A month into my new clinic site, the differences between practicing at a community health center and a private practice are now coming to light. When interview candidates ask why I chose NECO, I always refer to the clinical program. In a city as diverse and crowded as Boston, students have the opportunity to rotate through multiple clinics and see different communities rather than staying at one clinic with one demographic.
In my fall semester, I was located at Dimock Health Center in Roxbury. Among a group of five students, four were third years and one was a second year. It is pretty daunting when you go in to a new placement location without your classmates, but the upper years were there to help me transition into the site and I was able to shadow them and learn how to use the health record system before getting into a routine of seeing my own patients.
Dimock has multiple exam rooms, which allows each student to conduct an eye exam with their own patients. Once I was on my own, I would perform an evaluation of the anterior portion of the eye, check in with a preceptor for dilation, and then evaluate the posterior portion before my final check-in. On Saturdays at Dimock, one preceptor and on occasion one resident are present to check in with during the exam. Every preceptor we work with is a practicing OD who helps us learn more about practicing optometry.
What I enjoyed about the community health center was the independence of going at your own pace (as long as you’re not taking forever). The only way to cut down on the speed of your exam is to practice. With the electronic health system keeping track of my exam times, I was able to see my personal improvement over the course of the semester. The system allowed the preceptors to see my updates to a patient’s record in real time, so the doctors can check in on students remotely to see our progress.
At the community health center, the patient demographic is very diverse and not everyone speaks English. What I appreciated most was the preceptor going over each patient’s case history with us on Saturday mornings before we began seeing patients. Rather than going into an exam room with no information, I was able to learn a bit about each patient before greeting them. I would know when to use a phone translator for a patient, what procedures needed to be done for specific patients, or if a patient was new to the center. As someone who was new to clinic, it was nice knowing what to expect during an exam.
This spring, my clinical placement is at Eye Associates of Somerville, a private practice. Rather than going to this placement with a group of students, I am the sole student assigned on a certain day. Although my clinic days have changed between the health center and private practice, I appreciate being able to experience the two and having the opportunity to form my own opinions about where I want to practice for the future.
In the Somerville practice, there is one exam room per doctor. Rather than being entirely on my own, my preceptor monitors the way I interact with patients and gives constructive criticism to help improve the speed of my exams. At the private practice, most patients have been with my preceptor for years, so they are comfortable with the doctor going over each case with me and taking time during the exam to go over his thought process. Watching patients interact with Dr. Titelbaum reminds me why I chose this path in the first place. This friendly doctor-patient interaction is something I strive for in the future and hopefully will be able to achieve one day.
Being on my own at the community health center has helped me learn how to interact with patients in a more flowing manner. In our Clinical Simulation lab over the summer, we practiced a basic format of patient interaction, but last semester I was able to really learn how to change the flow of interaction based on each patient. This semester I am focusing more on the analysis behind a patient’s visit and combining everything that I have learned so far and thinking more about the diagnosis and plan of action with each patient. I am glad to be able to takeaway a variety of lessons from each clinic site and looking forward to seeing where I will be in the summer!
Tiffany is a third year student at New England College of Optometry. Born and raised in Maryland, she graduated from the University of Maryland in both Biological Sciences and Psychology. Her initial interest in optometry stems from shadowing and working in practices that provide vision therapy.