Chapter 89

I figured I would talk a bit more about the clerkships because I think it’s worth mentioning. Furthermore, it’s a continuation of a previous concept/storyline that has been running in the background for a while. 

Just to clarify what’s going on here. In the fourth year of Optometry school, you are in school for 3 terms. During those 3 terms, you will be placed at a clinical site doing what was essentially an unpaid internship for 4 months. 

Not all clinical sites were made equal though and in fact, this was one of the reasons why the internships were only 1 term’s worth of time. To graduate you must show that you were able to practice as an eye doctor in an ocular health clinic, a primary care clinic and the UW Optometry school’s vision specialities clinics. 

Here’s a little bit more information on that:

Ocular Health Clinic

• Usually a rotation at a clinic that specializes in ocular disease
• More times than not, the rotation is at an Ophthalmology clinic and not an Optometry one. This means you are in the clinic of a surgeon or a specialist for eye diseases 

Primary Care Clinic

• This is your run of the mill optometry clinic
• You may find these sites in malls, but usually they are private clinics
• There are standards in place to ensure a safe and worthwhile internship but the auditors for the private primary care clinics sometimes seemingly have questionable decisions

UW Optometry Clinic

• This rotation is at our school but unlike in 2nd or 3rd year, you will be placed in rotation in the speciality clinics and NOT in primary care
• This means you will likely be situated in the school’s Ocular Health clinic for a few weeks, then at Pediatrics for a few weeks, then Low Vision, contact lenses and then a few other ones. 
• Aside from the bother of moving around your clinical room every now and then, it wasn’t a huge deal

The way that our class chose these clinics was a lottery system. Everyone would submit their top choices for each of the rotations and then, we would all be picked at random to choose a spot. If you were going last and all your sites were taken? Well…tough luck. You’d have to trade or swap with someone else…or just take the last pick of a clinical site. 

How most of my classmates and myself, included, chose clinical sites was based on reviews of the sites. For each clinical site, there was a folder that our class had access to that told us the location, demographics, specialty equipment, hours and past student reviews. With this information, we’d all then decide where we’d want to go. 

Despite all that information, most of us chose the clinics on location. I mean, we were all on our own for the most part and therefore, responsible for our own lodging. In this regard, location was very important because it could be the difference between paying $300 for rent and paying thousands. It also sometimes was the difference between needing a VISA or not since we had a few rotations in the US. 

For myself, I had the very good fortune of snagging TWO Toronto clinics. This essentially meant that all the terms I could be in Toronto, I was in Toronto. Furthermore, the only term I wasn’t in Toronto was in Waterloo, which was still just about an hour away. This was great because it meant for two terms, I could stay home and pay no rent. Despite the good fortune of this, I had actually not intended to stay in Toronto at all. In fact, I actually had a priority of a very particular placement. 

One of my terms was a mixed term. There was an opportunity to do a 2 month internship with a clinic in Hong Kong that is affiliated with our school and the minute I heard about this opportunity in third year, I decided then that I would prioritize my entire clerkships in fourth year around it. 

I had always wanted to live in a different city to study. Being an international student simply sounded too fun to pass on. This was that opportunity. And it was fleeting too since it came in my last year of schooling. The fact that this was in Hong Kong, a place I had always been curious about, was just the cherry on top. Sure, I had traveled around in my optometry career in the past doing humanitarian missions and yes, that was fun. But it was always just for a few days and never in an Asian country. This time, I would be there for an entire two months. 

We’ll get into that later on but for now, let’s get back to the clerkship rotations that I wasn’t a part of. I mentioned that although the dissatisfaction for clerkship was a minority of our class, it was still a large enough minority that it was a big enough deal that made everyone just a little more annoyed at the school’s audits of clerkship sites.

Some of my fellow classmates found themselves in situations where the clinics they were assigned to treated them like crap. Or worse…

A few had supervisors who were inappropriate, others had supervisors who were seemingly practicing illegal means and other times, my classmates essentially worked as free lab technicians and got to see no patients at all. 

For the record, these horror stories were a minority of my classmates. However, it wasn’t a small minority. The amount of clinics that didn’t have the intern’s best interest at heart seemed to be just enough that it was felt by everyone on some level. And with that, the seeds of discourse that were planted previously from curriculum changes across the school would grow. The students were getting more and more fed up with the school’s handling of their education.

Similar to how messy our school was with the whole curriculum change fiasco, they were just as messy with our clerkships. All of those horror stories were usually only possible because the auditors either didn’t do their job, or hadn’t done their job well enough. It was hard to pinpoint exactly what went wrong with the clerkship selection sites and auditing but here’s a few common complaints you’ll hear around the school.

“The auditor’s page was false advertising. The clerkship site was nothing like it was described on the summary page”

Pretty self explanatory here. Some clerkship sites were new and whenever that happened, the students only got the review and description of the auditors of the site to go off of. It seems quite often, the site descriptions were very different from the actual sites.

“The student reviews were horrible for this place, why is this clinic still available as a site?”

This was probably the most frustrating complaint. Some sites had horrible reviews and yet, were not taken off the list. The problem with this? There are often only a limited number of clinical sites to choose from and if you don’t take away the bad ones, it’s not a lot of incentive for the school to look for new sites. Occasionally, some clinical sites may become unavailable too, due to extreme weathers, Visa issues or otherwise, and that meant that someone may have to knowingly go to a bad clerkship site just to get their clinical hours in. 

“The school keeps rejecting my proposal for a new clinical site”

While the last complaint was frustrating, this one seems to be worse. The fix to the last issue seems simple. Just find more clinics and add in more clinical sites. However, we rarely see a new site come up. 

This is extra frustrating when you consider the fact that most optometry students have ties with optometry clinics. Sometimes optometry students even go into school with the express intention of working for an optometry clinic they know. If the school needs more clinical sites and their student population has knowledge of these sites, why not put two and two together and make it work?

To the school’s credit, they did tell us about asking clinics we knew to apply for a clerkship site. However, the problem was that they told us this in fourth year when they introduced the site rotations processes to us. And since you need at least a few months for the registration process to complete, it seems like a good idea coming at a bad time. 

While this was bad, it wasn’t that bad. On some level, I think despite everything, our class knew that the job of accounting for 90 students and their individual 3 clinical sites wasn’t going to be easy. This was a very difficult job and despite some questionable choices in auditing, we figured that maybe they were just doing the best they could with what they had. Maybe the sites had specific requirements that only a few clinics could meet or maybe the clinics we thought would be perfect sites have issues that we didn’t know about. Regardless, while we were all just a little annoyed with the clinical outreach of our school, we gave it a pass. 

(But stay tuned, our patience isn’t limitless…)

Now, as I mentioned, I was having a blast on the internships. It was enjoyable. Having nothing to do with classes or lectures and cramming and simply just having to deal with patient’s issues with their eyes and applying my skills to diagnose was where my comfort lay. 

Very quickly, I found a good balance for me. I was really happy with my setup. There was an equilibrium for study and work. It balanced out very easily and it let me be very positive mentally almost everyday. This was just the kind of thing I needed to get over all the internal demons I was still working out. 

This was also probably aided by the fact that I wasn’t cramming for any board exams at all since I had decided to take a break after school ended first before all that. Therefore, unlike my fellow colleagues who were at their respective clinical internships and cramming every night they weren’t working, I was just showing up to work and then going home to chill.

As I kept working as an intern with great mentors and a nicely balanced lifestyle, I got more accustomed to the battle I was having with my inner demons. I had worked out some things on my mental side of things. The biggest indication that I was doing better? I was starting to feel more grateful for things again. Instead of looking at things I don’t have, I looked at the things I did. In this particular time, I was focused on how my internships were going so smoothly. It gave me perspective. Sure, I’ve had academic setbacks in the recent past but career wise, it didn’t seem so horrible when you consider that some of my classmates may have been cheated out of an internship due to administration issues. 

I won’t go too much into detail about my particular clinical rotation sites despite all the positive feedback I’m inputting here because, to be honest, later on in the story there would be a bit of a scuffle with my supervisors (not with me). Just to add an extra layer of anonymity to everyone so as to not accidentally throw shade anywhere. I’ll just limit the information about the clinics I attended to the fact that they were both in Toronto. I don’t think that’s taking too much away from the story either since this chapter of my life is more about the mental game anyhow. 

My soul searching had almost come to an end. I felt it. There had been enough time and I was now in a mentally healthy enough spot in my life that I could move on and at the very least, get up in the morning. With so much positivity and stability, in the blink of an eye, time flew past me. Before I knew it, it was over. And next up? It was time for my Hong Kong internship. 

This one I don’t mind sharing about. First of all, it’s out of the country. Secondly, it is not a private incident either. In fact, it’ll be my brush with an international incident (not directly). 

That’s right. Let’s talk about Hong Kong.

Specifically. 

Hong Kong in 2019.