Working with MDs
In addition, a very valuable and sometimes challenging aspect was working with and under the MDs. Their lengthy schooling, internal medicine training, and resulting expertise was and remains very inspiring.
For ODs, there is an extraordinary opportunity for learning from and partnering with specialists as they all bring different elements to the table. Residency taught me how to navigate the expanse between us and how to capitalize on common goals and comanagement benefits.
Residency also taught me the benefits of optometrists’ strong training in optics—not just from a glasses or contact lens prescription standpoint. It can be used for calculating the power of intraocular lenses, mapping femtosecond laser arcuate incisions to minimize postoperative astigmatism, and gauging higher-level aberrations pre- and post- LASIK correction. We as ODs receive fantastic optics and refraction training (thank you Dr. Donald Mutti, Dr. Thomas Raasch, and Dr. Mark Bullimore of OSU), which can be a true service to ophthalmologists who receive less such focus.
MD-collaboration aside, another invaluable moment was understanding the relationship among ophthalmologic office visits, in-office procedures and outpatient surgeries.
Residency was my first true experience with independently managing peri-operative care. The responsibility of counseling patients before and after cataract surgery requires accurate and experienced knowledge of all the procedure’s components—from capsulorhexis, to aligning a toric intraocular lens, to the likelihood of developing posterior capsular opacification, and determining who is at risk for developing cystoid macular edema.
This skill, I learned, is also invaluable to ophthalmologists and gives optometrists a great responsibility and respected role. Similarly, learning time-out etiquette and side-side verification—both vital in every ophthalmologic operating room—was something that I experienced solely because of my residency.
Residency was not simply focused on ophthalmology/optometry interactions. The most vital interactions were those with my optometry mentors.
Dr. Katherine Mastrota, who was directing the bustling New York City Omni office, was an invaluable teacher and advisor. Not only was she expert in the various confounding visual field patterns that glaucoma patients who concurrently had suffered a neurological event could exhibit, but she also introduced me to the network of practicing optometrists that I would soon be calling colleagues.
Dr. Mastrota had answers to my most pressing questions:
• Which local organization to join?
• Which practices or schools offer continuing education lectures?
• To which nearby practices specializing in complicated contact lens fittings can we refer?
• Do you know an after-hours neuro-ophthalmologist I can call with a case?
• What happens if patients lose their medical insurance but are still within their 90-day post-op period?
Not only did Dr. Mastrota had the answers, she also provided the encouragement and wise words that helped me to land my current job at a multi-specialty tertiary-care hospital on the Upper East Side of Manhattan. Mentorship in residency is key because it forges lifelong friendships and demonstrates an example to us newer ODs how we too can all become mentors and teachers.
Residency built my career
To say that residency opened doors to my future is an understatement. Residency helped me to develop confidence in managing complicated diagnosis as well as comprehend the moving parts that is massive web of optometry and ophthalmology.
The two disciplines are in some ways inextricably partnered. This can be challenging but also very valuable and can result in a fantastic clinical experience. The ophthalmologists who I work with now are some of my most valued partners, advocates, and friends. Residency challenged me academically with case reports and presentations that resulted in American Academy of Optometry Fellowship and gave me the skills to now lecture regularly to societies and at the local and state levels.
Residency gave me the courage and knowledge to work side by side with MDs, it taught me to remain ever curious, and it has translated into current multi-specialty grant-funded clinical research projects.
I have no regrets with spending an extra year with a lower income than my colleagues who went directly into practice, nor do I consider myself in less of an optometry advocate by immersing my career alongside MDs.
Every day I am challenged by new manifestations of immunosuppressed patients from our medical retina doctors, complicated intraocular lens calculations (don’t forget to subtract 0.50 D for a sulcus-placed backup lens in the unlikely event that capsule breaks), triaging emergency room patients to the appropriate subspecialty, and feeling comforted that any patient I see will be afforded the proper continuation of care.
Had I not completed a residency, I am not sure that I would be lucky enough to have this challenging career today.