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Residency Profile: West Los Angeles VA Health Care Center, Los Angeles, CA

Exterior shot of building

Established: 1983
Positions: 4

West LA VA Healthcare Center (Map)
Optometry Dept. (123)
Eyecare Center Bldg. 304 Room 2-111
11301 Wilshire Blvd.
Los Angeles, CA 90073

Program Faculty

Coordinator: Pauline F. Ilsen, OD, FAAO

Attendings:

  • Chief of Optometry: Andrea Yiasemis, OD, FAAO
  • Assistant Chief of Optometry: Pauline F. Ilsen, OD, FAAO
  • Chief of Low Vision Services: Shawn Yu, OD, FAAO

Mission Statement

The mission of the program is to train post-doctoral optometry residents in advanced primary and secondary care optometry with an emphasis on ocular disease, systemic disease, and interdisciplinary collaboration through direct patient care, didactics, discussions, scholarship, and other activities, conducted by optometry and by other disciplines.

Reception DeskOptical OfficeExam RoomLow Vision Room

Program Description

Program Goals, Objectives, and Outcome Measures for Residents

  1. GOAL:  To develop primary and secondary optometric diagnostic and management skills of patients with ocular disease, ophthalmic manifestations of systemic disease, and ophthalmic side effects of systemic medications in an interdisciplinary health care setting.
    A. Objective: To gain experience in direct optometric patient care.
       1.Outcome: Each resident will see at minimum 1000 patient encounters at Optometry Clinic, Community Living Centers (“CLCs”—nursing homes), and Geriatric (GRECC) inpatient ward. 
    Measure: An “encounter activity report” for each resident tabulating the number of patient encounters, diagnoses, and procedures performed by the resident will be generated from the facility’s computerized patient record system by the program coordinator on a quarterly basis
       2.Outcome: Each resident will see at minimum
         a. 15 Therapeutic Contact Lens Clinic patient encounters
         b. 12 Vision Rehabilitation/Low Vision Clinic patient encounters
    Measure: An encounter activity report tabulating the number of patient encounters, diagnoses, and procedures for the specialty clinic to which the resident is assigned for one rotation (3 months) will be generated from the facility’s computerized patient record system by the program coordinator on a quarterly basis
    B. Objective: To gain experience interdisciplinary patient care.
      1. Outcome: The resident will consult with other clinics and primary care providers regarding provision of patient care and provide optometric care to those patients for whom optometric consultation has been requested by other Clinics.   
    Measures: The attendings will observe that residents are responding to consults from other providers during chart review and at weekly QA Case Reviews.  Attendings will discuss with the resident and observe the resident’s consultations with other disciplines by means of formal consultations, “curbside” discussion, phone call, or identification of providers in other disciplines as additional signers to the resident’s clinic note.  Consults with other disciplines will be discussed at weekly Case Reviews. Information technology (IT) personnel will report on the number of formal electronic consultations sent to other clinics on a quarterly basis.  
      2. Outcome: The resident will review and order laboratory and/or radiological studies as indicated for diagnosis and management.  At least 5 orders for labs and/or imaging will be placed by the resident by the end of the residency year.  
    Measures: Attendings will discuss with the resident and observe the resident’s review of relevant lab tests and imaging studies that have already been performed during patient care and at weekly Case Reviews to relate them to ocular findings. IT personnel will report on the number of laboratory and imaging study orders placed by the resident on a quarterly basis.
      3. Outcome: The resident will participate in interdisciplinary team meetings at GRECC, CLC 215 (nursing home), and CLC 213 (nursing home) with requirements as follows: GRECC Inpatient meetings: meetings are conducted on an “as-needed” basis, no minimum is required, but attendance by the resident is expected when meetings are conducted. GRECC Outpatient meetings:  the resident is to document in the resident activity report a minimum of 6 meetings attended. CLC 215 and CLC 213 meetings:  at least 50 patient reviews/reports, to be documented as team meeting notes in the patients’ medical records
    Measures: The program coordinator will extract from the computerized patient record system the number of progress notes authored by the resident containing team meeting reports on a quarterly basis.  The resident is to document attendance at team meetings and submit a resident activity report on a quarterly basis.
      C. Objective: To attend and participate in optometric primary care didactic and clinical education.
         1. Outcome: The resident will attend/participate in the Optometry Clinical Seminars Education Program, completing at least 80% of the program hours Measure:  attendance will be documented by sign in on a sign-in sheet.  Transcript-quality continuing education attended elsewhere may be counted in lieu of Seminars hours if documentation of attendance is provided.
         2. Outcome: The Resident will participate in a Clinical Seminars end-of-year review question-and-answer exercise. Measure:  direct observation by attending of completion of the exercise
         3. Outcome: The Resident will respond to questions posed by Attendings regarding optometric primary care. Measures: direct observation by attendings, completion of written quizzes held on a weekly basis; the program coordinator will keep a log of quiz completion over the course of the year
         4. Outcome: The Resident’s proficiency in advanced procedures will be monitored and documented by supervising faculty.
    Measures: Direct observation by attendings, completion of proficiency checklists at orientation
         5. Outcome: The Resident will attend and participate in weekly Optometry Case Presentations, eRounds, Quality Assurance Case Reviews; monthly Low Vision Lessons; monthly Journal Club meetings; and weekly quizzes. A minimum of 40 cases per resident will be reviewed by the end of the year in the quality assurance/case review meetings. The resident will read a minimum of 10 articles per quarter. The resident will take a minimum of 25 quizzes for self-assessment over the course of the year 
    Measures: Attendance at meetings will be reflected in the resident’s quarterly activity report.  Program Coordinator will keep a list of cases reviewed at weekly QA meetings and include the total for the resident in a quarterly patient care report.  The Program Coordinator will keep a log of weekly quizzes administered over the course of the year.  The Attending in charge of the journal club will keep a list of reading assignments to be submitted on a quarterly basis.
    D. Objective: To gain experience in administrative and quality assurance activities.
      1. Outcome: The Resident will submit a quarterly activity report to the Residency Program coordinator and SCCO Residencies Director reflecting the resident’s activities toward accomplishing the program’s stated objectives.
    Measure: The resident activity report document will be e-mailed by the resident to the program coordinator on a quarterly basis.
      2. Outcome: At least 40 cases per resident will be presented and discussed at weekly Optometry Quality Assurance/Case Review meetings over the course of the year and documented by the Program Coordinator.
    Measure: The Program coordinator will keep a list of cases reviewed at the weekly QA case review meeting and include the total for the resident in a quarterly patient care report.
    E. Objective: To attend and participate in interdisciplinary didactic and clinical education.
    1. Outcome: The resident will attend Neurology Grand Rounds when the Neurology department is conducting their Rounds Program (variable), no minimum required
    2. Measure: The resident will document attendance in the quarterly resident activity report.
    3. Outcome:  The resident will attend a minimum of 4 Diabetic Clinic lectures.

      Measure:  The resident will document attendance in the quarterly resident activity report.

    4. Outcome:  The resident will attend the fluorescein Angiography Conferences when available (no minimum number required).

      Measure: the resident will document attendance in the quarterly resident activity report.

    5. Outcome:  The resident will attend a minimum of 10 medical resident conferences by the end of the year.

      Measure: the resident will document attendance in the quarterly resident activity report.

  2. GOAL: To participate as a primary care member of an interdisciplinary health care team and to promote interdisciplinary management of patients presenting with highly complex and inter-related ophthalmic and systemic conditions and thus develop an understanding of the inter-relationships of the roles of the various health care disciplines contributing to the care of the patient.
    A. Objective: To gain experience in interdisciplinary health care.  See above.
    B. Objective: To participate in interdisciplinary didactic and clinical education.  See above.
    C. Objective: To serve as the optometric liaison at GRECC, CLCs, Diabetic Clinic, and with other healthcare providers at the West Los Angeles VA .  See above.
                             
  3. GOAL: To contribute to the health care community through scholarship and teaching.
    A. Objective: To develop clinical teaching skills.
      1. Outcome: The resident will participate in a Clinical Precepting workshop
    Measure: The program coordinator will conduct the workshop and document participation/proficiency on a proficiency checklist
     2.  Outcome: The resident will precept 4th year Optometry students in clinic under the supervision of an Attending; the resident will have a minimum of 40 precepting encounters by the end of the year
    Measure: The Resident will document their precepting in the computerized patient record system.  The program coordinator will obtain a list of instances when the resident was identified by a student as an expected cosigner (i.e., as a preceptor) and include the number in the resident’s quarterly patient care report.
      3. Outcome: The resident will educate medical trainees at GRECC and at the Eyecare Center with an emphasis on: ophthalmic manifestations of systemic disease; ophthalmic side effects of systemic medications; detection, preliminary diagnosis, and appropriate referral of common ophthalmic disorders when there is an opportunity to do so.
    Measure: The resident will verbally report when they have engaged in clinical teaching of fellow trainees; direct observation by the program coordinator when trainees visit the clinic.
    B. Objective: To develop didactic teaching skills.
      1. Outcome: When invited, the resident will present a lecture on diabetic eye disease to the Diabetic Clinic interdisciplinary care team.
    Measure: The resident will document in the quarterly resident activity report when they present lectures
      2. Outcome: The resident will present at least three lectures to Optometry trainees at Optometry Trainee Presentation meetings or eRounds
    Measure: The resident will document in the quarterly resident activity report when they present lectures
      3. Outcome: The Resident will present at least one case or relevant topic at Optometry Clinical Seminars
    Measure: Direct observation by attendings; the resident will document in the quarterly resident activity report when they present lectures
      4. Outcome: When invited, the Resident will present an in-service to nursing staff and/or medical trainees during the GRECC rotation 
    Measure: The resident will document in the quarterly resident activity report when they present lectures.
    C. Objective: To gain experience in Clinical Research/Scholarly Activities.
      1. Outcome: The resident will complete a thesis paper of publishable quality. 
    Measure: The resident will submit the paper to the attending who serves as their co-author in electronic format 
      2. Outcome: The resident is encouraged but not required to attend the annual meeting of the American Academy of Optometry, American Optometric Association, or equivalent. Measure: Documentation of participation is required, such as a printout of continuing education hours.
      3. Outcome: The Resident will read a minimum of 10 journal articles per quarter.  
    Measure: (See above)
      4. Outcome: The Resident will participate in the SCCO Library’s circulation lists for journals. Measure: direct observation/inquiry by Program Coordinator
      5. Outcome: The Resident will research literature on various topics as discussed through the course of patient care and meetings, and as assigned by attendings.
    Measure: Direct observation by program coordinator, inclusion of reference list of articles at the conclusion of Powerpoint presentations and through the course of Journal Club meetings

Typical Daily or Weekly Schedule in Clinic

ATTENDING & RESIDENT SCHEDULE 2019-2020

RESIDENT

MONDAY

TUESDAY

WEDNESDAY

THURSDAY

FRIDAY

GRECC

 

 

ROTATES TO LV NEXT

AGT BEDSIDE SCREENING EQUIP-RM2234

AGT ROUNDS 11-11:50

 

GRECC OUTPT MTG 8-9

Rm4639B 4West B500

ADMIN TIME

MED RES CONF 12-1 RM 3232

 

PT EXAM B304

 

 

PT EXAM 304

(LATE)

 

PT EXAM 304 (LATE)

BEDSIDE EXAMS B500 DIDACTIC 1:30

 RM 2400

TM MTG/RPTS 2:30 RM 2400

 

PT EXAM 304

 

PT EXAM 304

(LATE)

 

OPTOMETRY SEMINARS

 

 

PT EXAM 304

(LATE)

THERAPEUTIC

CONTACT LENS

 

 

ROTATES TO GRECC NEXT

 

PT EXAM 304

 

 

 

PT EXAM 304

(LATE)

TCL CLINIC

 Bldg. 304

MED RES CONF 12-1 RM 3232

DM CLINIC

8-9 Rm 4639 (4W)
ADMIN TIME

TCL CLINIC

B304

 

TCL CLINIC 304

 

PT EXAM 304

 (LATE)

 

PT EXAM 304

(LATE)

 

OPTOMETRY SEMINARS

 

PT EXAM 304

(LATE)

CLC

x42217

 

x42355

ROTATES TO TCL NEXT

PT EXAM 304

(LATE)

PT EXAM 304

(LATE)

ADMIN TIME

MED RES CONF 12-1 RM 3232

 

PT EXAM 304

 

 

PT EXAM 304

(LATE)

TEAM MTG CLC 213RM 105

CLC 215 RM 230 PT EXAM

TEAM MTG 215-2

CLC PT EXAMS

B 215/RM 230

 

PT EXAM 304

(LATE)

 

OPTOMETRY SEMINARS

 

CLC PT EXAM

B215/RM230

LOW VISION

 

 

ROTATES TO CLC NEXT

 

PT EXAM 304

(LATE)

 

 

PT EXAM 304

(LATE)

 

LV EVALS B304

 

PT EXAM 304

 

 

LV Evals B304

MED RES CONF 12-1 RM 3232

 

LV EVALS

 

 

PT EXAM 304

(LATE)

 

LV EVALS B304

 

 

OPTOMETRY SEMINARS

 

ADMIN TIME 

 

 

DR YIASEMIS

x83332

(EARLY)

 

PRECEPT

 

 

ADMIN TIME

 

ADMIN TIME

 

PRECEPT 304

 

 

ADMIN TIME

 

PRECEPT 304

(LATE)

 

 

PRECEPT 304

 

PRECEPT 304

(LATE)

 

 

OPTOMETRY SEMINARS

 

 

PRECEPT

 

DR ILSEN

x42356

(EARLY)

 

PRECEPT 304

 

 

PRECEPT 304

 

PRECEPT 304

 

PRECEPT 304

 

PRECEPT 304

 

 

ADMIN TIME

 

PRECEPT 304

(LATE)

 

ADMIN TIME

 

OPTOMETRY SEMINARS

 

PRECEPT 304

(LATE)

 

DR YU

x48726  or

x44780

(LATE)

 

PRECEPT

 

 

PRECEPT

 

WLA

PRECEPT

LOW VISION

 

 

ADMIN TIME

 

PRECEPT

 

PRECEPT

Low vision exams

 

PRECEPT

 

OPTOMETRY SEMINARS

 

 

LOW VISION EXAMS

 

ALL OPTO TRAINEES

 

 

TRAINEE PRESENTATIONS 7:45-8:15 RM2-118

LANDMARKS + STDS OF CARE 7:45

JOURNAL CLUB ALT c LOW VISION LESSONS

4:30-5:00

RM2-118

eROUNDS

7:45-8:15

RM2-118

 

 

QUIZ  AM

 

OPTO SEMINARS

1-5PM

 

RESIDENTS

PRECEPT PRN

SURG RES LUNCH 12-12:45 RM 6659

PRECEPT PRN

SURG RES LUNCH 12-12:45 RM 6659

PRECEPT PRN

SURG RES LUNCH 12-12:45 RM 6659

FA conf

7:45-8:15

rm 2-121

PRECEPT PRN

QA CASE REVIEWS

8-8:30

PRECEPT PRN

SURG RES LUNCH 12-12:45 RM 6659

Official clinic hours for patient care:  8:15 AM to 5:00 PM

“LATE”= STAY UNTIL ALL AM/PM PATIENTS ARE FINISHED

Rotation One: July 1 Through September 30
Rotation Two: October 1 Through December 31
Rotation Three: Jan 1 Through March 31
Rotation Four: April 1 Through June 30

The program is one year (365 days) long, but for residents to be eligible for health care insurance, they are required to work for more than 365 days. An additional day spent completing paperwork at our Human Resources department and in pre-orientation activities with outgoing residents in late June is recommended to meet the 365+ day requirement for health insurance.

*Description of Rotations

Didactics & Discussion Sessions

Optometry Didactics & Discussion Sessions—OVERVIEW 

Conducted as a series of lectures by members of the residency faculty, staff, and invited guest speakers, this program is designed to present the essential core of optometric knowledge in a manner conducive to learning and retention. To achieve this objective, each of the sections of the course curriculum contains related aspects of basic and clinical science.

As an educational program, the Optometric Clinical Seminars serves primarily as an adjunct to optometric residency training.

All SCCO-affiliated residents are invited to attend the Seminars. Written approval must be received from the instructor of the course and Chief of the respective facility's optometry program.

The Program runs 4 hours (1-5:00 PM) unless otherwise specified.

West LA VA residents are each required to do at least one case/topic presentation at WLAVA Seminars.

Optometric Clinical Seminars Recent topics

Trainee Presentations

All WLAVA optometry residents and interns participate in Trainee Presentation meetings held on Monday morning, which includes presentation by trainees of an interesting case and/or discussion of a topic. The Discussion portion of the presentation generally includes epidemiology, etiology, risk factors, differential diagnoses for the ocular condition and (if applicable) related systemic conditions, ocular management and (if applicable) related systemic conditions, prognosis, a conclusion with clinical application, and a list of sources/references.

Low Vision Lessons

All WLAVA Optometry residents and students attend Low Vision Lessons on Tuesday afternoons. Low Vision Lessons are conducted by the Low Vision Attending, Dr. Shawn Yu, and incorporate case presentations with a discussion of related ocular and systemic pathology.

Journal Club

All WLAVA Optometry residents and students participate in the Journal Club, which meets on Tuesday mornings to discuss landmark studies and standards of care, led by the Chief of Optometry, Dr. Yiasemis.  On alternating Tuesday afternoons,  the Journal Club meets to discuss contemporary journal articles; this meeting is conducted by Dr. Yu.

Fluorescein Angiography Conference

Optometry residents attend the Fluorescein Angiography conference with Ophthalmology, conducted by the retina specialists on Thursday mornings. Angiograms (and OCTs) performed during the preceding week are reviewed and interpreted by the Retina Specialists, then a patient management plan is developed.

Trainee Presentations

All WLAVA optometry residents and interns participate in Trainee Presentation meetings held on Monday mornings, which includes presentation by trainees of an interesting case and/or discussion of a topic.  The Discussion portion of the presentation generally includes epidemiology, etiology, risk factors, differential diagnoses for the ocular condition and (if applicable) related systemic conditions, ocular management and (if applicable) related systemic conditions, prognosis, a conclusion with clinical application, and a list of sources/references.

Disease and Pharmacology Quizzes

All trainees take a quiz on various topics in ocular and systemic disease on Thursday morning.  On Friday mornings, all trainees take a pharmacology quiz.  The Pharmacology quiz is based on the “top 100” list of drugs filled through insurance in the United States.  Residents are  required to participate. the quiz scores are not counted toward residency certification.

eRounds

Neurology Grand Rounds

Medical Residents’ Conference

The Medical Residents’ Conference is conducted on a daily basis from noon to 1:00PM.  It is open to all trainees. Topics recently covered include:

Compliance with HIV and HTN medication
Surfing-related trauma
Primary and secondary Raynaud’s disease
Aspirin Toxicity
Antipsychotic side effects
Peripheral arterial disease
MRSA and red man syndrome
Atopic dermatitis
Hospital-acquired pneumonia
Intrinsic myocardial disease
Probiotics and antibiotics
Nutrition in the hospital setting
Idiopathic pulmonary fibrosis
Postural tachycardia syndrome
Use of percutaneous endoscopic gastrostomy (PEG) in dementia
 

Supervision & Case Reviews/Quality Assurance

West LA Optometry has three Attendings. Dr Andrea Yiasemis is the chief of optometry; Dr. Pauline Ilsen is the Assistant Chief of Optometry and training program coordinator.  Dr. Shawn Yu is the Chief of Low Vision Optometry.  

Usually two optometry attendings are available for consultation while patients are being examined. There are specific written guidelines for resident supervision and what residents are permitted to do; the residents gain increasing levels of independence and responsibility over the course of the year. Supervision guidelines cover consultation with attendings in regard to medication prescription, laboratory & radiology orders, consultations with other clinics; bedside examination; team meeting reports; low vision evaluations; and therapeutic contact lens services, etc. Consultation with attendings may consist of discussion of the case, review of data, and examination of the patient by the attending or of discussion and data review only, depending on the particular circumstances of the case. All electronic notes written by optometry residents & interns are reviewed by the Optometry Attendings. Besides the standard supervision guidelines, residents are encouraged to consult with an Attending at any time.

On Friday mornings, the Optometry residents and Dr. Ilsen meet for quality assurance/case reviews. Over the course of the week, Dr. Ilsen prepares a list of interesting patients seen by Optometry. This includes patients seen by residents where Dr. Ilsen saw the patient along with the resident, discussed the case with the resident, or reviewed a clinic note for a patient seen by the resident. Residents are also asked at this meeting if there are any patients whom they would like to discuss with the group.

A case review generally involves a very brief summary of the case with an emphasis on a lesson learned, clinical pearls to be drawn from the case, suggestions for future care of the patient, clinical protocols, community standard of care, etc. The patient’s fundus photographs, anterior segment photos, fluorescein angiography, OCT, and/or visual fields may be viewed during Quality Assurance/Case Reviews.

Eyecare Center Facility

The Optometry and Ophthalmology Services moved into the EyeCare Center in January 2006, located in a refurbished wing of a building that is immediately adjacent to the main hospital on the West LA VA campus. While the two services are work side by side, Optometry maintains its professional autonomy and is administratively independent of Ophthalmology. The Eyecare Center equipment and arrangement includes the following:

Thirteen conventional examination lanes

  1. Low Vision exam lane
  2. Two visual field rooms (2 Humphreys 750i perimeters,  2 FDTs, Goldmann perimeter)
  3. Portable and table-mounted A/B ultrasound units (2)
  4. IOLMaster
  5. Zeiss digital fundus imaging system
  6. Optos California P200Dtx widefield photography and autofluorescence
  7. Pentacam corneal topographer 
  8. Heidelberg Spectralis OCT (2 units)
  9. Konan corneal microscope camera (for endothelial cell count and pachymetry)
  10. Oculus PARK1 autopachymeter/autorefractor/autokeratometer (3 units)
  11. Humphreys autolensometers (2)
  12. Optical Dispensary
  13. Optometry Residents have an office in the Administrative area of the clinic

Support Staff

Optometry usually has two technicians, sometimes three.  One or two are assigned to the optical dispensary and are responsible for all optical dispensing for both Optometry and Ophthalmology. Residents perform some minimal dispensing (for patients at nursing homes and GRECC inpatient ward).  One tech performs Optometry’s Humprheys visual fields.  When we have a third technician, techs may help with screening fields, autorefraction and some other entrance tests.

The Eyecare Center has four to six clerks for scheduling. There are "volunteers" for various minor supportive activities; the number of volunteers varies, as we occasionally get students from UCLA, the American College of Optics, and others who volunteer for limited periods of time.

Assistance from Ophthalmology’s health technicians is also provided in the performance of OCT, automated perimetry, and optical dispensary responsibilities, as well as maintenance of clinic supplies, equipment, etc., as time permits.

Vision Rehabilitation Program Staff

The Vision Rehabilitation program provides services on an outpatient basis to veterans who are legally blind and to those who are not legally blind but have significant visual impairment (there are specific criteria that must be met for “significant visual impairment”). Services are also provided to patients with traumatic brain injury (TBI). West LA VA has the following Low Vision staff:

Low Vision Optometry Attending
Visually Impaired Services Team (VIST) coordinator (case manager) for all of GLA
Blind Rehab Outpatient Specialist (BROS)
Low Vision Secretary (scheduler)
Orientation & Mobility specialist

Ophthalmology Trainees and Staff

Ophthalmology usually has three to four Resident trainees from UCLA’s Jules Stein Eye Institute who rotate approximately every 6 weeks. Additionally, Ophthalmology has fellows in Uveitis, Retina, Cornea, and Oculoplastics who may spend some time in the Eyecare Center.

Subspecialty Ophthalmology clinics include: Retina, Cornea/Anterior Segment, Uveitis, Oculoplastics, Neuro-Ophthalmology, and Glaucoma, as well as PDT and laser. Part-time subspecialty Ophthalmology Attendings include: one uveitis specialist, three glaucoma specialists, four retina specialists, three cornea/anterior segment specialists, two neuro-ophthalmology specialists, three Oculoplastics specialists, as well as three general ophthalmologists. Ophthalmology is good about providing follow-up information on patients referred to them and are quite generous in accommodating same-day requests or for consultation or “curbside” consultation. Optometry patients get returned to Optometry when their care with Ophthalmology has been completed.

Ophthalmology usually has 4-6 health technicians/nurses who provide pretesting and ancillary testing for the ophthalmology residents.

Rotation through other Services

Community Living Center (on-campus nursing homes)
Geriatric Research, Education, and Clinical Center (GRECC)/Acute Geriatric Team (AGT)
Medical Resident Conference 
Diabetic Clinic (Diabetic Clinic didactic, during LV rotation)
Neurology (Neurology Grand  Rounds)
Retina Clinic (Fluorescein Angiography Conference)
½-day observation in other services may be arranged on an individual basis during the resident’s Administrative time (Dermatology,Neuro-Radiology, Radiology, others).

Type and Number of Patients

The program emphasizes geriatrics, ocular & systemic pathology, and interdisciplinary health care. Our patients tend to have multiple complex, inter-related health problems; it is quite common to see the ophthalmic manifestations of systemic diseases and to be looking for ocular toxicity from systemic medications.

Our patients often have common chronic illnesses such as hypertension, diabetes, atherosclerosis, and COPD. Additionally, the West LA VA has a large homeless veteran program, neuropsychiatric program, and several neurology subspecialty clinics. The Polytrauma/Traumatic Brain Injury Clinic is a neighbor to the Eyecare Center in Bldg. 304. We have many patients with a history of homelessness, unemployment, drug & alcohol abuse, PTSD, stroke, movement disorder, neoplasia, seizure disorder, dementia, multiple sclerosis, etc. Our facility has an emphasis on tertiary care.

We have full therapeutic drug prescribing, laboratory, and radiology clinical privileges. As part of an inter-disciplinary healthcare team, we often receive consultations from other clinics and we often discover systemic problems which require consultation to other specialties. We have good working relationships with several other disciplines.

Each Resident is assigned to general optometric primary eyecare (with precepting of 4th year students typically on an “as needed” or “as desired” basis) at the Eyecare Center in addition to the Rotation-specific activities in other locations on campus and in specialty clinics.

Each resident is required to have a minimum total of 900 patient encounters to earn the residency certificate. Most residents easily exceed this minimum. The number of patient encounters per day varies greatly depending on the rotation and the day’s scheduled activities. Residents may typically see at least 2-4 and at most 6-8 patients per half-day of patient care.

Demographic Patient Information

Teaching Responsibilities

  • After orientation (includes precepting workshop and guided precepting encounters), residents are encouraged to precept fourth-year optometry students on an “as-needed/as-desired” basis.  Residents typically will precept students between seeing their own patients, after completing care with their own patients in the main eye clinic, or after completing their specialty clinic assignments (e.g., after finishing care at the CLC or GRECC).
  • Residents are encouraged to show medical trainees interesting ocular pathology while at the Geriatric unit (GRECC) or Community Living Centers (Nursing Homes) and to medical trainees visiting/observing in the Eyecare Center.
  • During periods when we have student volunteers, Residents are encouraged to train them to perform entrance tests, screening fields, autorefraction, pachymetry, and lensometry

Lecturing Opportunities

  • Residents are sometimes invited to make a presentation on diabetic eye disease to the interdisciplinary care team at the Diabetic Clinic during their rotation on the low vision rotation
  • Residents present lectures at Optometry Trainee Presentation meetings to fellow Optometry trainees generally on a quarterly basis
  • Residents each present a case or topic of interest at selected Optometry Clinical Seminars
  • Residents may be invited to conduct “in-service” education on eye disease to nursing staff or present a lecture about ocular disease to medical trainees while on the GRECC rotation
  • Residents participate in the annual Residency Forum at MBKU, presenting their thesis papers to 4th year students
  • Residents are encouraged to submit presentations to MBKU’s Continuing Education Department as Online CE courses

List of Lecture/Educational Presentations by WLAVA Optometry Residents

Scholarly Activities

Thesis Paper

The Resident is required to write an original thesis paper of publishable quality over the course of the year. Publication and/or presentation at the American Academy of Optometry, American Optometric Association annual meeting, or SECO is strongly encouraged but not required.

List of WLAVA Resident Thesis papers and publications in progress/written/published from 1993 through Spring 2018

Journal Clubs

  • Libraries:  SCCO’s library provides a subscription type of service, where Tables of Contents of ophthalmic journals are sent to Residents so they may request articles of interest.  Articles for thesis paper research may be requested through the SCCO library.  The VA Medical Library also can obtain articles through Medline for residents
  • Online Journals:  The VA subscribes to several journals online, which may be accessed through the VA’s Intranet website.  Medline-style and PubMed search engines are available. 
  • Online Textbooks:  the VA subscribes to several electronic medical and pharmacological textbooks that may be accessed through the VA Intranet
  • Articles of interest are distributed by the Program Coordinator as “required” reading
  • We have a journal club that meets every Tuesday morning and every other Tuesday afternoon.  The Tuesday morning meeting is to discuss landmark studies and standards of care; the afternoon meeting is to discuss current publications, research, and novel information.

Additional Employment Opportunities

  • “Moonlighting” is permitted with prior approval; separate liability coverage must be obtained by the Resident for external patient care outside of the VA.
  • Rarely, Optometry residents are asked to participate in systemic medication research by providing baseline and follow-up eye examinations on research subjects, for which they are paid on a “per case” basis, to be done on the resident’s own time.
  • SCCO's Continuing Education program pays an honorarium for courses accepted for presentation online.

Stipend

For 2018-2019, the optometry resident is paid an annual stipend of $39,484 The stipend is determined by VA Central Office and is subject to review once every two years. Any changes mandated by VACO will be implemented by the WLAVA. Paychecks are deposited via Direct Deposit biweekly.

Benefits

Health Health insurance is available.
Holidays All federal holidays are observed by the Eyecare Center (Martin Luther King, Jr’s birthday, Presidents’ Day, Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans’ Day, Thanksgiving Day, Christmas Day, New Year’s Day).
Educational Travel "Authorized absence" is granted for documented attendance at the American Academy of Optometry meeting in autumn or equivalent national professional meeting
A travel stipend is provided by SCCO from monies generated by attendance at the Optometry Clinical Seminars Education program by private practitioners.
Vacation Residents accrue 4 hours of "annual leave" (vacation) and 4 hours of sick leave per 2-week pay period. Annual leave must be taken at times that it would not interfere with patient care or educational activities. No vacation leave is granted during the last 2 weeks of the program in June.
Liability Liability coverage is provided for care of veterans and nonveteran employees referred by Administrative Medicine for eyecare. Liability coverage does not include care provided through “moonlighting.”
Continuing Education Residents earn over 120 continuing education credit for attendance at Optometry Clinical Seminars.
Information Resources

The VA has numerous ophthalmic, primary care, and healthcare specialty online journal and textbook subscriptions.
The VA has a medical library that can obtain print copies of articles by request.
The SCCO Library provides a journal service to residents: it provides up to 5 articles per month per resident on request. Remote access to journals is also available.
Local university libraries are open to the public.

Prerequisites

  • One must have received an O.D. degree from an Accreditation Council on Optometric Education-accredited school or college of optometry by the time the program begins on July 1.

  • One must pass Parts I and II of the NBEO and the TMOD prior to the ORMATCH matching deadline (usually the first Friday in March each year)
  • NBEO III and state licensure (in any state, not necessarily California) must be passed prior to or during the residency year.
  • U.S. citizenship is required. Immigrants must provide proof of US Citizenship prior to the application deadline in February.
  • An interview prior to the ORMATCH matching deadline is required. In-person interview is strongly encouraged, but an interview may be conducted by telephone if the candidate is unable to interview in person.
  • Although not formally required, computer skills are critical for daily activities in our setting (medication prescriptions, progress notes, laboratory & radiology requests, consults, etc., are entered by computer into electronic records).
  • Experience at a VA facility is quite helpful but not required for application.

WLAVA Application Process and Documents

  • Potential applicants are very strongly encouraged to contact current residents by e-mail or telephone to get their perspective on the program.  Current residents can be contacted at 310.478.3711 x42355, x41509, x44517, or x42596; contact Dr. Ilsen at 310.478.3711 x42356 or pauline.ilsen@va.gov for questions or to obtain current residents’ e-mail addresses
  • ORMATCH application:  materals to be submitted to the ORMatch website (www.natmatch.com) as follows:
    • ORMatch form
    • Letter of intent
    • Curriculum vitae
    • NBEO scores
    • Three letters of recommendation
  • An interview in person or by telephone is required prior to the ranking deadline. 

WLAVA Selection / Ranking Process

Only eligible candidates who have met all program prerequisites and who have completed the entire application process including interview will be considered for ORMATCH (Optometry Residency Matching System) ranking. Eligible applicants are afforded a review without discrimination based on sex, race, age, religion, color, national origin, disability, sexual orientation, or any other applicable legally protected status.

To view the items that are taken into consideration by the Program to determine ORMATCH ranking, click here.

Program Requirements

A summary outline of the requirements to earn residency certification is as follows (see Goals, Objectives, and Outcome Measures—the Outcome Measures are the program’s requirements):

  1. The resident must comply with all VA Greater Los Angeles Healthcare System and Program rules, regulations, procedures, protocols, and policies.
  2. The resident must adhere to the schedule of assignments in a prompt and timely fashion.
  3. The resident must provide patient care consistent with accepted clinical practice guidelines and within the parameters set forth by the Optometry Trainee supervision policy.
  4. The resident must maintain a neat, well-groomed, professional appearance and wear a VA-issued identification badge.
  5. The resident must keep patient care records up to date and must complete care notes and other patient-care related tasks within prescribed time frames.
  6. The resident must maintain and provide documentation of current basic life support CPR training and obtain optometric licensure (in any state) by the end of the residency program.
  7. The resident must complete all of the program requirements enumerated as Outcome Measures of the goals and objectives for the program as follows:
    1. See a minimum number of patient encounters:
      • 1,000 total patient encounters
      • 15 Therapeutic Contact Lens patient encounters
      • 12 Low Vision patient encounters
      • 40 student precepting encounters

    2. The resident will consult with other clinics and providers regarding patient care and provide optometric care to those patients for whom optometric consultation has been requested by other providers.
    3. The resident will review and order laboratory and radiological studies as indicated for diagnosis and management. At least 5 orders will be placed by the resident over the course of the year.
    4. The resident will participate in interdisciplinary healthcare team meetings at GRECC, CLC 215 (nursing home), and CLC 213 (nursing home) as follows:
      • GRECC Outpatient meetings: no patient reviews required; the resident must attend a minimum of 6 meetings.
      • CLC 215 and CLC 213 meetings: minimum of 50 patient reviews/reports
    5. The resident will attend/participate in the Optometry Clinical Seminars Education Program, completing at least 80% of the program hours, and participating in an end-of-year review question-and-answer exercise. Transcript-quality CE attended elsewhere may be counted in lieu of Seminar hours if documentation of attendance is provided.
    6. The resident will respond to questions posed by attendings regarding optometric primary care
    7. The resident will participate in workshops and other clinical training activities under the supervision of an attending
    8. The Resident will attend and participate in weekly Optometry Trainee Presentation meetings, eRounds, and Case Reviews/Quality Assurance meetings; monthly Low Vision Lessons and Journal Club meetings; and weekly quizzes.
      • A minimum of 40 cases per resident will be reviewed by the end of the year in the quality assurance/case review meetings.
      • The resident will read a minimum of 10 articles per quarter
      • The resident will take a minimum of 25 quizzes for self-assessment over the course of the year.
      • The resident will attend a minimum of 10 medical resident conferences over 
            the course of the year.
    9. The resident will participate in administrative and quality assurance activities as follows:
      • Submit a quarterly activity report to the program coordinator and MBKU residencies director reflecting the resident’s activities toward accomplishing the program’s objectives
      • A minimum of 40 cases per resident will be reviewed by the end of the year in the quality assurance/case review meetings.
    10. The resident will attend a minimum of the following interdisciplinary didactic and clinical education activities:
      • 10 Medical Resident Conferences  
      • 4 Medical Resident or GRECC/AGT Conferences or AGT Didactic Neurology Grand Rounds (when available, no minimum requirement)
      • 4 Diabetic Clinic lectures
      • Fluorescein Angiography Conferences (when available, no minimum requirement)
    11. The resident will participate in the following clinical precepting activities:
      • Clinical precepting workshop
      • Precept 4th year optometry students in clinic under the supervision of an Attending
      • Educate medical trainees with an emphasis on: ophthalmic manifestations of systemic disease; ophthalmic side effects of systemic medications; detection, preliminary diagnosis, and appropriate referral of common ophthalmic disorders when there is an opportunity to do so.
    12. The Resident will develop didactic teaching skills by making the following presentations:
      • When invited, a lecture on diabetic eye disease to the Diabetic Clinic interdisciplinary care team.
      • At least 4 lectures at Optometry Trainee presentation meeting or eRounds
      • At least one case or topic at optometry seminars
      • When invited, an in-service to nursing or medical trainees
    13. The resident will engage in the following scholarly activities:
      • Complete a thesis paper of publishable quality
      • Participate in the SCCO Library’s circulation lists for journals.
      • Read at least 10 journal articles per quarter
      • Research literature on topics as discussed through the course of patient care and meetings and as assigned by attendings
      • Attend the annual meeting of the AAO, AOA, or equivalent (encouraged but not required)
  8. The Resident must complete and submit all quarterly and end-of-year program and faculty evaluations.
  9. The Resident will submit a quarterly activity report reflecting the resident’s activities toward accomplishing the program objectives.

Program Accreditation

Fully accredited to June 2024.

Housing

Housing is not provided by the VA for trainees. There are a lot of apartments in the West LA general area.

Local Activities & Attractions

Campus Facilities

  • Food court” style cafeteria, including Starbuck’s coffee and ice cream stand
  • Gourmet food trucks (a different company each day)
  • VA canteen service (2 retail stores with electronics, clothing, snack foods, toiletries)
  • ATM
  • Vets’ garden
  • Golf course (putting green) $8 green fee
  • Japanese garden
  • Bird sanctuary
  • Rose garden
  • Jackie Robinson stadium
  • Farmer’s market

Los Angeles Westside

The West LA VA is located about 5 miles from the ocean and about 15 miles from the heart of downtown Los Angeles. The UCLA campus is 2 miles east of the VA grounds. Various attractions and activities are nearby, including:

Cultural Activities, Entertainment and Dining

Sports

Parks & Recreation

Shopping

Former Residents Testimonials

Potential applicants are very strongly encouraged to contact current residents by e-mail or telephone to get their perspective on the program. Current residents can be contacted at 310.478.3711 x42355, x41509, or x44517; contact Dr. Ilsen at 310.478.3711 x42356 or pauline.ilsen@va.gov for questions or to obtain current residents’ e-mail addresses.

Contact Info

Pauline Ilsen, OD, FAAO
Residency Coordinator
Optometry Dept. (123)
Eyecare Center Bldg. 304 Room 2-111
West LA VA Healthcare Center
11301 Wilshire Blvd.
Los Angeles, CA 90073

Judy W.H. Tong, OD, FAAO
Assistant Dean of Residencies
Southern California College of Optometry at
Marshall B. Ketchum University
2575 Yorba Linda Blvd.
Fullerton, CA 92831-1699
714.463.7568 • Fax: 714.992.7811• Email: jtong@ketchum.edu

Note:  Program activities and schedule are subject to change without notice.