Background
- Optometry is a significant provider of medical eye care services to Medicare beneficiaries ($1.33 billion annually) for conditions such as glaucoma, cataracts and retinal diseases, but is not included in the Graduate Medical Education Program (GME), the educational component of Medicare.
- Medicine, Podiatry and Specialty Dentistry receive $18 billion in GME support annually for postgraduate clinical education. Podiatry was included in GME in 1972 by amendment, and changed its clinical training model in 1990. Podiatry now receives regular GME payments to support resident training.
- It will be necessary to include Optometry in GME by amendment to appropriate laws/regulations or by inclusion in proposed legislation in advance of the introduction of a new optometry postgraduate clinical education model.
Clinical Training of Optometrists
- Optometry has traditionally provided clinical education within the four year optometry school curriculum with postgraduate clinical training being optional, thus, optometry’s current clinical education model does not meet GME requirements.
- Costly, optometric clinical education receives no Federal Support, and is largely financed by student tuition contributing to high graduate debt of approximately $200,000.
- Optometry graduates have the highest loan payments as a percentage (14.9%) of income of all professions.
- High debt is a contributing factor in that applicants to optometry schools and colleges have not effectively increased in 10 years.
Reasons Optometry Should be Included in GME
- Nationwide expansion of the scope of optometric practice by numerous changes to State Practice laws.
- A steadily increasing demand in providing Medicare beneficiaries with medical eye care services – Optometrists currently provide $1.33 billion in services annually managing serious eye conditions of Medicare recipients.
- A major increase in optometric management of serious eye conditions will accompany the proposed addition of refractive care (refraction, eyeglasses and contact lenses) in Medicare.
- The above will require the schools and colleges of optometry to restructure their traditional clinical education approach into a Postgraduate Medical Clinical Educational Model in order to provide the quantity and diversity of clinical teaching encounters necessary to properly prepare optometry graduates for clinical practice.
- In 1930 Medicine adopted required postgraduate clinical training because the 4 year medical school curriculum did not provide the quantity and diversity of clinical encounters to properly train physicians.
- Postgraduate optometric clinical education can be provided in cost effective outpatient facilities. GME’s hospital-based training requirement needs to be waived.
Optometry’s Inclusion in GME is Necessary
- GME is needed to support optometry’s postgraduate clinical education to meet current and future demand for well-trained optometrists in advanced medical eye care practice.
- GME support will ensure a sufficient number of well-trained optometrists to meet current and projected demand for eye care services of Medicare beneficiaries.