Pre-reg focus

“So far, I’ve achieved all the competencies at each visit”

Isha Saghir, pre-registration optometrist at Bennett & Batty, a Hakim Group independent practice in Liverpool, on successfully achieving all her required competencies for visit 1

Isha Saghir

When I first started my pre-registration placement I was solely dispensing, with the odd few sight tests on staff and family members to get used to the equipment. Once I was confident with my routine, I started seeing a few patients a day and getting feedback on each of them. This has built up to me seeing between eight and 10 patients daily.

Unlike in my first few weeks of pre-reg, I don’t have much of a break between patients – so in the morning I go through the clinic to see which patients are booked in and if any can be swapped into my clinic for potential competencies. By doing this I’m able to pinpoint anything that needs monitoring from their previous appointment or anything that I’m unfamiliar with, so I can read around the area to refresh my memory.

My lunch always coincides with my supervisor, so we tend to catch up on any interesting patient cases.

The last half an hour of my working day is more admin work. In this time, I update my logbook, ensure referrals are written and sent to the correct recipient, and check over any contact lens order forms.

In the morning I go through the clinic to see which patients are booked in and if any can be swapped into my clinic for potential competencies


Balancing work with study

At the time of writing, I’m four months into pre-reg, and I’d like to think that I’ve settled into a good routine. The first few weeks were overwhelming as I’d gone from working one day a week to five, so that was a big change that I had to get used to.

After I overcame this obstacle, it was time to prepare for my visit 1. I left my revision for this a little last minute – however, I’ve since learnt how to manage my time more efficiently. This doesn’t mean that I revise every day: instead, I dedicate a few hours of my days off to revising specific competencies for upcoming visits.

I use the visit framework as a checklist for my revision, to ensure I’ve covered each competency in detail rather than focussing on one or two specific areas. Closer to the assessment day, I revisit my notes and test my knowledge through active recall. This strategy has seemed to work well for me as so far, I’ve achieved all the competencies at each visit.

Location, location, location

When it came to finalising my pre-reg placement, I was confident I wanted to do it at Bennett & Batty. When I discussed this with tutors at university, some warned me about setbacks I may encounter while being at an independent practice, mainly revolving around not achieving enough patient numbers.

Luckily, this hasn’t been the case for me as I’ve seen a wide range of patients to achieve the numbers needed. I’m not worried about achieving the harder to get competencies either, as my team keep an eye out for these and book them in with me. My supervisors, Caoimhe, Neil and Nikki, all go above and beyond to guide me along the way and ensure I’m making the most of this experience. This support is the reason I know I’ve chosen the right location to do my pre-reg.

An interesting patient I saw was a woman in her early 50s, who had retinitis pigmentosa (RP) but had not been seen by anyone for over 15 years. When I saw the note on the appointment about the RP, I wasn’t expecting anything more than a tunnel vision visual field defect and reasonable visual acuity.

However, when I started assessing her it was clear this wasn’t the case. Fundoscopy showed large areas of scarring at both maculars. After investigating and discussing with my supervisor, we still couldn’t find a possible cause as there were no indications from her history. We then referred her to Spire for a private consultation, to see if the consultants could conclude what the root cause was.