Jagdeep Kaur: “The world of optometry is bigger than just working in one setting”

Here, Kaur tells OT about why she is glad she made the jump from consulting room to hospital clinic.

Can you describe working as a hospital optometrist in one sentence?

There are a lot of different learnings every day – you’re seeing very different patients, whom you wouldn’t usually see in your day to day, and you’re always learning new things.

How long have you worked as a hospital optometrist?

For around three years.

When and why did you decide to become a hospital optometrist?

I trained in community optometry and High Street practices. I worked in different multiples – I was a resident to begin with, after my pre-reg.

After that, for four or five years, I was locuming, which was really insightful. But at that stage of my career, I wanted to advance, and I also wanted to learn new things, so I felt hospital was a good opportunity for me. I think, how things are developing, there will be more opportunities for optometrists within extended care. I wanted to make sure I was staying on top of things.

Do you do any other work or volunteering alongside hospital optometry?

I have worked with Vision Care for Homeless People (now Vision Care) at Christmas. I also do other volunteering work – I’m a trustee and communications director of the Sikh Education Council, which promotes the Sikh way of life for the betterment of humanity. We publish academic journals, conduct research, and provide corporate consultancy on Sikh values and practices.

Working in both settings means you’re not disconnected from the rest of the optometry world. You can see firsthand what community can do, what hospital can do

How does working as a hospital optometrist support you as a High Street optometrist?

I’m at the hospital for three days, and for the rest of the week I’m in the community. I wanted to keep in touch with day-to day optometry, including routine examinations. Hospital and community are very different environments, so it breaks up my week.

One of the challenges I have faced working in community optometry, and especially as a locum, is that you don’t get feedback on what you have referred. There is a feedback loop that is missing.

Working in the hospital, on the other side, I have learned what happens when referrals get sent in: how they’re dealt with, what the urgency is, and what to look out for when you’re referring.

Part of my job is also triaging referrals, so I’m getting insight into what I’m looking at from the other side, and how to identify if something is a good referral based on what it includes or doesn’t include. This is good learning for me, which I can take back to the community: when I do a referral for this condition, I can make sure it has these things included. It shows me the bigger picture of how things work.

How does working on the High Street benefit you in the hospital setting?

I’m able to refer patients to community optometry, whilst knowing what is possible within the community. Right now, we are getting a lot of contact lens patients. I know that if a certain lens is prescribed, the patient can be managed within the community.

Working in both settings means you’re not disconnected from the rest of the optometry world. You can see firsthand what community can do, what hospital can do, and where the limits are.

What is the biggest challenge facing hospital optometry currently and why?

We are going through a process where we are having to upskill. From the hospital point of view, we are doing quite well. However, I think there is scope where community optometrists can take on more work. There are some things I’m seeing in the hospital that can be managed in the community. But overall, the funding isn’t there for community optometry do that. I think that is holding community optometry back. But I think a lot of work can be done by communities and hospitals working together.

What is hospital optometry’s biggest success in the past three years and why?

We have seen a shift, where we have gone from optometry being refraction and referring on, to optometrists taking on more extended roles.

There is a lot of encouragement within the sector and outside to upskill and be ready when we do get extended contracts. That has been the biggest change, and is something we didn’t have when we qualified. That is definitely a positive change that has happened within optometry.

What is your biggest success in the past three years and why?

Being able to transfer from community to hospital has been one of the biggest challenges, because it is a very steep learning curve. But I’m very fortunate that I’m surrounded by colleagues, including doctors and consultants, who have been really helpful in that transition. Adjusting from only ever doing community, into hospital, has been my biggest achievement.

What is the most surprising case you’ve seen in the hospital setting?

I’ve seen patients who have declined treatment, but when I’ve really dug into it, I’ve realised they didn’t understand fully what was happening.

You become more of a detective, trying to figure out why this person is saying a certain thing – rather than just accepting that they don’t want treatment, writing it down, and having it done with.

That has been my biggest learning: to dig deeper into why a patient is saying certain things. By digging deeper into it, I have realised what the fears were, what the patients weren’t understanding, and what preconceptions they had that needed to be cleared up.

Adjusting from only ever doing community, into hospital, has been my biggest achievement

What would you say to optometrists practising on the High Street about working in a hospital environment?

It can be a little bit of a jump, for sure – it is challenging. But from my perspective and based on my learnings, it is very rewarding. If you look at optometry as a career rather than a job, it gives a lot of job satisfaction. I’m much happier with my role now than I was previously.

My message would be to try new things. The world of optometry is bigger than just working in one setting. If you already work in hospital, it doesn’t harm you to work in the community. It works both ways. Explore the options that are available. Optometry is changing; it has changed quite a lot already. Explore all the areas that are available within optometry, because I think you will find huge opportunities.

Anything else to add on the subject of working as a hospital optometrist?

Hospital optometry has given me a lot more confidence in prescribing and managing things. Working in the community, you don’t often see a lot of pathology. It makes you feel like you don’t know things, or you might question what something might look like.

There’s a feeling that what you’re dealing with daily is what makes you a better optometrist. But seeing pathology helps you. It has cleared up my self-doubt. Once I see something that is wrong, I know what it looks like. It's always very different to what we see in the textbooks.