Cornea/Contact Lenses

Goal 1: To provide an extensive and varied clinical experience in management of ocular disease and corneal conditions, as well as treating various conditions with specialty contact lenses.       

Objectives: 

1.  The resident will become proficient and efficient in the provision of eye care services.
   1. Outcome: 
      • The resident will be involved in over 2000 patient care encounters.
   2. Measure: 
      • The resident will utilize the patient encounter log to track and report the number of patient encounters, including diagnoses, the level of case complexity, and the level of resident’s involvement (direct, precept,  observational/shared care or consultation).
2. The resident will provide care to a sufficient number and diversity of patient encounters to feel competent in the design, fitting, and problem-solving of both relatively easy-to-fit and challenging cases such as presbyopia, high astigmatism, keratoconus, and post-surgical contact lens care.
   1. Outcome:
      • The resident will be involved in over 800 contact lens fits and management.
   2. Measure:
      • The resident will utilize the patient encounter log to track and report the number of patient encounters, including diagnoses, the level of case complexity, and the level of resident’s involvement (direct, precept, observational, or consultation).
      • Daily case discussions, chart review, and quarterly medical record audits will evaluate the appropriateness of lens designs and patient management.
      • The resident’s performance will be communicated via daily feedback, and will be reflected in the written evaluations provided by the faculty at three-, six-, and twelve-month intervals.
      • The resident will track and report attendance at related conferences.
3. Under the supervision of attending staff, the resident will provide care to a sufficient number of patient encounters to feel competent in the design, fitting, and management of corneal reshaping lenses and procedures. 
   1. Outcome:
      • The resident will be involved in the care of over 40 corneal reshaping patients.
   2. Measure:
      • The resident will utilize the patient encounter log to track and report the number of patient encounters, including diagnoses, the level of case complexity, and the level of resident’s involvement (direct, precept, observational, or consultation).
      • Daily case discussions, chart review, and quarterly medical record audits will evaluate the appropriateness of lens designs and patient management.
      • The resident’s performance will be communicated via daily feedback, and will be reflected in the written evaluations provided by the faculty at three-, six-, and twelve-month intervals.
      • The resident will track and report attendance at related conferences.
4. Under supervision of attending staff, the resident will provide care to pre- and post-surgical refractive surgery patients.
   1. Outcome: 
      • The resident will be involved in the care of over 50 pre- and post-surgical refractive surgery patients.
   2. Measure:
      • The resident will utilize the patient encounter log to track and report the number of patient encounters, including diagnoses, the level of case complexity, and the level of resident’s involvement (direct, precept, observational or consultation).
5. Under supervision of attending staff, the resident will interact with cornea sub-specialists.
   1. Outcome: 
      • The resident will assist in pre- and post-operative care of over 400 patients and will observe a variety of laser and surgical procedures. 
      • The resident will assist in the diagnosis and management of 500 patients with diseases of the anterior segment.
   2. Measure:
      • The resident will utilize the patient encounter log to track and report the number of patient encounters, including diagnoses, the level of case complexity, and the level of resident’s involvement (direct, precept, observational or consultation).
      • Daily case discussions, chart review, and quarterly medical record audits will evaluate the appropriateness of lens designs and patient management.
      • The resident’s performance will be communicated via daily feedback, and will be reflected in the written evaluations provided by the faculty at three-, six-, and twelve-month intervals.
      • The resident will track and report attendance at related conferences.
      • The resident’s schedule will reflect the portion of his/her time that is dedicated to ophthalmology observation/interaction.
6. The resident will use appropriate data collection methods, case analysis, and treatment/management decisions during patient care
   1. Outcome:
      • The resident will perform at ‘expected’ or above for categories: data collection methods, case analysis, and treatment and management of the three-, six-, and twelve-month resident evaluation.
   2. Measure:
      • The residency supervisor and residency faculty will evaluate the resident’s performance in the areas of data collection, case analysis, treatment and management during the three-, six-, and twelve-month evaluation.

 Goal 2: To provide the resident with experiences and skills that will facilitate continued contribution to the profession of optometry through a variety of venues including the following: teaching, scholarly activities, and involvement in community and professional organizations.    

Objectives:

1. The resident will develop skills necessary for clinical optometric teaching.
   1. Outcome: 
      • The resident will precept optometry students in the delivery of patient care for over 400 encounters.
   2. Measure:
      • The resident will utilize the patient encounter log to track and report the number of patient encounters, including diagnoses, the level of case complexity, and the level of resident’s involvement (direct, precept, or observational).
      • Daily case discussions, chart review, and quarterly medical record audits will evaluate the appropriateness of lens designs and patient management.
      • The resident’s performance will be reflected in the written evaluations provided by the faculty at three-, six-, and twelve-month intervals.
      • At the conclusion of their rotation, third- and fourth-year optometry students will provide a written assessment of the resident’s performance.
      • The resident’s schedule will reflect the portion of time that is dedicated to clinical preceptorship of third- and fourth-year students.
2. The resident will participate in a wide variety of didactic offerings.
   1. Outcome: 
      • The resident will attend and actively participate in  several case presentations and interactive lectures, continuing medical/optometric education courses, Michigan College of Optometry’s  Grand Rounds and Resident’s Day Grand Rounds. 
   2. Measure:
      • The resident will track and report attendance and participation on a quarterly basis (activity log).
3. The resident will organize and serve as a workshop instructor at workshops throughout the year.
   1. Outcome:
      • The resident will organize and supervise the annual GP Lens Workshop, Soft Toric, and Soft Multifocal Workshops.
   2. Measure:
      • The resident will complete and submit an activity log summarizing these responsibilities on a quarterly basis.
4. The resident will develop skills necessary to prepare a scientific publication or presentation.
   1. Outcome: 
      • The resident will present a poster/paper at a professional meeting and prepare a manuscript of publishable quality.
   2. Measure:
      • For poster/paper presentation: the resident will be required to submit a copy of the poster and abstract to the program supervisor and present their findings in lecture format during optometry conference. 
      • For manuscript preparation:  the resident will be required to follow the standard format as detailed by Optometry and Vision Science’s “Instructions to Authors.”  A copy of the final manuscript must be submitted to, and approved by, the program supervisor.
5. The resident will be exposed to community and professional organizations and will be given the opportunity to participate.
   1. Outcome: 
      • The resident will be encouraged to attend and speak at the Michigan Optometric Association (MOA) and the West Michigan Optometric Society (WMOA) meetings.
      • The resident will be encouraged to contribute brief articles or journal reviews for publication in the Michigan Optometrist, Journal of Optometric Education, AOSA News, etc. 
   2. Measure:
      • Resident will submit an activity log on quarterly basis.
      • Resident will submit a summary or copy of handout.

Goal 3:  To enhance the resident’s ability to communicate verbally and in writing.

Objectives:

1. The resident will develop the skills necessary for effective verbal communication with patients and members of the medical community.
   1. Outcome: 
      • The resident will communicate clearly and use appropriate terminology when presenting information to patients, clinic co-workers, students, and attending/consulting staff.

1. 1. Measure: 
      • The resident’s performance in this area will be evaluated via frequent case discussions, including consultation with optometrists and ophthalmologists via Art Optical consultation service.
      • Resident’s performance will be communicated via frequent feedback and will be reflected in the written evaluations provided by the faculty at three-, six-, and twelve-month intervals.
2. The resident will develop the skills necessary for effective written communication within the medical community.
   1. Outcome: 
      • The resident will use appropriate medical terminology when documenting the clinical findings, assessment, and plan in the medical record. 
      • The resident’s entries will be accurate and of sufficient detail to ensure continuity of care for the patient.
   2. Measure: 
      • The resident’s performance in this area will be evaluated via daily chart review and will be reflected in the written evaluations provided by the faculty at three-, six-, and twelve-month intervals.
      • Quarterly medical record audits will assess performance in this area.
3. The resident will develop the skills necessary to prepare a scientific publication or presentation.
   1. Outcome: 
      • The resident will present a poster/paper at a professional meeting and prepare a manuscript of publishable quality.
   2. Measure:
      • For poster/paper presentation:  The resident will be required to submit a copy of the poster and abstract to the program supervisor and present their findings in lecture format during optometry conference. 
      • For manuscript preparation:  The resident will be required to follow the standard format as detailed by Optometry and Vision Science’s “Instructions to Authors”.  A copy of the final manuscript must be submitted to, and approved by, the program supervisor.
      • The resident will conduct and coordinate clinical research studies pertaining to gas permeable (GP) lenses, soft contact lenses, corneal reshaping lenses, contact lens care systems, etc.

 

Goal 4:  To develop skills/tools necessary to care for patients with complex problems.

 Objectives:

1. The resident will develop critical thinking and problem-solving skills that will enhance their ability to form differential diagnoses and management plans.
   1. Outcome: 
      • The resident and attending faculty will discuss case analysis, differential diagnosis, and management strategies of complex patients routinely throughout the year.
      • The resident will facilitate similar discussions with fourth year students via journal club discussions.
   2. Measure: 
      • The resident’s performance in this area will be evaluated via frequent case discussions, chart reviews, and conference participation. 
      • The resident’s performance will be reflected in daily feedback, as well as in the written evaluations provided by the faculty at three-, six-, and twelve-month intervals.
      • The resident’s performance in this area includes consultation with optometrists and ophthalmologists via Art Optical consultation service.
      • The resident will track and report attendance at conferences.
      • Seminars during the resident’s development time at MCO and during the consultation time at Art Optical will be interactive in nature and emphasize differential diagnosis/ case analysis.
      • At the conclusion of their fourth-year rotation, optometry students will provide a written assessment of the resident’s performance.
2. The resident will improve his/her understanding of experimental design and statistical analysis, and will apply this knowledge in critical review of the ophthalmic literature.
   1. Outcome: 
      • The resident will present a detailed review of at least one landmark study (including a discussion of the hypothesis, experimental design, results, conclusions, and limitations of the study). 
      • Residents attending the American Academy of Optometry (or other similar scientific meetings) will be required to present an overview and critical analysis of new ideas and information learned at the meeting.
   2. Measure: 
      • Resident performance in this area will be reflected in the written evaluations provided by faculty at three-, six-, and twelve-month intervals.
      • The resident will record participation/presentations in optometry conferences.  

 

Goal 5: To gain expertise in advanced technical skills.

 Objectives:

1. The resident will become proficient in diagnostic and therapeutic anterior segment procedures.
   1. Outcome: 
      • The resident will perform a variety of anterior segment procedures including, but not limited to, foreign body removal, and punctual plug insertion/removal (5 for each procedure). 
      • Resident will become familiar with the indication for each technique and the interpretation of the findings.
   2. Measure:
      • Resident will utilize the patient encounter log to track and report the number of procedures performed.
      • The resident’s performance in this area will be evaluated via observation, case discussions, and chart review.
      • Resident’s performance will be communicated via daily feedback and will be reflected in the written evaluations provided by the faculty at three-, six-, and twelve-month intervals.
2. The resident will become proficient in ocular ultrasonography and photography.
   1. Outcome: 
      • The resident will perform a variety of diagnostic techniques including the following:  A-scan and B-scan ultrasonography, corneal pachymetry, color fundus photography, and color anterior segment photography (20 each procedure).
      • The resident will become familiar with the indications for each technique and the interpretation of findings.
   2. Measure:
      • The resident will utilize the patient encounter log to track and report the number of procedures performed.
      • The resident’s performance in this area will be evaluated via observation, case discussions, and chart review.
      • Resident’s performance will be communicated via daily feedback and will be reflected in the written evaluations provided by the faculty at three-, six-, and twelve-month intervals.
3. The resident will become proficient in problem solving complications of contact lenses.
   1. Outcome:
      • The resident will co-consult with Art Optical for over 600 consultations as he/she provides phone consultation with other doctors, located nationally and internationally, regarding proper fit and management of GP contact lenses.
      • The resident will learn optical rehabilitation for the patient with corneal disease and management of contact lens complications.
   2. Measure:
      • The resident’s performance in this area will be evaluated via observation, case discussions, and chart review.   The resident will observe and interact with the consultant for the first 10 weeks and the consultant will listen to and critique the resident for next 10 weeks.    During the third and fourth 10 weeks, the resident will provide consultation by him/herself.   
      • The resident’s performance will be communicated via daily feedback and will be reflected in the written evaluations provided by the faculty at three-, six-, and twelve-month intervals.
      • The resident will utilize the patient encounter log to track and report the number of contact lens induced complications or management problems.
4. The resident will become proficient in obtaining and interpreting topography records.
   1. Outcome: 
      • The resident will perform and interpret 100 topographies for a variety of corneal diseases, corneal reshaping patients, and other contact lens induced irregular astigmatism.
      • The resident will co-consult with Art Optical as they provide phone consultation with other doctors located nationally and internationally regarding proper fit and management of GP contact lenses. 
      • The resident will utilize the patient encounter log to track and report the number of procedures performed.
      • The resident’s performance in this area will be evaluated via observation, case discussions, and chart review.
      • The resident will utilize the patient encounter log to track and report the number, type, and complexity of consultations at Art Optical.  The resident will observe and interact with the consultant for the first 10 weeks, then the consultant will listen to and critique the resident for next 10 weeks.    During the third and fourth 10 weeks, the resident will provide consultation by him/herself.    
   2. Measure:
      • The resident’s telephone performance will be evaluated via observation and case discussion.
      • The resident’s performance will be communicated via daily feedback and will be reflected in the written evaluations provided by the faculty at three-, six-, and twelve-month intervals. 

Approximately four to eight hours per week is allotted for professional self-development. This includes time to work on grants, examine clinical research subjects, review the literature to abstract articles, prepare for the weekly seminars or working on a research paper.

The resident is expected to be present 10 half days each week. When the clinic is closed, or there are no patients scheduled, the resident should use this time to work on clinical studies, literature reviews for the newsletter, writing projects, new seminars and Contact Lens Service responsibilities.

The resident is expected to provide coverage and or supervision of fourth year students during school breaks for contact lens and primary care patients. The resident will be notified in advance of any on-call assignments.

Scholarly Activities:

The resident is required to present a poster or paper at a nationally recognized professional meeting, and prepare a manuscript of publishable quality, and participate in an ongoing clinical study at the Michigan College of Optometry 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 five educational leave days. 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 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 and/or East West Conference Annual Meetings.

The University Eye Center (UEC) is a full-service eye care clinic located within the Michigan College of Optometry (MCO) at Ferris State University. The clinic services University employees, students, the Big Rapids community, and Northern/Western Michigan. In addition to providing comprehensive care, the UEC has specialty clinics in the following areas: Ocular Disease, Pre- and Post-Surgical Care, Specialty Contact Lenses, Pediatrics, and Binocular Vision & Vision Therapy. Each specialty clinic is run by dedicated doctors who are leaders in their areas of expertise, and often receive referrals from practitioners all over the state of Michigan.

• Employment for a 12 months period commencing on July 1 and ending June 30 of the residency year
• Stipend of $41,000
• Medical and malpractice insurance
• Ten leave days for personal/professional activities. An appropriate amount of leave for illness. Extended sick leave requires documentation of medical necessity from the resident’s physician

Completion is monitored by the supervisor via patient logs, scholarly and didactic activity logs  and communication with faculty and other cinical staff.

1.  Obtain all the requirements necessary to practice optometry in the state of Michigan, including state Optometric licensure and updated CPR training
2. Perform to the best of his/her abilities in all assigned duties
3. Completion of all residency requirements, including:
   • Serve as a resident for the entire period of time specified above
   • Complete a manuscript of publishable quality and present a scientific poster at the American Academy of Optometry (or other similar approved venue)
   • Maintain patient and activity logs with reasonable accuracy
   • Provide self-assessment and summary reports as requested by the Program Supervisor to assist in determining whether the program is meeting its objectives
   • Actively participate in didactic activities (i.e. Journal club, MCO Grand Rounds, Resident’s Day Grand Rounds)
   • Present several case and interactive lecture presentations to students, staff and/or colleagues at the Michigan College of Optometry or other location
   • Organize and serve as a workshop instructor for contact lens workshops
   • Conduct and coordinate clinical research studies pertaining to rigid gas permeable lenses, soft contact lenses, corneal reshaping lenses, etc.
   • For any attended conferences (i.e. AAO, GSLS, etc.), present an overview and critical analysis of new ideas and information learned at the meeting
4. To maintain standards of competence in clinical practice 
5. To act in a professional manner at all times
6. To observe all rules and regulations of the MCO Optometry Clinic, including:
   • Practice within the scope of clinical privileges
   • Practice according to the rules of residency supervision 
7. To refrain from participating in any activities (personal or non-MCO employment related) that would interfere with the effective performance of all assigned duties and responsibilities
8. To refuse fees or payment in any form from patients, staff physicians or others, unless agreed upon by the residency supervisor