COMMENTARY

Has the Time Come for Mandatory Optometry Residencies?

Christina M. Sorenson, OD

Disclosures

September 04, 2013

If ever there was a 2-sided argument, this could be it. The residency discussion has bubbled up to a debate in recent years with the onset of board certification in optometry. Either you think that optometrists are fully formed upon graduation, or that they are not. I happen to be in the Quasimodo camp.

I believe residency for optometrists should be mandatory. It is time for optometry to grow up and join the ranks of independent practitioners of other specialties. As a specialty matures, the care provided to patients widens and grows in depth. Optometry is, and has been, at this crossroads for many years. The education afforded most optometric students is solid enough to develop the skills necessary to render primary eye care. However, the additional year (or years) to fully form critical thinking and diagnostic triage under the tutelage of a skilled mentor can only be provided by residency training; as the demands on the optometrist to completely integrate into the healthcare system grow, so should their training.

Optometry offers 11 areas of residency training that are recognized by the Accreditation Council on Optometric Education (ACOE), the accrediting body for optometry, and the Association of Schools and Colleges of Optometry (ASCO).

These 11 areas of residency are:

Primary eye care;

Family practice;

Ocular disease;

Cornea and contact lenses;

Brain injury rehabilitation;

Low vision rehabilitation;

Geriatric optometry;

Community health;

Pediatric optometry;

Vision therapy; and

Rehabilitation and refractive ocular surgery.

If we go outside of the accreditation model, there are additional opportunities for residency training in nonaccredited programs.

The current challenge in optometry is the limited number of residencies available for the graduating classes. Optometry currently has only approximately 25% of the positions needed for the number of graduates. The number of residency positions continues to grow annually, but not at rate that would allow a giant leap to a required residency for each graduate.

Many believe that residency for optometry is unnecessary. Optometry has a long, proud tradition of excellent primary eye care. If you look at our care outcomes and malpractice rates, you will see that in comparison with other specialties, optometry enjoys an exceptionally low rate of malpractice claims, with an outstanding patient satisfaction report. Given these 2 well-established benchmarks, why would optometry consider requiring more education, greater cost, and little perceived benefit to the practitioners?

It is time to embrace our future fully. We have taken the step to board certification; we should now take the step to required residencies. For more information on optometric residency programs, visit the ASCO Webpage on this topic.

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