Joe Ayling: What would you like to achieve in your career as an optometrist?
Joshua and Michael Mandel (J&M): We both would like to achieve a medicalised optometry profession and ensure the public can access high quality eye care across the UK where all optometrists function as primary health care providers. We hope for the eye test to become known only as the eye exam where optometrists are fairly compensated for their clinical expertise.
Aarani Sivanesan (AS): In my career, I would like to work as a hospital optometrist, specialising in an eye disease field as well as participating in research.
JA: How optimistic are you about finding a job following your course?
AS: I am fairly confident that I will find a job following my course, with the experience I have gained and the support from my lecturers. Fortunately, the course enables me to complete a pre-registration year before I graduate.
JA: How do you see the profession changing with technology over time?
J&M: To begin, we both see that Opternative is now licensed in 37 States. How long before it comes to the UK? Opternative allows individuals between the ages of 18 and 55 years to have a refraction in their own home. It is not an eye health check, but most people will then likely demand a specialist for their eye health and eye care needs. A medicalised, autonomous, and therapeutic optometry profession now appears the only way forward.
AS: With advancing technology and functions becoming more automated, the role of an optometrist may consist of more multi-disciplinary work and may be able to attain further training. As technology grows, the equipment required to provide visual care will advance, which could allow optometrists to detect eye diseases at earlier stages and diagnose eye conditions more efficiently.
JA: Do you think your education is fully preparing you for the workplace? If not, which areas are missing from current optometry courses?
AS: In my lectures and seminars, learning involves gaining knowledge and solving clinical scenarios. Clinical optometry skills lessons are conducted within clinical simulated environments, which allows us to have a feel of the workplace. The examinations consist of real life patients that help us prepare for our future examinations and practice.
Fortunately, we’ve been able to receive practical experience from the beginning of our course. Not only are we allowed to practise in the clinical simulated environment during our clinical lessons, but also allowed to access the clinics upon request to gain more practice.
J&M: We both believe the current workplace in the multiple optometry climate in which a 20-minute eye test is the industry standard is something which very few pre-registration optometrists are equipped or prepared to deal with once finishing their degree at university. Conversion rates to subsidise our clinical expertise should not exist. Furthermore, we need the optometrist to be viewed as a clinical entity who provides a medically valuable eye exam. Respectfully, the industry needs to take a stance against 20-minute eye exam appointments. This single change would unquestionably help new graduates, pre-registration optometrists, to adapt in the workplace. The average member of the public currently envisions an eye test as being shorter than 40 minutes and this definitely makes it harder for pre-registration optometrists and student optometrists to gain clinical experience.
In terms of specific undergraduate education we need more of a focus on treating disease with therapeutics, optical coherence tomography, glaucoma management and more patient contact in which we see patients more regularly and earlier in our training. Adding an extra year or a half year to the pre-registration year similar to foundation training, where pre-registration optometrists are fairly compensated, may achieve this result.
For all optometry schools attachment to an eye hospital in which regular clinical experiences are conducted over all years should be mandatory. Electives in specialist areas of practice and interdisciplinary teaching with nurses, midwives, pharmacists, medics and dentists may also be beneficial especially if using problem-based learning. However, it should be said optometry courses are rigorous and mostly fit for purpose in the current environment. Ideally, there should also be more opportunities to network in the independent optometry sector.
JA: How would you like to see the profile of the profession improve and how might the ‘Doctor of Optometry’ title help with this?
J&M: In conclusion, there is no doctor online. The perception of the average member of the public is most important. The eye exam must be revealed as not a retail experience but a medically necessary and thorough investigation.
The public already understands the title doctor as meaning clinically valuable. Doctor is a Latin word. It means ‘to teach’. It is a reflection of a clinician educating and advising their patient. Surveys conducted by COMRES show that optometrists are still not the average member of the public’s first port of call for eye issues. The optometry profession has specialist knowledge, we need to be recognised for this and many other things. In summary, as two pre-registration optometrists it may be argued that this is not our place to discuss the average member of the public’s perception of optometry, but from our perspective this needs to change.