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My Residency at Massachusetts Eye and Ear Infirmary

Insights into residency text in front of phoropter photo

An optometric residency is an additional year of post-graduate clinical education that can be pursued by optometrists who desire to advance their patient care abilities beyond entry level practice. New England College of Optometry offers residencies in community health, cornea and contact lens, low vision rehabilitation, ocular disease, pediatric optometry, primary care optometry, VA primary eye care, and VA ocular disease. Lenna Walker, OD, shares her experiences pursuing the Ocular Disease/Cornea and Contact Lens Residency at Massachusetts Eye and Ear Infirmary, Boston.

I decided to pursue an ocular disease residency because I knew I wanted to practice medical optometry in a hospital, community health center, or OD/MD clinic setting. A residency provides advanced training that makes you a more competitive applicant for these jobs, and, in general, a more confident, better-rounded clinician. I decided to apply to Massachusetts Eye and Ear Infirmary (MEEI), specifically, because the program is truly one-of-a-kind. 

Lenna Walker in front of a poster. Global Specialty Lens Symposium 2019 – Poster
At MEEI, the program is focused on both ocular disease and specialty contact lenses. (You don’t have to choose!) If I had to put numbers to it, I would say I spend about 80% of my time managing ocular disease and 20% of my time fitting specialty contact lenses. The program is broken into four 3-month rotations, where each rotation has a different schedule, and each day is spent in two different clinics. In total, I will rotate through five different sub-specialties: Optometry/Contact Lens, Vision Rehab (aka Low Vision), Cornea, Neuro-ophthalmology and Oculoplastics. In addition to spending time in these services, I work in the Emergency Department each week. 

Group of students in holiday sweaters. Holiday Party with NECO Residents
I could write a novel detailing all of the different, uniquely valuable experiences I have had in each service, but here I will focus on two of my favorite aspects of the program. First, the program is very heavy in cornea care and this education lends itself well to a specialty contact lens practice. Within the Cornea service, I work with a number of different ophthalmologists who each have their own specific disease interests. For example, I work with one doctor who focuses on severe ocular surface disease (think GVHD, SJS, Sjogrens), another doctor who focuses on full-thickness corneal transplants and Boston KPro implantation, and another doctor who focuses on refractive surgeries as well as FED and endothelial keratoplasty, ETC. You can imagine how these various ocular surface and corneal conditions require specialty lenses – sclerals for dry eye, RGPs for irregular corneal surfaces, bandage contact lenses for KPro protection, etc. I love the bridge between these two services and I feel like it is a great example of how Ophthalmology and Optometry can work together to best serve a patient’s needs.

Lenna wearing surgical mask and scrubs. Preparing for surgery observation!
The second aspect of the program that I find very valuable is the time spent in the Emergency Department (ED). In the ED, I work alongside the junior ophthalmology residents as well as one or two attending doctors, and here, you see a bit of anything and everything. We have walk-ins from the street as well as referrals from all over New England. You see a lot of interesting, genuinely urgent cases and, I think just as importantly, you see a lot of routine cases. You quickly learn how to distinguish between urgent and non-urgent, and you learn how to triage and/or manage those cases efficiently. It is an exceptional learning experience. 

Outside of clinic, I attend morning lectures. Monday through Wednesday there are Chief Rounds which are lectures given by the chief ophthalmology resident to the junior ophthalmology residents as they prepare for boards – think of it as a review of everything. In my role attending these are optional, but highly encouraged.  On Thursday, there are two lectures: Neuro-Ophthalmology Conference and Grand Rounds. These involve interesting case presentations often outlining a rare condition or a novel treatment. Friday there is the Resident Lecture Series. These are usually lectures given by attending doctors on their specialty, or a journal club on research publications. (It is important to note that Thursdays and Fridays involve free breakfast!)

In addition to lectures in Boston, I have had the chance to attend several different conferences across the country. I went to the GPLI Institute in St. Louis —a wonderful, immersive program about specialty contact lenses that is only open to contact lens residents. This is a chance for you to learn more about contact lenses as well as meet the other CL residents from across the country and network with representatives from all the different manufacturing companies.  I also went to the American Academy of Optometry meeting in San Antonio where I was required to present a poster. Most recently, I went to the Global Specialty Lens Symposium in Las Vegas – another specialty contact lens conference in Las Vegas with great lectures, poster presentations, and a chance to reunite with everyone I met at GPLI.

Global Specialty Lens Symposium 2019 – Scleral Lens Education Society Reception Global Specialty Lens Symposium 2019 – Scleral Lens Education Society Reception

I could go on and on about the MEEI residency program, but I’ll stop here. I feel so fortunate to have been matched with MEEI and to be learning from some of the top eye doctors in the nation. I encourage everyone with a strong work ethic and a serious interest in ocular disease and specialty contact lenses to apply!

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