The 3 Little Pigs can teach you something about shadowing!

To prepare for the interview, shadowing is the single most important experience you will need. The story you tell about your shadowing experience should be the key element of your response to that first interview question, “Why do you want to be an optometrist?”

I see it year after year: the single biggest reason applicants fail in an interview setting is lack of shadowing experience. Why? In an interview setting, talking about your shadowing experience becomes your personal testimonial. How can a testimonial authentically express how much you want to be an optometrist without a working knowledge of the profession? How can you commit to a professional lifetime in optometry, not to mention the rigors of a professional degree program, without being able to articulate why optometry is your dangling carrot? That is why shadowing experience is the most explored topic during the interview. So how can you speak intelligently to these key questions without first-hand experience, a.k.a shadowing?! That’s right, you can’t!

I guarantee that shadowing is more than you think it is. Shadowing is the vehicle through which you will synthesize your own personal story relative to the profession of optometry–a story that is compelling enough to convince interview panelists that you are motivated enough to get through the program. It is a story that must be real to you, just as if you experienced it in first person. You must tell that story from the viewpoint of being an insider, one of the initiated. If you can’t project yourself into your own future as an optometrist, if you can’t convince an interview panelist that that future, that dangling carrot, is out there and motivating you to succeed, you will be making a fatal interview mistake.

I’ll use the story of The Three Little Pigs to make my point. The story of The Three Little Pigs begins with a declaration from Mother and Father Pig, “It’s time for you to leave home and make your own houses.” Each little pig, according to the wisdom they have accrued and their own personal industry, decides to build their house out of one of three materials. The first and second little pigs use the cheapest, fastest, most convenient building materials, straw and twigs, while their more industrious brother employs wisdom and delayed gratification. He opts for the more expensive investment in time and materials to make his house out of bricks. He is mocked by his brothers for his seemingly foolish waste of time while they party hearty—that is until the Big Bad Wolf comes on the scene. As huffing and puffing ensues, no big leap in logic is required to know which two little pigs are going to end up on the Big Bad Wolf’s BBQ spit.

Metaphorically, when it comes to shadowing experience, you are choosing the fate of one of those little pigs because you are deciding how to build your own “house” in the form of the story you will tell in your interview. Invest some time, get advice. Shadow until you develop a solid testimony, one made out of bricks! If we continue with this metaphor, the interview panelists, dare I saw it, are like the Big Bad Wolf. It’s their job to huff and puff and blow your house down. Sounds cruel? Not when you consider they have an ethical responsibility not to let you get into a situation (i.e. optometry school) where you might get in over your head, commit to a goal that you seek only halfheartedly, borrow money, and in some cases move across the country, only to drop out when you come to the realization that optometry is not for you. You bet they’re going to be blowing on your house to see what it’s made of! Keep the story of the Three Little Pigs in mind as an example of what you should achieve with shadowing: to build your own solid, in-depth, evidence-based, and compelling story that foresees your future in optometry. Discover tangible evidence to articulate what drives you. That’s a testimonial that no Big Bad Wolf can blow down!

Perspectives to Explore While Shadowing

Two common misconceptions about the goal of shadowing are 1) it’s thought of solely as observing a doctor seeing patients and 2) for the shadowing student to learn as much as possible about the eye and the testing procedures to examine it. Most students interested in optometry have themselves been a patient of an optometrist and so, they have already had that particular experience, so you’ve seen an optometrist deliver patient care and can check that off your list. Also, shadowing is not learning about the eye, components of the eye exam or ocular disease. That’s what an optometric professional educational program is designed to do. Shadowing is not an internship. The main goal of shadowing is to gather enough evidence to prove that optometry is right for you. This objective can be achieved in a variety of ways, the least of which is watching a doctor deliver care. You can even interview an optometrist via the telephone to help broaden your shadowing experience. Here are examples of what you should explore while shadowing:

• The Daily Task of Seeing Patients: what are the best aspects of patient care and what are the some of the more challenging ones? This will be different for each person depending on one’s unique temperament. Get to know yourself relative to this responsibility. Can you deal with the public? Do you like to help people? Will you listen empathetically to people/patients?
• Solving Problems: patients have problems they need doctors to solve. Do you like to solve problems? Can you work with a patient on a problem in a solution-oriented way without getting frustrated? Are you curious? Can you work through a complex set of tests and symptoms to find out indeed what is going on with a patient?
• Taking on the Responsibility of Being Someone’s Doctor: you will have the liability and authority to make autonomous, executive decisions as it pertains to a patient’s care. Can you take charge? Are you willing to take on that responsibility and all it involves?
• Commitment to Life-Long Learning: being part of the ever-changing fabric of health care delivery requires continuing education. Are you willing to invest the time in being the life-long learner inherent in being a doctor?
• Responsibility to the Profession: doctors of optometry have a responsibility not only to their patients but to their profession as well. You will be joining a professional community with rights, responsibilities, and privileges. Examples of professional organizations are the AOA and the AAO. Will you be faithful to that responsibility? Will you join and contribute to professional organizations?
• Future of the Profession: optometry has come a long way in its relatively short lifetime. Where is it headed? What are some of the challenges optometry faces? How will it be impacted by such issues as national healthcare?
• “Would You Do It All Over Again?” is a quintessential question I encourage students to ask of the shadowing doctor. If he/she had the chance to start all over again, knowing what he/she knows now, would he/she have chosen optometry? If not, what other career choice would he/she have considered?

It is important to shadow in many venues and talk to as many optometrists as possible. A goal would be to shadow at least five optometrists. There is no one typical optometric practice and there are different subspecialty areas within optometric practice—vision therapy, low vision, pediatric vision, ocular disease and contact lenses. Also, you can obtain valuable shadowing experience from an ophthalmologist, a physician whose specialization is the eye, as well. Don’t limit your shadowing experience to only optometry. All shadowing experience in healthcare environments is valuable.

How to Successfully Arrange for a Shadowing Experience

It can be intimidating to ask a doctor for a shadowing opportunity. To help you with your confidence, I can assure you that asking to shadow an optometrist is not an unusual request. Most optometrists went through this same process back when they were making a decision about their future career and should therefore understand the nature of your request.

The best way to approach an optometrist about shadowing is to make your request in writing. Hand-address an envelope and write “personal” on the outside of the envelope. The reason for this is that front-office staff process the doctor’s mail. If they open and read your mail, your request for shadowing and, there’s no polite way to say this, don’t want to be bothered, you’ll run the risk of having your request end up in the waste basket. If you write “personal” on the outside of the envelope, opening will be done by the doctor him/herself. In your letter, make your request to shadow along with brief personal information. Include a photo of yourself. Explain to the doctor that you’ll be phone calling within the next week to discuss your request in more detail and to hopefully schedule an appointment for shadowing. Show you respect the doctor’s time by asking to shadow for a limited 1-2 day period which is plenty of time to gather the experience and information you’ll require. A request for a shadowing opportunity will be better received if the term of the commitment is defined and brief, so that is why it’s best to specify your expectation for only a 1-2 day visit. Make sure the doctor has received your hand-written request for at least a week before you follow-up with a call. Also, make sure to follow-up with a thank-you note either after your request is granted or after you’ve completed the shadowing experience.

Don’t make your written request by using words like “internship,” “job,” or “training.” All these words imply a long term relationship, salary, time-consuming training, or employment. You simply want to shadow which means to passively observe and to interact with the doctor when there are no patients present.

Okay, so now you’ve had a request granted to shadow. Now to proceed…

Use the Phrase: “Tell Me…..”

A great phrase to use when seeking information in a context where you have limited experience is: “Tell me about….” You can talk to anyone about almost any subject by using this phrase. Here’s an example of what I mean. Let’s say you’re sitting and enjoying a cup of coffee wearing a raggedy old red sweatshirt. You love this sweatshirt because it is the one your mom gave you when she sent you off to college. It is your lucky red sweatshirt, so cozy and comfortable and you love to wear it. Let’s say a stranger walks up to you and asks bluntly, “Hey, what’s up with that red sweatshirt?” It’s not necessarily an offensive question; however, this is a stranger and you don’t know where he/she is coming from so the question may feel potentially threatening. You’re fully aware that your beloved sweatshirt is showing some wear. Can’t you just imagine how defensive you would feel as you hear that question while making the realization that your sweatshirt is a bit worn out? Even though the question is truly harmless, it could seem to have an aggressive, offensive tone. The result could be that you’d shut down.

Given this stranger has a sincere desire to know more about your sweatshirt, what if he/she had rather said “Hey, tell me about the red sweatshirt you are wearing.” Can’t you just feel how much more responsive you would be to a request phrased this way? You would probably have said something like “This is my favorite sweatshirt. I wear it every Saturday morning when I have coffee. My mom gave it to me and it reminds me of a special day!” Two approaches with two completely different responses and outcomes.

The “Tell Me” phrase gives permission to the person being asked the question to answer any way they wish. There is no right or wrong answer to the “Tell Me” request. The person answering feels relaxed and willing to share their perspective without the threat of judgment.

Use the “Tell Me” phrase with the optometrists you plan to shadow. “Tell me about optometry past, present and future” or “Tell me about your experience with optometry, past, present and future.” “Tell me if optometry is fulfilling your career goals?” “Tell me, would you be an optometrist if you had it to do all over again?” “Tell me why optometry gaining the rights to prescribe therapeutic drugs changed its position in the U.S. healthcare delivery system so dramatically?” “Tell me about where you went to optometry school.” “Tell me about the optometric program at the optometry school you attended.” Using the “Tell Me” inquiry will give the responder confidence that you are willing to hear any perspective they have to offer which may get you even more insights than you bargained for—more bricks for your house!

Even More Perspectives to Explore While Shadowing

Each optometrist you encounter will have differing views about the future of the profession and the political issues that face optometry. Optometry has made huge strides in the last 20 years due largely to securing rights to prescribe therapeutic pharmaceuticals which allow optometrists to treat ocular disease. This one change in optometry’s scope of practice has changed the profession dramatically. Not all optometrists have embraced these changes. Talk to each optometrist you shadow and explore this notion. How has this change affected the profession as a whole? How has this privilege to prescribe drugs repositioned the optometric profession within the health care delivery system?

Experience some of the optometric sub-specialties practiced: ocular disease, contact lens, pediatrics, low vision and vision therapy. You will have done enough shadowing when you can speculate about how you see yourself in optometry’s future. In the interview, when asked about your shadowing experience, don’t recite a “laundry list” of your shadowing experience but rather, be able to describe each experience and how your opinion of optometry was changed by it. Form tangible thoughts about how you see yourself one day fitting into the profession. Explain how optometry is a good fit for your temperament and personality.

“Do you know the difference between an optometrist (OD) and an ophthalmologist (OMD)?” is a favorite interview question. There are obvious differences between the two professions; but, do you know the more subtle differences? If not, this would be a topic worthy to discuss with a shadowing optometrist. There is no “one word” answer to this question which is why it would be helpful to hear various perspectives from practicing ODs. The “trick” to the question is that, over time and as optometrists change laws to increase their scope of practice, there is getting to be less and less difference between optometry and ophthalmology. The basic difference is in the educational roots and therefore treatment philosophy—OMDs start out in medical school and then specialize in the eye disease/surgery. ODs take a more integrated approach to the human visual system. Treating ocular disease is a part of that integrated approach. ODs are trained to treat a range of functional vision problems from low vision (patients not functionally corrected with glasses or contact lenses) to learning problems. Finding out how an OMD differs from an OD in education, scope of practice and healthcare philosophy is a topic worthy of research and discussion.

After successfully shadowing at one venue, ask the doctor if he/she can make a recommendation for you with some of his/her colleagues for more shadowing.

Phone-interviewing an optometrist is another way to expand your exposure to the profession. Given the current responsibility a doctor has to protect a patient’s privacy, it may be difficult to find a doctor willing to allow you to witness a patient encounter. In that case, augment your shadowing experience by doing a phone interview with the doctor. Asking your questions in phone conversation is a perfectly valid way to gather information.

To summarize, shadowing helps you develop your own story in optometry, one you can share with enthusiasm and commitment. Make a list of the positive qualities you observed in the shadowing doctors and look for those qualities in yourself. When you find them, find effective ways to articulate your stories about what you learned and how you see yourself functioning as a doctor of optometry, a healthcare provider. Remember, you’re not just trying to “get into” a school, but rather, you are seeking admission into a program that will prepare you to be a doctor of optometry, ready to take on that yoke of responsibility. Convince the interview panelists that you have explored the full nature of that responsibility and are determined to proceed. Take these recommendations, put them to use, and you’ll build your house with bricks, you wise Little Pig #3!

There is no substitute for the experience you get from shadowing.