I can't believe how fast the days have gone by...next Tuesday is Part II of my National Boards (NBEO II)! For the past few weeks I've been doing some review, and the last few days I've put my studying on overdrive with some last minute cramming. The content is much more clinically based, with 60 patient cases divided into two 3.5 hour sessions in one day. I hear over and over again that this test is expected to be not as challenging as NBEO I, especially with our school's passing rate historically - over 90-95% over the past several years. Even though it's not supposed to be as hard as Part I, I'm still doing as much studying as I can so I don't have to repay the whopping $625 should I have to retake it! So I'll let you all know how it goes down, keep posted and wish me luck!

Also, Happy Thanksgiving everyone!


Source

Yesterday, I had an 83 year-old Caucasian Female that came in for a glaucoma follow-up. Previously she had a complaint of redness and irritation with her Lumigan (Bimatoprost) glaucoma drops, so she was switched to Travatan-Z (Travoprost). The latter drug was shown to have less redness, which is likely why she was switched (Source: Review of Optometry: The Glaucoma Handbook, Sep 2009). Interestingly enough, she actually felt that Travatan-Z had more redness, so the staff doctor decided to switch her back to Lumigan, which turns out to be better now. The lesson learned here is that even though studies will tend to show that patients should expect to respond a certain way to drugs, there will always be the exception; thus we can't always assume that switching to a drug that has been shown to produce less side effects will act as expected on all patients.

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I can't believe that I'm already past the halfway point through 4th year! I am currently in the beginning of my 3rd out of 4th rotation (each rotation is roughly 10 weeks), which is back at the Eye Care Center (ECC) here at Fullerton. It's been pretty hectic here since there has been a new Electronic Medical Records (EMR) system that has been put in place. The system takes some time to get used to, but most of all I feel much less efficient with time since there are other side things we have to do in addition to recording findings (and that alone can be time consuming in itself). For example, we have to scan anything that is outside of the electronic chart, e.g. health histories, contact lens order forms, glaucoma imaging, etc. It can be a hassle at times especially since I'm used to just finishing up my chart usually by the time the patient leaves. So of course, we won't have time to scan documents while the patient is around so ultimately I have to end up spending extra time after the clinic closes to finish up charts.

On top of this, we have our Part II of our National Boards (NBEO)coming up very soon (December 1st). So by the time we get home from a long day of clinic, we have to study as much as we can. A day spent at the ECC is so tiresome though, with all of the EMR stuff going on and also we are very closely monitored here versus other outreach sites. So once I get home, I don't get much studying done unfortunately. But the good news is that SCCO has historically had a high NBEO Part II pass rate (something like over 90-95%). The content is very clinical and there are many concepts that will be tested that we should be already familiar with. But on the flip side, this board exam has been changed from last year, so I'm hoping that we won't be surprised with anything drastic. The worst thing ever would be to fail this exam because I have underestimated it! The exam has a heavy emphasis on ocular disease, which fortunately I do enjoy so I hope that will play into my favor!