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“Expanding Your Practice through Education: Becoming a Specialty Contact Lens Externship”
Moderator: Dr. Gloria Chiu
Panelists: Drs. John Gelles, Barry Eiden, Marsha Malooley, and Ashley Tucker

This program was sponsored by a very distinquished group of contact lens specialists in the US who meet and share “best practices” in eye care and new technologies: the Society of Eye Care Specialists. This includes Drs. Robert L. Davis, Jeffrey Sonsino, Jordan Kassalow, Amy Nau, Douglas Inns, Aaron McNulty, Moshe Schwartz, Lamar Zigler, Barry Eiden, Todd Bowman, Jeff Cooper, Randall Fuerst, David Seibel, Selina McGee, and Shalu Pal.

Dr. Chiu initially recognized the Specialty Contact Lens Clinical Externship Committee which includes her as Chair, and GPLI Advisory Board and “Rising Star” committee members Drs. Anita Gulmiri, Dan Fuller, Pam Satjawatcharaphong, Laurel Kelley, Mari Fujimoto, Grace Tseng, Madison Moss, and Dr. Sherry Mei.

Goal of this program: To significantly increase the number of specialty contact lens clinical externship sites.

The purpose of the webinar was to identify challenges and how to overcome them, understand logistics of student rotations, and encourage more optometrists to consider hosting interns in your practice.

All four experts on the panel have a lengthy history of having clinical externs rotating through their practice and they provided input to the following questions.

How has student mentorship enhanced your practice?

1) Elevated our level of practice; an incentive to practice at a higher level

2) Building lifelong relationships. It’s rewarding to spend a few months with them and, in fact, it is not uncommon for some of the externs to become future members of your practice

3) You can take such gratification on the impact you have had on their professional life; many will end up embracing specialty contact lenses and will impact many others

4) You actually have the opportunity to be a teacher. As an addendum from Ed Bennett, the best rotations at Indiana University and UMSL were the ones in which the supervisor liked to meet with the intern, quiz them, give them assignments, and stay longer on occasion to discuss cases.

5) There is a level of prestige to patients as they see you as an academic practice

How do you oversee flow to ensure efficiency of examinations with students?

1) Your office flow can be much more efficient and you can book more patients if you have students working with them. The students can be active in the fitting process and the supervising doctor can do what they are most trained for: analyze the information and develop a management plan.

2) You can connect with patient first and explain the role of the student so they feel comfortable that you will be very involved but that the student is very capable such that they gain the patient’s trust. Then the doctor does the closure of the examination.

What responsibilities do the student interns have?

1) Patients typically enjoy getting to know the student interns. They are accustomed to seeing technicians so the transition to a student is quite simple.

2) The responsibilities of the interns will change as their 4th year progresses and they have gained additional experience; likewise, the abilities and knowledge of interns may vary and they can be given more responsibilities if merited.

3) Dr. Gelles is very open to his interns that he will be for them whatever they want him to be. If they have no questions they could be done by 4:30PM. If they have questions and want to discuss certain cases, he could be there well into the evening.

4) In many cases they will do the initial lens evaluation and help in the fitting process. They will – either initially or soon after – be able to apply and remove lenses. You can certainly ask questions (often outside the examination room) to help them learn troubleshooting.

5) They can also learn special testing and perform some of the traditional technician responsibilities such that they are comfortable with OCT, topography, etc.

At the beginning of the rotation how do you ensure the students are up to par before allowing them to see patients?

1) You could have them shadow the first week as well as learn the instrumentation and record-keeping system. They could associate with a lead technician that week. They also can gain confidence in lens handling.

Do I need any different liability insurance when onboarding interns into my practice?

1) It is important to not have the intern involved with assessment and plan and their name is not associated

2) The University typically works with your practice such that coverage is provided

What do you do if you are having difficulty with a particular intern?

1) If it is a problem with knowledge or ability you can sit down with them and explain your thoughts and provide them with the resources to help them become more knowledgeable and experienced perhaps bringing them along at a slower lever. If it is an attitude problem, then that must be addressed promptly; typically, the student will be fine after this. Worst case scenario you would need to contact the externship director at the college of optometry.

What tips do you have for successful integration of students into your practice?

1) Every college has an externship director and typically that person can be found on the college’s website. If in doubt simply contact the chief of the contact lens service at your desired college(s) if you are interested in having student externs.

What are the logistics/grading of working with an optometry school?

1) Typically, a simple and straightforward process. It can vary from school to school but you do provide feedback – often online – on their professionalism, clinical ability, etc.

You can find more information on what you need to know about becoming a specialty contact lens externship including a recording of this webinar, a mentor handbook, and an application survey at www.gpli.info/externships. The Contact Lens Clinical Externship Committee will ultimately make decisions and include the recommended practice sites into a booklet to be provided to all of the Schools and Colleges of Optometry