Blair Macdonald
Joining a practice as a pre-reg student can be a daunting experience as workbooks are swapped for the workplace and the skills and knowledge acquired at university are put into practise with real patients.
‘The progression from university to pre-registration optometrist is definitely a larger leap than I first anticipated,’ says Blair Macdonald, who joined Optical Express as a pre-reg optometrist in 2020.
‘You go from seeing one patient a day at university to seeing multiple patients within the space of a couple of hours. This enabled me to develop skills quicker and I am grateful for that,’ he says.
Macdonald says he was lucky to have a great relationship with his supervisors and clinical director, which made the whole experience enjoyable.
‘People say the pre-registration year is one of the most difficult years of your life, but I was fortunate to have such a strong support system that it really did not feel that way,’ he says.
Supportive supervisors
Supervisors at Optical Express encouraged Macdonald to make independent clinical decisions early on, which he found less daunting than some of his peers from university due to the support he received. ‘We have access to support from our clinical services team, who are at the end of a phone or email,’ he says.
The multiple also funded training courses and mock exams for Macdonald, including a communication workshop, which provided the skills and knowledge to effectively communicate with patients and a case scenario workshop on managing challenging situations. Covid-19 presented the biggest challenge during Macdonald’s pre-reg year, with most courses delivered online.
‘The pandemic delayed a lot of assessments and also having to wear personal protective equipment added an extra layer of stress, but I worked through it and I am very proud of myself for getting through pre-reg during a difficult time,’ he says.
Time management was also a challenge, Macdonald says: ‘You are essentially working a full-time job and studying simultaneously. It can be tricky to juggle all this, while also trying to maintain a social life too, but I was lucky enough to always maintain a good work-life balance.’
Paediatric optometry is an area that appeals to Macdonald and he feels fortunate to work for an eye care provider that covers frames, contact lenses, refractive surgery and cataract operations. ‘I am looking forward to exploring all options in the future,’ he says.
Macdonald, who now practises at the multiple’s Paisley clinic, advises other students to enjoy the whole experience: ‘Take in as much information as you can and try not to worry if you do not feel prepared for pre-reg at the end of university. The life skills and core learning really begin that very first day you walk into the clinic,’ he says.
Practise makes perfect
Zyia Patel, a pre-reg optometrist at Specsavers in Cannock (pictured right), says that having a professional yet relaxed relationship with managers and supervisors is the key to maintaining a successful pre-reg year.
‘My managers are exceptionally supportive. Each week they celebrate even the smallest of wins and are always there to provide me with the advice I need,’ she says, adding: ‘Being able to do my pre-reg alongside another new optometrist is a supportive mechanism in itself. It allows us to express our thoughts with each other, knowing that we both understand how we are feeling,’ she says.
As part of her pre-reg, Patel has also spent a day with second year students from Aston University, providing them with a glimpse of what life is like as a pre-reg. ‘This experience allowed me to reflect on my journey so far,’ she says.
For Patel, things really ‘stick’ when she experiences them first hand: ‘Encountering a patient, for example, who had high pressures in the right eye accompanied with superior thinning of the retinal nerve fibre layer and a corresponding visual field defect, has stuck with me six months on,’ she says.
Equally, performing retinoscopy and subjective refraction repeatedly, seven times a day, four days a week, has also ensured the skills become second nature.
‘I struggled in third year, navigating my way around the posterior eye. Now I can perform indirect ophthalmoscopy within minutes. The difference was that at university I was picking up my Volk lens once a week, now I use one between 20 to 35 times a week,’ she says.
Patel spent two of her placements at franchise opticians, which she said gave her huge insight: ‘I was able to get a feel of what it was like on the practice floor and inside the testing room - a big contributor to my communication skills,’ she says.
Patel says it is vital to have strong communication skills ‘from speaking to the patient, listening to their needs, understanding their feelings and managing their expectations to portraying appropriate body language and facial expressions’.
She recommends getting a weekend optical job during university to develop these skills. ‘I got my first role as an optical assistant towards the end of my third year. It will teach you things like how to explain lenses to a patient, how to recommend a frame based on a prescription and what additional coatings would be best suited to their lifestyle,’ she says.
After completing her pre-reg year, Patel would like to continue expanding her optical knowledge in practice and later pursue medical retina and diabetic retinopathy. ‘Another one of my ambitions is to volunteer in a country where access to care isn’t as readily available as in the UK,’ she says.
Work experience
Newly qualified optometrist Isha Saghir (pictured right), who did her pre-reg at Bennett and Batty Opticians, a Hakim Group independent practice in Merseyside, says the transfer from university to the testing room involves piecing together theoretical knowledge, gaining clinical experience and refining techniques.
‘I can’t fault the support I received, from blocking out clinic time to go through points with my supervisor to the verbal encouragement from the rest of the team,’ she says.
Saghir started off with two-hour test slots, which helped the transition to go smoothly, before reducing testing times and performing more sight tests to ease her into ‘optom life’.
‘Repetition is a key component for most things, including the techniques used during an eye exam. Performing sight tests during your pre-reg year contributes to the reinforcement of the skills developed whilst at university,’ she says.
Following a university placement at Manchester Royal Eye Hospital, Saghir carried out a pre-reg hospital placement at SpaMedica, where she observed the patient journey from high street practice referral to surgery and discharge.
‘I also sat in on a YAG clinic and seeing the process from start to finish has really helped me support my own patients requiring cataract surgery,’ she says.
With a vast range of additional qualifications available, Saghir is keen to further expand her knowledge and medical retina is top of the list. ‘I think it will be really useful in my day-to-day practice,’ she says.
Saghir emphasises the need to build a strong foundation for clinical skills: ‘Make the most of your supervisors during supervised clinical sessions and your peers during self-directed practice. The clinical skills needed are pretty much the same for each routine eye examination, so it is important you are confident with the basics.
‘If you’re unsure about anything, seek advice from the tutors - they’re there to help.’ She also recommends working on verbal and written communication skills ahead of the pre-reg year. ‘Having an idea of how to explain the prescription or pathology to a patient in a manner they will understand is handy. Naturally, your confidence will develop as you progress through your optometry career,’ she adds.
Communication skills
Clear communication and sound clinical knowledge are also highlighted by optometrist Aaron Uraon (pictured right), who qualified in 2021 and joined OutsideClinic in 2022.
‘It is important that patients’ understanding and expectations are managed appropriately, to ensure the optometrist, patients and relatives are all aligned,’ he says.
Throughout university and his pre-reg year, Uraon ensured he developed a good understanding of common eye conditions and their implications on patients’ vision and prescription to be able to communicate effectively with patients.
‘I love working in domiciliary optometry,’ he says, adding: ‘Some people think it’s daunting to be out on your own seeing patients, but I’ve found that it really builds my confidence and I know I am fully supported. With our professional services team and other optometrists only a phone call away I can get a second opinion in minutes.’
Uraon advises university students to develop an awareness of opportunities, try different fields within optometry and to ‘continue to fall in love with the profession’. He says he has started to develop a diverse range of experience including ‘high street practice, domiciliary care, locum work, teaching at university and running pre-registration courses’.
‘Over the next few years, I wish to continue to diversify and build confidence, knowledge and expertise in different areas. Optometry is a large field that extends much further beyond everyday practice. Opportunities are plentiful, but you need the desire to actively seek and chase them,’ he adds.
