Residency in Primary Care/Ocular Disease
VA New England Healthcare System
White River Junction, Vermont
Established: 2003
Number of Positions: Two
Program Coordinator: Dorothy L. Hitchmoth O.D., FAAO
Assistant Program Educator: Richard Frick O.D., FAAO
Additional staff: Joseph Gallagher O.D.
This residency is funded by the Department of Veterans Affairs. The New England College of Optometry is the residency program affiliate.
Drs. Hitchmoth and Frick are award winning clinical preceptors with over 20 years of combined experience in optometric education.
Residency Mission, Goals and Objectives:
The following information outlines the mission, goals, and objectives of this residency program. Your progress through this program will be objectively documented and measured using several different tools. The resident and the program coordinator will be responsible for keeping separate journals to document the residency year.
The Mission of the Optometry service is to provide or ensure delivery of the highest level of quality eyecare for our nation’s veterans. This care will be delivered with compassion and in consideration of the Department of Veterans Affairs credo, which in part states;
"We believe our first responsibility is to America's veterans, the patriotic men and women who have defended our freedom and are one of our Country's greatest sources of pride. They have earned the health care and benefits provided by a grateful nation……" We must deliver quality medical care ……We must contribute to learning through medical education…."
The Mission of our education program is to educate post-graduate optometrists, optometric student interns, medical students, interns, and residents of Dartmouth medical school and center, as well as other members of the medical staff on all aspects of medical eyecare. The depth of education will be commensurate with the goals of each individual program.
The mission of our optometric residency program is to provide residents with extensive clinical experience within a patient population of veterans with multiple complex medical conditions. Care of these patients will require extensive utilization of specialty services as well as continuous consultation with other members of the medical team. This program will require participation in didactic and clinical care in both eyecare and internal medicine with emphasis as it applies to the practice of optometry and to the benefit of patient care. This program will foster and promote critical thinking through requirements to participate in the study of clinical research methods, case reports, formal lectures, posters or other publications at regional or national meetings. Ultimately this program will provide the resident with the skills necessary to pursue lifelong learning by ensuring competency in program objectives.
This program shall be of such excellence as to merit accreditation by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the Accreditation Council on Optometric Education (ACOE).
Goals:
Goal 1: Provide an educational and clinical environment that creates advanced competency for the resident in ocular disease, emergency eye care, vision care, and systemic disease.
Objectives for Goal 1:
Residents will be assigned to a patient care schedule at least 4 days per week. The resident will be the primary provider, within residency supervision guidelines, for patients exhibiting a wide variety of ocular diseases. The resident will have the opportunity, under supervision, to participate in advanced techniques.
Attending staff will maintain appropriate credentialing in advanced diagnostics. This service will recruit and maintain highly competent optometrists to serve the residents as clinical mentors, including credentials and experience in the following: fluoroscein angiography, laser scanning tomography, visual field analysis, scleral depression, 3-mirror fundus evaluation, gonioscopy, corneal topography, CT and MRI interpretation, minor extra-ocular and peri-ocular surgical procedures, and ocular photography through still, digital, and video image capture.
Residents will be required to rotate through our on-call service. After duty and weekend hours are covered 24hours/day/365 days/year. During call residents will be responsible for inpatient or care of patients presenting to our drop-in clinic or emergency room according to residency supervision guidelines.
Residents will have the opportunity to participate in post-operative care for patients who have undergone cataract surgery, retinal surgery or laser, or glaucoma procedures such as ALT or trabeculectomy. Residents will be responsible, in conjunction with an attending, for examining post-surgical patients who undergo surgery at any of our affiliate surgical sites. See the description of surgical sites in Goal 2.
Goal 2: Deliver an optometrist that has superior ability to function as an integral part of today's interdisciplinary health delivery system.
Objectives for Goal 2:
Residents will be assigned a fifth day to one of the following clinics on a rotating basis.V.A: ocular fluorescein angiography, visual field testing, laser retinal tomography, retinal photography, internal medicine, emergency medicine, radiology, neurology, and dermatology. Dartmouth-Hitchcock and Alice Peck Day Memorial: retinal surgery, cataract surgery, glaucoma surgery and clinic. Patients will also be encountered post-operatively either at the VA or affiliate facilities.
Residents will be required to consult with medical team members for all inpatients admitted for acute medical or surgical care to include respite, spinal cord injury, rehabilitation, and psychiatric admissions that present with ocular disease or ocular sequelae of systemic disease.
Residents will be members of the hospital house staff. Residents will be required to refer to other members of the hospital staff as well as receive consultation and referrals from staff members.
Residents will be responsible for prescribing medicines, ordering diagnostic tests such as laboratory studies, radiologic images, and vascular studies under the direct supervision of attending staff.
Goal 3: To expand the resident's knowledge base and ability to apply such knowledge in the clinical setting. Emphasis will be placed on both medical eyecare and internal medicine.
Objectives for Goal 3:
Residents will attend medical conferences and grand rounds presented by the Dartmouth Hitchcock Medical Center every Friday. Experts from around the country and the world present at these morning rounds. Optometry grand rounds will be held on Friday afternoon following patient care. Residents will be required to attend these conferences every week.
Internal medicine, mortality and morbidity, and radiology conferences are present during the lunch hour on Tuesdays and Thursdays. Optometry residents will be required to attend at least one of these conferences every week.
Goal 4: To support and advise the resident in completion of a research project, clinical case report, or other scholarly activity.
Objectives for Goal 4:
Residents will be responsible for submitting for publication one case presentation, literature review, or research project to a medical or optometric journal.
Residents will be responsible for preparing at least two presentations over the course of one year on general eyecare topics to the V.A. medical staff and residents.
Residents will be responsible for preparing a brief case presentation for our Friday afternoon eyecare conference on a monthly basis. This presentation will be completed with the assistance of one fourth-year optometry student.
The resident will be required to attend the two NECO Residency Conferences and give a formal presentation at the Spring Conference.
Goal 5: To encourage and require residents to participate in clinical teaching and guidance.
Objective for Goal 5:
Optometry residents will team with one fourth year optometry intern, medical student, medical resident, nurse practitioner candidate or physician assistant candidate as dictated by the respective program one-half day per week during clinical encounters. The resident will be directly responsible for clinic care and teaching in this capacity. When working with an optometry student, the optometry resident will be present during the exam(s) to provide guidance to optometric interns. Similarly, optometry residents will perform eye exams and provide direct clinical instruction in basic ocular exam and eye conditions to medical students, interns, and residents, or the aforementioned disciplines in accordance with their respective programs. For example, a medical student may need instruction on the proper use of the ophthalmoscope. The optometry resident would provide this instruction on a live patient during the course of an eye exam. This activity would also increase interdisciplinary understanding of the OD degree.
Goal 6: The program director and all other attending doctors will serve as examples of the consummate optometric professional.
Objective for Goal 6:
Attending doctors will serve as leaders in optometry, healthcare, or academics by participating in local, state, or national optometric programs. Such programs may include state or national association committee or board membership. They may also include board participation on hospital or local academic committees. Residents will be required to participate in at least two board meetings, as an observer, during the course of their residency year.
Attending doctors will provide information and instruction on administrative topics influencing healthcare today. Seminars or mini-lectures will be provided on such topics as health care legislation, HCFA regulation, HIPPA regulation etc. One topic every other Friday after the grand rounds will be presented.
Length of Residency and Duty Hours:
This residency commences on July 1st every year and ends June 30th of the following year. A total of twelve months must be completed. Duty hours are Monday through Friday 7:30a.m. to 5:00 p.m. On-call hours will be in addition to regular duty hours and will not exceed 48 hours bimonthly. Specific call hours are determined by the clinic schedule.
Compensation and Benefits:
The current annual salary is $30,009. This residency is currently funded through the Department of Veterans Affairs, Office of Academic Affairs. The White River Junction VAMC is fully accredited by the Accreditation Council on Optometric Education (ACOE).
Annual leave (vacation) is earned at the rate of 4 hours for every 80 hours on duty not to include on-call hours. Sick leave is also provided at the same rate. Education leave is granted annually for all days of the AOA Congress and AAO meeting. Other educational meetings may be considered.
Professional liability coverage is provided by the Department of Veterans Affairs. It should be noted that there is no active policy provided by VHA that covers residents in practice outside VHA. It should also be understood that VHA professional liability coverage is not maintained in the form of a paid policy. VHA provides liability protection through “self insurance” directives. Questions about liability should be directed to the VHA Department of Human Resources or the residency program director.
White River VAMC Optometry Residency Program receives funding through VHA OAA. Health insurance benefits are provided through VHA. Health insurance benefits are the same benefits offered to regular employees of the White River Junction VAMC. Currently two comprehensive plan options, through Blue Cross Blue Shield of Vermont, are available. All questions about health insurance coverage should be directed to Kathy Mason, Human Resources Department, phone 1-802-295-9363, email: Kathy.mason@med.va.gov.
Application Requirements:
Applicants must have completed the Doctor of Optometry degree (O.D.) from an AOA/COE accredited school and be license eligible.
Applicants must have completed and passed Parts I and II of the National Board of Examiners board exams. Official copies of such scores will be required.
Applicants must seek licensure in any state of the US and must obtain licensure as soon as possible and according to the board rules of the particular state of application.
Preference is given to citizens of the United States. Foreign citizens cannot be considered.
A personal interview is strongly encouraged.
Applicants must apply via the Optometry Residency Matching Services, Inc. (ORMS) and follow the application guidelines www.orms.org
Deadline for applications is February 1st every year.
Three letters of recommendation from clinical preceptors are also required. Each letter must come from a clinical preceptor with whom you had direct clinical care experiences.
Official school transcripts with seal are required.
All Department of Veterans affairs policies with regard to discrimination are followed in the selection process. No preference or exclusion will be given to any candidate based on gender, race, color, creed, age, or national origin.
Criteria for Completion of Residency:
The goals and objectives of this program must be followed and understood to successfully complete this program. The program director and assistant director will provide formal evaluation at the 3, 6, 9, and 12-month intervals. Each evaluation period goals and objectives will be carefully reviewed. Professional conduct as outlined in the orientation material must be followed. All Department of Veterans Affairs policies as outlined in the self-study module must be followed. A journal and log of all activities will also be required for completion. A scholarly work of publishable quality must also be completed. All residents will be required to apply and sit for the Advanced Competency in Medial Optometry (ACMO) exam. A certificate of completion is awarded by the New England College of Optometry once all of the above requirements are met and at the cessation of the residency year.
Questions and Answers:
Dr. Dorothy L. Hitchmoth
Program Director
Surgical Service/Optometry Section
Department of Veterans Affairs
White River Junction, VT 05009
802-295-9363 ext. 5248
Or
Dr. Douglas Hoffman
Director of Residencies
The New England College of Optometry
940 Commonwealth Avenue
Boston, Massachusetts 02215
617-587-5511 ext. 5177