Pre-reg focus
“Pre-reg has highlighted how much learning happens on the job”
Zak Saleem, pre-registration optometrist at Nottingham University Hospitals NHS Trust, tells OT about adaptability, reflecting on his progress, and the value of his pre-reg supervisor
04 March 2026
So far, my pre-registration journey has been both challenging and rewarding.
At the time of writing, I am currently in Stage 1, with Visit 3 coming up in a few weeks. Pre-reg has highlighted how much learning happens on the job. Each clinic brings something new, whether that’s a complex case, a communication challenge, or a chance to refine my specific techniques.
A key learning for me has been understanding the importance of adaptability in clinic.
No two patients are the same, and I’ve learned to tailor my approach depending on individual needs and communication styles. This has helped me become more flexible in my assessment.
My supervisor has been instrumental in supporting my progress.
I have a dedicated session each week where we go through my clinical work, review competencies, discuss cases, and set progress goals. These sessions provide a space to ask questions and clarify areas I’m unsure about. Their feedback is always constructive, helping me build confidence while also challenging me to improve.
When I reflect on my first day compared to now, the difference feels significant.
Initially, I relied on guidance and reassurance from colleagues, but I feel more confident initiating discussions with both patients and colleagues. I’m becoming more aware of my own learning needs and seeking opportunities to address them, which feels like an important step.
I’m becoming more aware of my own learning needs and seeking opportunities to address them, which feels like an important step
One of the stand-out moments has been seeing how much patients value clear explanations and reassurance.
Being able to help someone better understand their eye health has been incredibly rewarding, and it emphasises the wider impact optometry can have beyond the consulting room. This aligns closely with my career aspiration in public health, as it highlights the importance of education, prevention, and empowering individuals to take ownership of their eye health.
Over the next few months, I hope to improve my speed and efficiency with full routine sight testing, without compromising care.
The end-to-end eye examination is a routine that I do not often complete in the hospital eye service. However, I am now lucky enough to be doing full routine testing, once a week, at an independent community practice.
The most important thing I have learnt in the past 60 days is…
That progress comes from actively engaging with learning opportunities by asking questions and embracing feedback. I’ve realised that confidence is built through experience, and that making mistakes is part of the process – as long as you take time to learn from them.
About the author
Zak Saleem 
Pre-registration optometrist
Zak Saleem is a pre-registration optometrist at at Nottingham University Hospitals NHS Trust
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