Is a Residency Right for You?

The benefits of doing a residency can be phenomenal. Here's a closer look at what's required and how to choose a program.

By Carol Weinman, Contributing Editor

AS YOU ENTER the final stretch of optometry school, you may be weighing the pros and cons of applying for a residency. Or, maybe you've decided to do one, but you're unsure which specialty or program will be best for you.

Determining whether to enter a residency program is the single most important career decision you'll make because it will impact the rest of your professional life, says Diane T. Adamczyk, O.D., F.A.A.O., director of residencies at the State University of New York (SUNY) State College of Optometry.

How do you make this all-important decision? You should approach it as you would any major crossroad in your life: Learn as much as possible about what's involved so you can make an informed decision.

This article will discuss the benefits of a residency and how to prepare for one. It also will describe some of the programs and specialties available.

What a Residency Offers

Residencies aren't mandatory, but they can be necessary, depending on where you want to practice and whether or not you want to specialize. Typically, a residency program takes place in a clinical setting that caters to a diverse number of patients with complex eye disorders. Acquiring hands-on experience in this unique setting gives you an opportunity to hone your clinical decision-making skills while cultivating a highly marketable talent. Plus, a residency "gives a doctor the opportunity to focus on a particular segment of the profession he or she is most passionate about," says Vinita Henry, O.D., clinical professor of optometry and director of residencies at the University of Missouri — St. Louis, College of Optometry.

If you choose not to do a residency, you're free to begin practicing in a private setting and in some hospitals. Generally, however, VA hospitals, companies, corporations and educational institutions prefer to hire optometrists with advanced training. "If you want to be in the running for a position at a hospital, in teaching, a comanagement clinic or a multidisciplinary practice, you need the advanced training," says Robert Newcomb, O.D., M.P.H., residency director at The Ohio State University College of Optometry.

Even O.D./M.D. private practices favor residents over nonresidents in hiring decisions. That's because in medical/surgical practices, you treat many different patients with more challenging eye conditions and ocular disease. The extra year of clinical experience in a residency program prepares you for that, Dr. Newcomb says.

Most residencies last for a year from July 1 to June 30. You should contact the residency program you're interested in during the fall of your fourth year. Residents are typically paid a stipend between $27,000 and $35,000. Some programs offer residents the same benefits provided to faculty and staff, such as health insurance. And, if you have a student loan, you may be able to defer payment until after you've completed the residency.

Other perks: A residency enables you to become a better doctor because of the intense clinical experience you gain, which can lead to a more satisfying professional career, says J. Bart Campbell, O.D., director of residency programs at Southern College of Optometry in Tennessee.

Choosing the Right School

Even more challenging than deciding to do a residency is choosing which school will be right for you, and this may depend on the specialty you select. Bear in mind that while some schools may have similar residency programs, no two are exactly alike. VA hospitals, for instance, usually have the more coveted residency spots. That's because patients in VA hospitals tend to have more challenging eye diseases and conditions than in other residencies — although there are some non-VA programs involving women and children who have problems that are just as out of the ordinary.

If you already have a specialty in mind, visit The Association of Schools and Colleges Web site at asco.org. Enter your specialty from the drop-down list for the names of schools that offer those residencies. You can contact the director of residencies at each of the schools and colleges of optometry in which you're interested and ask them what the curriculum entails and what the application process involves. It's also a good idea to talk to current residents or doctors who've recently completed a residency at the college you're considering. They can provide details about the programs, the academic environment, housing, etc. (Residency directors can give you their contact information.)

According to Karen Fern, O.D., F.A.A.O., director of residency programs at the University of Houston, "Graduating students should focus on which residency offers the learning environment that's best for them." And once students choose a program, they should visit the school to determine if it truly will be the right fit.

If you want to choose a program based on what's considered the hottest specialty, apply for a residency spot in ocular disease and contact lenses. With the elderly population on the rise, low-vision residencies are gaining in popularity. On the other hand, when the University of Houston's College of Optometry surveyed O.D. grads, they reported that pediatric optometry is number one on their wish list.

Like many graduating students, you may be anxious to get in on the ground floor of an up-and-coming specialty. If that's the case, check out "acquired brain injury" at the College of Optometry at SUNY. The college established this unique optometric specialty just a couple of years ago. Residents work alongside neurologists and directly with patients in the Raymond J. Greenwald Rehabilitation Center at the College. The Center specializes in vision problems in people who've experienced head trauma from an accident or stroke. For more information on this cutting-edge specialty, go to sunyopt.edu.

Says Bernard H. Blaustein, O.D., associate professor of clinical education and director of residency programs at the Pennsylvania College of Optometry, the scope of optometric practice is expanding and has become much more complex. So much so that Dr. Blaustein foresees the day when residency education will become a prerequisite to the practice of optometry.

How to Stand Out

There are far more applicants than there are available spots in residency programs, so the competition is sti ff. How can you set yourself apart from the crowd? Your grade point average will be a factor, but program directors also will evaluate the following:

• Two or three letters of recommendation, usually provided by those who teach or supervise you in a clinical setting
• A letter of interest from you stating why you want to participate in the program
• Test scores from the National Board of Examiners in Optometry (NBEO) exam
• An interview with the school or college.

How to Prepare for the Interview

Your grades, scores and recommendation letters are important, but the interview often can make or break your chances of being accepted into the program. Here's how to ace the interview:

• Gather background information about the residency program so you can discuss it and ask questions.
• Discuss how you can contribute to the residency program.
• Be prepared to answer questions, such as "Why do you want to do a residency? Tell me about a case you were involved in. What treatments were prescribed and what was the outcome?"

Up for the Challenge

The extra year of training you'll receive during your residency will consist of comprehensive clinical experience, grand rounds, workshops, research, lectures, writing and presenting — definitely not a walk in the park. But the rewards will be apparent quickly. You'll gain the self-confidence that comes only with experience. And you'll find that more doors will open up for you that would otherwise be closed.nOD