This year, my classmates and I are being introduced into the clinic. We get to do what we came to optometry school to do.
Sweet.
The rules of the game:
The class is broken down into two groups.
Each group has six clinic shifts – one each week.
One group gets to be in clinic for the first half of the quarter; The second group takes the second half.
Students work in pairs to do clinical exams on real patients.
They must perform the skills they know how to do.
The Attending Clinician will take over the rest of the exam.
One student takes the role of doctor, the other is the note taker.
The students alternate each week.
On the first day, I remember walking into my examination room with my equipment and my usual air of overconfidence. My partner, Lisa Pham, had already set up. This would end up being a common theme for our next six weeks together. Her equipment had been immaculately arranged on the desk and her suitcases put away neatly in the corner of the room, while I, in my ignorance, casually mentioned how excited I was. We decided to use Lisa’s equipment since it had already been set up; we also decided that I would be doctor.
And then, it was go time. Lisa and I met our attending, Dr. Foreman. After an introduction, she promptly and kindly handed us a patient record and sent us on our way with one direction: skip keratometry and use the patient’s lensometry reading to begin manifest.
And that was it. I don’t know what I expected, but it was pretty underwhelming.
We went to pick up our patient from the waiting room. We introduced ourselves, took her to the examination room, and then the trial by fire began.
The skills I spent first year honing were developed in a sterile environment. The people I practiced with usually gave me the answers I expected and my directions were always followed without confusion. My skills didn’t play out that way in a clinical setting. Patients who don’t know how the tests are done need clear and simple instructions, unlike my classmates who knew exactly how to respond and gave me answers I always expected. I kept my cool, but as the testing went on, my pool of confidence evaporated into a meager puddle. I began to doubt myself and my results. Then, I began to make a few mistakes, which Lisa helped me correct.
I consider manifest refraction to be one of my strong points, but I couldn’t do it that day. We had to call in Dr. Foreman to help us get through it- something I should have been able to do on my own. My confidence took a huge hit after that. Dr. Foreman was very kind and re-did the refraction herself. In short, it was embarrassing. Everyone in the room knew that I messed up.
Not wanting to repeat my experiences, I spent some time leading up to my next clinical session practicing my skills. On our third week (my second week as doctor,) things went a lot more smoothly. I was nervous during that clinic session, but the extra time spent practicing helped a lot. It turns out that I wasn’t a bad clinician; I was just rusty.
During my second week as doctor, I was able to make a difference in someone’s life. The moments leading up to it involved some doubting on the patient’s part. She knew I was a student and mentioned that I was making her vision blurry during manifest, which is a normal part of the process. I reassured her as best as I could, but felt doubt creeping back into my thoughts. Flashbacks from the first week made it a little difficult to concentrate, but once I had her final prescription and she could see clearly, she laughed, complimented my work, and said that “there’s a method to your madness.”
That moment made me realize that I’m more than just a student. It also made me realize that no matter how badly I embarrass myself, I can always turn things around- provided I get enough practice in before the next time I get a chance to try again.
I have a long way to go, but I’m still making tangible progress. It feels good. Sometimes you hit a wall and want to give up, but you have to brush it off and dedicate some time to rounding out your weaknesses. I came to ICO to learn to be a clinician, and no amount of embarrassment will stop that from happening.
I’m sure that every other optometry student experiences something similar at some point in their career. So, if you’re hitting a rough patch in clinic right now, hang in there. You can do this.