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The Externship Lotto at ICO

Fourth year Rina Sheth’s latest blog was Seven Tips for ICO Externships. But, how do fourth years get to a certain externship site? This past month, ICO third years buckled down to make those choices.


Imagine picking your fantasy team, but with real results that affect your life. How do you figure out where you want to go? When should you go? Will it work with the other sites you want? What happens if you have a low number and your site is taken? As someone who worries a lot, I spent a lot of time figuring out ten different scenarios.


During summer quarter, third years received notification that externship sites were finalized. We finally had all the available sites to start looking at. We also received an email about requirements for graduation. We need certain hours in different “specialities,” such as low vision, pediatrics and vision therapy, primary care, contact lenses, and advanced care. We also have to be at IEI during one quarter, but we can choose what department we want to work with. Another requirement is that one quarter must be spent at a VA hospital. The remaining two must be at “speciality sites”.

Heading back to Detroit for our second externship site and living next door in Windsor!


Picking sites is based on a lottery system. First, the class is split into three tiers. Each tier gets to be at the top, middle, and bottom once each. Within a tier, that group of people is randomized. The fourth selection is completely randomized. The first selection is for IEI, the second is for the VA site, and the third and fourth are for the speciality sites.


You can trade numbers, and if you want, you can pair with someone. The benefit of pairing is that if you pick a two-person site, you know the other person will get the second spot. However, if you decide to pair with someone, you always drop to the lower number (later pick). I decided to pair, which actually made the selection more nerve-wracking for me.


So, how does one pick a spot? Some people base their decision on location, site, cost, or who else is going.  Everyone has their reasons for wanting certain sites. An ideal location could be closer to home, or somewhere warm for the summer. Some people want free housing, others don’t want to have a car.

Excited for our road trip to Daytona Beach, Fl for our third externship site before heading back to the IEI for spring and graduation

Excited for our road trip to Daytona Beach, Fl for our third externship site before heading back to the IEI for spring and graduation


The IEI selection felt very stressful. Only so many people can get a certain quarter (summer filled up first.) Within a quarter, there are limited hours in each department. Next, VA selection felt less difficult because most VA hospitals are very similar. The only thing that made it tough was that everyone needed 5 hours of low vision. There are very few low vision hours at the IEI, so the VA is where people wanted to earn them. The next two “drafts,” the specialty sites, were the most exciting. While there are many different sites, each one has a limited number of students they accept. Your selection has to fit in with your IEI and VA schedule.


Even though during the process you can hear gasps, claps, and shock, everyone has a great rotation at the very end. If you are unhappy, there is a grace period to switch with someone else or to an empty spot.


Somehow, my pair ended up getting all of our top choices. We will be in Sartell, MN for advanced care in the summer, Detroit, MI for contact lens and low vision in the fall, and Daytona Beach VA, FL in the winter. To end fourth year, we will be returning to the IEI for advanced care and pediatrics.


It is exciting and sad to be saying goodbye to our classmates for an entire year. We are having our first real world experiences as eye doctors. No matter what, we will all be reunited in the spring when we graduate and become ODs together.


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