Expanded Practice Laws
Over the past 47 years, State optometric practice laws have been expanded to include more medical procedures, treatments and management of medical conditions but often with restrictions. Individual State regulatory boards have reacted to expanded practice laws by requiring additional clinical training and/or instruction to perform the new clinical privileges granted. Thus, requirements for optometry practice can often vary by State.
State officials and legislators are reluctant to grant the full range of clinical treatments and procedures to optometrists because of limitations in optometrists’ clinical training. There is concern about the number and diversity of clinical encounters currently experienced in the four year optometric curriculum. Medicine and optometry both have four year basic curricula, however, medicine requires postgraduate clinical training while it is optional in optometry.
Optometry Four Year Curriculum
The entire optometry curriculum (academic and clinical) must be completed in just 4 years with no required postgraduate clinical training. Consequently, clinical training is limited, especially in the number of medical clinical teaching encounters, and in diversity of encounters to thoroughly prepare the graduate for the provision of current medical procedures, treatments and management. Also, not all optometry schools have access to sufficient numbers of patients with medical conditions necessary for clinical teaching.
Postgraduate Clinical Training
Medicine introduced postgraduate clinical training in 1930, as one year internships (now considered first year of residency), to compensate for the limited number of student clinical teaching encounters in the Medical School curriculum. One to three years postgraduate (residency) clinical training is now required for medical licensure. Overall, physicians spend an average of 4 years in postgraduate specialty clinical training leading to specialty board certification. See also American Board of Medical Specialties (ABMS).
Recommendation: Mandatory Postgraduate Clinical Training
It is time for optometry to follow medicine’s example by mandating a minimum of one year postgraduate clinical training (residency) in an accredited medical optometry postgraduate program or equivalent for licensure to compensate for limited student clinical encounters in medical procedures, treatments and management in the optometry school 4 year curriculum, and to ensure uniformity in clinical medical training among all states.
Additional Benefits of Mandatory Postgraduate Clinical Training
- Mandatory postgraduate clinical training followed by Board Certification in Medical Optometry should convince skeptics at the State and Federal level that optometrists are prepared to comprehensively treat eye disease without restrictions.
- Mandated postgraduate medical clinical training would place the graduate on an expeditious path to Specialty Board Certification in Medical Optometry. See also American Board of Certification in Medical Optometry (ABCMO).
- The Federal Government supports postgraduate training through the Graduate Medical Education (GME) Program. States’ enactment of optometry’s mandatory postgraduate requirement for licensure would be another step toward optometry’s inclusion in the Graduate Medical Education (GME) Program. See also Changes Necessary to Include Optometry in the Graduate Medical Education Program (GME)
