“So what’s your list of differentials? What signs and symptoms are you seeing? What studies dictate how we should treat our patient?” I have the answers, but for some reason my voice is broken. I’m stuttering and can’t get the words out. A bead of sweat drips down my forehead, and I quickly swat it away. I can’t let him see me sweat. I take a deep breath and open my mouth to try and answer again, but then there’s a loud ringing making my voice sound muffled. I look around to determine the source of the sound. Is it the fire alarm? Did someone open an emergency exit door? Finally, I recognize where the sound is coming from and I’m stirred from my dream enough to knock my phone off my night stand, ending the ringing once and for all. I wouldn’t call my dream a nightmare; I’ve had it too many times to be scared. It’s more of a sign of how all-consuming optometry school has become by the third year. We’ve had enough time in class by now to prove we know a long list of ocular diseases, how to treat them, and what studies have lead us to our management decisions. But now we’re striving to prove that clinically we can recognize the signs and symptoms, and piece together our exam findings like a puzzle, coming to the right conclusion, or at least a few options.
At Salus University’s Pennsylvania College of Optometry, our fall semester of our third year is our final didactic semester before we leave to go on our clinical externships. While we can taste the freedom of being out of the classroom and finally living something close to the schedule of a real practicing optometrist, we can’t get too ahead of ourselves because it is one of the hardest schedules of our academic career.
So, I finally realize I must’ve snoozed my alarm more than my two allotted times, and now I won’t have time to make breakfast. Long gone are the days of first and second year when I would wake up at 6:30 a.m. to make eggs and bacon – sleep has come to outweigh the benefits of a home cooked meal. But thankfully, by the time I get dressed for clinic and head to campus, I decide to take a detour on my way to class for some of Darrell’s famous potatoes in the University’s on-campus Culinart Café. I say a silent thank you to God because today Darrell added sautéed onions and peppers to his diced home fries. I guess oversleeping has it perks sometimes too.
On this particular day I had two, two-hour lectures in the morning before heading to The Eye Institute (TEI) – the University’s Optometric clinical facility - at noon. These are probably the longest days as a third year, but somehow, they always seem to fly by after the first clinical shift. After paying for my meal with Ms. Jackie in the café , the sweetest and most kind woman, and she’s ensured me that I look “so handsome” in my clinic clothes, I’m ready to make the trek to the third floor for our lecture hall.
The lecture hall looks like any other classroom, long rows of tables with rolling office chairs, a large projected PowerPoint presentation already loaded on the front screen and smaller televisions hanging from the ceiling every few rows once you get far enough back. I spot my group of friends occupying two rows in the middle of the room and head over. On days when we have two lectures back to back, I’m usually pickier about where I sit. I have every intention of being alert and taking notes for the four hours we’ll be sitting there, but I’ve finally come to terms with the fact that I’m going to need someone to whisper to when I’ve hit that wall of maximum retention of knowledge for the day.
I pull out my laptop and make sure to check that I have the right lecture pulled up. First up is a lecture on “Treating Esotropia” as part of our Normal and Abnormal Binocular Function class. I realize quickly that the presentation is only 40 slides and do a silent cheer. That must mean class is going to end early. I quickly find out that in reality it means we are going to start the next lecture so we can stay ahead of the material. I should have knocked on wood. Being one of my favorite classes though, I don’t mind, it stays interactive and before I know it we’re on break before our Vision Rehabilitation lecture. By 11 a.m., the potatoes have been converted to fuel for note taking, question answering, and just paying attention in general. I break out my lunch and decide to eat now, so I don’t have to scarf down my salad right before patient care. The rest of the lecture flies by and before I know it, it’s time to head to clinic.
By the time fall in the optometry program’s third year comes along, we’ve been doing exams on our own for seven months and are really working to perfect our exams. The “clinic jitters” aren’t really there anymore and we finally have the confidence that we’ll be able to tackle any type of exam or difficult patient that sits in our exam chair. TEI has recently been renovated and is about a 10-minute drive from the main campus. From the time we start classes and labs during our first year, we are split into four different sections among our classmates. This ends up being the same group that you are in clinic with however; the 40 or so students are split into three different “suites” within TEI, each with their own group of preceptors.
So as a “Section B, Suite 3” student, I headed to Suite 3 to set up my equipment in my exam room. Each suite is also equipped with a team room where students can mingle and talk about their cases and it also houses the three doctors/optometry faculty who are working during that shift, each of them in their own office space. There are nine exam rooms in each suite and on that day, I was lucky number 307. After getting all of my equipment set up just the way I like it, I headed into the team room to find out if there was a patient ready for me to take back. Luckily, there was, and after doing some background research on them (why they were here, what ocular conditions they had, etc.), I head to the waiting room to get them.
My first exam of the day was a glaucoma follow up with an IOP (intraocular pressure) check. Working with the doctors one- on-one really provides a great learning experience to see how different preceptors handle a case. By 3:45 p.m., all of the patients scheduled were being seen or had already left, so that allowed for a quick dinner, which I bought in the small café upstairs at TEI. This small group of students that you are spending hours in labs, classes, and clinic with become your second family. So, dinner time in the café can get a little rowdy as we’re all in high spirits from getting the hands-on experience in the career choice we love, and it’s also that much closer to being able to head home and to bed.
The evening shift flies by and by 8 p.m. we’re ready to do a round table. These are some of the most educational experiences we have where we sit with our preceptors and all of the students in our suite to go over cases we had and what we learned from that particular day. So even on a day where you thought all of your exams were pretty straight forward, your friend in room one probably saw some crazy retinal detachment that you can still learn a lot from. If we don’t have an early class the next day, we may all go out for a drink after to unwind and share more than we were able to at the round table. The people in your small sections will most likely become your best friends while you’re in school because you spend so much time with them and you go through some of the most challenging parts of your schooling with them. Before long though, it’s time to head home, and crawl into bed after peeling off your dress shirt and tie. As my eyes start to get heavy and my body slowly relaxes, I slip off into a deep sleep and a dream washes over me. “Well according to the OHTS study we know that in our glaucoma patients…”