One year qualified

What was your first day in practice as a qualified optometrist like?

Hayley Smith (HS): I will admit that my first day as a qualified optometrist felt very similar to my final weeks as a pre-reg since I already had full clinics and was seeing a mixture of contact lens checks, sight tests and emergencies. This definitely helped make the transition from pre-reg to newly-qualified smoother. One thing that did feel odd was not checking in with a supervisor, since I was now the sole optometrist responsible for the patients I was seeing. That part did feel daunting, and I did feel the pressure, but I also liked the independence.

Lizzie Shaw (LS): My first day as a qualified optometrist was in Moorfields Eye Hospital, where there’s no such thing as a typical day. I still had to check most of my records on the day due to the complexities of them –luckily, I was very much encouraged to still ask for help if I felt I needed it. I do remember seeing one straightforward refraction patient who I felt confident managing alone, which felt quite nerve-wracking and a bit surreal. It took me a while to get into the swing of being firm in my own management decisions.

Hayley Smith

Newly-qualified optometrist, Hayley Smith

I feel proud of myself when I realise how much I have developed in just one year. I wish I could have seen a snippet of me now, back then

How have you developed your confidence over the last year?

HS: My confidence has gradually built over time with each patient I see. Repeating the same skills every day means I have naturally become quicker and more confident about the tests that I am doing. Pattern-recognition has also made a huge impact – if I manage one case and then see a similar case, I can recognise similar signs and symptoms to reach a diagnosis and management strategy sooner. I also think seeing the successful outcomes of patients I have managed has helped solidify that I am using my knowledge and skills correctly, which is really reassuring.

LS: My confidence has grown exponentially over the last year. I left Moorfields full-time five months post-qualification to work in a hospital eye service closer to home, which was a big change. Working in new clinics, especially glaucoma, has solidified so much for me and made me much more assured in my optic nerve assessments. I am still learning so much, but a key thing that my pre-reg period taught me was comfort in asking questions, which I will still frequently do, as my contact lens colleagues can attest to.

What has been your highlight from the last 12 months?

HS: It’s difficult to pick just one highlight. Reflecting back and seeing how far I have come in terms of skills and confidence as I used to doubt myself regularly. I feel proud of myself when I realise how much I have developed in just one year. I wish I could have seen a snippet of me now, back then.

LS: My highlight since qualifying has been seeing where my colleagues and I have ended up. Having started our pre-reg placements at the same place, I am now starting a PhD, one friend is going travelling, and two others are staying at Moorfields in different positions – I am so excited for all of us to see what happens next and where we go in our careers.

What has been your biggest challenge and why?

HS: Although my confidence has improved, I still get times where I doubt myself. This usually happens when I see an obscure or uncommon case, or when I see someone who has returned because their previous management plan has not worked and it is my responsibility to decide the next steps. The uncertainty with cases like these has been my biggest challenge, but I know I can always ask one of my colleagues for a second opinion. Two brains are sometimes better than one.

LS: My biggest challenge has been working in the community. My hospital experience has meant there has always been someone else to speak to, whether it be other optometrists or ophthalmologists. In the community I have been by myself for the first time and it’s a different ball-game. I have been going back to basics and when in doubt relying on triage guidelines.

My community experience paid off recently when I was able to identify my first retinal detachment in a patient. It was one of those ‘wow’ moments.

My advice for those qualifying now is to open yourself up to any opportunities that come your way and do not limit yourself in your work

Lizzie Shaw

Newly-qualified optometrist, Lizzie Shaw

What are your three key learnings over the past 12 months?

HS:

1. It’s important it is to build rapport with patients. Of course, knowledge and skills are just as important, but building trust and being empathetic with patients will give better results as the patient will feel more comfortable and confident in their treatment plan
2. The learning never stops. There are always new treatments and changes to management strategies, so staying up to date with these is essential to ensure you’re managing patients in the most suitable way
3. Confidence doesn’t happen overnight. At the start, being fully qualified seemed very daunting, but my confidence has naturally built over time and the difference between then and now is night and day.

LS:

1. Utilise your resources as much as you can or want to. I will often check triage guidelines, send advice requests to the hospital, or even check scenarios with colleagues. There is a wealth of information available, and nobody has minded me asking. You will either solidify a tentative plan and ensure you have more confidence at the next occasion of that particular query, or learn something new to take forwards
2. Be open to working in new environments; whether it be a new setting to practise in, or even just a new practice. It is much easier to find your favourite place or type of work when you know what you’re comparing against, and I have learnt so much about my clinical skills and the optometric industry through variety
3. Keep your career goals in mind. I have had a lovely balance over the last six months, which has taught me a lot, but I know that ultimately my current work pattern would leave me unfulfilled. I am very keen to take my first steps into research, which I hope will lead me into a pathway that I will be able to continue contently until retirement.

What are you most excited about for the next 12 months?

HS: I am hoping to start the independent prescribing course, so I am excited to expand my knowledge and skillset and eventually have wider scope when managing patients. I am looking forward to the hospital placements as I think they will be very interesting to see how cases are managed after I refer patients. This also means I can understand more about the process after referral to better explain to patients what to expect.

LS: This September I am starting a PhD, which I am extremely excited about. The project is looking at creating a sport-specific classification system for visually impaired archery, so I am able to work in an area I am extremely passionate about (visual impairment), alongside continued work in a low vision clinic. I have been interested in research for years and I am so eager to be able to use my training to contribute to a tangible future change.

What is your goal over the next five years?

HS: My goal is to expand my skillset as much as possible and immerse myself in the specialty clinics on offer at our store. Hopefully I will become an independent prescribing optometrist, and I also want to become better at fitting specialty contact lenses, specifically scleral lenses as they are the most complex and take a lot of perseverance when learning.

LS: In five years, I will have finished my research degree. I would like to be able to split my time between hospital work and academia. I don’t have any specific goals beyond finding a balance that I enjoy.

Any advice for those qualifying now?

HS: Being fully qualified doesn’t automatically mean you are expected to know everything. Don’t be afraid to ask questions and ask for support from your peers if you are unsure. Confidence will build over time, but some cases are a bit more obscure and actually benefit from a second opinion.

LS: My advice for those qualifying now is to open yourself up to any opportunities that come your way and do not limit yourself in your work. You may see yourself as being a community optometrist, or a hospital optometrist, but I have found having a blend of both invaluable to my professional development. There is still so much beyond that which I have yet to explore and I can’t wait to see where optometry takes me.