Osteopathic Health Sciences Centers across the Nation currently offer “ground-breaking” curricula in medical and other health care professions’ education, and now have a unique opportunity to develop and offer a ground-breaking program in optometric education and residency training. Such a new program would replace the traditional optometric curriculum where clinical training is contained within the four year degree program and having no requirement for postgraduate clinical training. Consequently optometry is not eligible for the Graduate Medical Education (GME) program. In the absence of Federal support for student and resident training, the rapidly increasing clinical training costs of optometrists are passed on to the student in the form of higher tuition and student debt.
Optometrists are classified as physicians under Medicare law and are judged by medical standards including advanced competency clinical training and board certification. Optometric education must now align with national standards and guidelines derived from medical education.
Such a proposed restructuring plan is politically challenging with numerous sensitive professional and educational issues. Implementation of the plan requires bold leadership. I look to Osteopathic Health Sciences Centers with their tradition of leadership and innovative programs to lead the change in optometric education. This proposal recommends restructuring optometric education and postgraduate training by placing it in parallel with medicine.
State and Federal legislative advocacy would need to be initiated concurrently with the development of the new optometric educational model. The new program would consist of:
Three Years for OD Degree + One Year Postgraduate Training = Licensure & Board Eligibility
Three years of didactic, laboratory education and clinical clerkships to earn the Doctor of Optometry (OD) degree followed by one year of postgraduate clinical training for licensure and board eligibility in General Practice.
- Residency Training License issued after receiving the OD degree.
Advantages of the New Curriculum and Clinical Training Model Include:
- By restructuring the curriculum and requiring postgraduate clinical training, optometry would become eligible for Graduate Medical Education (GME) payments to address increasing clinical training costs.
- Current “residents” would become postgraduate (PG-2 & PG-3), recognized by the Department of Health and Human Services (HHS) and also eligible for GME.
- GME funding would facilitate the availability of new residency positions.
- The Department of Veterans Affairs is currently the major source of funding for optometric residents (PG-1, PG-2 & PG-3)
- The current student-centered clinical training model is vulnerable to the Center for Medicare/Medicaid Services (CMS) compliance violations as students cannot provide billable services. However, residents can provide billable Medicare services.
- The new model would encourage advanced competency clinical training and board certification as emphasis would shift from student clinical training to postgraduate clinical training.
- Optometry student debt would be greatly reduced with accelerated undergraduate admissions, a three year OD degree program and with resident stipend payments in the postgraduate year.
- The Student Applicant Pool would be strengthened with the promise of significantly reduced debt and shortened education to qualify for board certification.
Apply for a Center for Medicare/Medicaid Services (CMS) Innovation Grant to Fund a Pilot Project Entitled — “Restructuring of Optometric Education”
CMS Category: Transforming the Financial and Clinical Model: Addressing increasing optometric clinical training costs is essential to workforce development and for meeting the demand for eye care services in a rapidly growing Medicare/Medicaid population.
- Award the Doctor of Optometry (OD) Degree After Three Years
- Reclassify current 4th Professional Year as General Practice Residency (PG-1)
- Additional PG, post licensure residency training required for board eligibility in specialties (Level II credential)
- Three Years of PG residency training required for sub-specialties (Level III)
- Place classifications of current optometric residency programs in conformance with medical terminology.
- Establish consistent standards among various optometric certification boards
- Form an oversight board — American Board of Optometric Specialties (ABOS).
- Amend States’ optometric licensing laws/regulations to require a minimum of one year of postgraduate, residency training in General practice for licensure.
- Amend the Social Security Act to include optometry in the Graduate Medical Education Program (GME) and expand GME support of residency training to all optometric clinical training venues.