An Optometry Externship at the VA
This quarter I have been in Florida, The Sunshine State, enjoying the beach when it is warm enough. During the day, I spend my time surrounded by veterans at the Daytona Beach VA outpatient clinic. As this quarter comes to an end, I decided to write a blog about how the VA is different from other externships and what to expect if you haven’t been yet.
The patient population at the VA is very different compared to any other site you will go to. This population is mostly older men, a few women, and occasionally, a young person. The youngest I’ve seen is 22 and I made the record board! Ages normally range from 50 to 100. A lot of these patients also suffer from TBI and a number of other war-associated problems. Each patient has a very unique story and they usually love to share.
When I was a third year, I heard about the VA’s electronic health records (EHR) system. Some people love it, others hate it. I personally really like the EHR. It is like using a Word document; you free type everything. Some VAs let you create your own order, but our VA has a pre-programmed template that we can use for new patients. Old patients are just a quick copy, paste, and then edit as needed. The other perk of using the VA EHR is that it is connected to the other departments at the VA. Instantly, I can see a patient’s medication list, problem list, and all of their lab results. I think this is the best part because you can see everything and don’t need to rely on patient history as much.
Freedom with Imaging:
The VA has a lot of freedom. The doctors want us to manage the patients as if they were our own. We can order almost any test if we think it is necessary. We also have a lot of devices at our disposal. We have Spectralis, Cirrus, Visante, fundus photography, slit lamp photography, and a B-scan. The VA provides us the opportunity to learn how to use all of this different equipment and solidify how to interpret them.
You see a lot of comprehensive exams at the VA, but you also see some interesting cases. You will get a ton of practice with post-operative day 1, week 1, and month 1 for cataract surgery. We also see a good amount of glaucoma patients as well as ARMD. We have seen a vitreous cyst, band keratopathy, pseudoexfoliative glaucoma, CSCR, and wet ARMD. You will see a little of everything at the VA, which keeps it interesting and a fun environment to learn in.
At my current VA, we get the option to dress up or to wear scrubs every day. For me, scrubs are the better choice because they are super comfortable and have enough pockets to keep everything. If you haven’t done your VA site yet, this is something to look forward to!
Overall, don’t be scared when you go on your our VA externship. It is a great opportunity to learn and work in a different setting.