Wyoming VA Community Based Outpatient Clinic

Goal 1: The resident will gain proficiency in the diagnosis and management of ocular disease and become adept in managing the associated systemic complications encountered in eye care.

• The resident will be actively involved in over 1500 patient encounters through direct care and observation.
• The resident will assume responsibility for the care, follow up, and appropriate referrals of their patients under the supervision of the attending optometrists.
• The resident will be involved in an interdisciplinary approach to eye care and be responsible for maintaining a working relationship with internal medicine and other associated specialties to ensure total care of the patient. The sending and receiving of electronic consults and personal interaction will be utilized.
• The resident will be responsible for appropriately ordering and performing/interpreting special testing involved in eye care including visual fields (Humphrey and FDT Matrix), optical coherence tomography (OCT), pachymetry, gonioscopy, and digital photography.
• The resident will be responsible for appropriately ordering imaging (CT, MRI, carotid Doppler) and laboratory tests and consulting with other physicians when indicated.
• The resident will become proficient in techniques of physical assessment (ie: blood pressure, pulse, cranial nerve screening, mental status assessment, carotid auscultation).
• The resident will become proficient in examination of ocular structure utilizing a variety of techniques including contact and non-contact lens examination and scleral depression.

 

Goal 2: The resident will gain proficiency in advanced treatment of eye disease including performing minor surgical procedures.

The resident will become proficient in the following:

• Corneal Foreign Body Removal 
• Epilation 
• Dilation and Irrigation of the Nasolacrimal System 
• Subcutaneous injection 
• Incision and drainage of periorbital cysts (sebaceous, sudoriferous, etc.) 
• Excision of periorbital tumors

Goal 3: The resident will develop effective communication and interpersonal skills.

The resident’s verbal skills will be assessed and measured through the following:

• Effective education of patients regarding assessment and plan. 
• Presentation of their case summary in a clear and succinct manner to the attending faculty. 
• Appropriate direct interaction with interdisciplinary providers. 
• Quarterly case presentations at Grand Rounds. 
• Lectures given at the Michigan College of Optometry’s Residency Day 
• Monthly lectures about diabetic eye care to newly diagnosed diabetics
• The resident’s written skills will be assessed and measured through the following:
• The resident’s medical terminology and written skills will be assessed daily through progress notes in the computerized medical records system. 
• Two case reports of publishable quality suitable for admission into the Academy of Optometry will be written. 
• The resident will prepare a poster to be presented at a professional meeting (American Academy of Optometry).

** The Resident will achieve the necessary points to achieve fellowship in the American Academy of Optometry (FAAO). A total of 50 points is needed: 20 points for the residency, 10 points for each case report, and 10 points for an Academy Poster. Should the Academy Poster not be accepted, a third case report of publishable quality may be substituted.

Goal 4: The resident will develop the necessary critical thinking and problem solving skills to effectively and correctly diagnose challenging ocular disease cases.

• The resident will be challenged by the attending faculty to appropriately collect and analyze the data to create a list of differential diagnosis needed to make the assessment. The resident will be expected to know the reason for every test ordered. 
• The resident will continuously strive to improve their knowledge of ocular and systemic disease and apply this knowledge in the evaluation, diagnosis and management of patients. 
• The resident will improve their understanding of experimental design and statistical analysis necessary to critically review medically published and online articles/studies.

Goal 5: The resident will be encouraged to develop into a leader of the optometric community and will develop the skills needed to provide lifelong contribution to the profession of optometry.

• The resident will learn how to effectively teach clinical skills by assisting the attending optometrists with fourth year optometry interns. 
• The resident will lead online case discussions through the WebCT program associated with the Michigan College of Optometry 
• The resident will be encouraged to join the West Michigan Optometric Association and other optometric service organizations as well. 
• The resident will present a poster at a professional meeting.
• The resident will be an active leader in monthly Grand Rounds which provides continuing medical education to area providers. 
• The resident will present a lecture to third year optometry students on the subject of ocular disease at the annual Michigan College of Optometry’s Residency Day. 
• The resident will gain proficiency in the diagnosis and management of ocular disease and become adept in managing the associated systemic complications encountered in eye care. 
• The resident will gain proficiency in advanced treatment of eye disease including performing minor surgical procedures. 
• The resident will gain experience in sub-specialty eye care. 
• The resident will develop effective communication and interpersonal skills. 
• The resident will develop the necessary critical thinking and problem solving skills to effectively and correctly diagnose challenging ocular disease cases. 
• The resident will be encouraged to develop into a leader of the optometric community and will develop the skills needed to provide lifelong contributions to the profession of optometry.

M-F 8:00am-4:30pm

Clinical Activities: 

The eye clinic serves primarily older males with a high incidence of systemic and ocular disease. A multitude of chronic eye conditions including vascular eye disease, glaucoma, and macular degeneration are commonly encountered. Acute ocular disease conditions including ocular infections, uveitis, and trauma present frequently as well.

The attending optometrists and residents are granted hospital privileges and are responsible for treating the vast majority of problems encountered by our patients. The optometrist performs and interprets dilated eye examinations, refractions, visual field testing, corneal pachymetry, gonioscopy, digital photography, and Optical Coherence Tomography (OCT). Minor surgical procedures are commonly performed including dilation and irrigation of the lacrimal system, epilation, foreign body removal, injection of local anesthetics, incision and drainage of periorbital cysts, papilloma removal, and intralesional injections of chalazions. Our attending and resident optometrists are privileged to use topical, oral, and Injectable medications for diagnostic and treatment purposes and commonly order imaging studies including computed tomography (CT), magnetic resonance imaging (MRI), and carotid Doppler ultrasounds.

Patients requiring eye care outside the scope of optometry are referred within the VA system to Ann Arbor VA Medical Clinic located two hours southeast of Grand Rapids.
However, the majority of patients choose to be referred locally to Grand Rapids area ophthalmologists. Grand Rapids VA Eye Clinic enjoys an excellent working relationship with several local eye surgeons. 

• Employment for a 12 months period commencing on July 1 and ending June 30 of the residency year
• Stipend of $43,924
• 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

• Successful completion of all of the residency’s goals and objectives. 
• Maintain a patient log and provide feedback to the residency coordinator at least monthly 
• Write two case reports of publishable quality 
• Submit a poster to a national optometry meeting 
• If a poster is not accepted, a third case report of publishable quality may be substituted 
• Obtain complete agreement from all residency faculty that the resident should be granted a certificate 
• Complete all required evaluations and submit them to the residency coordinator at the appropriate time.