“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
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.
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 studyAt 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.
My least favourite part of pre-reg is... trying to achieve competencies. It has been difficult to find time in between clinics whilst ensuring that I have grabbed every opportunity. This is due to my clinic working on a rolling scheme: whoever walks in can be seen by anyone, so it can be difficult to plan the day ahead.
Before I started my pre-reg I wish I had known... that every placement operates differently. It is important not to take your situation to heart if things don’t necessarily go how you imagined. For example, I thought I would be testing within the first three months, but I was mainly on the shop floor for dispensing. I’m now beginning to test more – so never give up, continue to have patience.
Rochelle Anderson is a pre-registration optometrist at Vision Express Chiswick