At the beginning of orientation I was told that time spent in optometry school had a strange ability to pass both incredibly slowly and quickly at the same time. Without getting sappy, I have to agree with this statement. During second year at PCO, the curriculum’s focus changes drastically from the broad optical and physical health to a more focused study on ocular anatomy, diseases, pharmacology and clinical techniques. Things begin to come together more, the content starts to build upon itself, friendships have developed, and routines have been made.
During the summer between the first and second year all students have to complete a 105 hour rotation at an optical of their choice. I chose to do my rotation in the suburbs of Philadelphia. During the rotation students are supposed to work on their optical skills, assisting patients with frames selection, measuring fitting height for progressives and pupillary distances for frames, as well as working as a technician in the office. During my externship I was also able to use my time to learn about contact lenses, how to be successful in the business end, and what some of the different products on the market are. Overall, I had a great experience during my summer clerkship.
- Optics III
- Ocular Biology
- Clinical Skills
Following the summer clerkship students have to take a number of classes. The first class that we take is an online optics course. When we return to campus we also begin learning the clinical skills behind the slit lamp, the structure of the retina in ocular biology and principles of the visual system in PPMV. Overall, the summer session is short and serves as an introduction to the fall semester curriculum.
In the fall semester the classes that I took were:
- Clinical Skills
- Ocular Biology
- Contact Lens I
- Clinical Problem Solving
- Optional Dr. Gurwood lecture series
By far the biggest challenge this semester is focused on clinical skills. In the fall semester of second year we had clinical skills lab for 6 hours a week, and we had 10 practicals on the health portion of the eye that we had to pass to enter into clinic. Many hours were spent perfecting our skills (with one eye dilated) as we learned how to master all of the techniques to become eye doctors. A word of advice is to practice early and often. Make sure that you have somebody watching and correcting you from the beginning, and try to remain calm as best as you can. Practicals can be a very stressful experience, but with enough practice they are all manageable.
By practicing with one another you will eventually gain an understanding of what a normal patient’s eyes look like. This becomes useful when you are making comparisons in clinic the following semester. As for the didactic part of the semester, Ocular Biology was the densest course in terms of the amount of material, as we learned all about the structures of the eyes, clinical correlates, and developmental anatomy. Aside from ocular biology we learned the principles behind soft contact lenses as well as how to fit them, the fundamentals behind visual perception, and we continued to shadow in the clinic.
I really enjoyed my time shadowing in clinic as I got to practice explaining the case findings with my patients and interacting in a more direct way. One last class that I took was an optional lecture series taught by Dr. Gurwood. During this class Dr. Gurwood provided an overview of many of the retinal diseases such as AMD, Hypertensive Retinopathy, Diabetic Retinopathy and glaucoma. Having attended these lectures I felt more comfortable in clinic having had some informal lectures prior to starting classes in posterior segment.
The spring didactic classes that I took were:
- Anterior Segment and Disease
- Posterior Segment and Disease
- Ocular Emergencies
- Contact Lens II
- Ocular Motility
- Normal and Abnormal Binocular Function
- Clinical Problem Solving
In the spring semester second year students at PCO take over the clinic. This was both extremely exciting and nerve wracking. In clinic we are given our patient and in 30 minutes we are supposed to present to our preceptors the findings from our exam and be prepared to dilate our patients. Working independently and with patients (who unlike classmates won’t keep their eyes open indefinitely) was quite a change. Additionally, dealing with new diseases, a population base that has a high incidence of ocular and systemic diseases, and patients of all ages provided new challenges.
Once my nerves settled and I was able to get into more of a flow with patients, and clinic became more and more enjoyable. Students are assigned to 8 hours of primary care clinic as well as roughly 4 hours of a specialty clinic which can be visual fields and imaging, pediatrics, low vision, glaucoma, or a satellite clinic. Specialty assignments were rotated throughout the semester. While beginning clinic may sound daunting it is important to understand that the doctors who you are presenting to are more interested in seeing that you are working efficiently, thinking at an appropriate level, and beginning to spot abnormalities than they are in your ability to make the correct diagnosis.
Not all of the classes run throughout the entire semester. The heaviest class that we took in second year in terms of course material was Anterior Segment and Disease. Contact Lens II also ran throughout most of the semester and this time focused on RGP and specialty lenses. We began to learn about binocular vision, starting with ocular motility and advancing into normal and abnormal behavioral function, which focused on convergence and accommodation abnormalities. Towards the end of the semester we had smaller half credit classes in glaucoma, ocular emergencies, and the beginning of posterior segment.
As hard as I made my second year sound, it wasn’t all work and no play. This past year I really
started to learn about the city of Philadelphia. I spent more times eating lunch at Reading Terminal Market than I should admit. I had the wonderful opportunities to attend two Special Olympics vision screenings, attend Vision Expo East, and the PCO Quiz Bowl.
While second year at PCO is intense, learning clinically relevant material and beginning to see your own patients is a wonderful feeling. It’s amazing looking back at where I came from just a year ago and seeing where I am now. Throughout all of the stress of tests and practicals you can get through it, and emerge a competent third year student.