Pre-reg focus

“The confidence does come with practice”

As OT ’s 2022–2023 pre-reg contributors approached their OSCEs, they shared what they have learnt in their first year of optometry practice

Rochelle smiling

What was the standout moment of your pre-reg?


Akshay Shah

Occupation:Pre-reg optometrist, Moorfields Eye Hospital


Isha Saghir

Occupation:Pre-reg optometrist, Bennett and Batty Opticians

Rochelle Anderson

Rochelle Anderson

Occupation:Pre-reg optometrist, Vision Express Chiswick

Akshay Shah (AS): Just the other day, I encountered a patient who had recently had stitches removed from a corneal graft. Their current vision in that eye was 6/60, and after a successful refraction using both my retinoscopy skills and subjective routine, I was able to improve their acuity to 6/7.5. The impact that the refraction had made was a truly humbling experience, and the joy of the patient who was able to see so clearly again was a great feeling.

Isha Saghir (IS): The standout moment of my pre-reg would have to be seeing the number of patients who have left me positive feedback.

It is hard to pick one key experience as a standout, though. Being that listening ear for patients who are alone, giving them the sense that someone is interested and there for them, is what really motivates me.

Rochelle Anderson (RA): The standout moment has been the patients who have really appreciated my work and advice. It warms my heart whenever I get patients asking to see me again, or saying it was their best sight test ever and even offering me chocolates – it’s really sweet.

What has been your scariest or most intimidating moment?

AS: One of the most intimidating moments was the first time I had to fit a keratoconic patient with rigid lenses. This is typically done using corneal topography, and whilst I was vaguely familiar with interpreting scans from the theory at university, being able to put this into practice was quite intimidating.

However, whilst it seemed overwhelming, I had a great deal of support and guidance from my clinic supervisor, and together we effectively made decisions to ensure the best outcome for the patient. This experience helped me to grow my confidence to be able to deal with similar encounters in the future, and taught me about the multitude of adjustments you can make on rigid lenses to ensure a good fit.

IS: Introducing myself as a pre-registration optometrist to my first ever patient when they attended for their annual eye examination. I was worried they would doubt my competence, however, this was far from the truth. They were very understanding and patient with me, which turned what I thought would be a negative experience into a positive one.

RA: Looking after a post-cataract patient who was experiencing signs and symptoms of recurrent uveitis. It was the first time I saw cells and flare in person. I got several opinions from my colleagues, which I really appreciated. Learning who to refer to afterwards was definitely a learning curve and great experience that I can take into the future.

Rochelle, you passed Stage 2 in June – how are you feeling?

RA: I had five or six weeks to prepare for my Stage 2 after completing Stage 1. Thankfully, I passed my Stage 2 during the last week available before the OSCE application deadline. I would definitely advise students to practise as much as they can on the paper records and lid eversion on family or friends, as that helped me a lot to prepare.

How prepared do you feel for your OCSEs?

AS: I feel quite prepared. I am spending my spare time revising the theory, and using the clinical experience at work to enhance my technical skills. I feel over this year I have developed and gained new skills whilst enhancing my communication, all of which are helping to prepare for the final OSCE examinations.

IS: I always find it hard to judge how my revision is going for any sort of exam. However, the confidence patients and other staff members have in me has been very reassuring.

I was worried I wasn’t doing enough studying each week, but I realised that being at work is a form of revision as I am continually dealing with patients and practising my clinical and communication skills.

I was worried I wasn’t doing enough studying each week, but I realised that being at work is a form of revision as I am continually dealing with patients

Isha Saghir, pre-reg optometrist

How do you expect your day-to-day work to change once your pre-reg is over?

AS: I expect after qualifying that my decision making will become a lot more independent. Whilst there are still supervisors to go to for advice and guidance, as a qualified optometrist, there is a larger direct responsibility for ensuring the best patient care.

IS: Once pre-reg is over I think the biggest change will be working independently and having full autonomy on managing my own patients. I will be working between a few independent practices, which is something to look forward to as I’ll be encountering a range of patients from different areas.

RA: I’m excited to solely focus on testing, so I can focus all my time on my patients and make sure I can remain organised in what I need to do during the day. Currently I’m still in the middle of testing and being on the shopfloor, but I’m looking forward to embracing my full role, cutting down my testing time and studying further.

I’m excited to solely focus on testing, so I can focus all my time on my patients

Rochelle Anderson, pre-reg optometrist

Have you started to think about your plans for afterwards?

AS: I began interviewing for new roles in May, including exploring the different options for newly qualified work. I am excited to have secured a conditional offer to begin a three-year placement at Moorfields, which is due to begin in September. This new role will involve expanding into extended role clinics within the hospital eye service, whilst studying a Master’s programme alongside. This will allow me to continue to develop clinically and gain extra qualifications at the same time.

IS: My immediate plan is to continue to build on my knowledge and confidence as a newly qualified optometrist. During this time, I will be able to get a feel for the aspects within optometry that interest me. This will help me make an informed choice in which further qualifications to peruse.

With optometry being a forever-advancing field, I would like to be able to play a role in the education side, whether that be as a supervisor to my own trainee in the coming years or within a university setting.

RA: I’ve already set up another great opportunity, to work within a practice closer to home, which makes me very excited. The team seem super friendly and the store is a great size, so I’m excited to place my roots and start a patient base there.

I am excited to have secured a conditional offer to begin a three-year placement at the hospital, which is due to begin in September

Akshay Shah, pre-reg optometrist

Where do you see yourself in five years’ time?

AS: I anticipate that I will have completed some professional certificates in the next few years and have begun the independent prescribing course too. I am hoping to continue my clinical growth in the hospital eye service, whilst gaining more experience, and becoming more involved in research and clinical audit.

RA: I see myself potentially becoming more invested in IT optometry. I want to be part of a team that develops the imaging technology we use in daily practice. Alternatively, potentially having my own practice and spreading more awareness on this profession to minorities.

What’s the one piece of advice you’d give to those starting out on their pre-reg journey?

AS: It’s a challenging year, but it involves lots of learning. Take each step at a time and remember that organisation is the biggest key to success. There is always help around, so don't be scared to ask for it when needed, and over the year you will become a lot more confident in your work and ability.

IS: Pre-reg is challenging as you’re balancing working full time alongside studying to pass assessments, so it is important to be consistent with your revision.

The year goes by quickly and before you know it, you’re prepping for OSCEs. That is daunting in itself, and you don’t want to be over-stressing in the weeks leading up to it because you’re behind on revision.

Even doing a couple of hours a week is better than cramming it all at the end. The key is to break things down into small chunks and take one step at a time as you progress through the different stages.

RA: Look through the frameworks of each visit in Stage 1. I feel like a lot of competencies can be achieved earlier, but not everyone may know you can swap one competency for another – so look ahead.

If you could say one thing to your early pre-reg self, what would it be?

AS: Trust the process. Whilst its daunting to begin pre-reg with limited experience, over the period of the year you will develop your skills and refine techniques and by the end, you will be confident into stepping into a qualified position.

IS: If I could go back and give myself advice at the start of my pre-reg, it would be to be more confident.

Naturally, the confidence does come with practice, but having that faith in yourself will stop you panicking unnecessarily and will make every experience easier to learn from.

RA: You will grow in confidence through performing sight tests for everyone from little babies to elderly patients, so don’t feel so nervous. No one knows everything as we’re all still learning, but things will become more natural the more you gain experience.