Chapter 106

Right after graduation, I saw pictures of my classmates traveling around. Some were able to secure jobs working as a “delegate”, which basically meant that they would work as optometrists under someone else’s license before they could get their own. While this setup seemed a bit fragile… It was pretty common. Most optometrists in Canada all come from Waterloo so there was a lot of trust between our profession as a group. Furthermore, this allowed the main licensed optometrists to secure a hire for when my classmate did get their license. 

In Canada, there are more optometrist jobs than there are optometrists. Therefore, finding a hire was pretty important. This fact and the fact that all licensed optometrists are, by law, equipped with malpractice insurance for their individual clientele meant that hiring optometrists was also low risk. Because of that, most of the time we’d get hired based on our availability more than anything else. Personally, I had always been given job offers before the employer saw my resume. 

Now, as I mentioned, delegates did exist but I’m not entirely sure it was the norm. If I had to guess, I’d say around 40% of our class decided to do this just so they could start earning money right away. The others? They just took some time off. Sure there were restrictions in place due to COVID but you can still travel around via car or fly domestically within our borders. 

Speaking of flying. There was one last thing on the agenda before I started my next term with CNIB (Canadian National Institute for the Blind) and Low Vision. I had to drop off NA. While I moved back to Toronto when the classes were somewhat cancelled, NA stayed behind. He was from Alberta so flying home while we waited for our school’s wishy-washy indecisions was slightly too much risk. This meant that towards the end of the term, NA was still back at our student residence. Since I, too, needed to move out the final bits of my stuff at the end of our lease, I drove up to Waterloo and decided to help NA move out when the time came. 

This, as it turns out, would become a pretty popular trend in the upcoming years. NA and I would share a variety of conversations en route to the airport. During this trip, we talked about what we were going to do while waiting for the OSCE’s. He knew my plans, I had a term of clinic to do. For him, he was going to do the whole delegation thing. While we drove, we also talked about all cursed events that we suffered through as members of the class of 2020. What a ride it has been. 

After that was out of the way, it was now time for my new and last clinical rotation. The clinical rotation was pretty straight forward. For those who don’t know what Low Vision is, think of it like palliative care for eyes. That is to say, it was a clinic that saw the end stage of diseases. As in diseases that can’t be reversed and have no cure. The duty of the clinic was to optimize what little vision was left in the patients. There were special glasses for contrast, telescopes and even machines that trained eccentric fixation. All tools which were available at both the location downtown and at the CNIB. While CNIB has the word “blind” in it, a lot of people don’t know that blindness is categorized in a lot of different ways. This is often why there are people on the subway holding walking canes while still owning cell phones that they view. Sometimes blindness just refers to restricted peripheral fields with normal central vision. 

I still did some normal exams at my time with CNIB and the Low Vision affiliate but to be honest, since I was mainly focused on end stage diseases, oftentimes there wasn’t that much to do for the patients. The highlights from working here versus all the clinics I worked at in the past was mainly just how many diseases I got to see and what we implemented to optimize their vision. Well, that and all the COVID protocols which were very recently implemented which mainly just involved extra sanitary processes and wearing a mask whenever I was at either one of the clinics. 

During this period of time, there was kind of only one thing that was on my mind. It was a question of if I should do my board exams this year or not. At some point during the term, my class got wind that the OSCE’s originally set for April – May or so, was now going to be pushed back to around September. This meant that the new OSCE date was going to be just a few weeks after the 2021’s written portion of the licensing exams. So, if I played my cards right, this meant that there was a chance I could get licensed with the rest of my classmates at the same time despite all the setbacks I had. All I had to do was write the written portion of my license exam with the class of 2021, then do the OSCE’s with the class of 2020. 

My rotation at the current clinics was a period of June – October. While, technically, it should’ve only been around 4 months, unfortunately, due to COVID protocols, I had to extend my time there a bit. This was mainly because on some weeks, I could only work around 4 days at the clinic in the Low Vision clinic due to reduced operating hours. As far as the timelines went, this meant that should I decide to try and enter practice at the same time as the rest of my class, I would be writing the written license examination and the OSCEs while I was still on my rotation. 

I didn’t like this setup. Not only had I wanted a break after finishing all my clerkships, but studying for 2 major license exams at the same time during my current clerkship was rather stressful. However, even with that in mind, getting the Canadian licensing exam out of the way was a rather tempting offer. This was especially true when you consider how nobody was sure when the next written exam nor OSCEs were going to be held. This was the height of COVID. There were a lot of uncertainties. 

In the end, I decided to go through with it. It’s just too risky to await to see how COVID shapes the next year. However, right after I registered, I quickly discovered why I had wanted to take a break after graduating from Waterloo. 

Right after I got enrolled into the OEBC, I found myself busy as hell everyday. Though the OEBC exams were supposed to be easy, having around only 3 – 4 months to study for both the written licensing exam as well as prepare for the OSCE practical examination was kind of a tough order when I was still working 4 -5 days a week. I honestly didn’t have that much time on my hands between working, my commute downtown and finding parking downtown despite reduced traffic from COVID.

But even then, that wasn’t the main issue I was dealing with. The main issue, as it’s become abundantly clear, was apathy. I was not only burnt out from work, I was burnt out of motivation. While a strong argument could be made that I kind of just got lazy, I do want to still say my piece about this because to be honest, I think it’s worth talking about. Be warned though, I’m about to get a little political.

Up to the point when my registration for the Canadian licensing exam was complete, I never really thought about how the syllabus may look. Since I had thought about the American NBEO a lot in the past, I had looked over that syllabus and I assumed that I would find something similar on the Canadian one. But it was not similar at all. When I saw, for the first time, the Canadian syllabus, I felt the last of my motivation go. 

I think this feeling has been building for a while. I think I best describe it as “if the system is so flawed and lazy, why am I trying so hard?”. I had this feeling with the Waterloo coordinators in Hong Kong and then with the school faculty during COVID. The final straw for me, it seems, was seeing this play out again with the licensing committee. I know it can feel like an excuse and believe me, we’ll be getting into that soon, but during the time, this was how I felt about the entire ordeal. Looking back, my journals during this time were constantly filled with a simple message: I don’t feel motivated to do my part because the regulatory bodies responsible for me don’t seem to care about their part.

Are you still unclear as to how I can feel like that by looking at a test’s outline and syllabus? Let me just give you an example of what I mean.

If you look at the American NBEO’s website with regards to their written exam’s content, you’ll find various sections describing their part 1 and part 2 exams in clear detail. There are entire pages with sections detailing what topics will be covered, a list of drugs you may expect to see on the exam and even an outline breaking down every type of question you may expect. If that wasn’t impressive enough, the topics themselves are also further clarified into relating to anatomy, biochemistry, physiology and pharmacology too. The content overview of the test is ridiculously overwhelming but the information is there. If you went through all of it, you’d be prepared for it. 

On the Canadian OEBC side of things, the study guide online begins with a history lesson of how the OEBC came to be and how it came to be founded. Scroll a bit further and you’ll come to find a section called the written exam “blueprint”. In this blueprint, you are given a brief summary of everything you can expect from the Canadian board exam such as “patient centered care”, “assessment”, “diagnosis and planning” and “scholarship”. 

Now, I’m not sure about you but for me, it feels like a matrix with a link telling me every single topic that may be covered on the exam is just a bit more detailed than a table on a PDF that says “scholarship” as something you can be tested on. What does scholarship even mean on a written multiple choice exam? 

Need more convincing? Let’s do a simple test regarding a topic that’s very important for the eyes. The Retina. On the American NBEO site, aside from just listing all aspects of the retina you need to learn about, you are also given an example of a sample question related to each section. There’s a sample question for biochemistry, physiology and even pharmacology. On the Canadian site? The word retina isn’t even mentioned. 

At this stage, I was done. I felt like the Canadian optometry system, while it did have good intentions, was bloated to the brim with inefficient and ineffective administration. I was okay with a little bit of tugging around but seriously? This much red tape in EVERYTHING? What the hell was wrong with us? Furthermore, why did the Canadian licensing exam, in all of its lazy organization and consisting of only two parts, cost $4,500 CAD total when the American NBEO was just around $3,500 CAD for all three parts? 

(**These numbers were pulled from my bank statement in 2020 when the cost of NBEO was $850 USD for each section**).

In my mind, I was very conflicted. I wanted to help patients see and I loved the job but the administration side of my chosen profession in Canada was absolute hell. I hated every part of it from stemming our school, into our regulatory body, and extending towards the licensing board. I felt like there were too many people in high positions of administration who didn’t do their jobs well and yet held too much power to be taken down. The profession was great, the regulation was trash. This hate at times was even enough to make me wonder if I chose the right profession to go into. 

When you hate the system so much, it becomes increasingly hard to try and abide by it. In the case of the system being the licensing board of Canadian optometry, it was getting harder and harder to study for a test designed by these people. To keep going forward, I became more and more apathetic to the entire ordeal. I simply couldn’t bring myself to care anymore about the test nor the OSCE’s. 

I feel like the real reason I needed a break after graduation was that I needed a break from the administrative side of things. I was progressively hating my profession more and more because of the bureaucratic side and I needed time away from that. I found myself drained dry of any desire to abide by regulations made by the parties in power. I know we need regulation but how are things this messy? 

A few nights before the written examination was to happen I came to realize that I studied very ineffectively. Hundreds of diagrams, charts and tables were written in my notebooks and yet, I felt like I remembered none of them. I had unconsciously or consciously quit trying at some point. With this level of indifference, you can kind of predict what happened in the next few weeks as the written licensing exam and the OSCE’s finally took place. I performed horribly. But a part of me also didn’t really care anymore. In fact, after I completed all the tests, the only thing on my mind was that I wanted to go back to the clinic the next day to remind myself of the part of the job I actually liked doing. Which is the actual job.

I enjoyed my time in the Low Vision clinic and at the CNIB thoroughly, it reminded me about how optometry really was. It was meant to be helping people. Not about following rules or regulations that, while mandatory, were managed incredibly poorly. I tried to remind myself of this sentiment as I finished my last few weeks of the term.

When the term finally ended, I felt grateful for my time spent. This was in stark contrast to when I got the email from my school congratulating me for passing. For that email I bared batted an eye. Even when my Doctor of Optometry Diploma came in the mail, I looked at it with indifference. It just reminded me of the sour management I had to survive in order to get here. 

But the thing is… I still needed to complete and pass my licensing exams to work. So while I was indifferent about it all up to now, right after I was done with my clinical rotation, I felt this surge of anxiety. 

“Wait a minute, was I asleep the entire time until now? Why did I half *ss the licensing test studies? Why didn’t I try harder? I need to pass the tests to work. WTF”

With that surge of emotional distress, I was suddenly wide awake to the realization of just how the past few weeks played out. Amidst all my apathy, the exams and tests were important and I had not treated them with the priority they deserved. I cared too little too late. 

f**k

It really was too late now.