Ocular disease residencies are one of the most sought after and competitive residency type programs for optometry. I was able to chat with Dr. Dean Fasciani about why he chose to pursue a residency in ocular disease, and how this decision shaped his future career.
Dr. Dean Fasciani graduated salutatorian from the Southern California College of Optometry in 2012. Upon completion of residency at Hu Hu Kam Memorial Hospital on the Gila River Indian Reservation in 2013, Dr. Fasciani was hired as a staff optometrist and is now currently taking over the student externship program at this location.
I decided to do a residency late in the application process. Residency was something that I had considered throughout my third and fourth years. Not until December or January of the application year did I decide to apply. I think the deciding factor for me was my clinical externships. I completed an IHS (Alaska) rotation in the summer and was halfway through my winter Tucson VA rotation when I submitted my formal application. Being at those sites proved how much more I wanted to learn clinically and become better prepared to handle difficult patient cases. Due to my experience at both the IHS and VA rotations, my post-graduation vision changed from being in private practice to hospital/medical based optometry. Residency training is required for many of these available positions.
My decision to do an ocular disease residency was easy. Disease was the aspect of optometry I was most passionate about throughout school. Rotating through ocular disease clinical externships solidified my decision to pursue this avenue of optometry. In school, we receive a great deal of didactic training in disease; however, it isn’t until externships that we start to clinically learn how to accurately diagnosis and manage disease both locally and systemically. I felt that 6-9 months of training (during my 4th year) wasn’t sufficient; I needed more experience to reach a level where I felt comfortable in providing the standard of care.
Unlike many other residency sites, I didn’t have a set daily schedule. The precepting doctors had patients scheduled and the residents were responsible for working off those schedules. I really felt that this enhanced my residency experience, allowing me more time with difficult cases. I didn’t feel rushed when patients needed extra examination or education time. In addition to routine patient care, I was given a myriad projects to work on. These included grand round presentations, small lectures, case reports, journal club, etc. I did spend a good amount of time outside of clinic reading journal articles and text books pertaining to cases that I had managed throughout the week.
I think the extra year of training is invaluable. Besides the direct patient exposure, the extra time spent researching for papers, preparing for lectures, and retina/glaucoma grand round presentations really expands your knowledge base and changes your approach to these cases.
I get this question often from prospective resident applicants and it is a difficult inquiry to answer. After my residency, I was hired by my residency site as a preceptor, so fortunately for me, I work with the same group of people and manage the same patient population. What has changed most is my comfort level and confidence. As a resident, I used to feel flustered by difficult or unfamiliar cases, but that has drastically changed following my residency. The residency training taught me how to think logically through each and every case; enhancing my ability for educated decisions on the appropriate management.
I absolutely would recommend a residency in ocular disease. Obviously I am biased, but I think any ‘disease’ resident would agree.
I don’t think there are many downsides to completing a residency. I believe many students are hesitant because of the potential to make good money right out of optometry school. Residencies pay enough to live comfortably for a year. The only other downside would be if the residency program wasn’t a good fit, meaning the resident didn’t mesh well with the attending doctors or staff. This is why an in-person interview is crucial during the application process.
Ocular disease is a great residency to pursue. There are so many awesome sites throughout the U.S.; from Indian Health, VA hospitals, to community health optometry, and private practices. Because of the great variety of residency sites, choosing which location best suits an individual can be difficult. I saw myself working in a hospital based setting, so I applied to IHS and VA locations. Some may prefer to work for an ophthalmologist after residency, so that individual may want to look into a co-management program. In addition, I’d recommend a site visit. As much as the doctors are interviewing the individual for the residency position, the individual should be interviewing the doctors to make sure they foresee an enjoyable mentoring relationship which will help to ensure they get as much out of the program as possible.
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