I recently completed my first rotation as an OD4 at a Veteran’s Affairs (VA) Hospital and found it to be one of my favorite clinical sites to date. All NECO students are required to complete 4 three-month long rotations at various sites, during their final year in the program: a Veteran’s Affairs Medical Center, a specialty site, a Community Health Center and an elective site.
As most of my clinical experience over the past 3 years had been at community health centers, I didn’t know what to expect on that first day of my VA rotation. There I was, a newly minted OD4, going from one day of clinic a week as an OD3 to working full time as an optometry intern (with only a two-day break in between). The learning curve was steep and the VA-specific methods of completing charts and performing patient care took some getting used to. However, by the end of my rotation, I was truly sad that my time working at the VA had come to an end.
I found the VA Hospital to be similar to a community health center in that in both settings I was mainly performing comprehensive eye examinations (rather than specialty services). Where community health centers and VAs tend to differ is in the pace at which you are expected to conduct each eye examination. Unlike a Community Health Center, an interpreter was rarely needed at the VA, which meant that we were expected to complete our eye examinations at a much quicker pace.
The average patient age also differed. At a community health center, the age range was extremely large. I could see a patient anywhere from a 1 month old to a 99 year old in a single day. At the VA, on the other hand, the patient population was most often over the age of 60. This meant that I gained greater experience with diseases and conditions that occur more commonly in these age groups, such as glaucoma, diabetic retinopathy, cataracts and age-related macular degeneration.
One of the aspects of the VA I liked was that most of the patients were established, and had been patients of the VA Hospital for many decades. Every patient chart contained many years worth of labs, primary care visits, and eye care exams. It may have taken me a little extra time to review this abundance of pre-existing information, but I found it very helpful being able to start each eye examination already knowing most of my patient’s medical and ocular history. It often made tailoring the exam to their specific medical needs much easier.
At my VA rotation, student interns were expected to spend a certain amount of time each week working in the optical and dispensing. I had not had much experience fixing and fitting spectacles up to this point, so I was glad to have the opportunity to become more familiar with these techniques in a setting where I could ask for assistance and advice.
Working at a Veterans Affairs hospital for my first rotation was fast paced and the veterans I met were a friendly, worldly, and understanding group of individuals. I learned a great deal and I would definitely recommend a VA site to any future students. It was a truly unique experience working with these amazing people.
Maria is a Canadian student in her final year of the four year OD/MS dual degree program. For her MS project, she is working with Dr. Vera-Diaz and Dr. Panorgias examining color vision and early age-related macular degeneration.