Residency Profile: Zuni Comprehensive Community Health Center

Residency Programs
Zuni Comprehensive Community Health Center (Zuni Indian Hospital)

Established: 2011

Positions: 1

Zuni Comprehensive Community Health Center

Eye Department
PO Box 467
Zuni, New Mexico 87327
505.782.7485 

Program Faculty

Residency Co-Coordinators:

• Kieran McMillan, OD
• Sophia Ries, OD

Mission Statement

To give residents exceptional knowledge, skills and abilities; and experience competently applying them in diagnosing and treating patients in a culturally and personally sensitive manner, in concert with other health disciplines, as a career platform leading to employment in a clinical, educational, research or administrative position.

Program Goals

1. Residents will acquire, refine and apply advanced clinical skills.
2. Residents will appreciate scholarly activity and its beneficial impact on one’s ability to provide patient and public health services.
3. Residents will effectively integrate their delivery of eye care with other healthcare disciplines, programs and levels of providers.
4. Residents will acquire and apply cultural, community and individual patient sensitivities to maximize patient care outcomes and success of public health programs.
5. Residents will acquire knowledge, skills and resources enabling them to secure post-residency employment in a clinical, educational, research or administrative position.

Objectives

1. Residents will participate in Department competency training and certification in operating clinical equipment as well as performing, ordering and/or interpreting clinical tests, including medical laboratory tests and imaging services. They will also participate successfully in the Hospital Competencies Program. Residents will also demonstrate competencies by passing state and national board written, oral and clinical exams.
2. In their first month, residents will submit to the Faculty a personal goals list of areas in which they are especially interested in advancing and capabilities which they feel a particular need for improvement. They and the Faculty will orchestrate a plan and accomplish these goals.
3. Residents will provide direct patient care to over 1,200 patients. The Residency Coordinator, with consideration of each resident’s strengths, weaknesses and interests, will tailor the resident’s clinical schedule and patient exposure to the resident’s maximum benefit. Residents will primarily work in their own exam room. Along with their own scheduled patients, they will be the first provider for urgent walk-ins and for unscheduled referrals and consult requests from other departments. Residents will also see patients in Emergency Department, Urgent Care Clinic, Out-Patient Clinic, in-patient rooms and at other institutional settings. They may also provide care at patient home visits. As directed by the Residency Coordinator, residents will respond during non-clinic hours to hospital staff requests for telephone and in-person patient consultation, diagnosis and treatment.
4. Residents will participate in eye health screening programs for a variety of community groups such as pre-school children, primary and secondary school children, special needs children, public safety staff (firefighters, police, etc.) and detention center residents.
5. Residents will learn and effectively use the IHS Electronic Health Record (EHR) and Resource and Patient Management System (RPMS).
6. Residents will achieve a passing score in a standardized peer review and healthcare records audit designated by the Residency Coordinator.
7. Residents will participate in designing, conducting and analyzing of a patient satisfaction survey of random patients they have served.
8. Residents will participate in personal and organized learning including:
   • Department Staff Literature and Digital Information Sharing Program
   • Grand Rounds
   • IHS Residents Journal Club
   • Medical Staff Continuing Education Program
   • Continuing education at a national/regional professional meeting.
9. Residents will conduct a scholarly project as approved by the Residency Coordinator and meeting SCCO designated completion deadlines. This may be a case report, literature review, or original research. They will report their work in a manuscript suitable for publication and will present it at a professional meeting venue agreed upon by the Residency Coordinator.
10. Residents will participate in Department and Medical Staff rounds.
11. Residents will observe at:
    • Other hospital departments as arranged by the Residency Coordinator.
    • Outside specialty eye care practices and institutions.
12. Residents will personally make and follow-up on patient referrals to specialty eye care and other healthcare providers.
13. Residents will attend all Eye Clinic Staff Meetings and participate as a member of the Medical Staff in hospital functions including Medical Staff Meetings.
14. Residents will attend a presentation on Zuni culture and concepts of healthcare and wellness. Subsequently, they will attend Zuni Pueblo cultural activities such as ceremonies, dances and community events.
15. Residents will observe Community Health Nursing Department activities including home visits.
16. Residents will contribute to the publication of the Department Newsletter by writing articles raising public awareness and understanding of eye conditions common in Zuni, their impact, prevention and treatment.
17. Residents will be instructed in how to use USAJobs and other employment resources. They will be tutored in résumé writing and interview technics; and networked with key contacts.
18. Residents will read journal articles and other reading materials assigned by the resident director. 

Workload and Schedule

• Clinical experience will include diagnosis and treatment of these conditions (estimated patient visit numbers per year).

• Ammetropia (1,500)
• Strabismus and binocularity anomalies (40)
• Glaucoma (120)
• Iritis (40)
• Trauma (60)
• Keratoconjunctivitis, infectious (40)
• Keratoconjunctivitis, other (70)
• Diabetic eye disease (1,200)
• Cataract (200)
• Maculopathy (300)
• Lid inflammations, ptosis, etc. (100)
• Central nervous system anomalies (100)

• Patient demographics.

• 78% Zuni, 19% Navajo, 3% other, randomly including all ages, male and female.

• Rotation length: 12 months, August 1 – July 31.
• Work Schedule;

• The schedule is based on 2-week periods following a "flex schedule" providing 80 hours of work in each period with eight 9-hour workdays and one 8-hour day, with one weekday off.
• The Eye Clinic is open from 08:00 to 12:00 and 13:00 to 18:00 all weekdays and closed on weekends and national holidays. The resident will also participate in after-hours call as designated by the Director.
• Time allotment for each 2-week period:
  • Clinic...................... 63.5 hours  (80%)
  • Didactic Activity...... 3.5 hours    (4%)
  • Meetings and Rounds 8.0 hours  (10%)
  • Scholarly Activity.... 5.0 hours    (6%)
  • TOTAL................. 80.0 hours

Teaching and Lecture Opportunities

The resident will present clinical cases at regular Eye staff Rounds as well as present an in-service training to the Medical Staff and present a scholarly, reviewed journal quality paper at a national, state or other appropriate professional venue as designated by the Director.

Scholarly Activities

As required by the Accreditation Council on Optometric Education, the resident will write a publishable paper suitable for submission to a refereed professional journal under the guidance and support of the Faculty. The resident will also participate in Indian Health Service Optometry Residents Journal Club by presenting a reviewed article at each meeting and hosting one meeting of the group at the Zuni Hospital. The resident will record and analyze their clinical workload, i.e., patient visits by pathology category, treatments and referrals, and high-risk patients as designated by the Director. Didactic time is set aside for case discussion with the Faculty. The resident will also attend Medical Staff rounds as designated by the Director.

Compensation and Benefits

The resident will be compensated as an employee of the Hospital and thus will be required to meet all conditions of Federal employment including background check, licensure, etc. The total monetary compensation is approximately $102,477 based upon a GS-11 step 1 pay level. Refer to Indian Health Service Special Salary Rate Table for optometrists effective January 2019. As a Federal employee the following benefits are provided.

Housing

Houses and apartments for rent near the hospital are usually available with costs ranging from $350 to $900 monthly. It may be possible for the resident, if interested, to share a unit. Housing is also available in Gallup, 35 miles north of Zuni.

Application Process

Applications are processed through the Optometric Residency Matching Service (ORMS) http://orms.org

• Must be a citizen of the United States of America. 
• OD degree conferred by a school or college of optometry accredited by the ACOE. Applicants must furnish complete transcripts of all optometric education.
• NBEO success completing of all sections, including TMOD.
• Letter of intent including statement why the applicant is pursuing residency training and what goals they hope to achieve during the program.
• Applicants must hold a currently active and unrestricted license to practice optometry in a state, territory, or commonwealth of the United States, or in the District of Columbia that includes the use of therapeutic drugs to treat eye conditions prior to the beginning of the residency period.
• Completion of an interview with the Director is mandatory, preferably in person or when not feasible by telephone.
• Three letters of recommendation.
• Completed application must be submitted to the Optometric Residency Matching Services, Inc. (ORMS) no later than January 31st prior to the respective program start date.
• All applicants will be evaluated for selection without regard to sex, race, color, creed, age, national origin, or non-disqualifying physical disabilities.

Selection Procedure

• The Residency Coordinator evaluates all completed applications prior to ORMS match day. 
• The Residency Coordinator and all members of the Optometry Department rank the residency candidates using a Potential Resident Grading Scale after the  interview process and all required documents are received.  These results are  considered, however, the Residency Director makes the final selection using a  systematic process based on the quality of the applicants’ credentials as well as  personal and professional characteristics. 
• The characteristics below are graded 1 (unsatisfactory), 2 (satisfactory), 3 (exceptional), or 4 (excellent) by each staff member. Scores for each characteristic are averaged, then average scores are totaled.
  • APPEARANCE, ATTITUDE,  COMMUNICATION SKILLS, PROFESSIONALISM AND PROFESSIONAL INVOLVEMENT
  • ACADEMIC & BOARDS PERFORMANCE
  • IHS CAREER POTENTIAL
  • ADAPTABILITY TO ZUNI COMMUNITY & HOSPITAL ENVIRONMENT
  • RECOMMENDATIONS

The ranking order will be identified by the Residency Coordinator and provided  to the ORMS.

• The name of the matched candidate will be provided to the SCCO’s Director of  Residency Programs, who will then make a recommendation for appointment of  the selected candidate to the Vice President and Dean of Academic Affairs.
• The matched candidate is then offered a written contract from SCCO for the  residency position.
• Once selected, a candidate is required to apply through the USAJobs website for  the ZSU optometry resident position, medical staff membership and privileges.   It is mandatory that the resident be fingerprinted and a background check is  completed at no charge to the resident. 
• The ZSU maintains the right of refusal of any candidate.

Requirements for Residency Completion and Awarding of Certificate

• The resident is required to keep a detailed log of all required program aspects, which will be reviewed by the SCCO Director of Residency Programs, and the ZSU Residency Coordinator.
• The resident is required to provide patient care services at a level deemed satisfactory by the Residency Coordinator and faculty, in line with the highest levels of current optometric standards of practice.
• The resident is required to participate in the Navajo Area Indian Health Service (NAIHS) Residents Journal Club.
• The resident is required to submit a paper based upon original research, literature review, and/or clinical case or cases suitable for publication in a peer reviewed optometric journal.  A topic for the case report or research project must be selected by the October 3rd; the abstract of the case report or research project is due on December 1st; the 1st and 2nd draft of the paper will be submitted by March 1st and May 1st respectively; and the final paper is due on July 2nd.
• The resident is expected to deliver patient care services in a professional manner and to observe those proprieties of conduct and courtesy that are consistent with the rules and regulations governing SCCO and the IHS.
• Upon evidence of satisfactory performance in meeting all requirements of the program, the resident will be awarded a Certificate of Residency Completion by the SCCO.

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 2023. The next currently scheduled site visit will take place in 11/ 2029.

Hospital and Setting

The Zuni Community Comprehensive Health Center is a facility that provides broad primary and secondary health care services to an active user population of some 19,000 patients living mostly within a 50-mile radius. Departments include:

• Audiology
• Dentistry
• Emergency Room 24/7 Service with surface and air ambulance services
• Environmental Health
• Eye Service including optical dispensary services<
• Field/Public Health Nursing
• Inpatient Services including obstetrics, pediatrics and med/surg
• Medical Imaging including x-ray, CT and ultrasound.
• Medical Laboratory
• Mental/Behavioral Health
• Outpatient General Medicine Clinic
• Physical Therapy
• Podiatry
• Renal Dialysis
• Specialty Clinics including rheumatology, diabetes, neurology and nephrology.
• Women’s Health
• Other resident and student intern programs are conducted at the hospital. Medical students rotate from Johns Hopkins, Columbia, Harvard and other schools throughout the country.
• The Hospital sits on a hill overlooking the Zuni Pueblo and surrounding village.
• Nearby world class recreational venues include hiking/backpacking, camping, biking, climbing, skiing, snowboarding, spelunking, etc.
• National Park Service venues within one to several hours drive:
  • Grand Canyon National Park
  • Mesa Verde National Park
  • El Morro National Monument
  • El Malpais National Monument
  • Petrified Forest National Park
  • Canyon DeChelly National Monument
  • Natural Bridges National Monument
  • Hubble Trading Post National Monument
  • Chaco Canyon National Monument
  • Bandelier National Monument
  • Carlsbad Caverns National Park
• Other outdoor venues
  • Cibola National Forest
  • Zuni Mountains
  • Mount Taylor (annual quadrathalon is popular)
  • Sandia Mountains (longest tower to tower tram in the world)
  • Humphreys Peak
  • Lake Powell
  • Pecos Wilderness
  • Gila Wilderness
  • Ski resorts including Sandia, Santa Fe, Taos, Purgatory, Telluride, Wolf Creek, and White Mountains. There is ample access to cross country skiing in the Zuni Mountains nearby also.
• Nearby metropolitan areas include Gallup, Albuquerque, Santa Fe, Flagstaff, and Phoenix.
• Commercial airports serving the area are at Gallup, Albuquerque, Flagstaff and Phoenix.
• The climate is high desert at an elevation of 6,800 feet. Summers are mild with highs reaching the mid-90s and winter temperatures range from below zero to 50’s with snow common.

Points of Contact / Faculty

Kieran McMillan, OD
Optometry Residency Program
Eye Clinic, Zuni Comprehensive Community Health Care Center
P.O. Box 467, Zuni, NM 87327
505.782.4488 • Fax: 505.782.7489 • Email: Kieran.McMillan@ihs.gov 

Sophia Ries, OD
Optometry Residency Program
Eye Clinic, Zuni Comprehensive Community Health Care Center
P.O. Box 467, Zuni, NM 87327
505.782.7485 • Fax: 505.782.7489 • Email: Sophia.Ries@ihs.gov 
Indian Health Service, Zuni-Ramah Service Unit Website

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
714.449.7429 • Fax: 714.992.7811• Email: jtong@ketchum.edu