“Pre-reg has given me a greater appreciation of the role that optometrists play in people’s lives”

What was the standout moment of your pre-reg?

Hayley Smith (HS):Getting my Stage two results. My overarching and direct observation assessments were two weeks apart, which made the wait unbearable. However, the wait was worth it – the relief of passing paired with the excitement that I was now onto the OSCE stage was unmatched.

Lizzie Shaw (LS):Taking the first low vision appointment for a patient with age-related macular degeneration. Supplying magnifiers and leaflets, and knowing that someone could help with the patient’s visual problems, was extremely gratifying. She expressed to me what a difference it would make to her life.

Oran O’Connor (OO): Pre-reg has been a rewarding experience, full of different highs and lows. Picking a standout moment is difficult. The feeling after finishing Stage one was fantastic, as it felt like my hard work up to that point was all worth it.

What has been your scariest or most intimidating moment?

HS: When I had to do my first emergency referral, whilst also having a full diary. Trying to juggle the diary whilst also trying to get through to the triage nurses and write a referral letter was intense.

LS: During my community placement, when I saw a patient with bilateral extremely swollen discs, alongside significant sub-retinal and intra-retinal fluid. We sent the patient to A&E immediately. This was my first ocular emergency, and although I was extremely glad we’d seen the patient, I was also very concerned for him. His vision was still 6/6 in both eyes.

OO: Back at the start of my pre-reg, when I was beginning to see real patients for refractions and contact lens appointments. This was the first time I had done this since university, and I had little confidence in my own ability. This was a feeling that lasted for some time – gaining confidence in dealing with patients was a gradual process.

Gaining confidence in dealing with patients was a gradual process

 

How prepared do you feel for the next stage – whether Stage two or OCSEs?

HS: I don’t want to jinx it, but I’m managing to prepare well for the OSCEs. I’m actually finding it easier than the other stages, as I already have the foundations from studying for Stage one and two and have more experience in practice now. I’m also doing some mock OSCEs, which have been helpful to prepare me for what to expect.

LS: At the time of writing, I have just completed my Stage two exams and have booked a July OSCE. I haven’t had a chance to start thinking about OSCE preparation yet, but I feel secure in my capabilities and knowledge. I know that past Moorfields pre-reg intakes have had a mock OSCE at work to help prepare, so this will help solidify my preparation.

OO: I have recently completed Stage one, and am now moving on to Stage two. At this point I have gained great experience and knowledge, which I can bring into both parts of my Stage two assessments. I plan to prepare by going over the frameworks from Stage one and through the different case scenarios for Stage two, to ensure I understand them well. I also need to focus on my clinical skills, allowing them to continue to develop.

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

HS: At the moment, I am spending most of my days testing and a few days dispensing. When my pre-reg is over, I expect I will move to solely testing.

LS: After I qualify, I will have more time to start to take on more complex patients and potentially even work in new clinics, such as intravitreal injection. I will still primarily have similar work in core clinics, but it will be nice to have a new cohort of pre-regs around to see how far we’ve come.

OO: The great thing about Specsavers is that, when pre-reg ends, I will still benefit greatly from the guidance of more senior optometrists, who are always more than willing to give me a helping hand. I expect my working day to be busy, with an increased amount of responsibility. I’m looking forward to it.

Have you started to think about your plans for afterwards?

HS: I am lucky enough to be able to stay at Peter Ivins Eye Care when I am qualified. I am very grateful and excited, after building a great rapport with the patients and staff as well as having the opportunity to take part in many specialised clinics.

LS: I have started to look at PhDs for after I qualify. I have been interested in research since my second year at university, and would love to pursue a research-based career. I would hope to be able to take some bank shifts in hospital though, to keep my hand in.

OO: After pre-reg I’d love to continue working in my current practice. I have formed a good relationship with my supervisors, and they can help me on my journey as a newly qualified optometrist. I also would like to gain further qualifications, broadening my knowledge, to become the best optometrist possible and deliver care for patients.

Did you have any misconceptions about optometry before you started your pre-reg, which have now been rectified?

HS: Although I didn’t necessarily have any misconceptions before pre-reg, before I started studying optometry at university, I didn’t realise just how much information you can get about the rest of the body and a patient’s general health just from the eyes. It’s amazing.

LS: I am sometimes surprised by how patients view optometry and our role as optometrists. I had an afternoon in urgent care recently, and every patient we saw could have been seen in a High Street practice, but had chosen to come to A&E.

I think we still have a long way to go in encouraging people to visit their local opticians for problems beyond needing an update in spectacles. I believe more education on how extensive the role of an optometrist can be could help to cut hospital waiting times and improve service users’ experiences.

OO: Pre-reg has given me a greater appreciation of the role that optometrists play in people’s lives. Patients are also increasingly understanding how their optometrist plays a vital role in allowing them to see clearly, as well as monitoring the health of their eyes and managing them appropriately.

I had an afternoon in Urgent Care recently, and every patient we saw could have been seen in a High Street practice, but had chosen to come to A&E

 

Where do you see yourself in five years’ time?

HS: I would love to continue broadening my skills and expertise by delving deeper into the specialist clinics at Peter Ivins Eye Care, including visual stress, scleral lenses and dry eye. I am also planning on doing the independent prescribing (IP) course as soon as possible, to allow me to prescribe and manage a greater range of pathology.

LS:I hope to have completed a postgraduate degree and split my time between hospital work and academia. I would really like the opportunity to be a university lecturer one day.

OO: There are many career pathways with Specsavers, including support for gaining additional clinical qualifications, such as IP, and professional certificates. This would make me more equipped to offer my patients the best possible care. Over the next five years, I would like to build up a good reputation as an optometrist and be somebody that patients want to see.

What is the one piece of advice you would give to those starting out on their pre-reg journey?

HS: As cliché as it sounds, be organised. Completing my logbook after each patient to ensure I was always up to date, and keeping a note of which patients I could use for certain competencies, really helped me feel prepared. Pre-reg is stressful, so do as much as you can to minimise that.

LS:I would advise keeping ahead of the competencies, especially if they are patients you won’t see very frequently. Document everything, not only for yourself, but for your colleagues. And try not to worry. Everyone has been where you are now.

OO: Stay on top of things from the start. Read through the assessment frameworks and find out what patient encounters you need to see. Make those in the practice booking appointments aware of this.

Also, don’t forget about your clinical skills. Use a trial frame regularly, don’t be afraid to dilate patients, and do Goldmann often too.

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

HS: Stop putting so much pressure on yourself. At the start of pre-reg, I would get frustrated if I didn’t know what a certain pathology was or how to manage something. But it all comes with experience, and I feel much more confident now.

LS:That it’s ok to be bad at things, as long as you keep pushing through and learning from the mistakes. Nobody is expecting you to be perfect the first time.

OO: Plan ahead when it comes to visits and assessments. Get all the paperwork for the visits prepared well in advance, so that in the weeks coming up to your visits you can focus on going through the framework, ensuring you have a good knowledge of each competency.

Also, see each patient as an opportunity to gain knowledge and experience – both from a clinical perspective, but also in communicating effectively with them.

Any regrets, or things you might have done differently?

HS: Pre-reg is very busy and full on, so it is easy to lose that work-life balance. Although you do have to make some sacrifices to ensure you’re on track for every assessment, I wish I was able to find a better balance as I think this would have helped stop me from getting overwhelmed during the harder stages.

LS: There are four pre-regs in my cohort at Moorfields. I would try not to compare myself to the others so much. Pre-reg is tough enough as it is, and everyone is going to have a different approach and timescale. We all have the same goal, and however and whenever we complete it is ok. I am lucky to be surrounded by such intelligent, supportive, and high-achieving peers.

OO: I might have gone through the different case scenarios earlier in my pre-reg, as I found them quite useful in terms of how to think about each patient individually – what questions I should ask, what tests I should do, and how I should manage them. This would have been a very useful tool early in the year.