Centennial
Born and raised in Montreal, Canada, Dr. Luigi Bilotto has traveled the globe teaching and practicing optometry in places such as Singapore, Munich, Norway, Israel, South Africa, and many more.
In 1994, he completed his residency at The Eye Institute (TEI), and has served as an adjunct professor for the Pennsylvania College of Optometry (PCO) since 1995. For the last ten years, Dr. Bilotto has served as the Director of Global Education at the Brien Holden Vision Institute Foundation and in 2017, he worked alongside PCO alum, David McPhillips, OD ’85, in the development of the first optometry program in Haiti.
Below is a Q and A with Dr. Bilotto as he discusses his experience as an international resident at TEI and his successful, fast-moving career ever since.
What made you choose to come to PCO to complete your residency?
I was one of the first two optometrists from l’École d’optométrie de l’Université de Montréal (The School of Optometry at the University of Montreal) to undertake a residency in the United States. For graduates of our French-speaking school, it simply was not in the culture to seek further accreditation in vision care outside of Canada. Having graduated in 1990, a few years before Diagnostic Pharmaceutical Agents (DPA) became a legislative reality in Quebec (1995) and over a decade before Therapeutic Pharmaceutical Agents (TPA) were added to the law (2003), this was a daunting experience. I needed an institution that would not only facilitate and guide the expected steep learning curve, but also provide a solid educational experience that would take me to the next phase of my professional career and beyond. Indeed, I sought to acquire TPA knowledge and certification with the explicit intention of applying this new knowledge base and clinical experience to bring the standards of clinical practice in my alma mater to a new level and advance optometry as a whole.
The residency at PCO had a solid reputation for being able to do just that and a visit to the institution prior to applying for the residency, where I had the opportunity to exchange with residents, faculty and other key staff involved in the institution, very much confirmed that impression and clinched my decision.
Tell me about your experience as a resident at Salus/PCO, how did it prepare you for life after residency?
The residency at Salus/PCO served exactly the intended purpose stated above and more. Clinically, it was simply a phenomenal experience! Not only did I see quantities of patients with a panoply of conditions, both common and rare, I was able to manage them under the supervision of some of the top optometrists and ophthalmologists in primary eye and subspecialty services. The faculty knew and understood my background and I was always very openly encouraged and given the opportunity to seek advice on anything from the most basic to the most challenging of cases. They gradually, yet rapidly, encouraged me to act independently driving me to push my limits, at times, admittedly, brushing against the optometric boundaries! My fellow residents did the same and we embraced the chance to learn from each other, as there was acknowledgement that I came from an environment where complementary areas of traditional optometry were solidly rooted.
In addition, within the progressive academic environment that the institution provided and the educational role that residents assumed - in which the motto “see one, do one and teach one” prevailed - my knowledge, skill and confidence increased exponentially. While these experiences served me well in setting the stage for my academic and clinical life, the overall residency experience probably served me most in strengthening my capacity to assuredly face challenging circumstances and deal with the unknown, a trait which prepared my post-residency life also on a personal level.
What does your schedule look like now? How often are you traveling and teaching in different countries, and for how long at a time?
My schedule is atypical of an optometrist! My job entails, among other educational initiatives, a key role of setting up optometry where it does not exist. I work for the Brien Holden Vision Institute Foundation, a non-profit eye health organization that seeks to develop new solutions to eliminate vision impairment and avoidable blindness. With the recognition that 1.2 out of the 1.3 billion people in the world that are blind or visually impaired because of an uncorrected refractive error, the organization set off to create the sustainable systems that would provide optometric services to respond to that challenge. Underpinning that is the need for the qualified human resource - namely optometrists, which is the key to developing the local capacity of nations to sustainably and autonomously answer to their eye health needs.
In that role, I foster partnerships between Governments, NGOs, Educational Institutions and other stakeholders, and provide strategic guidance in setting up optometry schools and programs in developing countries. I am currently overseeing the strategic development of Optometry and Optometry schools in countries like Malawi, Mozambique, Eritrea, Mali, Kenya, Uganda, Vietnam, Nicaragua, Mexico, Bolivia, etc. I do not actually teach in these schools, but rather facilitate the planning phase (background and advocacy, curriculum development, stakeholder/funding mobilization, project development, regulatory schemes, etc.), the implementation phase (curriculum rollout, educational resources, infrastructure and equipment procurement, faculty recruitment, QA, etc.) and transition phase (local faculty/leader development, international linkages, deployment support, CE, etc.). My travel schedule currently takes about 30% of my time, while the rest of it is desk-based where I remotely interact with the various members of the organization and the schools.
Can you give us any updates on the school in Haiti? How has it been doing since it started?
The school in Haiti is the latest born having started in late 2017 but officially inaugurated in April 2018 after five-years of preparation. Developed at the Université d’État d’Haïti within the Faculty of Medicine and Pharmacy, the program is supported by an international consortium composed of complementary partners namely the Brien Holden Vision Institute Foundation (Australia), Optometry Giving Sight (Australia and USA), VOSH International (USA), Charity Vision (USA) and l’Université de Montréal (Canada). The program has two cohorts now with a group of 19 pioneer students in the second year and a second one of 15 in the first year. The program is (well was!) evolving well with a dedicated building for the school being refurbished and equipped and two international faculty recruited and dispatched to Haiti. Recent political unrest, however, has delayed the program with the two faculty having been repatriated for safety reasons. The country has returned to a calmer state and the academic program for foundational courses has started again, but the faculty has yet to return to the country awaiting for official international government safety recommendations to return to acceptable levels, something that tends to take time. In the meantime, measures are being worked on to deliver as much education as possible using remote applications.
What does optometry look like around the world? What are the major differences/similarities?
Optometry is a young profession and it differs tremendously from country to country, being non-existent even illegal in many countries, and a highly regulated and valued profession in many others. ‘Optometry’ education can range from three to six month in-house training programs to a six-year university degree. While the World Council of Optometry (WCO) officially requires that an optometrist completes a bachelor’s degree or the equivalent education from a tertiary level institution, this is obviously not respected uniformly across nations. However, with the growing demand of eye health services, and in particular optometric care, and the increasing global recognition of the profession by organizations like the WHO and the IAPB, optometry is emerging and/or evolving to the level set by the WCO and even beyond being equivalent to the profession in USA/Canada in a few jurisdictions.
What advice would you give to new graduates of Salus/PCO?
I had the good fortune of being able to bring together many facets that I am passionate about into my current work, namely, optometry development, academia, public health and travel/cultural discovery, making what I do… well ‘not work’! However, it did not just present itself and several ‘leaps of faith’ were required to achieve this. In simple terms, then I would suggest that graduates explore the many different pathways that our profession and life can offer before jumping and settling in standard practice mode.
