What is a Residency?

An optometry residency is an extra year of advanced training under an experienced mentor that is usually at an academic institution, Veteran’s Affairs hospital, Indian health service, or other large clinic. There are several specialties that a resident may choose to apply for including, vision therapy and pediatrics, ocular disease, contact lenses, or low vision rehabilitation. 

The Accreditation Council on Optometric Education (ACOE) defines an optometric residency program as “A planned program of post-OD clinical education that is designed to advance significantly the optometric graduate’s preparation as a provider of patient care services beyond entry level practice.” A residency must be a minimum of 12 months and must be composed of appropriately supervised clinical eye/vision care provided by the resident. A residency should also include a well-designed mix of self-directed learning, seminar participation, instructional experiences, and scholarship. 

What is Expected of Residents?

Completing an optometric residency is not an easy feat. You are usually working full-time in a clinic 5 days per week with a full schedule difficult patient encounters, and long hours of preparing for patients and completing charts. Most residences require oral case presentations and a formal paper. You may also be asked to attend grand rounds, participate in journal club, or prepare an present a poster at an optometric conference. 

A residency is a lot of work, but the most successful residents are those who recognize early that what one gets out of a program is directly correlated to the effort and dedication that one puts into the program. Although demanding, the rich rewards gained from the additional year of training will greatly enhance career opportunities, add to the level of confidence you will have as a doctor, and allow you to have deeper knowledge to ensure that your patients are being taken care of at the highest level possible. 

How Many Residency Programs and Positions are Available?

Currently, there are more than 200 accredited optometric residency programs which allow for over 400 approved positions. 

Do I Have to Complete a Residency?

Residencies are not mandatory for everyone, but they may be required, depending on the mode of practice you wish to pursue. If you are considering teaching at an academic institution at any point in your career, most schools and colleges of optometry require residency training as a basic qualification for employment. Additionally, the Veteran’s Health Administration also usually requires an applicant to be residency trained in order to be considered for a position at a VA hospital. 

For those of you wishing to work in an ophthalmology clinic or multi-disciplinary practice, the value-added benefits of residency training is usually recommended over an applicant who has not had this additional training. I can also tell you that in certain areas of the country there is a lot of competition for quality jobs, and having a residency on your resume will definitely set you apart from someone who may not. 

Why Should I Pursue a Residency?

There are number advantages to completing a residency, but I believe that the amount of knowledge that one will gain during the 12 months of training is invaluable. There is no other clinical setting that you could you into post-graduation that will give you such a wide array of knowledge in such a short period of time. 

During my year of residency at the VA hospital in San Diego, we participated in a variety of patient encounters which included primary care, treatment and management of ocular disease, and low vision and traumatic brain injury evaluations and rehabilitation. We also had a weekly “journal club” meeting in which we reviewed an summarized important clinical articles and investigations.

Additionally, we spent time in every other clinic throughout the hospital, including occupational and physical therapy, neurology, primary care, dermatology, podiatry, sleep clinic, audiology, etc. so that we could better integrate and coordinate a patient’s entire health and medical history. We also spent time learning and practicing minor lid procedures such as papilloma removal, suturing, and injections. I can’t think of any other way I could have experienced all of these things without doing a residency. 

Are There Disadvantages to a Residency?

A residency in optometry is not for everyone. If you are a person who already has a job lined up, in a location that you desire, with good pay, you may not want to risk losing that position or money by taking an extra year to complete a residency. During the year of residency, compensation for your work is typically not enough to be able to pay your student loans during that time. Therefore, most residents will need to defer their loans, change the repayment to “income based,” or go into forbearance on the loans for the year. This will usually mean that your interest will continue to accrue and your loan amount will increase during this time. This can be a deterrent to doing a residency. 

Also, as I have mentioned many times before, a residency is a lot of work. If you aren't willing to put in the long hours, extra effort for presentations and papers, or constantly deal with difficult patient encounters, a residency is probably not the best option for you. 

Dr. Dexter