question.

Students sometimes start to think they’re always right, and refuse to listen and learn when they’re wrong. At my friend’s work, she laments often about coworkers who EVERYONE knows is at fault for a particular problem, yet that coworker is too prideful to admit they made a mistake and the politics of the matter makes life difficult to get things done.

So what’s the point of this post? It’s really just to say “don’t take yourself so seriously.” At SCCO they try to teach confidence in the clinic, to make a decision and stick to your guns. This is the right approach, but while learning always remain open to accept criticism for your mistakes.

Thinking like a doctor… not only as it pertains to optometrists

One short anecdote I forgot to mention at the RAM.  My friend Denh was talking to Dr. Gordon, a staff doctor over at OCLA about ocular disease. It went something like this:

“Dr. Gordon! How much disease do you see at OCLA?!”

“Oh we see quite a bit, I guarantee you’ll learn a lot if you come here”

“Awesome! The more disease the better. We just learned about Trachoma in class yesterday, about ARLT’s line it was fun!”

:Chuckling: “A little knowledge can be a dangerous thing.”

I thought it was interesting what Dr. Gordon said, but he is right on the money. How many times do I expect to see Trachoma in the United States in my lifetime? Possibly ZERO times ever. It should very rarely be on my list of differentials. Inclusion bodies from Chlamydia, possible, but not Trachoma. So why do we learn it?

Some will fault optometry school, saying what’s the point of teaching all this “junk” information. Or mention that in a private practices someone shadowed, they never do phorometry on every single patient – so they’re mad that opt schools make us waste our time.

My opinion is that the point of optometry school is to learn as much as possible so that if I ever run across it, I can make the appropriate call. Definitely, it would be financial suicide to do 2 hour exams on all our patients when we graduate, but for now it is academic suicide to not practice all the skills we’ve been taught and to do a thorough (this is the emphasis, not speed) exam.

Why do a residency in optometry? Let’s look into the pros and cons.

Most optometrists who have ever done a residency in optometry told me they were glad they did it. Many people who didn’t do one say they are glad they didn’t forfeit the extra year of earnings and that they felt adequately prepared to handle things with the training they received during optometry school.

So what should a third/fourth year optometry student to do? What are the pros and cons of doing a residency in optometry?

Let’s take a look at the pros and cons:

Pros of an optometry residency:

1. You do get paid, probably to the tune of $30-35,000. Not a lot, but that’s 2 times my current spending budget in optometry school so it’s an upgrade!

2. You get REALLY good at something that might have taken many years to get good at. How many keratoconus, prosthetic eye candidates, low vision, or strabismus would you see in private practice? In a residency you’d see multiple EVERYDAY. In saturated optometry markets, carving a specialty niche can be very beneficial. Word of mouth referrals for niche specialists spreads fast which will help your bottom line.

3. Don’t have a job lined up? Don’t know where you want to set up your practice? Remember, in optometry you can succeed as long as you avoid the train-wreck. Ducking away for 1 year gives you more time to shop around for practices, interview, and network with other optometrists to find that perfect opportunity – and not being unemployed. Who knows, maybe the residency itself will help you find a job or partner who requires your unique expertise. Regardless, it’ll give you more time to more carefully examine your post-grad options without leaping for an opportunity out of desperation. Like John Wooden, the famous UCLA basketball coach said, “be quick, but don’t hurry.”

4. Less need to refer because you are better trained. This keeps life more interesting when you can manage the more interesting cases.

5. If you plan on doing academia, teaching, or working in a hospital setting, then a residency needs to seriously be considered. Not only seriously considered, it might even be required.

6. You can apply and still withdraw if you change your mind (but only up to a certain point, afterward it is extremely bad form to not honor your commitment). So it doesn’t hurt to just apply up to a point. You never know what doors could have opened if you never gave it a shot.

7. Psychologically, it’s nice to know you’ve got something going on after you graduate rather than just twiddling your thumbs and nervously looking for fill-in work or a corporate gig after graduation.

8. You can still find fill-in work maybe a couple days a month if you choose to pad your income. I know of an SCCO resident who did just that.

9. Learning is fun. One of the major draws I had to going back to school after I graduated with my BS from UCLA was that I loved learning. In a work environment, you do learn some things here and there, but it’s not your JOB to simply learn. One of the fun things about a residency is that it is still mentored education. You’ve got more responsibilities and privileges, but it is still a learning experience.

10. Board certification passed last year at the AOA meeting. If your intention is to become board certified, I believe you get to leapfrog some of the time-requirements if you complete a residency. This could potentially be a great added benefit to doing a residency if board certification is mandated or looking very favorably on by insurance.

11. It is only one year, honestly.

Cons of an optometry residency:

1. You forfeit a year of real salary. Which can be significant if you’re tired of living life on strict financial restraint.

2. Applying for a residency is like applying to school again. You have to hunt for letters of rec and interview. Could be difficult if you never fostered meaningful relationships with your current faculty.

3. You might not end up geographically where you want to be. If you have a spouse or significant other, is it worth being apart for another year?

4. Not all residencies are created equal, you may end up just being at a “5th year” of optometry school.

5. You may feel already confident with your skill set and any future obstacles can be self-taught.

6. Once you start, you can’t jump ship in the middle of the year. Say you find a can’t miss opportunity, well you might have to wait until you are done with your residency and by then it might be too late. The practice you wanted was sold, the job opening was filled etc.

RAM, Remote Area Medical, and SCCO student volunteerism

It’s much more common to hear about myopia at my age and less so with hyperopia. But the prevalence of hyperopia really struck me when I volunteered for Remote Area Medical last week. What is RAM? Basically it is an event where free healthcare is given to those who cannot afford it on their own.

I volunteered in the lab making glasses as well as dispensing them. With no stretch of the imagination, it seemed at least 75% of the glasses I made were for hyperopes. Some had it bad like +4.00 with a +2.00 add. It makes me wonder how long these people, who could not afford to update their glasses, have been functioning especially at close. With that much uncorrected hyperopia at near, I can’t imagine they could have been reading all that well.

Could the inability to read presently, and the accommodative demand manifesting as eye strain in their pre-presbyopic days have been a significant impact on their current financial plight? This is debatable but I would think it could have certainly impacted their performance in school and ability to learn due to a visual problem.

To me it just highlights the need to see an optometrist regularly. Undetected vision problems can certainly impact one’s ability to learn and just function. How many of these underprivileged people that RAM served could have avoided their situation altogether if they had proper eyecare at a young age?