Tag: New graduates

Writing NBEO Exams as a Canadian Optometry Student

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In this article, I will outline each of the three parts of the American optometric board examinations administered by the National Board of Examiners of Optometry (NBEO) as well as my personal experiences completing these exams as a Canadian optometry student, the study material I used, and my tips and tricks for success.

Part I of the NBEO exam is typically challenged in March of your third year of optometry school. This is an 8-hour exam consisting of 350 scored and 20 non-scored items, divided into two sessions with 185 questions within each session.

This exam covers various subjects that you have learned over your first three years of school, with a strong emphasis on ocular disease, ocular anatomy, optics, pharmacology, and binocular vision.

Part II of the NBEO exam is administered in December of your fourth year of optometry school and consists of 45-55 full cases, 15-20 mini-cases, and 15-20 solo items. This exam is also 8 hours divided into two sessions.

Approximately 120 questions are categorized as TMOD, which stands for treatment and management of ocular disease.

Part III of the NBEO exam can be taken beginning the summer of your third year and onwards. This exam must be taken at the National Testing Centre in Charlotte, North Carolina and is a practical examination performed on patients.

This exam consists of 4 stations where you perform specific skills on standardized patients.

What it Takes for Success

All three of these examinations involve loads of preparation and mental stamina.

To tackle Part I and Part II of NBEO, I purchased the KMK Signature course, which contains videos, flashcards, practice exams, a daily guided study plan, live lectures, the booster course, and the crash course, and so much more.

I decided to purchase this course because I wanted to ensure I provided myself with all the resources I would need to succeed. I think the extra content was valuable and would recommend this course if you want more structure.

The Core and Plus KMK courses also provide you with the content videos, practice questions, and practice exams, and many people use these courses and still succeed with their studying.

My Journey
In October of my third year, I started studying for Part I by going through the videos and started studying more intensely around December of that year. I was supposed to write Part I in March of 2020 but due to the COVID-19 pandemic, this got pushed back to July of 2020.

I paused my studies for a few months and came back to it around June of 2020. After completing Part I at the end of July, I gave myself until September to rest and recharged my brain before starting to dive into Part II.

I wrote Part II in mid-November. Two and a half months is ample time to study for this exam.  I had just written Part I, which left a lot of that information fresh in my mind, so some light review during the summer months might be helpful.

In addition to using the KMK signature course to study for Part II, I purchased OptoPrep for more practice questions. OptoPrep provides you with loads of practice questions and practice exams that simulate the actual NBEO examinations. I found this extremely helpful as the cases OptoPrep provides were comparable to the cases found on Part II of NBEO.

I completed Part III of NBEO in March of 2021. To prepare for this, I created a script for myself based on the rubric provided by NBEO.

Practice Makes Perfect

My advice is to practice, practice, practice and did I mention practice!

You want to have the script down like you are performing. I recorded myself going through the different stations and would listen back to make sure I hit all the points. I would practice saying my script to friends and family until I felt completely comfortable and barely had to think about what I was saying.

When it comes down to doing this exam, the testing environment is high stress, and if you practice enough, your nerves shouldn’t take over. It is essential to practice the skills and go through the motions full out with a friend or family member.

All three of these examinations are high stress and involve loads of stamina, so my main pieces of advice are finding some mental outlet, take breaks when you need them, and most importantly don’t forget to breathe.

You will make it through, and even if there are hiccups along the way or you don’t get the outcome you wanted on your first try, you will get it next time.

Trust your instincts, as this is the last hurdle you need to overcome to become a Doctor of Optometry.

 

ALEXA HECHT

Contributor NewOptometrist.ca

Undergraduate Studies:
University of Manitoba in Psychology/Biology

Optometry:
University of Waterloo – Class of 2021

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What’s New in Specialty Contact Lenses from Dr. Rosa Yang

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By Jaclyn Chang, OD

Residency trained optometrist Dr. Rosa Yang shares her knowledge on the ever-changing topic of specialty contact lenses in the following conversation with NewOptometrist.ca editor, Dr. Jaclyn Chang.

Dr. Rosa Yang

Jaclyn: What are the indications for scleral lens use?

Rosa: Scleral lens use has been growing and gaining more attention in recent years. The scleral lens vaults over the cornea and has increased comfort.

Previously, the primary indication for scleral lenses was corneal ectasia; the main one being keratoconus. Now we have learned about other benefits of scleral lenses, for example, patients with dry eye. Scleral lenses provide constant lubrication to the ocular surface. While dry eye is a multifactorial disease and scleral lenses aren’t for every patient with dry eye, there is a specific subgroup of patients who would benefit from them. These include patients with exposure, such as with a facial palsy.

Jaclyn: What equipment is necessary for fitting specialty contact lenses?

Rosa:  Topography is essential to the fitting of specialty contact lenses. When you think about managing glaucoma, you think about how important OCT is to glaucoma specialists. The analogy for a contact lens fitter is topography.

It is an effective method to assess ortho-K treatment, for example. While the patient may have optimal vision and the lens may appear well-fitted open-eye, this may not always correlate with optimal ortho-K treatment overnight. The treatment may be decentered but provides enough treatment through the optical center to give good vision. However, this does not equate to optimal treatment.

There is also value in topography with scleral lens fits. The amount of time needed to select the initial lens can be minimized. The topography can aid us in determining the initial sag of the lens. We have also learned that many scleras have toricity. Some topographers can map out scleral contour to help us decide if the patient would benefit from a toric peripheral design.

Jaclyn:  Can you talk a little bit about specialty soft contact lenses?

Rosa:   Sure, there are specialty or customized soft contact lenses for high prescriptions outside of range. For example, I had a patient whose prescription was -22D. We put this patient in a soft contact lens called Intelliwave. Keep in mind that this lens lasts for three months so the patient has to be diligent with cleaning.

Jaclyn: What is new in the world of fitting specialty contact lenses?

Rosa:  Profilometry is fairly new. With this, the topographer and the software are linked to the contact lens manufacturer. Normally, we would do a diagnostic fit, where you put a lens on the eye, check the fit, and then specify the change in parameters. Profilometry is a method in which the contact lens manufacturer can generate a lens with a specific parameter based on the topography itself.

Aberrometer is also a relatively new technology being implemented. Higher order aberrations (HOAs) can lower best corrected VA and quality of vision. HOAs can be measured and neutralized to improve vision in scleral lens wearers.

Jaclyn:  Great, thanks so much for that refresher and update!

 

Previous discussions with Dr. Rosa Yang: 

Perspectives on Myopia Control
Pursuing a Contact Lens Residency

JACLYN CHANG, OD

Editor NewOptometrist.ca

Dr. Jaclyn Chang graduated from the University of Waterloo (UW) with an Honours Bachelor of Science in Biomedical Sciences before continuing at Waterloo to complete her Doctor of Optometry degree. She is currently a practicing optometrist in Toronto.

Dr. Chang is committed to sharing information and bringing new resources to her colleagues. As a student, she sat on the Board of Trustees for the American Optometric Student Association, organizing events to connect students with industry. She was the Co-Founder/Co-President of the award-winning UW Advancement of Independent Optometry Club, the first club at UW dedicated to private practice optometry. Dr. Chang is also a passionate writer, who aims to make information accessible and easily digestible to her colleagues. She has published in Optometry & Vision Science and Foresight magazine and contributed to Optik magazine. She is excited to bring valuable resources to Canada’s next generation of optometrists with NewOptometrist.ca.

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Your Guide to Multifocal Contact Lens Fitting with Jocelyn Leung, OD

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Dr. Jocelyn Leung is passionate about contact lenses. Here she discusses how she implements multifocal contact lenses into her everyday practice to provide patients with vision that fits their lifestyle.

Jaclyn:  How do you identify successful candidates for multifocal contacts?

Jocelyn: Once patients reach presbyopia, possibly getting eyestrain and headaches, you can have the conversation about multifocals.

If the patient is already a contact lens wearer, fantastic. Patients who wear contact lenses are used to not wearing glasses and want to maintain this lifestyle. Glasses are inconvenient for any athletic activity, traveling, especially nowadays with the masks causing constant fogging!

I discuss the options with the patient: glasses over contacts, monovision, or multifocal contact lenses.
Before a multifocal fitting, I set expectations and let the patients know that they won’t necessarily have 100% clarity of vision but will get convenience. I usually say that they can achieve about 80-90% of what they would be able to see with glasses and gauge the patient’s response.

Patients who prioritize convenience over perfect vision are ideal candidates. It is important to make sure that the patient understands the way multifocal lenses work and what is optically possible.

Jaclyn: How is the conversation different if the patient is not a previous contact lens wearer?

Jocelyn:  Multifocal contact lenses are a good option for presbyopic patients whose end goal is to be glasses free, even if they have not previously worn contact lenses. The process does take a little bit more time, with teaching insertion and removal and educating on contact lens hygiene.

It really depends on the patient’s personality and visual demands. Last week, I fit a patient who has never worn contact lenses but did not want to wear glasses anymore due to the mask and fogging. She was very, very happy with her lenses right off the bat and I finalized her prescription with only one more visit.

Jaclyn: Can you walk us through your process of fitting multifocal lenses?

Jocelyn: I first discuss the process and fitting fees with the patient. On average it is going to take three visits and some time to find the right prescription. I let the patient know that it’s very likely they won’t be fit on the first try, and then if they are fit earlier, they’re even happier.

I look at the prescription and what lenses the patient has worn in the past. Using a brand or modality similar to what they’re currently wearing can help ease the transition. I usually stick with DAILIES TOTAL1 as my number one go-to option for multifocal lenses.

The fitting guide, which is individual to every brand and contact lens, is very important. My tip is to find two or three multifocal lenses that you like and memorize those fitting guides. Then if you need to pivot, you can look up the fitting guide for the other tertiary lenses.

Grab your first trial lens and have the patient try the lenses on in the office. It does take some time for the lens to settle and for the patient’s brain to adjust, so let the patient know that you do not expect perfect vision right now.

Make sure that the patient is functional before they leave the office: meeting the driving standards, comfortable seeing far away, and can read their phone. Then you can send them home with some lenses.

I do a one week follow up, but the patient can take two to four weeks to adapt. I like to see the patient at least every week, maximum two weeks, for a follow up to get their feedback. Otherwise, the patient may try the lens, forget about their vision, and not be able to provide you with comments. If there’s something the patient isn’t happy with, they need to vocalize that to you. You need to ask the right questions and be able to adjust from there.

At the first follow-up appointment, I get feedback on the comfort and vision at distance, intermediate, and near. I do use a reading card for a metric number at near, but I do not base my success on a number. I am not aiming for a certain visual acuity. I am aiming for what the patient is happy with because everyone has different visual demands.

We see if the patient wants to improve their distance or near vision and make sure that the comfort of the lens is good. We can then do an over-refraction to see what adjustments need to be made.

After a few appointments, if we find a lens that the patient is happy with, we can finalize the prescription. If the patient still is not getting comfortable vision, we can give it another shot for a few more weeks before switching to monovision or back to glasses if necessary.

Jaclyn: Can you give us some insight into your discussion on fitting fees with the patient?

Jocelyn: I always discuss fees first so there are no surprises. If financials are a deciding factor, then we only discuss options within their absolute cutoff budget.

We can always educate and bring awareness to our patients on the options available. However, if the patient is very happy with over-the-counter readers or taking their glasses off to read, they likely won’t be convinced to try multifocals. It’s what they’re used to and that’s what they’re happy with. To try multifocal lenses, you have to be enthusiastic and engaged in the process.

If the patient is willing to give multifocals a try, that’s when we can add the most value. I’ll explain that a contact lens fitting is a process, and the fitting fee is a one-time fee that covers trial lenses and multiple appointments.

As long as the patient understands that we are putting in the effort to try to get them the best vision possible, they will be more open to that fitting fee. Depending on the clinic, fitting fees may also cover appointments for any sort of infections or emergencies related to contact lenses. This gives the patient reassurance that we’re going to be there every step of the way.

Jaclyn: Great, thank you so much for all your tips on being more successful with our multifocal fits!

JACLYN CHANG, OD

Editor NewOptometrist.ca

Dr. Jaclyn Chang graduated from the University of Waterloo (UW) with an Honours Bachelor of Science in Biomedical Sciences before continuing at Waterloo to complete her Doctor of Optometry degree. She is currently a practicing optometrist in Toronto.

Dr. Chang is committed to sharing information and bringing new resources to her colleagues. As a student, she sat on the Board of Trustees for the American Optometric Student Association, organizing events to connect students with industry. She was the Co-Founder/Co-President of the award-winning UW Advancement of Independent Optometry Club, the first club at UW dedicated to private practice optometry. Dr. Chang is also a passionate writer, who aims to make information accessible and easily digestible to her colleagues. She has published in Optometry & Vision Science and Foresight magazine and contributed to Optik magazine. She is excited to bring valuable resources to Canada’s next generation of optometrists with NewOptometrist.ca.

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Finding a Job and Navigating Contracts

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Finding your first (or even second or third) job within the optometric profession can be a challenge for new optometrists. Dr. Jocelyn Leung walks us through the process from interviewing to contracts.

Jaclyn:  When you graduated, how did you go about finding a job? Can you touch on your interviewing experience?

Jocelyn: When I graduated, I found the Ontario Association of Optometrists to be a good resource. At the University of Waterloo, there is the student association that had job listings and an interview day. Word of mouth can also be a strong connection.

Most clinics start off with a phone interview. That’s when you can ask your questions to learn more about the office: How many doctors are there? How many exam lanes? What type of equipment does the clinic have? What are the hours? Does the clinic dispense? What are they looking for in an associate?

Before this phone interview, I would suggest checking the clinic’s website or social media. As much as they are interviewing you, you are also interviewing them to make sure that it’s a good match.

For an in-person interview, it’s helpful to go in on a working day. I always like to shadow so I would ask the hiring doctor if I could come in 30 minutes to an hour before the interview. Every practice runs differently; with a different number of staff and different procedures.. It is important to see how the staff interact with each other and with the patients.

The one-on-one interview with the hiring owner is when you get to know each other on a more personal level and see if your personalities and interests match long term.

Jaclyn: Looking for a job all starts with location. Did you mostly look at job postings in Toronto?

Jocelyn:  Yes, my family and friends are in Toronto and my partner also secured a job in Toronto. I value my personal life and that was something that I was not willing to compromise; my support system is very important to me.

Some people think Toronto is very competitive and you won’t get the same salary as you would in a different province or even in the suburbs. Generally speaking, that is true. However, I believe that if you find the right place for you, and you hustle and work hard, then it will all pay off in the end.

Jaclyn: What advice can you offer to new graduates on contracts and negotiation?

Jocelyn: Contracts are a bit scary at first. Before signing a contract, you want to get an idea of other contracts in the area. Contracts definitely vary from one area to the next.

In general, there are two compensation models: the dispensing model and the retail model. Depending on the model, compensation is based on a percentage of exam fees, a percentage of the gross revenue, or a percentage of the profits.

Within the contract there is always fine print, such as non-competes or non-solicits. Double check these and make sure it’s something you’re okay with. Bring up any questions or concerns in a very respectful way. If you feel like you are not fairly compensated, or you want a specific term modified, always bring it up, because you should know what your worth is and then do the best you can to meet in the middle.

Jaclyn: Yes, it is also important to know that just because an opportunity has come up, it doesn’t necessarily mean that you need to take it or it’s the only one out there.

Jocelyn: Exactly! When I graduated, everybody was looking for a job at the same time. Depending on when your board exams were, you would want to start practicing in August or September. Practice owners don’t work on our school schedule – they hire when they want to hire, and that can be all 12 months of the year.

You have student loans, you have the pressure of securing a job, and you are eager to enter the workforce, but I think it’s worth waiting and finding the right spot. Don’t sell yourself short just to secure a job.

Jaclyn: Great advice! Thanks for all your insight into the job hunting process!

JACLYN CHANG, OD

Editor NewOptometrist.ca

Dr. Jaclyn Chang graduated from the University of Waterloo (UW) with an Honours Bachelor of Science in Biomedical Sciences before continuing at Waterloo to complete her Doctor of Optometry degree. She is currently a practicing optometrist in Toronto.

Dr. Chang is committed to sharing information and bringing new resources to her colleagues. As a student, she sat on the Board of Trustees for the American Optometric Student Association, organizing events to connect students with industry. She was the Co-Founder/Co-President of the award-winning UW Advancement of Independent Optometry Club, the first club at UW dedicated to private practice optometry. Dr. Chang is also a passionate writer, who aims to make information accessible and easily digestible to her colleagues. She has published in Optometry & Vision Science and Foresight magazine and contributed to Optik magazine. She is excited to bring valuable resources to Canada’s next generation of optometrists with NewOptometrist.ca.

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Perspectives on Myopia Control

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By Jaclyn Chang, OD

I recently had the chance to discuss how myopic control can benefit our patients with contact lens residency trained optometrist, Dr. Rosa Yang.

Here is the conversation.

Dr. Rosa Yang

Dr. Yang pursued a post-graduate residency program in Cornea and Contact Lenses at the University of Waterloo.

She is the recipient of the Sheldon Wechsler Contact Lens Residency Award from the American Academy of Optometry and was awarded First Place in Clinical Poster from the Global Specialty Lens Symposium.

Dr. Yang has particular interests in myopia control (including ortho-K), dry eye and corneal disease management.

 

Jaclyn:  What myopia control options are available?

Rosa:  There are several options including the MiYOSMART spectacle lenses by Hoya, MiSight soft contact lenses or off-label use of soft multifocals, Atropine, and ortho-K.

As a clinician, I think it is good to be aware of all the options so you can choose the most appropriate option for your patient.

Jaclyn: How do you choose one myopia control option over another for a patient? Is it very individual to that patient’s comfort level and particular case?  

Rosa: I don’t want to oversimplify, but, yes, there are selection criteria where we weigh one option over another. These include prescription, the parents’ budget, and the underlying eye condition.

A big factor is also how comfortable the patient is with handling contact lenses. Do they want to handle the contacts themselves or is it something that the parents might want to be more involved with? For the latter, ortho-K might be the better option because it’s mainly done at home at night.

For a patient who doesn’t want to wear hard contact lenses or glasses, and if the parents are hesitant about putting their kids on a medication (Atropine), soft contact lenses are the option we would be considering.

The only FDA approved soft contact lens for myopia control is MiSight, but it is limited by the fact that it is not available with astigmatism. In patients who have astigmatism, multifocal soft contact lenses can be used to implement the peripheral defocus effects.

Jaclyn: Under what circumstances might you select specifically designed spectacle lenses (like  MiYOSMART) for the patient?

Rosa: Some patients have been wearing spectacles and would like to continue wearing them. For them, it makes sense to keep them in myopia control lenses like MiYOSMART.

There are also patients who are uncomfortable pursuing contact lenses (i.e. they have trouble handling CLs, they are poor CL candidates) or the parents are uncomfortable having their kids on long-term atropine drops, then we would consider spectacles.

MiyoSmart lenses may also have larger prescription ranges than the contact lenses.

Jaclyn: When would you initiate myopia control treatment? Do you monitor until you see progression or initiate at the onset of myopia?

Rosa: Currently there is no consensus amongst clinicians, but when I see evidence of fast progression, then I initiate myopia control. Average progression is -0.50D per year, so anything above that might urge me to start myopia control; sometimes you may want to monitor a little bit more to see.

There are also clinicians that see myopia control as a preventative treatment that should be used more widely, especially considering the global myopia pandemic, so it’s a grey area.

Jaclyn: Are there certain things that we can say to our patients to help them better understand the importance and benefit of myopia control treatment? How can we help them understand the health implications associated with myopia?

Rosa: This is a very good question, because this is a topic that I discuss with every parent when we talk about myopia control. I tell them that the reason we pursue myopia control is not just the high prescription itself, it’s not just the inconvenience of having really thick glasses, it’s the ocular health implication.

“When you have a high prescription, the eyeball is usually more elongated, which means that the tissues in the eyeball get stretched out and are thinner; this predisposes them to certain ocular health complications, some of which are vision threatening. There is a higher risk of retinal detachment, maculopathy, and glaucoma.”

When I emphasize this, parents usually understand. With myopia control, it’s very important that parents understand what you’re doing, why you’re doing it, and how you’re doing it.

Jaclyn: Thanks for that – hearing the way that other doctors counsel always helps me with how I counsel my patients. Education makes such a big difference to patient care. 

Rosa: Yes, exactly, with myopia control, sometimes parents wonder why their child’s prescription still increases. That’s why with myopia control, it’s very important to have a consultation.

The management we’re doing is not to stop myopia, it’s to slow down the progression of myopia; regardless, the child is still going to progress.

Another thing to realize, for example, with ortho-K, is that some parents may think that once you wear the ortho-K lenses, that the prescription is completely gone, so explaining the process and treatment is very important.

Jaclyn: Thank you so much Dr. Yang! This gives our audience some things to think about and implement into everyday practice. 

Previous discussions with Dr. Rosa Yang: 
Pursuing a Contact Lens Residency: 

JACLYN CHANG, OD

Editor NewOptometrist.ca

Dr. Jaclyn Chang graduated from the University of Waterloo (UW) with an Honours Bachelor of Science in Biomedical Sciences before continuing at Waterloo to complete her Doctor of Optometry degree. She is currently a practicing optometrist in Toronto.

Dr. Chang is committed to sharing information and bringing new resources to her colleagues. As a student, she sat on the Board of Trustees for the American Optometric Student Association, organizing events to connect students with industry. She was the Co-Founder/Co-President of the award-winning UW Advancement of Independent Optometry Club, the first club at UW dedicated to private practice optometry. Dr. Chang is also a passionate writer, who aims to make information accessible and easily digestible to her colleagues. She has published in Optometry & Vision Science and Foresight magazine and contributed to Optik magazine. She is excited to bring valuable resources to Canada’s next generation of optometrists with NewOptometrist.ca.

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Pursuing a CL Residency: A Conversation with Dr. Rosa Yang

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Young Optometry residents in conversation

By Jaclyn Chang, OD

As graduates approach the final stretch of optometry school, the decision to spend an additional year immersed in a residency program might come into view for some near-to-be optometrists.

Dr. Rosa Yang

While a residency provides the advantage of specialized training in a unique clinical setting, it may also defer the process of landing a job or starting your own practice.

Dr. Rosa Yang graduated from the University of Waterloo School of Optometry in 2019.  She interned at various clinics in Canada and in the USA, including Houston Eye Associates in Texas, where she worked closely with ophthalmologists specializing in cataract, glaucoma, and corneal diseases.

Dr.Yang pursued a post-graduate residency program in Cornea and Contact Lenses at the University of Waterloo.

Dr. Jaclyn Chang discussed Dr. Yang’s residency experience.

Jaclyn:  I really admire anyone who has done a residency and I’ve never heard anyone say they regret doing one. Can you comment on the opportunity that residency provides? 

Rosa:  For sure! Residency gave me the platform to meet people and experience a variety of opportunities. I was able to connect with eyecare specialists not just in Canada, but on an international level. Some of them became my mentors and friends. Now, when I need help to tackle a difficult case, they are my go-to people.

I have always loved teaching and residency allowed me to TA in labs and provide clinical supervision for students. I got to write case report, oral presentations, and conference posters. Through the process of preparing for them, I feel like I became a stronger critical and independent thinker – these are important traits for a clinician to have. I also travelled to so many places to attend conferences – I think I flew to five difference places in half a year, imagine how many more places I could have gone to if COVID did not happen.

Overall, it is such an enriching year with memories that I will never forget!

Jaclyn: That’s awesome! How did you feel about jumping in and doing things that we didn’t necessarily have a lot of experience with? For example, teaching, being a clinical supervisor and presenting at conferences.

Rosa: Of course, I was nervous. I am the type of person who thinks I need to be 100% prepared and execute with perfection.  That is not how real life works. More often, you learn along the way, but only if you have a good attitude and put in the hard work. I feel extremely lucky and thankful of my residency mentors. They have always believed me even when I doubt myself. Their encouragements have meant a lot to me and I think have been monumental for my growth!

Jaclyn: Can you talk a little bit about why you decided to go into residency?

Rosa: In my fourth year, I worked with a corneal ophthalmologist. Many of his patients had dysfunctional lives because they had corneal diseases and saw very poorly. With surgeries, many of them saw vision improve, but I wondered “I don’t do surgeries, is there anything that I can do for these patients?” The surgeon often told his patients “I do surgeries, but there are these special contact lenses that will probably make your vision even better. I don’t do them, but I will send you to the right people.” The surgeon was referring to us – optometrists, and he reminded me that specialty contact lens is a niche thing that optometrists do.

Then, I was mentored by a specialty contact lens optometrist. We saw a patient who had keratoconus. He started out desperate and very hopeless – he was struggling with his vision and he was told by several doctors that the only option was corneal transplant. We told him about scleral lenses and I can never forget the change in his facial expression the moment he looked around the room after we inserted the lens. The change was a total 180. I thought, this is something I really want to do.

Jaclyn: It’s cool how people who we encounter throughout our school, especially our supervisors in fourth year, really influence us on where we want to go.

Thank you so much for your insight. It’s always great to learn more about residency and your experience is very encouraging to other prospective students. I can’t wait for you to share your expertise with us on how we can better incorporate specialty contact lenses into our practice with our next talk!

JACLYN CHANG, OD

Editor NewOptometrist.ca

Dr. Jaclyn Chang graduated from the University of Waterloo (UW) with an Honours Bachelor of Science in Biomedical Sciences before continuing at Waterloo to complete her Doctor of Optometry degree. She is currently a practicing optometrist in Toronto.

Dr. Chang is committed to sharing information and bringing new resources to her colleagues. As a student, she sat on the Board of Trustees for the American Optometric Student Association, organizing events to connect students with industry. She was the Co-Founder/Co-President of the award-winning UW Advancement of Independent Optometry Club, the first club at UW dedicated to private practice optometry. Dr. Chang is also a passionate writer, who aims to make information accessible and easily digestible to her colleagues. She has published in Optometry & Vision Science and Foresight magazine and contributed to Optik magazine. She is excited to bring valuable resources to Canada’s next generation of optometrists with NewOptometrist.ca.

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Be a Lifelong Learner!

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By Jaclyn Chang, OD

Continuing Education is a requirement of maintaining membership with your College, but it also gives you the opportunity to learn on your own time and expand your knowledge in areas that you are particularly interested in learning more about.

Consider the Source.
Many commercial organizations provide sponsorship in the form of an unrestricted educational grant to the education provider. Commercial grants usually allow the education provider to make the course content available without charge.

Non-granted CE does not entail commercial sponsorship or provide any grant towards the development of the CE. A typical charge of $15 – $25 USD per accredit hour is normal.

CRO (Clinical & Refractive Optometry) Online CE, derived from the CRO peer-reviewed Journal is a good example of a resource that provides CE without commercial grants.

COPE has Strict Rules.
Course instructors are required to declare their involvement, if any, with commercial entities at the outset of a course.

The course content, however, is supposed to be absent of any commercial influence in the development, promotion and delivery of the content.

Below are some resources to help you out – visit the websites for more details and the most up-to-date information.

Non-granted Continuing Education.
Clinical & Refractive Optometry (CRO) offers paid CE hours, with some free hours available. Access to course content and preview of the test is free. Course authors almost exclusively come from challenging clinical settings such as optometry school clinics and US Veteran’s Affairs clinics.  Courses are present in text format and can be taken at any time.

CRO is also on the approved list of Journals for AAO Fellowship application. Fellowship applicants can earn 10 points by having a paper accepted and published in CRO.

Optocase offers paid CE hours, with some free hours available: https://optocase.com/

CE Wire, a virtual CE conference, is a commonly used resource to obtain many CE hours at an affordable price. They offer 64 CE hours and 4 live events: https://www.cewire2021.com/

The Academy of Ophthalmic Education, offers paid CE hours with some free hours available: https://www.aoece.com/education

Many optometry schools offer continuing education, including the University of Waterloo:
https://uwaterloo.ca/optometry-vision-science/continuing-education

For continuing education from SECO, including paid CE and occasional free courses, visit:
https://secouniversity.com/cope-individual-courses-full-listing/

Eye Code Education offers paid CE hours: https://www.eyecodeeducation.com/collections?category=continuing-education

 

Granted Continuing Education

Review of Optometry: https://www.revieweducationgroup.com/

MedEdicus: https://www.pathlms.com/mededicus

Review of Myopia Management: https://reviewofmm.com/category/continuing-education/

CL Spectrum: https://www.clspectrum.com/continuing-education-center

EyeSchool.ca: http://www.eyeschool.ca/

Evolve Medical Education offers free CE for a number of specialties, including optometry: https://evolvemeded.com/

Healio offers free CE for a number of specialties, including optometry: https://cme.healio.com/optometry

Industry partners often sponsor CE, including TLC Laser Eye Centers. Notifications of upcoming webinars are emailed out if you are on their mailing list. The previously used link has not yet been updated for 2021, but is here for your future reference: https://www.tlcvision.com/ceseries/

For Your Learning (non-COPE)

Dr. Ike K Ahmed, MD hosts Prism Eye Rounds: https://www.prismeyeinstitute.com/webinars/

Zeiss offers educational webinars: https://www.zeiss.ca/meditec/en/c/zeiss-educational-webinars.html

They also have texts available for download for a limited time:
https://www.zeiss.ca/meditec/en/c/effective-perimetry-free-book.html
https://www.zeiss.ca/meditec/en/c/practical-angiography-free-book.html

Other Resources
Gonioscopy: http://gonioscopy.org/
Iowa Glaucoma Curriculum: http://curriculum.iowaglaucoma.org/

OCTs: https://www.octcases.com/

Resources from Dr. Ron Melton, OD and Dr. Randall Thomas, OD: https://www.eyeupdate.com/

KMK Educational Services also produce updates for ODs: https://www.kmkoptometrypro.com/

Videos and other resources from Dr. Timothy Root, MD: https://timroot.com/

Resources from ophthalmology residents: https://eyeguru.org/

Spending the time to learn more about a subject is an investment in your future and helps you become the best OD you can be!

 

CRO (Clinical & Refractive Optometry)  Journal (www.CROJournal.com)  will provide  one free COPE credit for any new OD signing up to the NewOptometrist.ca e-newsletter.  The free credit can be applied to any course in the CRO Catalogue.

Click Here to Sign up Now.

JACLYN CHANG, OD

Editor NewOptometrist.ca

Dr. Jaclyn Chang graduated from the University of Waterloo (UW) with an Honours Bachelor of Science in Biomedical Sciences before continuing at Waterloo to complete her Doctor of Optometry degree. She is currently a practicing optometrist in Toronto.

Dr. Chang is committed to sharing information and bringing new resources to her colleagues. As a student, she sat on the Board of Trustees for the American Optometric Student Association, organizing events to connect students with industry. She was the Co-Founder/Co-President of the award-winning UW Advancement of Independent Optometry Club, the first club at UW dedicated to private practice optometry. Dr. Chang is also a passionate writer, who aims to make information accessible and easily digestible to her colleagues. She has published in Optometry & Vision Science and Foresight magazine and contributed to Optik magazine. She is excited to bring valuable resources to Canada’s next generation of optometrists with NewOptometrist.ca.

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A CE Primer for new Ontario ODs

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By Jaclyn Chang, OD

One of the mandatory requirements of maintaining your membership with the College of Optometrists of Ontario is completing a specific number of continuing education (CE) hours every three-year period.

The new three-year cycle begins on January 1, 2021.

There is an auditing process following each three-year cycle, so it is important to make sure you complete your hours and receive credit for them. Keep reading for a quick summary and visit the College website for more information (Members -> Quality Assurance -> Continuing Education).

For New Registrants (New Graduates)
If you just graduated, you first need to register with the College as you can only claim continuing education hours completed after registration.

Then, you can set up your online account with the Association of Regulatory Boards of Optometry (ARBO), using this link: https://www.arbo.org/. ARBO will assign you an OE Tracker number; OE Tracker is the system the College uses to store CE data for optometrists.

The subscription for ARBO was paid for by the College for the previous cycle (To clarify, once you have paid your College fees, you do NOT need to pay anything additional).

When you get your OE Tracker number, you are ready to start uploading your CE certificates to ensure you receive credit for the hours you have completed.

Some CE providers will upload the certificate for you and will ask for your OE Tracker number (sometimes this can take a while to show up in your account!).

Certificates can be uploaded using one of the following methods (~5 business days to show up in your account):
-Mobile App: https://www.arbo.org/oet_app.php
-Website:  https://www.arbo.org/oetracker_login.php
-Email: arbo@arbo.org – ARBO is usually pretty responsive and it is easy to email in your certificate!
-Fax: 1-888-703-4848

For more information, visit:
https://www.collegeoptom.on.ca/members/quality-assurance/continuing-education/oe-tracker/

For new registrants, the number of CE hours required are prorated based on the number of complete years left in the cycle following the year registered.

Here are the number of CE hours required based on your graduation year/year of registration:

-1st year of the cycle (2021) – 47 total hours, 34 COPE (14 disease), 13 other
-2nd year of the cycle (2022) – 24 total hours, 17 COPE (7 disease), 7 other
-3rd year of the cycle (2023) – 0 hours

After Initial Registration – 70 Credit Hours/Cycle
Members of the College are required to complete at least 70 credit hours of continuing education every three-year cycle. *There have been changes since the last three-year cycle in which CE hours were previously classified as Category A and B. Please see the new information below.

Of the 70 hours, 50 hours must be Council on Optometric Practitioner Education (COPE) accredited.

Of the 50 required COPE accredited hours, a minimum of 20 hours must be lecture-based in ocular disease and management or related systemic disease. Fellowship or Diplomate in the American Academy of Optometry (FAAO) or Fellowship in the College of Optometrists in Vision Development (FCOVD) counts as 30 COPE accredited hours.

Members need a participation verification certificate for COPE accredited CE. This is to be submitted to OE Tracker by the member or CE provider.

The other 20 hours can be COPE accredited or other learning activities.

Other learning activities can include organized events and distance learning activities that are not COPE accredited, graduate studies, residency, publication in a refereed journal, clinical supervision, CPR certification, and others.

Members are required to complete the ‘Continuing Education: Other Learning Opportunities’ form to claim credit for other learning activities. This is to be submitted to OE Tracker.

Members are required to report their CE hours in their Annual Report to the College. This is then verified through OE Tracker.

For more information, visit:
https://www.collegeoptom.on.ca/members/quality-assurance/continuing-education/

Click here to view the new 2021-2023 COO Policy on Continuing Education. 

CRO (Clinical & Refractive Optometry)  Journal (www.CROJournal.com)  will provide  one free COPE credit for any new OD signing up to the NewOptometrist.ca e-newsletter before  Feb 5th, 2021.  The free credit can be applied to any course in the CRO Catalogue.

Click Here to Sign up Now.

 

JACLYN CHANG, OD

Editor NewOptometrist.ca

Dr. Jaclyn Chang graduated from the University of Waterloo (UW) with an Honours Bachelor of Science in Biomedical Sciences before continuing at Waterloo to complete her Doctor of Optometry degree. She is currently a practicing optometrist in Toronto.

Dr. Chang is committed to sharing information and bringing new resources to her colleagues. As a student, she sat on the Board of Trustees for the American Optometric Student Association, organizing events to connect students with industry. She was the Co-Founder/Co-President of the award-winning UW Advancement of Independent Optometry Club, the first club at UW dedicated to private practice optometry. Dr. Chang is also a passionate writer, who aims to make information accessible and easily digestible to her colleagues. She has published in Optometry & Vision Science and Foresight magazine and contributed to Optik magazine. She is excited to bring valuable resources to Canada’s next generation of optometrists with NewOptometrist.ca.

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Be Prepared for the Future: A Resource for New Optometrists

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EyeCareBusiness Canada is pleased to introduce a new contributor. Dr. Jaclyn Chang, a UW School of Optometry 2018 grad, will be providing contributions within the “NewOptometrist” section of the website. Dr. Chang’s introductory post follows below.

by Jaclyn Chang, OD

I have always wanted to be well prepared for the future. I chose my career at an early age and have known since then that I wanted to become an optometrist.

Throughout high school and my undergraduate studies, I researched the application process, programs across North America, and even the cost of tuition.

Later on, when I was in professional school, I spoke with practicing optometrists at various events to find out more about what my immediate future had in store.

I often received the same unprompted comment: The first five years after graduation were the most challenging – there were clinical uncertainties, employment issues, and questions about the future.

After Graduation
I graduated from the University of Waterloo just over two years ago. According to many experienced optometrists, I am right in the middle of the most challenging time that I will go through as a practitioner.

When I first graduated, I realized how different being my own doctor was from having clinical supervision.

After my first day of work, I walked my boss through every single thing that happened that day over the phone. She assured me that I would be fine…and that this was probably unnecessary to do after every day of work.

As I continued practicing, I started seeing repeat patients – a very different situation to having several short rotations as a student, where I was not always able to find out the results of a particular treatment.  Now, if there was ever a problem, I would be the one to hear about it.

Staying Connected
As I continued to adjust to the clinical differences between being a student and a practicing optometrist, I was simultaneously attempting to figure out other aspects of being part of the profession from administrative responsibilities to taxes as a self-employed person.

I heavily relied and continue to rely on my friends and colleagues to get the latest information and reminders. I discuss interesting cases, variations in practice management, and my everyday frustrations and excitements in these small circles.

I have been lucky enough to get guidance from truly great optometrists that have made it past this initial difficult period in all our careers. Additionally, I did seek online resources and support from our College and Association.

I am sure that many new optometrists have their own small circles, mentors, and use the same resources I did. With my support system, I navigated through my first two years of optometric practice mostly unscathed.

I worked as an associate at various private practices in Toronto and became a practice owner. However, as prepared as I had tried to be, there were still things that I could have done better, and it is these details and subtleties in my experiences that I would like to share amongst our demographic.

Our Unique Challenges & Opportunities
We have unique challenges as a distinct group. As a new graduate, I was an idealist. In school, I was given access to the latest in technology and a wide selection of equipment. I was given lectures by doctors and researchers aware of the latest clinical developments in every optometric specialty.

I was taught to go above and beyond to treat every one of my patients as a family member, sometimes over a three-hour appointment. Two years later, my appointments are a little bit shorter, but I still want to provide that same high level of care.

I want to soak up as much information as I can. I am open to new brands, products, and ideas, and the next few years will be critical in determining my individual practice style and ultimate career path.

Your Invitation to Engage
I hope that you can relate to some of the experiences I have shared, and with that, I welcome you to NewOptometrist.ca: a platform dedicated to the unique challenges and experiences new optometrists in the first five years of practice across Canada face. This website is a place where we can collect relevant materials for reference and share our stories.

We are the next generation of optometrists that will grow to become seasoned practitioners, loyal associates, practice owners, and leaders in the eye care industry.

The way I see it, the more prepared we are, the better.

 

New ODs, in their first five years of practice, are invited to join the New OD e-newsletter.


Click here to sign up now.

JACLYN CHANG, OD

Editor NewOptometrist.ca

Dr. Jaclyn Chang graduated from the University of Waterloo (UW) with an Honours Bachelor of Science in Biomedical Sciences before continuing at Waterloo to complete her Doctor of Optometry degree. She is currently a practicing optometrist in Toronto.

Dr. Chang is committed to sharing information and bringing new resources to her colleagues. As a student, she sat on the Board of Trustees for the American Optometric Student Association, organizing events to connect students with industry. She was the Co-Founder/Co-President of the award-winning UW Advancement of Independent Optometry Club, the first club at UW dedicated to private practice optometry. Dr. Chang is also a passionate writer, who aims to make information accessible and easily digestible to her colleagues. She has published in Optometry & Vision Science and Foresight magazine and contributed to Optik magazine. She is excited to bring valuable resources to Canada’s next generation of optometrists with NewOptometrist.ca.

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Becoming an Independent Practice Owner – My Story

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Growing an Independent optometry pPractice Toronto

Jaclyn Chang graduated from UW School of Optometry in 2018. In 2019, less than two years after graduating, she took the plunge and purchased an existing independent practice in an urban setting with plans to grow. She shares her story below.

 

By Jaclyn Chang, OD

I bought the practice in the middle of November, 2019. It was not a decision I made lightly.

The owner of one of the clinics that I was working at as an associate, in mid-town Toronto, was ready to retire and offered me the opportunity to buy the practice from him.

He had been working as an optometrist for over 38 years and had been in the office’s current location for the last 18 of them.

The equipment was original to the practice’s current location and was in need of an update; this meant that I would essentially be taking over an existing patient base, paying one lump sum for the patient records.

The office sold contact lenses but there was no dispensary or any auxiliary testing available.

Considerations
With a deadline, I had to consider my options and get back to the owner with my decision.

Because I had been working in the practice a few days per week over the previous year, I knew the patient demographic, staff, schedule, and location very well – a huge advantage as I was making my decision.

I liked the idea of building on a smaller existing practice as opposed to starting from scratch or paying a higher price for a larger practice.

There would be patients walking through the door on day one but I would still be able to put my stamp on the practice and really make it my own.

Ideally, I wanted to provide patients with more technology, including a retinal camera, OCT, and visual field. With this equipment, I would be able to continue to grow my skills as a practitioner in treating and managing disease.

Difficulties
Eventually, I would also want to give patients the convenience of having access to a dispensary in my own clinic – something which would not be possible at the current location.

As a newer practitioner, I was also limited financially and by the amount of business knowledge and experience I had.

I would have to figure out what equipment to purchase, how to finance it, and decide on the new fee structure for patients.

I would have to go through the process of creating a dispensary and hiring and training staff.

By adding new revenue streams that previously did not exist for this practice, there was no reference as to how the patient base would respond.

I worried about how long it would take to get to the stage I wanted and whether or not I would be able to afford it.

An Opportunity
Then, another opportunity came up for me to move the practice into a nearby clinic with the technology and dispensary that I was looking for.

As with any practice purchase, patients would experience a doctor change, but if we moved, we would also be putting patients through a physical location change and switching to a very different way of practicing suddenly.

However, it would also mean that I would be able to practice the way that I wanted to, with the equipment I wanted, immediately.

My Decision
I knew there was extensive work to be done on the practice and a steep learning curve to becoming a practice owner, but this was an opportunity that I could not turn down.

By December 2nd, 2019, I had moved the practice into the new office and had officially seen my first patients as a new independent practice owner.

This process did not happen the way I would have ever imagined, but now that one year has passed, I look back on it proud of the progress we have made and am excited to continue sharing my story with you!

JACLYN CHANG, OD

Editor NewOptometrist.ca

Dr. Jaclyn Chang graduated from the University of Waterloo (UW) with an Honours Bachelor of Science in Biomedical Sciences before continuing at Waterloo to complete her Doctor of Optometry degree. She is currently a practicing optometrist in Toronto.

Dr. Chang is committed to sharing information and bringing new resources to her colleagues. As a student, she sat on the Board of Trustees for the American Optometric Student Association, organizing events to connect students with industry. She was the Co-Founder/Co-President of the award-winning UW Advancement of Independent Optometry Club, the first club at UW dedicated to private practice optometry. Dr. Chang is also a passionate writer, who aims to make information accessible and easily digestible to her colleagues. She has published in Optometry & Vision Science and Foresight magazine and contributed to Optik magazine. She is excited to bring valuable resources to Canada’s next generation of optometrists with NewOptometrist.ca.

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