The Ex Files: Accelerated OD Program’s Externships

As Alissa Coyne, OD ‘10, Resident ‘11, FAAO, previously mentioned in the most recent iteration of this series titled Patient Care Perspectives in the Accelerated OD Program, the amount of time students in the Pennsylvania College of Optometry (PCO) at Salus University’s Accelerated Scholars Doctor of Optometry (OD) Program spend at the main clinical facility, The Eye Institute (TEI), is considered an internship, which is followed up with both on and off-site externship rotations. This next series features Rachel Brackley, OD ‘09, Resident ‘10, FAAO, PCO assistant professor, and Bhawan Minhas, OD, FAAO, Resident ’14, going into more detail about the externship options and selection process. Students Michael Furey ‘22OD and Anna Hess ‘22OD then provide the student perspective in selecting externship sites and what they were looking for.

Q: Can you tell us a little bit more about yourself and your roles here at PCO? 

Brackley: Hi, I'm Dr. Rachel Brackley, I’m originally from Milford, Massachusetts. I did my undergrad at Regis College in Western Massachusetts, and then came to PCO to complete my optometry degree. At the completion of my OD degree, I did a residency in primary care at The Eye Institute. I worked externally for three years before becoming a faculty member at PCO. I'm currently an assistant professor in the program. I work in both the Traditional and the Scholars program. In the Scholars program, I have a really special role because I work with the students from day one in the Clinical Skills Lab until the day they graduate as I work through their externship year.

Minhas: And, I'm Dr. Minhas - I'm from the opposite coast, in Canada, from Calgary, Alberta. I went to the Illinois College of Optometry (ICO) for my optometry degree and then came to PCO for my residency and never left. The externship experience that is at PCO is definitely something that is cultivated by strong mentorship and one-on-one mentorship from Dr. Brackley. She does a really great job of working with each individual student to make sure their externship goals are fulfilled on top of our goals and requirements for the externship sites.

Q: How many externship sites do the students have to complete and what are the specific rules?

Brackley: There's four different externship sites - the first one would be a disease or hospital site that's often done in an OD/MD practice, often at a Veterans Affairs hospital or an Indian Health Service (IHS); the second is in a contact lens practice; there's one that's focused on pediatrics; and the last is internal at The Eye Institute. At that time, you'll either work in primary care, pediatrics, contact lenses, neuro-ophthalmic disease, or low vision.

Minhas: I know that students have different reasons for why they pick different externship sites. I know when I was a student, I wanted to pick things that were very different. I came to the U.S. for school and I wanted to pick places that were all across the U.S. I even did one in Australia.

Q: How many sites are there to pick from for the students?

Brackley: We have sites in 47 different states, as well as throughout Canada and in three countries. Those countries, of course, one would be Canada, another one's Japan and the last one is there's two sites in India. What I've found is students really can do whatever they want. If they want to go overseas, they will. So, we've had students go to Japan. I've had a lot of students in the Scholars program go to the Indian Health Service (IHS) site in Alaska. And, then I've had other students who have just stayed local, because that's what they prefer. We really can customize the program to what the students are looking for.

Q: When do you start meeting with students to talk about externships?

Brackley: Normally about six months into the program we start the selection process. And, then in March of their first year, I meet with them to really guide them through the process. Because we know that in the beginning, when you've been here for six months, it's a lot to pick what you're going to do during that final year. So I meet with everyone individually and I'm there to walk alongside the selection process with them.

Minhas: And I know that's one of the things I really valued about ICO that is similar to PCO. There's a huge alumni network, meaning that there's a bunch of different sites that are available, a bunch of different alumni that serve as preceptors that are part of the PCO family. So that's one of the things that's really special about PCO's externship sites in general is that they've kind of been established forever.

Brackley: Exactly. I would also say what's become special is the Scholars Program as a whole. And, the alums of the Scholars Program really look out for each other and they really like to connect with each other. Someone who graduated a few years ago is still willing to help a first year student as they pick their sites.

Externship Sites

Q: Can you introduce yourself and explain the selection process for externship sites?

Furey: Hello, I'm Michael.

Hess: And, I'm Anna. We're going to talk about the externship selection process and the whole externship process you'll be going through in the third year of the Scholars Program. For your externship sites, there are four different sites you have to do. One of them has to be a pediatric site. One of them is a VA hospital site. One is a contact lens site. And, one of your rotations will be at The Eye Institute (TEI) in the specialty service of your choosing.

Furey: The specialties at TEI are neuro-ophthalmic disease, pediatrics, contact lens, primary care, and low vision. For the selection process, you already know what type of sites you have to go to - it really depends where. For some people, like myself, I looked at the extensive reviews Salus put together where the sites are reviewed and commented on by previous students so you're able to see which ones you like or which ones would interest you. For example, for my contact lens site, I wanted to see a lot of specialty hard lenses. And, everyone wrote that "I got to see a bunch of specialty hard lenses at my contact lens site." Those tend to be really accurate and really helpful.

Hess: Also, I chose sites similar to Michael after looking at the reviews. I have a large family and I'm from Pennsylvania so I want to practice in the area. I structured mine within staying in the state and making contacts throughout the state for after graduation. But lots of people I know in our class are traveling throughout the country right now and seeing where they might want to practice and live in the future. So it's a great opportunity to get out into different regions for three months at a time, see if you like it, see if you like the area and the practices in that area. There's more than 250 sites you can choose from, so there is a very large variety throughout the country and throughout Canada as well. So, you'll definitely find something you like. 

Furey: They really are everywhere. I know we have a couple of classmates are headed to Alaska, in the spring.

Hess: And, some are throughout the East Coast in Florida right now. So, it's interesting to always see what everyone's up to. It's your first time on your own and learning the ways of different practices, so you definitely learn and grow a lot during that time period.

Furey: It's really about choosing what you want, what you think is going to help you grow as an optometrist, what's going to help you learn the best, and what you would like to specialize in or not specialize in.

Capstone

At the culmination of your externship experiences, therein lies the capstone project or as described in the curriculum, the elective research project, in which Dr. Coyne explains the specific concentrations.

Dr. Coyne: As part of the Scholars Program there is a capstone project, and you'll see within the curriculum it's actually listed under fourth year. Again, this Doctor of Optometry degree is a three-year Accelerated Program, but the reason this is listed under the fourth year is it occurs after commencement. You will walk in the commencement ceremony at the end of May, however, your degree is not conferred until the very end of June. After graduation, and before the end of June, we typically have you return to campus for a capstone day, or capstone week, and just bring everything together.

Part of your capstone is a research elective. And, with that, you perform or complete a few different projects. Those include a poster abstract, a case report of publishable quality. And the last is a final culmination of your Grand Rounds. Now, you have Grand Round presentations throughout your time here as mentioned previously in segment, but this ends up being one that's a little bit more in-depth. We ask you to present for 25 to 30 minutes and we have your cohort attend. We have another Scholars cohort that comes. And, of course the faculty and administration are always invited to see how you've brought together all of your knowledge and presentation skills over your academic career.

The poster abstract is something we promote because we see this at different optometric conferences, and we want you to feel comfortable having that experience and moving forward and possibly utilizing that as a publication in the future. The case report is an expanded portion of that poster abstract, where we're expecting you to write something of publishable quality.

One of my favorite parts of this is that you are assigned a mentor, which is a faculty member who gives you advice on the different topics you want to choose, the feedback as far as where you're looking for your research, and really putting that together and offering guidance so you feel confident and supported throughout this entire project. It is one of the best, most all-encompassing aspects of the entire program. And, it also brings you back together one final time with your cohort, again, during what we consider that fourth year or that final aspect of the capstone week.