TLC Eye Care of Michigan 

Mission

The Residency Program in Ocular Disease at TLC Eye Care of Michigan provides a superior optometric graduate with an advanced clinical and didactic experience in the diagnosis and treatment of ocular disease, as well as the assessment and management of refractive surgery patients.  Upon completion of the program, individuals will be qualified to deliver the highest level of patient care, make significant contributions to education and to the profession of optometry.

Residency Supervisor

Angela Cumming, OD
Regional Director
TLC Eye Care of Michigan
1116 West Ganson
Jackson, Michigan 49202
(800) 551-7347
AngelaCumming@tlcmi.com  

Affiliate and Residency Program Director:

The Michigan College of Optometry at Ferris State University provides educational direction and support for this program.  Dr. Bruce Morgan, who serves as MCO’s Director of Residency programs, may be contacted as follows:

Bruce Morgan, OD, FAAO
Email:  morganb@ferris.edu
Phone:  (231) 591-2180
Fax:  (231) 591-2394

Mailing Address:

Michigan College of Optometry
Ferris State University
1310 Cramer Circle
Big Rapids, Michigan 49307-2738

Goals and Objectives
Goal 1:   Improve the resident’s proficiency in the detection and management of ocular disease and the ocular signs of systemic disease.
Objectives: 

• The resident will be actively involved in over 1500 patient encounters
• The resident will be responsible for ordering appropriate imaging and laboratory tests
• The resident will assume primary responsibility for the care and follow up of their patients under the supervision of attending staff

Goal 2:   Provide the opportunity to interact with other disciplines in the care of patients.

Objectives:

• The resident will interact with other health care providers by sending and receiving consults (including but not limited to the following disciplines:  primary care, neurology) mainly when working in specialty clinics with faculty.  The resident will interact on a routine basis with ophthalmologists, including observing/assisting in surgery.

Goal 3:   Enhance resident’s ability to communicate verbally and in writing

Objectives:

• The resident will communicate clearly and use appropriate terminology when presenting information to patients, co-workers, as well as attending staff
• The resident will use appropriate medical terminology and make accurate entries into the medical record
• The resident will prepare and present a poster/paper at a professional meeting, prepare a manuscript of publishable quality, or participate in a clinical study through TLC Eye Care of Michigan
• The resident will present lectures to patients, MCO students and to fellow optometrists throughout the duration of the program

Goal 4:   Gain expertise in advanced technical skills to promote development of differential diagnosis, treatment and management skills

Objectives:

• The resident will observe and interpret A-scan and B-scan ultrasonography; perform and interpret corneal pachymetry and topography
• The resident will become proficient in interpretation of glaucoma diagnosis modalities such as HRT OCT and automated visual fields
• The resident will observe and interpret fluorescein angiography
• The resident will become proficient in examination of the retina utilizing a variety of techniques including contact and non-contact lens examination and scleral depression
• The resident will perform diagnostic and therapeutic anterior segment procedures (including but not limited to:  foreign body removal, scrapings and cultures, suture removal, punctal dilation and irrigation, and punctal plug placement/removal)

Goal 5:   Assist the resident in development of critical thinking and problem solving skills

Objectives:

• The resident and attending faculty will discuss case analysis, differential diagnosis and management strategies of complex patients routinely throughout the year
• The resident will improve his/her knowledge of basic and medical sciences and apply this knowledge in the evaluation, diagnosis and management of patients
• The resident will gather data and provide statistics in a patient study
• The resident will participate in virtual grand rounds through MCO
• The resident will be directly involved in the management of emergent type patients by being on call 10 weekends throughout the residency
• The resident will be directly involved in management of pre- and post-operative patients in a variety of specialties

Goal 6:   Provide the resident with experiences and skills that will facilitate continued contribution to the profession of optometry through a variety of venues including:  teaching, scholarly activities, and involvement in community and professional organizations.

Objectives

• The resident will actively participate in didactic activities (including WebCT grand rounds and lectures)
• The resident will present a poster/paper at a professional meeting, or prepare a manuscript of publishable quality, or participate in a study
• The resident will be exposed to community and professional organizations and will be given the opportunity to participate (Michigan Optometric Association, Southwest Michigan Optometric Society, VOSH, etc)
• The resident will be encouraged to contribute brief articles or journal reviews for publication in the Michigan Optometrist

Program Curriculum

The residency will be for a period of 12 months, commencing July 1 ^st and ending June 30 ^th.  The resident’s schedule will vary according to patient care and training needs.   There are four TLC Laser Eye Centers located in Ann Arbor, Detroit, Kalamazoo and Lansing.   There are also five TLC Eye Care offices located in Jackson, Battle Creek, Chelsea, Ann Arbor and Lansing.  The resident is scheduled for patient care primarily in the offices in Jackson and Lansing.  Infrequently, the resident must drive to the other sites to provide care when needed.   A minimum of 40 hours per week is required.  Approximately 4 hours per week may be spent participating in a patient study.  Approximately 4 hours per week will be allotted for research, development and organizing data for the study.  The remaining 32 hours per week will be spent in direct patient care.  Approximately 8 of those 32 hours will be allotted for primary care examinations by the resident.  Approximately 24 hours per week will be spent working closely in various specialty clinics with different ophthalmologists, specializing in cornea, cataract, glaucoma, retina/vitreous, oculoplastics and refractive surgery.

When assigned to direct patient care, the resident will also be responsible for performing specialty diagnostic testing and for seeing walk-in emergency patients.  Outside of normal clinic hours, the resident is on-call 24 hours per day, approximately 10 weeks out of the year, for acute ocular emergencies that present through the laser centers’ on call service.  Attending staff back-up call is provided at all times to the resident.  Many of the lectures and seminars given by the resident are outside of normal clinic hours.

Direct patient care provided by the resident is included in the quality management plans currently in existence at TLC.  Those quality management activities include:

• Pre/post cataract care
• Annual retinal evaluation for diabetic patients
• Log of patient encounters 
• Outcome information gathered for each LASIK patient
• Patient satisfaction surveys

In the first 3-4 months of the program, all resident charts are reviewed by attending staff and regular feedback is given to the resident regarding quality of documentation (accuracy and completeness) and appropriate care (necessary testing, correct diagnosis, appropriate treatment and follow up).  Many more are reviewed as the year progresses.

Scholarly Activities

The resident is required to present a poster or paper at a nationally recognized professional meeting, prepare a manuscript of publishable quality, or participate in an ongoing clinical study at TLC in order to fulfill the requirements of residency certification. Residents with the intent to submit a poster/paper for presentation at a refereed meeting (AAO, SECO, ARVO) will be eligible for a $500 travel scholarship from the Michigan College of Optometry and are granted 5 educational leave days from TLC.   Additional scholarly activities will include participation in evidence based virtual grand rounds, didactic instruction of third year optometry students at MCO, and lectures/case presentations. 

Didactic Activities

At least once yearly, the resident will be required to present a lecture or case presentation to students, staff and/or colleagues at a collaborative venue with the affiliate, Michigan College of Optometry.  Resident will also participate in distance learning activities offered by MCO (virtual grand rounds through WebCT).  The resident is required to participate in TLC’s annual fall educational, providing a case presentation or short lecture to fellow optometrists. 

The resident is encouraged to attend local continuing educational offerings, as well as courses offered through Michigan College of Optometry and the Michigan Optometric Association.  The resident is also encouraged to attend the American Academy of Optometry’s annual meeting.

Background of the Practice:

In 1978, Paul Ernest, MD founded an ophthalmology practice in Jackson, Michigan, where he began his research and trials for no-stitch cataract surgery.   Three cornea fellowship trained partners have since joined him in the practice. Subsequently, ophthalmologists specializing in glaucoma, pediatrics, oculoplastics and retina/vitreous were added to the practice.  His practice has grown from one site to five sites across lower Michigan and provides medical/surgical services primarily to optometrist - referred patients.  Dr. Ernest believes in being on the forefront of technology, so all sites have current instruments for diagnosis and treatment of ocular disease.  In  1996, Dr. Ernest’s practice merged with TLC Laser Eye Centers.  The new practice was named TLC Eye Care of Michigan. There are now eight locations where optometrists and ophthalmologists provide a wide range of services, while working closely with  referring optometrists in Michigan.  The Clinical Director of each site is an optometrist with outstanding qualifications.

Residency Supervisor

Dr. Angela Cumming, O.D. graduated with honors from Western Michigan University, Kalamazoo, Michigan. She obtained a Bachelors of Arts in Political Science and French. Her Doctor of Optometry degree was obtained from the Michigan College of Optometry, Big Rapids, Michigan. Post-Graduate studies consisted of a Residency in Ocular Disease at TLC EyeCare and Laser Centers of Michigan.

Dr. Cumming is a Clinical Director at the TLC Jackson clinic and is a clinical investigator for studies on Restor intraocular implants, Meibomian Gland Dysfunction and Macular Degeneration Treatment. She specializes in glaucoma treatment, diagnostic and therapeutic treatment of ocular disease, cataract and refractive surgery co-management.

Application and Admissions:

Applicants for TLC residency must have received a Doctor of Optometry degree from an accredited school or college of optometry by July 1 of the residency year.  Prior to completion of the residency, it is expected that the applicant will have passed the National Board exams and will obtain state licensure.   These criteria are widely published and contain a statement regarding non-discrimination.

This program participates in the national Optometric Residency Matching Service (ORMS, Inc.).  The application procedure, required supporting documentation and the matching algorithm may be found on the organization’s internet home page ( http://www.optometryresident.org/) or the applicant may contact ORMS, Inc. at:

Dr. Charles L. Haine
151 Principia Court
Claremont, CA  91711
(909) 267-9795 - office and fax
chaine@hainews.com

Application deadline is February 1st

Application and Instructions

Download one of the following

MSWord - allows you to type in responses and print
Pdf - allows you to print blank form for manual completion (requires Adobe Reader)
Rtf - Download, complete using your word processing program 

Following receipt of the necessary documents and personal interviews (preferably in person), the faculty collaborates to review and rank candidates.  The three primary criteria (which are discussed with the applicants during the interview) are as follows:

• Basic knowledge (determined by interview, letters of recommendation, NBEO scores, transcripts of grades)
• Clinical skills (determined by interview, letters of recommendation, clinical grades and previous clinical experiences)
• Personal attributes including eagerness to learn, work hard and professional goals (determined by interview and letters of recommendation)

Resident’s rights:

The resident is entitled to the following:

1. Employment for a 12 months period commencing on July 1 and ending June 30 of the residency year
2. A stipend in the amount of $31,000 for this period
3. Medical and malpractice insurance
4. Ten (10) leave days for personal/professional activities
5. An appropriate amount of leave for illness.  Extended sick leave requires documentation of medical necessity from the resident’s physician.
6. Access to clinical instruction and facilities sufficient to meet the missions, goals and objectives of the program
7. Access to a general schedule and program curriculum at the start of the program
8. Uniforms, cell phone/pager and mileage reimbursement
9. A certificate upon satisfactory completion of the residency 

Resident Tour of Duty and Privileges:

1. The resident practices under the privileges of the attending optometrists/faculty.  TLC Eye Care of Michigan covers malpractice for practitioners within the scope of these privileges.  The practitioners will have all authority regarding patient management; subject to supervision by the Executive Director.
2. The tour of duty for the resident will be assigned at the beginning of the program and modified depending on the needs of the clinic and the resident.  The schedule is likely to contain irregular number of hours for each workday; however, the weekly average will be 40-45 hours of assigned duties.  (This does not include outside development time necessary for research, lecture preparation, journal reviews, manuscript preparation, etc. The resident will be on call for various weeks during the program.  An attending will always be available by phone. 
3. The resident may not hold a second position of employment.  The resident may, however, work outside of TLC if the following criteria are met:
   • Clinic/practice opportunity provides an academically oriented experience
   • Outside work does not interfere with the resident’s ability to fulfill their obligations to the residency program
   • The program supervisor gives his/her concurrence
   • Malpractice insurance is the sole responsibility of the resident or other employing facility

Resident Responsibilities and Requirements for Completion of Program:

1. To serve as a resident for the entire period specified above
2. To perform to the best of his/her abilities in all assigned duties
3. To maintain and complete supervisor evaluations, patient logs, etc. 
4. To complete one publishable quality paper, or participate in a significant clinical study 
5. To maintain standards of competence in clinical practice 
6. To act in a professional manner at all times 
7. To observe all rules and regulations of TLC Eyecare and Laser Centers and the Michigan College of Optometry including:
   • Practice within the scope of clinical privilege
   • Practice according to the rules of residency supervision  
   • To refrain from participating in any activities (personal or other employment related) that would interfere with the effective performance of all assigned duties and responsibilities 
   • To refuse fees or payment in any form from patients, staff physicians or others

Current educational and informational resources

The program enjoys a wide variety of current educational and informational resources that are readily available to the resident.

• Extensive library of ophthalmic text books located in conference room and offices (other texts available by request through inter-library loan)
• Journal subscriptions (Optometry and Vision Science, The American Journal of Ophthalmology, The Journal of the American Optometric Association and Review of Optometry)
• Med-line search (articles available by request through Library)
• Computer based medical references (Micromedex, Journal of the American Medical Association, Morbidity and Mortality Weekly Report)
• General medical text books
• Full access to MCO library facilities and librarian services (including literature search, article retrieval and inter-library loan)
• Additional library facilities within 1-2 hour drive include:  Michigan State University School of Medicine and University of Michigan School of Medicine.

For more information, please contact:

Angela Cumming, OD Residency Supervisor
TLC Eye Care of Michigan
1116 West Ganson
Jackson, Michigan 49202
(800) 551-7347
AngelaCumming@tlcmi.com

Bruce Morgan, OD, FAAO
Director of Residencies
Michigan College of Optometry
Ferris State University
1310 Cramer Circle
Big Rapids, Michigan  49307
(231) 591-2180
morganb@ferris.edu

2009-2010 Resident Bio and Contact Information