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Have Optometry Students Changed?

Recently, the NBEO released the Institutional Yearly Performance Report for 2022-2023. This is basically the 1st time-taker passage rates for each optometry school across the country for the 2023 Graduating Class. The data in this report has people asking the question, "Have optometry students changed?" I'll do my best to answer that question, but lets first review the data. On average, the 1st time-taker passage rate was 62.65% for Part 1. This number alone should shake up the optometric community. Why is this number so low? If we look at Dental Medicine or Osteopathic Medicine, the passage rates were 88.3% (lowest ever) and 92.2% respectively. Of the 23 accredited optometry schools, the passage rates ranged from 91.8% to 19.3%. This gives a standard deviation of over 20! So, what's going on here? Why is optometry the outlier among health professions? If I knew the answer to this big question, my consulting rates would go way up! But, it is clear that there are multiple factors at play here.

First, the scope of optometric practice has changed rapidly over the past 100 years, perhaps more than any other health profession. Think about the technology that has impacted our clinical practices from- visual fields, to OCT, to laser surgery! I personally don't think I've seen that many dramatic changes in my dentist's office. He still uses an old fashioned drill on me most of the time! It is my contention that the NBEO has added content to Part 1 to keep up with the profession. But, I believe that they are still testing antiquated optics formulas and clinical procedures while simply adding new and additional content. I don't think this is right. To hold on to the past while pushing the profession forward has led to a breath of testable information that is unmatched in health care. Why does the NBEO still want optometry students to be able to trace the optics of a keratometer? Does that impact one's ability to be a great clinician? I don't think so.

Second, the applicant pool for optometry schools has been flat or only slightly growing over the past 5 years. In this time period, three new optometry schools have opened and several more are expanding now (SUNY) or are "in the works" (High Point, Detroit Mercy, etc). The lack of applicants has created a 1.3 to 1.0 ratio of applicants to available seats in optometry schools. Soon that will be 1.0 to 1.0 if the applicant pool doesn't increase. Already, we see schools struggling to fill their class with applicants (qualified or not). We've seen some schools eliminate the OAT exam requirement with hopes that the larger pool of GRE students would help with recruitment. I've argued strongly that this is a mistake as the GRE is a very different type of exam than the boards that students will encounter during optometry school. One optometry school removed the requirement for an entrance exam completely 3 years ago. It will be interesting to watch their student's performance on Part 1 this coming March 2024.

And, finally, I'll try to answer the question "Have optometry students changed?" Well, the answer is yes, of course! Every generation of students change. No parents like the music that their kids listen to, no parents understand the technology their kids grew up with, etc. People change over time, but it is the best educators that can adapt to the needs of their students. I am a follower of the late Dr. Paul Hersey who created the "Situational Leadership Model". He said that leaders must adapt to the needs of their followers. I think this same wisdom applies to educators. For, old guys like me to start every recommendation with, "When I was in school...." does no good. When you were in school does not apply to 2024. What we need to help our students retain this massive amount of content in 2024 is new ideas and new approaches to learning. These ideas are likely not going to come from some grey-haired guy typing a blog, but rather a young optometrist who lived and felt the challenges of optometric education in 2024.

So, my advice to everyone is "be patient" and change will come. I believe that the NBEO will evolve in the future. They are taking steps to contemporize Part 3 this year, let's hope that they work on Part 1 soon! I think that some of the "old guys" need to really think about what is important to practice contemporary optometry. Is it the ability to calculate the edge thickness of a -6.00 lens in a 57 eyesize frame on a piece of paper or rather to manage a patient's glaucoma with precisely placed laser shots in the trabecular meshwork? I think that we are living through a transition at the moment and I have hope for the future of our students and profession!

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