The moment a newly qualified optometrist walks into their first solo clinic is unforgettable. I remember my moment vividly. It was a potent mix of pride, excitement, and a healthy dose of sheer terror. The safety net of your supervisor is gone. Suddenly, every clinical decision rests squarely on your shoulders.
I recall being plagued by the fear of missing something, of being caught out. Over a decade later, I can confirm that no secret assessor has ever jumped out from behind a visual fields screener to challenge my decisions. That initial fear has been replaced by experience.
“…no secret assessor has ever jumped out from behind a visual fields screener to challenge my decisions.”
Jason Searle – The Eye Care Advocate
This article is the guide I wish I had back then. It is for every newly qualified optometrist standing at that same thrilling, daunting starting line. I want to share the real-world wisdom that you only learn once you are fully responsible for the patient on the chair in front of you.
The Myth of the ‘Routine’ Eye Exam
If I could give just one piece of advice to a newly qualified optometrist, it would be this: abandon the concept of a “routine” eye examination. The term itself is becoming obsolete.
In today’s world, almost every patient encounter is complex. Increased screen use is leading to a surge in aesthenopic symptoms. The prevalence of myopia in children is rising. More and more, we are the first port of call for patients struggling to get a GP appointment. This means we are seeing more undiagnosed systemic conditions, like hypertension, presenting in our clinics.
The idea of a patient with no prescription, no concerns, no symptoms, and no findings is now the exception, not the rule. Your day will be a constant stream of problem-solving. Expect the unexpected. A newly qualified optometrist who learns to be adaptable will thrive.
Reading Between the Lines: A Skill Every Newly Qualified Optometrist Needs
Your degree teaches you to interpret clinical signs. Your career will teach you to interpret patient ideas and narratives. This is a subtle but crucial skill.
Please, always take your patient’s concerns seriously and treat them with the utmost respect. However, it is vital for a newly qualified optometrist to understand that not every word you hear is an absolute truth. Memories can be unreliable.
A patient may genuinely not remember having a test before, even if it is in their notes from last year. Others may have misunderstood a previous diagnosis or procedure. I once had a patient tell me that during their cataract surgery their eye had been taken out, polished, and put back in!
“I once had a patient tell me that during their cataract surgery their eye had been taken out, polished, and put back in!”
Jason Searle – The Eye Care Advocate
Your role is to listen with empathy, but also with a critical ear. If the story does not add up, you must be prepared to probe further. The patient who denies having diabetes but tells you they take metformin, gliclazide and insulin and have regular retinal photos at the hospital needs you to connect the dots.
You’ve Got This! (But Stay Humble and Keep Learning)
To every newly qualified optometrist, I want to say this loud and clear: you have earned your place here. You would not have passed your final exams if you were not competent and safe. You’ve got this!
However, your learning journey has only just begun. The incredible, experienced clinicians you admire were all in your shoes once. Their confidence and knowledge were built day by day, patient by patient.
Mistakes will happen. Hopefully, they will be minor, but they are an inevitable part of your growth. Embrace them as learning opportunities. The most dangerous thing a newly qualified optometrist can do is act with arrogance. On day one, you do not know everything, and that is okay. Be humble. Actively seek advice from your senior colleagues and, most importantly, listen to the feedback you are given. It is offered to help you improve.
Navigating the Real World: Beyond the Consulting Room
One of the biggest shocks for many a newly qualified optometrist is discovering the non-clinical challenges of the job. You will have to navigate tight testing times. You may face pressure from non-clinical managers whose business goals can seem at odds with your clinical duties. These issues are real, and they can be incredibly stressful.
It is so important to know that you are not alone in facing them. The AOP Peer Support Line is an invaluable, confidential resource where you can talk through these exact issues. Often, just verbalising a problem is the first step to solving it.
Remember to build a strong relationship with your practice team. A great team dynamic is your biggest asset when a clinic is running late or you need support with a challenging case. Remember – you can’t do your job without them! Don’t always expect them to be the one to make you a drink or strike up conversation – be sociable where you can and demonstrate you are more than just a cog in the team. Be someone they enjoy working with!
Your ability to balance your role as a healthcare professional with the commercial realities of the business is a skill that will develop with time. Stay honest, stay open, and always advocate for the best possible care for your patients.
A Summary of Advice for the Newly Qualified Optometrist
Your journey as a newly qualified optometrist is one of continuous growth, extending far beyond the university lecture hall. The most profound lessons are learned daily in the test room: embracing the unpredictability of each patient, honing the art of reading between the lines, and navigating the non-clinical pressures of the job.
Be kind to yourself, lean on your practice team and professional support networks, and never lose the curiosity that drove you to this wonderful profession. Your confidence and expertise will grow with every single patient you have the privilege to care for.
If this guide has been helpful, please consider sharing it with your newly qualified colleagues or those approaching their final exams. Supporting each other on this journey is how we all become better clinicians.
Frequently Asked Questions by Newly Qualified Optometrists
What is a realistic testing time for a newly qualified optometrist?
A newly qualified optometrist should aim to be thorough rather than fast. Initially, focus on your routine and accuracy. Speed will come naturally with experience. Many practices offer slightly longer testing times for their newly qualified optometrist colleagues to support this.
Whilst there is no official guidance here, The Eye Care Advocate would suggest no less than 30 minutes per appointment for at least the first year post qualification.
How can a newly qualified optometrist build confidence in their clinical decisions?
Confidence for a newly qualified optometrist comes from repetition and reflection. Review your patient records at the end of the day, discuss interesting cases with senior colleagues, and trust the comprehensive training you have received.
I also strongly recommend signing up to the Ask Fellow Optoms App – this is currently a free app that allows you to ask for advice (either identifiably or anonymously) and has been a great addition to my toolset – even 11 years after qualification. I learn so much from this and it is an absolute must-download for any newly qualified optometrist.
This app is covered in more detail here: Ask Fellow Optoms: Say Goodbye to Clinical Isolation
What are the most common things a newly qualified optometrist might miss?
A newly qualified optometrist might sometimes focus on the primary complaint and overlook subtle peripheral retinal signs or binocular vision anomalies. Developing a robust routine is key to ensuring all bases are covered.
Don’t be afraid to extend your history and symptoms, perform additional tests or dig deeper into the patient records should something provide you a clue to do so!
How should a newly qualified optometrist handle a patient who disagrees with their findings?
A newly qualified optometrist should listen calmly, explain their findings again in simple terms, and use tools like retinal imaging to show the patient what they see.
If the patient remains unconvinced, offering a second opinion from a senior colleague is a professional and reassuring step. Not only reassuring to the patient, but provides further chance to learn and gain experience within your role.
What is the best way for a newly qualified optometrist to manage pressure from non-clinical managers?
A newly qualified optometrist should maintain open and professional communication. Explain your clinical reasoning for decisions and focus on patient safety as a non-negotiable priority. Document any concerns and seek advice from professional bodies if needed.
What are the key red flags a newly qualified optometrist should never ignore in a patient’s history?
A newly qualified optometrist must pay close attention to symptoms like sudden vision loss, new onset flashes and floaters, eye pain, and diplopia. These always warrant thorough investigation.
What resources are available for a newly qualified optometrist seeking peer support?
The AOP Peer Support Line is a fantastic confidential resource. A newly qualified optometrist can also download Ask Fellow Optoms for clinical questions, join online forums and local optical committees to connect with and learn from their peers.
If you would like to reach out to me, my email is jason@theeyecareadvocate.co.uk and I will do my best to support your query.
What should a newly qualified optometrist do if they are unsure about a diagnosis?
A newly qualified optometrist should never be afraid to ask for help. Discuss the case with a senior optometrist in the practice or use apps such as Ask Fellow Optoms for a second opinion if no other optometrists are working in practice. Patient safety must always come first.
In cases where this happens, use these as learning objectives for when you reflect on your days. By building in time to your day to reflect on unusual or challenging cases, you increase your knowledge and confidence.
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