NUMBER OF RESIDENCY POSITIONS: Two
PROGRAM SUPERVISOR: Aaron Case, OD, FAAO
PROGRAM AFFILIATE: Michigan College of Optometry
ACCREDITATION STATUS: Fully accredited by the Accreditation Council on Optometric Education.
The VA hospital in Fort Wayne, Indiana has been active in optometric education for nearly four decades. Dr. Dale Fath, in collaboration with Indiana University (IU) School of Optometry, initiated a fourth year student extern program at this facility in the early 1980’s. In 1991, Dr. Timothy Messer expanded the student program by establishing a student affiliation with Michigan College of Optometry (MCO). Under the direction of Dr. Sara Schamerloh, the student program continued to expand in complexity with the addition of fellowship trained ophthalmology consultants, residency trained optometric staff, ophthalmic technicians and clerical support. In 2002, an optometric residency program in ocular disease and primary eye care was established and in 2007, this program was expanded with the addition of a second resident
At present, five full time optometrists, two optometry residents, and two optometry students provide full scope optometric care to a large Veteran population. Common services include: dilated eye examinations, refraction, automated perimetry, A/B scan ultrasonography, corneal pachymetry, anterior/posterior segment digital photography, low vision rehabilitation, diabetic tele-retinal screenings, traumatic brain injury screenings, pre/post operative care, minor anterior segment procedures, HRT 3, posterior and anterior segment OCT and additional ophthalmic imaging modalities including infra-red, red-free and auto-fluorescence. Secondary and tertiary eye care is provided on site by three ophthalmology consultants and a part-time VA based ophthalmologist. Expertise among these providers includes fellowship training in oculoplastics and cornea, as well as advanced training in glaucoma. Common ophthalmologic services include: cataract extraction with intraocular lens implant, ptosis repair, blepharoplasty, entropion/ectropion repair, excision of malignant lid lesions with or without reconstruction, minimally invasive glaucoma surgery, ophthalmic laser procedures, and intraocular injections. Specialty ophthalmology services, including neuro-ophthalmology, glaucoma, and retina/uvea, are also provided by local specialists or staff at other VA Medical Centers.
The clinic population is comprised primarily of males in their 6th – 8th decades of life and is characterized by a high prevalence of ocular disease. While some “normal” eyes are examined, the vast majority of patients present with one or more chronic ocular conditions including: glaucoma, ocular hypertension, retinal vascular disease, age-related macular degeneration and/or cataracts. A significant number of patients also present with acute conditions including various infectious and inflammatory conditions of the eye, ocular trauma and neuro-ophthalmic conditions including tumors, cranial nerve palsies and optic neuropathy.
RESIDENCY MISSION STATEMENT:
The optometry residency at the VA Northern Indiana Health Care System will provide post doctorate clinical experiences resulting in advanced competency in the evaluation, treatment and management of a wide variety of ocular conditions, with a special emphasis on ocular disease. The residency will equip the resident with the necessary tools for life-long learning, thereby enabling continued advanced level competency throughout his or her professional career. Furthermore, the residency will highlight the trainee’s responsibility for future contributions to the profession of optometry.
PROGRAM GOALS AND OBJECTIVES:
- Provide experience in the evaluation and management of patients with ocular disease
or ocular manifestations of systemic disease, utilizing advanced diagnostic and treatment
modalities when indicated.
- The resident will provide care for a large number of patients with complex and/or multiple ocular problems.
- The resident will become proficient in performing and interpreting advanced diagnostic procedures.
- The resident will become proficient in performing and interpreting advanced therapeutic procedures
- Enhance the resident’s ability to communicate with patients and other health care
providers in a way that promotes patient-centered care.
- The resident will promote effective patient-centered care by effectively communicating with patients and their families.
- The resident will promote collaborative patient-centered care by effectively communicating with other health care providers.
- Provide an opportunity for the resident to function as a valuable member of the health
care team in a way that promotes appropriate resource utilization and effective, coordinated
- The resident will practice cost-effective health care and resource allocation without compromising quality of care.
- The resident will be aware of health care system resources and will collaborate with other health professionals to ensure provision of comprehensive patient-focused care.
- The resident will be exposed to a multidisciplinary model of low vision care.
- Foster continuous patient care improvement through quality improvement activities,
including the resident’s self-evaluation.
- The resident will be responsible for life-long learning and their own practice assessment and improvement strategies.
- The resident will participate in quality improvement activities within the hospital and utilize the information to improve patient care.
- Facilitate the resident’s acquisition, analysis and application of current medical
and scientific information to improve their patient care practices.
- The resident will develop critical thinking and problem solving skills that will enhance their ability to form differential diagnoses and management plans.
- 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 demonstrate the ability to acquire, analyze and apply scientific and medical literature to improve the care of patients, and will utilize information technology where applicable.
- 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.
- The resident will facilitate the learning of optometry students and other health care professionals through participation in scholarly activities
- The resident will facilitate the learning of optometry students and other health care trainees by participating in preceptor assignments.
- The resident will be exposed to community and professional organizations and will be given the opportunity to participate.
The program curriculum is comprised of four basic components: clinical instruction, didactic instruction, teaching and research.
Over 80% of the resident’s scheduled time is dedicated to clinical education, and the vast majority of this time is spent providing direct patient care primarily in the outpatient clinical setting. The resident is responsible for attending to the patient in a comprehensive fashion, taking into account the patient’s subjective complaints, general medical health, examination findings, as well as psychosocial, cultural, and religious factors. Comprehensive care provided by the resident includes:
- Primary eye care, including screenings, wellness exams, and diagnosis/treatment of vision disorders
- Diagnosis and treatment of ocular diseases, including emergency and urgent care
- Diagnosis and treatment of ocular manifestations of systemic diseases
- Pre- and post-operative care, including suture removal
- Excision of ocular adnexal lesions
- Low vision counseling and rehabilitation (very minor component)
- Performance and interpretation of specialized ophthalmic testing procedures
- Ordering and interpretation of laboratory, radiology and other diagnostic studies
- Counseling of patient and their family
- Interaction with other health care providers to ensure continuity of care; this includes consultation, referrals, and follow up
The resident’s experience is enhanced by daily case discussions with faculty and review of clinical images (photographs, OCTs, FAs, CTs, MRIs, etc.) during clinic and conference time. Strong emphasis is placed on development of critical thinking and problem solving - two skills that are essential for independent practice and life-long learning. A continuous effort to improve patient care through acquisition, analysis, and application of current medical information is expected of the resident.
Observational interdisciplinary rotations assist the resident in understanding the role of other health professionals. Rotations may include: dermatology, neurology, emergency care, primary care, imaging (MRI, CT, ultrasound), physical therapy, occupational therapy, cardiac stress testing and other specialties as available. The resident also has the opportunity to observe ophthalmic surgery and/or laser.
While not a formal part of the curriculum, participation in medical mission trips is facilitated and encouraged.
The resident participates in weekly optometry conference with attending staff and students. This conference utilizes a variety of didactic instruction methods including: case presentations and slide review, journal club, interactive faculty lectures, and resident/student presentations.
The resident is encouraged to attend outside continuing education offerings through the affiliate, as well as those offered by the American Academy of Optometry, the local optometric society and other academic or professional organizations.
It is expected that the resident will undertake a variety of independent study activities. To facilitate the resident’s efforts, a large library of medical and ophthalmic resources is readily available.
The following scholarly activities are required of the resident in order to satisfy program completion criteria.
- Complete a manuscript of publishable quality OR present a poster or grand rounds presentation (or equivalent) at the American Academy of Optometry (or other similar approved venue) prior to the end of the residency year; Residents who submit a poster/paper (or equivalent) for presentation at an approved meeting will be eligible for a $500 travel scholarship from the Michigan College of Optometry.
- Present a lecture or case report to students, staff and/or colleagues at Michigan College of Optometry’s Residency Day (or other similar approved venue)
Additional scholarly activities may include: journal club, lectures, and case presentations.
The resident is responsible for clinical instruction and supervision of 4th year professional students from Indiana University and Michigan College Optometry during the latter part of their residency year. At minimum, the resident will be assigned to work with the students an average of one half day per week for 6 months.
A minimum of 40 hours per week is required. The majority of the time is spent providing direct patient care in the outpatient setting. Also included in the schedule are weekly journal club and optometry conference, time for research and development, surgical observation, interdisciplinary rotations, and instruction of fourth-year optometry students. Additional time beyond assigned hours will be necessary for purposes of charting, patient follow-up, independent study and scholarly activities. Residents do not officially take call, but are occasionally called upon to provide after-hours urgent care or follow-up in consultation with attending staff.
The professional staff is comprised of 5 full time optometrists, two optometry residents, (two optometry students), three part-time consulting fee ophthalmologists and one part-time VA-based ophthalmologist. Ancillary staff includes two full time clerks and five full time ophthalmic technicians. There are many other employees throughout the hospital who provide support for the program, including the surgical service secretary and administrative officer, as well as staff from the medical library, central supply and processing, pharmacy, lab, radiology, transcription, coding/billing, release of information, information technology and media production. A contract optical is available on-site and MCO provides additional library and media production services in support of our program.
CLINCIAL TEACHING FACULTY (RESIDENCY PROGRAM):
Aaron Case, OD, FAAO (Program Supervisor)
Dr. Aaron Case is a 2006 graduate of Indiana University School of Optometry (IUSO). He completed a residency in Ocular Disease and Primary Care at the VA NIHCS in 2007 and he joined the NIHCS residency faculty in 2008. He holds adjunct clinical faculty appointments at IUSO and MCO, is a Fellow of the AAO, serves as Vice-chair for the AAO admittance committee, and has successfully passed the National Board of Examiners in Optometry (NBEO)’s Advanced Competency in Medical Optometry (ACMO) examination.
Dr. Case participated in laboratory research at the IUSO (mammalian retinal morphology) and served as a clinical research assistant for a pilot study involving antioxidants and endothelial dysfunction (Cardiology Group in Fort Wayne, In). Additionally, he collaborated with researchers at Johns Hopkins University School of Medicine to develop the phenotype for Sticklers, subtype 2. Dr. Case’s research in the area of Stickler Syndrome was presented at the American Academy of Optometry in 2006 and 2016.
Dr. Case has been involved in clinical and didactic instruction of students and residents at NIHCS since 2008. He also lectures to 4th year students at IUSO, presented a lecture to the local Optometric Society, and has authored or co-authored several posters and resident presentations at the AAO. Additionally, Dr. Case coordinates the optometric continuing education program and low vision/optometric traumatic brain injury services at our facility, and provides optometric care in the community on a part-time basis.
Matthew Anderson, OD (Program Faculty)
Dr. Anderson graduated from the Michigan College of Optometry in 2006 and completed a one-year residency in Primary Care/Ocular Disease at the Fayetteville VA Medical Center in Fayetteville, AK. He then became a staff optometrist at the Lake City VA Medical Center in Lake City, Florida where he also coordinated the student externship program and served for a period of time as the acting Chief of Optometry. In 2010, Dr. Anderson transferred to the James H. Quillen VA Medical Center in Mountain Home, TN, where he served as the Chief of Optometry from 2013 until he transferred to NIHCS in the fall of 2015 where he is now serves as the clinic lead.
Dr. Anderson has been involved in the clinical and didactic education of optometric students and residents since the completion of his residency in 2007. He holds certification in Anterior Segment Laser Therapy and Minor Surgical Procedures of the Eyelid (Oklahoma License), is a fellow of the American Academy of Optometry (AAO), has successfully passed the National Board of Examiners in Optometry (NBEO)’s Advanced Competency in Medical Optometry (ACMO) examination and is a reviewer for the Council on Optometric Practitioner Education.
At the lead optometrist at NIHCS, Dr. Anderson is responsible for a wide range of administrative duties related to smooth and safe functioning of the optometry clinic. He currently holds an adjunct clinical faculty appointment with MCO and participates in the didactic and clinical education of students and residents at NIHCS.
Lovelee Sayomac, OD (Program Faculty)
Following graduation from The Rosenberg School of Optometry, Dr. Sayomac completed a one-year residency in ocular disease at the VA Northern Indiana Health Care System in Fort Wayne, Indiana, after which she joined the NIHCS optometry staff as a full-time provider in October of 2017.
Dr. Sayomac has been involved in the clinical and didactic instruction of students and residents since 2016, and beginning in 2018 will serve as co-mentor for the journal club. Additionally, she has lectured on local and regional levels, and co-authored a case report that was presented at the American Academy of Optometry in 2016.
APPLICATION AND ADMISSIONS ELIGIBILITY CRITERIA:
Applicants for VA residencies must be citizens of the United States* and have earned a Doctor of Optometry (OD) degree from an ACOE accredited school or college of optometry by the start of the program. It is expected that the resident will have passed the requisite NBEO exams and will have obtained state licensure (in any state) prior to the start of the program.
* United States citizenship is required to qualify for VHA appointment in a paid VA optometry resident position funded by the Office of Academic Affiliations. Reference: VA Handbook 5005/57, Part II, Chapter 3, Paragraph 3.g.(1) & (5)(c), dated June 14, 2012.
Applicants must utilize the national optometric residency matching service (ORMatch). Detailed instructions regarding the application procedure, application deadlines, supporting documents and the matching algorithm may be found on the organization’s internet home page. https://natmatch.com/ormatch/
Application requirements include:
- Application through ORMatch by ORMatch published deadline. After this date, residents may still apply by submitting an application package directly to the program supervisor, however, late applications will be reviewed on an individual basis and acceptance is at the discretion of the program supervisor.
- Completion of MCO’s “Application for Admission” form
- Submit electronic or hard copy directly to the program supervisor no later than close of business, February 1. Acceptance of late applications is at the discretion of the program supervisor.
- Supporting documentation – Submit electronic or hard copies directly to the program supervisor by close of business, February 1. Acceptance of late documents is at the discretion of the program supervisor.
- Letter of Intent (Brief statement from the applicant regarding the individual’s desire to complete a residency)
- Curriculum vitae
- Official transcripts from applicant’s school or college of optometry. Copies may be sent initially, however, official transcripts must be received by the specified deadline. Official school transcripts may be transmitted through “electronic transcript delivery services” if available through your school.
- National Board of Examiners in Optometry (NBEO) scores (Unofficial copies are acceptable; ORMatch will forward the official scores)
- Copy of state license, if applicant is already licensed to practice optometry
- Letters of recommendation – Arrange to have three letters of recommendation to be sent directly to the program supervisor by February 1. Electronic copies are acceptable if signed and/or sent directly to the program supervisor by the person providing the recommendation. Acceptance of late letters is at the discretion of the program supervisor. It is preferred that at least two of the three letters are from faculty (on campus or off campus) who are familiar with the applicant’s clinical skills.
Submit materials to:
Aaron Case, OD, FAAO, Program Supervisor
Eye Clinic 112B
VA Northern Indiana Health Care System
2121 Lake Avenue
Fort Wayne, IN 46805
Following receipt of the necessary documents and interviews (preferably in person), the faculty members collaborate to choose and rank candidates. The three primary criteria that are used in candidate selection are:
- 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, learning preferences and professional goals (determined by interview and letters of recommendation)
The ORMatch results will be emailed to the candidate and program supervisor by the date specified on the ORMatch website. Within 10 days, the program supervisor will send a confirmation letter to the matched candidates who are required to sign and return the letter within 30 days of the release of the ORMatch results.
The VA NIHCS residency program adheres to Executive Order 13160, “Nondiscrimination on the Basis of Race, Sex, Color, National Origin, Disability, Religion, Age, Sexual Orientation, and Status as a Parent in Federally Conducted Education and Training Programs”, and adheres to the VHA policy that prohibits “discrimination in federally-conducted education and training programs and activities on the basis of age, race, color, national origin, religion, ethnicity, culture, language, physical or mental disability, socioeconomic status, sex, sexual orientation, gender identity or expression, transgender status, pregnancy, marital status, political affiliation, genetic information, LEP, and status as a parent.” The program also prohibits harassment of any person or retaliation against any person who files a charge of discrimination based on any of these criteria.
Residents and applicants for residency who believe they have been subjected to discrimination may seek assistance under certain circumstances from the Merit Systems Protection Board, the Office of Special Counsel, the Agency’s Negotiated Grievance Procedure, or the Agency’s Internal Grievance Procedure.
The program enjoys a wide variety of current educational and informational resources that are readily available to the resident.
- Extensive on-line journal and medical references are available through VA NIHCS, Michigan College of Optometry and Indiana University. Well over 100 ophthalmic journals are available with full on-line text. These resources are also available to the resident 24 hours per day; 7 days per week.
- Numerous ophthalmic and general medical textbooks are located in the clinic and area available to the resident 24 hours per day; 7 days per week.
- Full access to library facilities and services through Michigan College of Optometry, including article retrieval and inter-library loan.
PHYSICAL FACILITIES AND EQUIPMENT:
The learning environment is enhanced by state of the art facilities and equipment including the following:
Patient waiting areas
Medical Support Assistant’s office
Auxiliary Examination Equipment
Imaging and special testing room
Visual field room
Fully equipped examination room with ophthalmic lasers
-CO2 laser available in OR for oculoplastic cases
Fully equipped examination room with low vision equipment
6 Fully equipped examination rooms
-Heine binocular indirect ophthalmoscopes, Haag Streit biomicroscopes 900 LED series, applanation tonometers, Reliance chair/stand units with wheel chair glides and computerized acuity testing systems
Patient education corner
Private offices for program supervisor and faculty
Tech work station
Staff break room
Numerous networked computers are located in offices and clinical areas (including each exam lane) and all are connected to a networked laser printer. From these computers, residents may access the following:
RESIDENT RIGHTS AND RESPONSIBILITIES:
The resident is entitled to the following:
- Employment for a 12 months period commencing on July 1 and ending June 30 of the residency year
- A stipend in the amount of $35,152* for this period, paid in 26 biweekly payments (*AY18-19 rate; check with program supervisor for current stipend)
- 13 days of paid annual leave, accrued at the rate of 4 hours per pay period; Unused leave may be “cashed out” at the conclusion of the program
- 13 days of paid sick leave, accrued at the rate of 4 hours per pay period; Extended sick leave requires documentation of medical necessity from the resident’s physician.
- 10 paid Federal Holidays
- Additional days of “authorized absence” may be granted at the supervisor’s discretion for purposes of attending professional activities that are part of the formal program curriculum.
- Eligibility to participate in the Federal Employees Health Benefits Program and the Federal Employees Group Life Insurance Program.
- Access to clinical instruction and facilities sufficient to meet the missions, goals and objectives of the program
- Access to a general schedule and program curriculum at the start of the program
- Uniforms (clinic jackets and/or scrubs)
- A certificate upon satisfactory completion of the residency (requirements for completion detailed below in section on “Resident Responsibilities”)
Resident Tour of Duty and Privileges:
- Appropriately supervised residents acting within the scope of their educational program are protected from personal liability under the Federal Employees’ Liability Reform and Tort Compensation Act 28 U.S.C. 2679 (b)-(d). The supervising practitioner is professionally and legally responsible for the care provided by the resident(s) and has final authority regarding patient management.
- 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. A minimum of 40 hours per week is required and the schedule is likely to contain an irregular number of hours for each workday. The weekly average will be 40-45 hours of assigned It is expected that the resident will spend additional time beyond the assigned hours for the purposes of chart completion, patient follow-up, research, lecture preparation, journal reviews, manuscript preparation, independent study, completion of patient log, and preparation of reports. While the residents do not officially “take call”, they are occasionally (typically less than once/month) called upon to provide after-hours urgent care in consultation with attending staff. Residents may be excused in the event of illness or out of town obligations.
- The resident may not hold a second VA position of employment. The resident may, however, work limited
hours in a non-VA setting if the following criteria are met:
- 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
- Evidence of malpractice insurance, which is the sole responsibility of the resident or non-VA employing facility, is provided
Requirements for completion:
- Serve as a resident for the entire period of time specified above (or the equivalent)
- Complete a manuscript of publishable quality OR present a scientific poster or grand rounds presentation (or equivalent) at the American Academy of Optometry (or other similar approved venue) prior to the end of the residency year
- Maintain patient and activity logs in a timely and accurate manner
- Provide periodic self-assessment and summary reports as requested by the program supervisor to assist in determining whether the program and resident are meeting stated goals and objectives
- Actively participate in didactic activities including conference, journal club, and lectures/case presentations
- Prior to the end of the residency year, present a lecture or case presentation to students, staff and/or colleagues at Michigan College of Optometry’s Residency Day (or other similar approved venue)
- Log at least 1700 patient encounters by the end of the residency year; exceptions may be made at the discretion of the program supervisor
- Demonstrate overall “satisfactory” or better clinical performance throughout the residency year
Residents are also expected to:
- Precept 4th year optometry students (last 6 months)
- Perform to the best of his/her abilities in all assigned duties.
- Refrain from participating in activities that interfere with the effective performance of assigned duties and responsibilities.
- Act in a professional manner at all times.
- Observe the rules and regulations of the Medical Center including
- practicing within the scope of clinical privileges
- practicing according to the rules of residency supervision and graduated levels of responsibility within the VA
- refuse payment from patients, staff physicians or others
FOR ADDITIONAL INFORMATION CONTACT:
Aaron Case, OD, FAAO
Residency Program Supervisor
VA Northern Indiana Health Care System
Email: [email protected]
- Summary of VA educational opportunities, including optometric residency and fellowship training: Follow link entitled “Education and Training”.
- Benefits of a VA Career in Optometry: Follow link entitled “Career as an Optometrist”.
Commonly asked questions about optometric residencies, residency directory and several other residency related links
List of accredited residency programs; Questions or concerns may be addressed to:
Accreditation Council on Optometric Education (ACOE)
243 N. Lindbergh Blvd. | St. Louis, MO 63141
P: (800) 365-2219, ext. 4262 | F: (314) 991-4101
Optometric Residency Matching Service – ORMatch
Matching forms and residency directory
Summary of MCO affiliated residency programs, including the Ocular Disease/Primary Care Residency at the VA Northern Indiana Health Care System in Fort Wayne, Indiana
Advanced Competence in Medical Optometry (ACMO) Examination - For Doctors of Optometry who have completed or who are in the process of completing an ACOE-accredited residency program. Also open to Optometrists who are actively involved in the training and education of VA optometry residents or who are clinically privileged to provide optometric patient care services to VA patients.
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