GME Archives - Charles F. Mullen

Potential Factors Contributing to a Decade of No Growth in the Optometry Student Applicant Pool

Image of the Profession

While the University of Chicago’s NORC surveys indicate optometry is considered a high prestige profession, the increased visibility of Retail Optometry is projecting an image different from potential applicants’ expectations of what it means to be a “doctor.”
Association with the selling of eyeglasses: Is an optometrist a health care provider or a merchant?
While the applicant pool has not increased in 10 years, less qualified matriculants have increased thereby diluting the quality of the optometric workforce.
New schools of optometry exacerbate the situation of less qualified matriculants.

See: An Analysis of the Optometric Applicant Pool Relative to Matriculants

Income to Debt Ratio

A high percentage of income is required to pay educational debt: 15% of income is the highest of all health care professions.
Starting income is relativity low when loan payments are considered.
Income growth accrues primarily to private practice owners. Retail optometrists’ and employed optometrists’ income remains effectively level throughout their careers.
The magnitude of debt takes years to repay.

Oversupply of Optometrists

Lewin Survey Finds Large Optometry Surpluses

Education

Concern education is too long and too costly for return on investment?
No Federal support for costly optometric clinical training.

Optometric Practice

Paradoxical Evolution of Optometry.
When scope of practice does increase additional education/clinical training is required.
No profession-wide recognized Specialty Certification Boards. The public considers Board Certification as the “Gold Standard” for quality practitioners. See: Optometry Specialty Certification Boards Provide a Uniform Indicator of Advanced Knowledge and Skills.

Recommendation

The first step in solving any problem is to honestly identify the cause or causes. Once the causes are identified then the task of implementing corrective measures should commence.

Optometry Specialty Certification Boards Provide a Uniform Indicator of Advanced Knowledge and Skills

Introduction

There is a need for increased postgraduate clinical training and Optometry Specialty Certification Boards to manage the rapid expansion of the Scope of Optometric Practice. See: Three Critical Components for Expanded Scope of Optometric Practice.

Board Certification is understood by the health care community and general public to mean that a physician has acquired advanced knowledge and skills in a specialty area such as Internal Medicine, Family Medicine, Pediatrics, etc.

Although there are many types of Optometry Residency Programs, only ABCMO offers residents the opportunity to be Board Certified in an Optometry Specialty. This leaves many other residents without the opportunity for Board Certification in their respective Specialties. This deficiency can be addressed by the development of additional Optometry Specialty Certification Boards.

To facilitate the development of Optometry Specialty Certification Boards, and to ensure high standards for all specialties, the American Board of Optometry Specialties (ABOS) was created. Similar to the American Board of Medical Specialties (ABMS), which provides oversight and guidance to independent Medical Specialty Certification Boards, ABOS provides oversight and guidance to independent Optometry Specialty Certification Boards.

American Board of Optometry Specialties (ABOS)

ABOS currently has one member optometry specialty certification board and recommends the formation of an additional three.

American Board of Optometry Specialties (ABOS)

Three Critical Components for Expanded Scope of Optometric Practice

Introduction

Medical Education leads the Medical Profession by developing the educational structure and clinical training programs in advance of new patient care initiatives. In contrast, State Optometric societies lead the Optometric Profession with Optometric Education reacting to the States’ expanded scope of practice initiatives with specific educational programs. Consequently, there is not a comprehensive educational structure nor a uniform indicator of an optometrist’s knowledge and clinical skills to support all of the States’ expanded scope of practice initiatives.

Requiring postgraduate clinical training in medical eye care for optometrists is not only essential preparation for Expanded Scope of Practice, but also positions optometry for inclusion in the $18 billion Graduate Medical Education Program (GME).

These are the three missing components that need to be developed:

1) Necessary Capacity for Advanced Clinical Training in Medical Eye Care

In 1931 Medicine acknowledged that clerkships contained within the four year medical school curriculum were inadequate preparation for rapidly changing medical practice, and instituted mandatory postgraduate clinical training.
Even though optometric practice has dramatically and rapidly expanded encompassing medical eye care, clerkships within the four year optometry curriculum remain the only required clinical training component.
The current four year curriculum does not provide optometry graduates with the types and quantity of clinical teaching encounters necessary to practice expanded scope of practice in all States.
Postgraduate clinical training in medical eye care is now essential preparation for advanced optometric practice.

2) Federal Funding to Support Advanced Clinical Training

Optometry is not included in the $18 Billion Graduate Medical Education Program (GME) because clinical education takes place primarily within the four year curriculum, and not in postgraduate residencies.
Inclusion in GME, the educational component of Medicare, would not only encourage the development of new residency positions in Medical Eye Care by providing funding to host facilities, but also by providing funding to directly support advanced clinical training.
Optometric Education needs to change from providing clinical education within the current four year curriculum to a Postgraduate Clinical Training Model to qualify for GME.
Like medicine, clinical clerkships or rotations would take place within the final years of the curriculum.

3) Nationally Recognized Certification Board to Provide a Uniform Indicator of an Optometrist’s Advanced Knowledge and Skills to Practice Expanded Scope of Practice Optometry

The American Board for Certification in Medical Optometry (ABCMO) is a well-established Board that meets GME expectations. However, ABCMO serves mostly Department of Veterans Affairs (VA) optometrists, and needs to be recognized by the entire Optometric Profession.