Primary Care Optometry: Emphasis on Ocular Disease

Mission statement of the School of Optometry and Vision Science residencies

To provide graduate optometrists with a program of concentrated mentored clinical experience and education designed to produce practitioners with advanced knowledge, skill, and judgement in a selected area(s) of optometric practice. This will enable them to deliver excellent clinical care, practice life-long learning and educate members of the profession.

General description of residency

This 13-month residency in Primary Care (emphasis Ocular Disease) is a clinical post-doctoral position that is designed to provide advanced clinical training in the areas of primary care; specifically in the diagnosis and management of a wide variety of complex eye and vision problems encountered in rural practice, including surgical co management.  While the emphasis of this residency is to achieve competence through clinical training, the resident will also engage in scholarly activities and will be required to participate in the clinical education of optometry students. Upon completion of this residency, optometrists will advance their competency, knowledge, and skill level in a rural practice setting, with an emphasis on providing care to local indigenous communities through interprofessional collaboration. This residency will be full time at FYi Doctors in Smithers BC.

Dates of residency: August 1st, 2025 - August 31st, 2026

Salary:  $42,000 per year, additional $2000 to be used toward travel to optometric meetings. For benefits and other information, please see the Residency FAQs.

Primary supervisor at FYi Doctors: Dr. Trevor Kreke

Secondary supervisor at the School of Optometry and Vision Science (UWOVS): Dr. Lisa Christian

Location

The majority of the residency will be at FYi Doctors - Smithers, BC . This is a well-established rural clinic with a long history of providing eyecare to the residents of the Bulkley Valley as well as the local Wet’suwet’en and Gitxsan First Nations.  The majority of patient care is provided in the main location with the opportunity to participate in outreach clinics to local indigenous communities.  Observation days of ophthalmic surgeries will be made available at Mills Memorial Hospital through Vision North Eye Centre in Terrace, BC.

Hours

The clinical component of the residency will be during operating hours at FYi Doctors  - Smithers, for five days per week (Monday – Friday) or equivalent.  Self-study is expected in the resident’s own time, although one half day per week is provided for self-study, administration and the didactic components of the program.   Providing eye care to local indigenous communities may result in longer days due to travel times.

Eligibility

Affiliated residencies at the University of Waterloo are available to those who have received an OD degree from an ACOE accredited program, and who are eligible to hold a full general license of registration in the province of British Columbia.

Requirements to begin residency

A general certificate of registration issued by the College of Health and Care Professionals of Britsh Columbia (BC) must be in place on entry to the residency.

Residency goals and objectives

Goal 1: Expert Role

To train the resident to competently examine and manage patients with diverse and complex clinical findings including refractive error, binocular vision disorders and sub-discipline areas of glaucoma, anterior segment disease, posterior segment and acute care.

Objective 1

To train the resident to accurately and efficiently assess and manage patients in the identified areas:       

Outcome measures:

  1. The resident will experience a minimum of encounters in primary care with a primary diagnosis of 150 for patients with complex refractive errors, 100 with binocular vision anomalies (non-strabismic), 350 with anterior segment diseases/disorders, 300 with posterior segment; as well as 200 independent encounters in imaging services and 200 in acute care. Visits will be primarily in direct care and supervised care.
  2. The resident will discuss patient encounters and/or have patient files reviewed by a supervisor until the resident displays adequate competency for each specific type of assessment based on level of difficulty.
  3. There will be at minimum of bi-weekly meetings scheduled with a supervisor to discuss case management.
  4. The resident will maintain an accurate log of all patient encounters.

Objective 2

The resident will become proficient in utilizing and analyzing the results of imaging instruments for the management of ocular disease:  

Outcome measures:

  1. Training will be provided to allow the resident to become more proficient with the use of the following:
    1. Optical Coherence Tomography (OCT) – anterior and posterior segment
    2. Scanning laser tomography
    3. Fundus Autofluorescence
    4. Fundus photography
    5. Perimetry
  2. A supervisor will review the files from the patients seen in imaging clinic until     adequate level of competency has been demonstrated.
  3. The resident will maintain an accurate log of all patient encounters.

Goal 2: Expert role

The resident will develop and solidify strong clinical diagnostic and management skills in the area of primary care.

Objective 1

To train the resident to understand advanced management options for more complex cases and to appropriately identify when referral is required:

Outcome measures

  1. Regular supervisor meetings to review knowledge will ensure exposure and understanding of the following:

a. The resident will discuss outcomes of patient care during meetings with supervisor.

  1. The resident will submit ePortfolio/Reflections based on a patient encounter during which experiences were gained, knowledge and skills learned, and changes developed to implement for improvement.
  2. The resident will maintain an accurate log of all patient encounters.

Goal 3: Scholar role

To develop the resident’s knowledge in the area of primary eye care including ocular disease and management and the ability to critically review the literature

Objective 1

The resident will create at least two evidence-based rounds/presentations

Outcome measures:

  1. Supervisor will work with resident to develop
    1. two evidenced-based rounds to be presented during scheduled UWOVS residency rounds sessions.
    2. a third case will be encouraged to be presented in a venue other than in internal rounds (e.g. continuing professional development venue)

Objective 2

To expose the resident to different continuing education experiences on various disease topics

Outcome measures:

  1. Attend at least one large optometric/ vision conference (American Academy of Optometry preferred). 
  2. Attend evening local optometry or ophthalmology meetings whenever possible
  3. (Virtually) participate in the Residents’ Evidence-Based Medicine/Journal club at UWOVS

Objective 3

Efficiently and effectively use library and other on-campus resources to develop skills, access literature and use evidence-based medicine

Outcome measures:

  1. (Virtually) attend and participate in resident enrichment didactic activities and workshops on topics such as writing skills, oral communication skills, case study development and supervision skills
  2. Participate in the Residents’ Evidence-Based Medicine/Journal club.

Goal 4: Communicator role

To become a skilled clinical communicator

Objective 1

The resident will participate in speaking and writing opportunities.

Outcome measures

  1. The resident will present at least four oral presentations during the year: two of these will be short rounds presentations and one will be a Grand Rounds (case-oriented) presentation. The final one may be another Grand Rounds or instead may be a lecture-style oral presentation.  All formal presentations should be suitable for COPE-approval. The two main presentations will be given at scheduled Residency Grand Rounds sessions / Residency seminar setting, as part of the University of Waterloo Optometry & Vision Science Graduate Conference or in a continuing professional education setting.
  2. The resident will be encouraged to submit a poster to a recognized optometry or ophthalmology conference.
  3. Develop a publishable quality paper based on a case in which the resident was involved.
  4. The resident will participate in a series of enrichment workshops on topics such as writing skills, oral communication skills, case study development and clinical teaching.

Goal 5: Collaborator role

To develop the resident’s communication and knowledge-base to be able to engage in inter-professional education, collaboration, and care.

Objective 1

The resident will collaborate with ophthalmology and other health professionals to optimize patient care

Outcome measures

  1. The resident will be responsible for communication through reports or directly with the  ophthalmology and medical community when needed .

Objective 2

The resident will communicate effectively and collaborate with ophthalmology and other healthcare professionals

Outcome measures

  1. The resident will have a seminar with their supervisor(s) on how to effectively and efficiently communicate with other health professionals
  2. Letters/reports for complex patients (e.g. blood work/imaging requests, glaucoma /ocular disease surgery referrals, etc.) will be reviewed by supervisor(s) prior to sending until appropriate level of competency has been demonstrated

Objective 3

The resident will help with supervision of 3rd and 4th year medical students from the University of British Columbia, School of Medicine.

Outcome Measures

  1. When a competent level of clinical knowledge is reached, the resident will supervise medical students shadowing in the clinic a few half days per month.

Anticipated weekly curriculum

Term 1 - fall (September - December) Term 2 - winter (January - April) Term 3 - spring (May - June)
4.5 days direct patient care

3.5 days direct patient care

1 day primary care supervision

2.5 days direct patient care

2 days primary care supervision
0.5 days = Self Study