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

 

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, O.D., F.A.A.O.

Attendings:

• Chief of Optometry: Andrea Yiasemis, O.D., F.A.A.O.
• Assistant Chief of Optometry: Pauline F. Ilsen, O.D., F.A.A.O.
• Chief of Low Vision Services: Shawn Yu, O.D., F.A.A.O.
• Julie Chao, O.D.

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.

Program Description

Program Goals, Objectives, and Outcome Measures for Residents

 

GOAL 1:  To develop the residents’ skills in providing primary and secondary eye care 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 and Community Living Centers (“CLCs”—nursing homes).

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. 12 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 each specialty clinic will be generated from the facility’s computerized patient record system by the program coordinator on a quarterly basis

3. Outcome:  The resident will review and order laboratory and/or radiological/imaging studies or obtain fluorescein angiography consent as indicated for diagnosis and management.  At least 5 orders for labs and/or imaging or FA consent 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 radiology/imaging study orders placed by the resident on a quarterly basis.

4. Outcome:  The Resident’s proficiency in advanced procedures will be monitored and documented by supervising faculty

Measure:  direct observation by attendings; documentation in the Orientation checklist, quarterly patient care encounter report, and quarterly resident evaluation.

B. Objective:  to gain experience in 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 may be discussed at weekly QA Case Reviews. Information technology (IT) personnel will report on the number of formal electronic consultations sent to other clinics on a quarterly basis.  Patient care notes written in response to formal consult requests from other disciplines will be reported on a quarterly basis.

2. Outcome:  The resident will participate in interdisciplinary team meetings at CLC 215 (nursing home), and CLC 213 (nursing home) with requirements as follows:  at least 50 patient reviews/reports, to be documented as team meeting notes in the patients’ medical record.

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.

3. Outcome:  the resident will visit/observe the GRECC/AGT inpatient team at the start of the academic year; thereafter they will go on an as-needed basis at the request of the GRECC/AGT to visit patients at bedside; answer questions from the team about vision, eye care, and the impact of severe visual acuity or visual field deficits on activities of daily living; and to coordinate patient care.

Measure:  the program coordinator will discuss their participation at GRECC with the residents.  The residents will record visits to GRECC in the resident activity log

C. 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 Assistant Dean of Residencies 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 the quarterly patient care report.

 

GOAL 2:  To provide the opportunity for residents to work with other medical professionals and foster their growth as members of an interdisciplinary health care team

A.Objective:  to gain experience in 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 may be discussed at weekly QA Case Reviews. Information technology (IT) personnel will report on the number of formal electronic consultations sent to other clinics on a quarterly basis.  Patient care notes written in response to formal consult requests from other disciplines will be reported on a quarterly basis.

2. Outcome:  The resident will participate in interdisciplinary team meetings at CLC 215 (nursing home), and CLC 213 (nursing home) with requirements as follows:  at least 50 patient reviews/reports, to be documented as team meeting notes in the patients’ medical record.

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.

3. Outcome:  the resident will visit/observe the GRECC/AGT inpatient team at the start of the academic year; thereafter they will go on an as-needed basis at the request of the GRECC/AGT to visit patients at bedside; answer questions from the team about vision, eye care, and the impact of severe visual acuity or visual field deficits on activities of daily living; and to coordinate patient care.

Measures:  the program coordinator will discuss their participation at GRECC with the residents.  The residents will record visits to GRECC in the resident activity log

B. Objective: To serve as the optometric liaison at GRECC, CLCs, and with other healthcare providers at the West Los Angeles VA .

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 may be discussed at weekly QA Case Reviews. Information technology (IT) personnel will report on the number of formal electronic consultations sent to other clinics on a quarterly basis.  Patient care notes written in response to formal consult requests from other disciplines will be reported on a quarterly basis.

2. Outcome:  The resident will participate in interdisciplinary team meetings at CLC 215 (nursing home), and CLC 213 (nursing home) with requirements as follows:  at least 50 patient reviews/reports, to be documented as team meeting notes in the patients’ medical record.

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.

3. Outcome:  the resident will visit/observe the GRECC/AGT inpatient team at the start of the academic year; thereafter they will go on an as-needed basis at the request of the GRECC/AGT to visit patients at bedside; answer questions from the team about vision, eye care, and the impact of severe visual acuity or visual field deficits on activities of daily living; and to coordinate patient care.

Measures:  the program coordinator will discuss their participation at GRECC with the residents.  The residents will record visits to GRECC in the resident activity log

                     

GOAL 3:  To enhance the residents’ knowledge base through participation in didactic activities

A.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

Measures:  attendance will be documented by sign in on a sign-in sheet or via ZOOM.  Transcript-quality continuing education attended elsewhere may be counted in lieu of Seminars hours if documentation of attendance is provided.  The residents will report attendance at Seminars in their quarterly resident activity log.

2. 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

3. Outcome:  The Resident will attend and participate in weekly Optometry Case Presentations, eRounds, Quality Assurance Case Reviews; Low Vision Lessons; weekly Journal Club meetings; and weekly quizzes.  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 for Outcomes 1-3:  Attendance at meetings will be reflected in the resident’s quarterly activity report.  The 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 Program Coordinator will keep a list of reading assignments for Journal Club to be submitted on a quarterly basis.

B. Objective:  to attend and participate in interdisciplinary didactic and clinical education.  A minimum combined total of 20 interdisciplinary didactic activities is required for the year.

1. Outcome:  The resident will attend the Fluorescein Angiography Conferences when available

2. Outcome:  The resident will attend GRECC outpatient didactic when available

3. Outcome:  The resident will attend the medical resident conferences (available daily)

4. Outcome:  The resident will attend the Head & Neck Surgery Tumor Board conferences (available weekly)

Measure for Outcomes 1-4: the resident will document attendance at interdisciplinary didactic activities in the quarterly resident activity report.

 

GOAL 4:  To provide residents with clinical precepting opportunities

A. Objective:  to develop clinical teaching skills.

1. Outcome:  The resident will participate in a Clinical Precepting workshop

Measures:  the program coordinator will conduct the workshop and directly observe proficiency; completion of the workshop will be noted in the orientation 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 20 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.

 

GOAL 5:  To afford residents the opportunity to disseminate their knowledge through scholarly activities

A. Objective:  to develop didactic teaching skills.

1. Outcome:  Each 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; the program coordinator will maintain a record of trainee presentations for each quarter.

2. Outcome:  The resident will present at least one case or topic of interest at Optometry Clinical Seminars

Measure:  Direct observation by attendings; the resident will document in the quarterly resident activity report when they present lectures.  The Program Coordinator will maintain a record of trainee presentations for each quarter

3. Outcome:  When invited, the resident will present an in-service to nursing staff and/or medical trainees

Measure: the resident will document in the quarterly resident activity report when they present lectures

4. Outcome: when invited, the resident will make a presentation at the annual SCCO Residency Forum.  This activity may be credited toward the Clinical Seminars presentation requirement.

Measure:  The resident will document in the quarterly resident activity report when they present a lecture at the annual SCCO Residency Forum; documentation will also be made via emails with SCCO administrative staff.

B. 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:  Residents must obtain documentation of participation, such as a printout of continuing education hours.

2. Outcome:  The Resident will read a minimum of 10 journal articles per quarter.                                                 

Measure:  The program coordinator will maintain a log of journal club reading assignments and submit a quarterly report to SCCO.

3. Outcome:  the Resident will participate in the SCCO Library’s circulation lists for journals (optional, highly recommended)

Measure: direct observation/inquiry by Program Coordinator

4. Outcome:  The Resident will research literature on various topics as discussed through 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; the program coordinator will maintain a log of journal club reading assignments and submit a quarterly report to SCCO.

5. Outcome:  When invited, the resident will participate in the annual SCCO Journal Club meeting.  This activity may be credited toward the lecture presentation requirement

Measure:  The resident will document participation in the quarterly resident activity report; email correspondence will also serve as documentation. 

Typical Daily or Weekly Schedule in Clinic

ATTENDING & RESIDENT SCHEDULE 2024-2025

RESIDENT	MONDAY	TUESDAY	WEDNESDAY	THURSDAY	FRIDAY
ONE x41509	CLC 8-11AM	304 (GRECC OP) MED RES CONF	304 (H&NS)	304	304
	304 (CLC IDT)	304 (CLC IDT)	ADMIN	SEMINAR	304
TWO x42956	304 MED RES CONF	304 (GRECC OP)	304 (H&NS)	304	CLC 8-11AM
	304 (CLC IDT)	304 (CLC IDT)	304	SEMINAR	ADMIN
THREE x44517	304	304 (GRECC OP)	CLC 8-11AM (H&NS)	304	304   MED RES CONF
	ADMIN (CLC IDT)	304 (CLC IDT)	304	SEMINAR	304
FOUR x42355	304	ADMIN (GRECC OP)	304 (H&NS) MED RES CONF	CLC 8-11AM	304
	304 (CLC IDTs)	304 (CLC IDTs)	304	SEMINAR	304
FIVE x44475	304	304 (GRECC OP)	304 (H&NS)	CLC 8-11AM	304   MED RES CONF
	304   (CLC IDT)	304   (CLC IDT)	ADMIN	SEMINAR	304
SIX x40252	304	304   (GRECC OP)	304 (H&NS)	304   GRECC 9-11	ADMIN   MED RES CONF
	304 (CLC IDTs)	CLC (CLC IDTs)	304	SEMINAR	304
DR YIASEMIS x53332 (EARLY)	PRECEPT	PRECEPT	ADMIN TIME	PRECEPT	PRECEPT
	PRECEPT	PRECEPT	PRECEPT	OPTOMETRY SEMINARS	PRECEPT
DR ILSEN x42356 (EARLY)	PRECEPT	PRECEPT	PRECEPT	PRECEPT	PRECEPT
	PRECEPT	PRECEPT	ADMIN TIME	OPTOMETRY SEMINARS	PRECEPT
DR YU x48726 (LATE)	PRECEPT	PRECEPT		PRECEPT
	PRECEPT	PRECEPT
DR CHAO x48726 (LATE)			PRECEPT	PRECEPT	PRECEPT
			PRECEPT		PRECEPT
ALL OPTO TRAINEES	TRAINEE PRESENTATIONS 8-8:15	Landmarks & Standards of Care (Dr. Yiasemis) 8:00-8:15AM JOURNAL CLUB ALTERNATE WITH LOW VISION LESSONS 4:00-4:30 RM2-118	eROUNDS 8:00-8:15	Disease QUIZ  AM   OPTO SEMINARS 1-4PM
RESIDENTS	PRECEPT PRN SURG RES LUNCH 12-12:45 RM 6659	PRECEPT PRN SURG RES LUNCH 12-12:45 RM 6659	H&NS PRECEPT PRN SURG RES LUNCH 12-12:45 RM 6659	FA/OCT CONF 7:30-8:00 rm 2-121 PRECEPT PRN SURG RES LUNCH 12-12:45 RM 6659	QA CASE REVIEWS 8-8:30 PRECEPT PRN SURG RES LUNCH 12-12:45 RM 6659

304 = OPT, VFS, LV, TCL

GRECC/AGT:  INITIAL VISIT AT START OF YEAR THEN PRN.

GRECC OUTPATIENT TUESDAY AM 8-9AM Rm4639A/B 4West; Residents to rotate taking turns participating when available.

FA/OCT CONFERENCE THURS AM  (SPORADIC)  Bldg. 304 Rm 2-121

IDT CLC 213-2 MON PMs  Room 105, Bldg. 213/TEAMS, residents to rotate taking turns participating

IDT CLC 215-2 TUESDAY PMs Room 113, bldg. 215/TEAMS, Residents to rotate taking turns participating

IDT CLC 215-3 THURS PMs (REPORTS ONLY); residents to rotate submitting reports

Medical residents’ conference bldg. 500 Rm 3232 12-1PM; residents to attend weekly on their assigned day

H&NS:  Head & Neck Surgery Tumor Board meets weekly 9:00-10:00 Weds AMs, residents to rotate taking turns participating, Room  0413B or ZOOM (link to be emailed)

Surgical Residents’ lunch:  available daily, may be discontinued without notice

*Additional residency positions may be added by VA Central Office

Additional residency positions at West LA VA

In addition to our 4 permanent positions, VA Central Office may transfer 1-2 unfilled positions from other programs in the VA system to West LA.  If this transfer occurs before the ORMatch deadline, the additional position will be included in the match.  If the transfer is made after the match, only candidates who have not already committed themselves to other residency programs will be considered.   This includes those who were matched with other programs through ORMatch and those who have accepted positions with other programs after the match. 

Official clinic hours for patient care:  8:00AM to 4:30PM; there are no “on-call” responsibilities.

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. Time spent completing forms for our Human Resources department and in pre-employment preparatory activities in March-June is acceptable to meet the 365+ day requirement for health insurance.  The program starts on July 1 and ends on June 30 of the following year.

*Description of Curriculum 

Advanced competencies

The residency emphasizes advanced competency in the following areas:

Complex ophthalmic and systemic disease

Systemic imaging and laboratory testing

Low vision, TBI

Therapeutic contact lenses

Bedside/Wheelchair patient care

Clinical precepting of optometry students

Interdisciplinary team care and communication

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 3 hours (1:00 PM-4:00 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.

Disease Quizzes

All trainees take a quiz on various topics in ocular and systemic disease on Thursday morning.  Residents are  required to participate. the quiz scores are not counted toward residency certification.

eRounds

INTERDISCIPLINARY DIDACTICS

Medical Residents’ Conference

The Medical Residents’ Conference is conducted on a daily basis from noon to 1:00PM.  It is open to all trainees.  Optometry residents are each assigned to attend the medical residents’ conference once a week, but they are welcome to attend additional days when there is an opportunity and interest.

Topics recently covered include:

• Compliance with HIV and HTN medication
• 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
• Blood transfusions

Retina Clinic Fluorescein Angiography/OCT Conference

The Retina Service conducts a conference on many Thursday mornings starting around 7:30-7:45 to about 8:00AM (intermittent) where the imaging from recent cases is interpreted, discussed, and a management plan is formulated.  All optometry residents are welcome to attend each week.

Head & Neck Surgery Conference

The Head & Neck Surgery service conducts a weekly conference on Wednesday mornings to review their interesting cases.  Optometry residents are assigned to attend on a rotating basis.

GRECC Outpatient meeting

The geriatric team conducts a weekly didactic lecture on Tuesday mornings covering different topics in the area of geriatric medicine.  Optometry residents are assigned to attend on a rotating basis, when available.

Supervision & Case Reviews/Quality Assurance

West LA Optometry has four 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.   Dr. Julie Chao is an Attending Optometrist

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
• Low Vision exam lane
• Three Humphrey HFA3 perimeters, Zeiss FDT, Goldmann perimeter)
• Table-mounted A/B ultrasound unit
• IOLMaster
• Optos California P200Dtx widefield photography and autofluorescence
• Pentacam corneal topographer
• Heidelberg Spectralis OCT (2 units, one with OCTA capacity)
• Zeiss Cirrus 5000 HD-OCT (1 unit)
• Konan corneal microscope camera (for endothelial cell count and pachymetry)
• Oculus PARK1 autopachymeter/autorefractor/autokeratometer (2 units)
• Nidek ARK-1S autorefractor (1)
• Humphreys autolensometers (2)
• Zeiss Visulens 550 autolensometer (1)
• Hand-held slit lamp, autorefractor
• iCare, Tonopen, Perkins hand-held tonometers
• Hillrom automated sphygmomanometer/pulse oximeter/thermometer
• Optical Dispensary
• Optometry Residents have an office in the Administrative area of the clinic

​Support Staff

The eye clinic has a variable number of eye technicians, typically 5-6, who primarily provide support to ophthalmology.  There is usually one technician assigned to optical dispensing and 1-2 assigned to maintain optometry’s exam room supplies.  Residents perform some dispensing (mainly for patients at the nursing homes).  Technicians are available to provide “as needed” assistance to troubleshoot problems with instruments and replenish supplies.

The Eyecare Center usually has 3-5 clerks for scheduling and related tasks.

Occasionally, we have "volunteers" for various minor supportive activities; the number of volunteers varies, as we may get students from UCLA, the American College of Optics, and others who volunteer for limited periods of time. 

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)

Orientation & Mobility specialists

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) (initial visit and observation, then as needed)

Medical Resident Conference

Retina Clinic (Fluorescein Angiography/OCT Conference)

Head & Neck Surgery 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.  There are three on-campus nursing homes.  We provide bedside care and participate in interdisciplinary team meetings at two of the nursing homes.  We provide in-clinic patient care to those who live at the third on-campus nursing home, most of whom have cognitive impairment (dementia).  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 activities at 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

• Residents participate in a precepting workshop/discussion at the start of the year.  After the workshop, residents will have some student precepting encounters that are closely guided by an attending.  Thereafter, residents may precept students for established patients and check in with an attending regarding the case.  Residents usually do not start precepting optometry students until they have been in the program for several weeks (typically start in the 3rd month of the year).  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
• 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 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
• 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 2024

List of WLAVA Resident Poster/Paper Presentation 1993-2023

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 2024-2025, the optometry resident is paid an annual stipend of $51,498.  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, Juneteenth, 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:  materials 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.

Additional residency positions at West LA VA

In addition to our 4 permanent positions, VA Central Office may transfer 1-2 unfilled positions from other programs in the VA system to West LA.  If this transfer occurs before the ORMatch deadline, the additional position will be included in the match.  If the transfer is made after the match, only candidates who have not already committed themselves to other residency programs will be considered.   This includes those who were matched with other programs through ORMatch and those who have accepted positions with other programs after the match. 

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 obtain optometric licensure (in any state) by the end of the academic year on June 30 to receive their residency certificate.  The VA’s Office of Academic Affiliations will not grant a training extension beyond the academic year.
7. The resident must complete all of the program requirements enumerated as Outcome Measures of the goals and objectives for the program as follows:

   • Each resident will see at minimum 1000 patient encounters at Optometry Clinic and Community Living Centers (“CLCs”—nursing homes).

     Each resident will see at minimum

               12 Therapeutic Contact Lens Clinic patient encounters

               12 Vision Rehabilitation/Low Vision Clinic patient encounters

     The resident will review and order laboratory and/or radiological/imaging studies or obtain fluorescein angiography consent as indicated for diagnosis and management.  At least 5 orders for labs and/or imaging or FA consent will be placed by the resident by the end of the residency year. 

     The Resident’s proficiency in advanced procedures will be monitored and documented by supervising faculty

     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.  

     The resident will participate in interdisciplinary team meetings at CLC 215 (nursing home), and CLC 213 (nursing home) with requirements as follows:  at least 50 patient reviews/reports, to be documented as team meeting notes in the patients’ medical record.

     The resident will visit/observe the GRECC/AGT inpatient team at the start of the academic year; thereafter they will go on an as-needed basis at the request of the GRECC/AGT to visit patients at bedside; answer questions from the team about vision, eye care, and the impact of severe visual acuity or visual field deficits on activities of daily living; and to coordinate patient care.

     The Resident will submit a quarterly activity report to the Residency Program coordinator and SCCO Assistant Dean of Residencies reflecting the resident’s activities toward accomplishing the program’s stated objectives.

     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. 

     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.  

     The resident will participate in interdisciplinary team meetings at CLC 215 (nursing home), and CLC 213 (nursing home) with requirements as follows:  at least 50 patient reviews/reports, to be documented as team meeting notes in the patients’ medical record.

     The resident will visit/observe the GRECC/AGT inpatient team at the start of the academic year; thereafter they will go on an as-needed basis at the request of the GRECC/AGT to visit patients at bedside; answer questions from the team about vision, eye care, and the impact of severe visual acuity or visual field deficits on activities of daily living; and to coordinate patient care.

     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.  

     The resident will participate in interdisciplinary team meetings at CLC 215 (nursing home), and CLC 213 (nursing home) with requirements as follows:  at least 50 patient reviews/reports, to be documented as team meeting notes in the patients’ medical record.

     The resident will visit/observe the GRECC/AGT inpatient team at the start of the academic year; thereafter they will go on an as-needed basis at the request of the GRECC/AGT to visit patients at bedside; answer questions from the team about vision, eye care, and the impact of severe visual acuity or visual field deficits on activities of daily living; and to coordinate patient care.           

     The resident will attend/participate in the Optometry Clinical Seminars Education Program, completing at least 80% of the program hours

     The Resident will respond to questions posed by Attendings regarding optometric primary care.

     The Resident will attend and participate in weekly Optometry Case Presentations, eRounds, Quality Assurance Case Reviews; Low Vision Lessons; weekly Journal Club meetings; and weekly quizzes.  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

     A minimum combined total of 20 interdisciplinary didactic activities is required for the year:

     The resident will attend the Fluorescein Angiography Conferences when available

     The resident will attend GRECC outpatient didactic when available

     The resident will attend the medical resident conferences (available daily)

     The resident will attend the Head & Neck Surgery Tumor Board conferences (available weekly)

     The resident will participate in a Clinical Precepting workshop

     The resident will precept 4th year Optometry students in clinic under the supervision of an Attending; the resident will have a minimum of 20 precepting encounters by the end of the year

     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.

     Each resident will present at least three lectures to Optometry trainees at Optometry Trainee Presentation meetings or eRounds

     The resident will present at least one case or topic of interest at Optometry Clinical Seminars

     When invited, the resident will present an in-service to nursing staff and/or medical trainees

     When invited, the resident will make a presentation at the annual SCCO Residency Forum.  This activity may be credited toward the Clinical Seminars presentation requirement.

     The resident will complete a thesis paper of publishable quality.

     The resident is encouraged but not required to attend the annual meeting of the American Academy of Optometry, American Optometric Association, or equivalent. 

     The Resident will read a minimum of 10 journal articles per quarter.                                                 

     The Resident will participate in the SCCO Library’s circulation lists for journals (optional, highly recommended)

     The Resident will research literature on various topics as discussed through course of patient care and meetings, and as assigned by attendings.

     When invited, the resident will participate in the annual SCCO Journal Club meeting.  This activity may be credited toward the lecture presentation requirement

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.

10. Health-related program requirements. Candidates accepted to the Program must provide the following prior to the July 1 start date:

              a. Evidence of self-certification of satisfactory physical condition based on a physical examination in the past 12-months;

              b. Evidence or self-certification of up-to-date vaccinations for healthcare workers as recommended by Centers for Disease Control (CDC) and

                  VA https://www.cdc.gov/vaccines/adults/rec-vac/hcw.html

              c. Evidence of tuberculosis screening and testing per CDC health care personnel guidelines https://www.cdc.gov/tb/topic/testing/healthcareworkers.htm;

Program Accreditation

The Accreditation Council on Optometric Education (ACOE - www.theacoe.org - 243 N. Lindbergh Blvd. - St. Louis, MO - 63141) granted the status of “accredited” for the program in April 2016. The next currently scheduled site visit will take place in Spring 2025.

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

• The Getty Center
• Skirball Cultural Center
• Armand Hammer Museum
• Royce Hall (Music)—UCLA
• Movie theaters and restaurants in Westwood
• Numerous restaurants within walking distance of VA on San Vicente Blvd. in Brentwood
• Los Angeles County Museum of Art
• Los Angeles Public Library
• Dorothy Chandler Pavilion
• Disney Hall
• Norton Simon Museum of Art
• Museum of Science & Industry
• Brentwood and Wadsworth theaters - on VA campus

Sports

• Staples Center
• UCLA

Parks & Recreation

• Santa Monica Pier and beach
• Malibu beach
• Venice beach & boardwalk
• Marina del Rey
• Griffith Park/Observatory
• Universal Studios
• Disneyland - 50 miles southeast
• Movie theaters - Westwood

Shopping

• Westside Pavilion
• Westwood district
• Century City Shopping Plaza
• Beverly Center
• Jewelry Mart and Garment District (downtown LA)
• 3rd Street Promenade (Santa Monica)
• Santa Monica Mall
• Montana Avenue Shopping District
• Fox Hills Mall

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 requirements, activities, and schedules are subject to change without notice.

Health Professions Trainees (HPTs) are appointed as temporary employees of the Department of Veterans Affairs. As such, HPTs are subject to laws, policies, and guidelines posted for VA staff members.  There are infrequent times in which this guidance can change during a training year which may create new requirements or responsibilities for HPTs. If employment requirements change during the course of a training year, HPTs will be notified of the change and impact as soon as possible, and options will be provided. The VA Training Director for your profession will provide you with the information you need to understand the requirements and reasons for the requirements in a timely manner.