Definition of a Primary Care Optometrist

The primary care optometrist is a practitioner with ongoing responsibility for the total visual, ocular and related care of a population of patients. Primary care optometry is a focus of practice activity that emphasizes the development and maintenance of a high level of knowledge and clinical ability over the entire area of eye/vision care and associated areas of eye-related health care.

Purpose of the Diplomate Program of the Primary Care Section

The purpose of the Diplomate Program of the Primary Care Section Program is to recognize that continually increasing competence is needed to practice as a Primary Care Optometrist. The Diplomate Program of the Primary Care Section Program is a distinction achieved by doctors of optometry who strive through their Primary Care practice activities and through this Diplomate Program to attain a level of excellence in patient management beyond the regular American Academy of Optometry Fellowship program.

Characteristics of a Primary Care Optometrist

The components of the process for achieving Diplomate status are designed in an effort to identify and measure characteristics of a Primary Care Optometrist. Thus, a Diplomate of the Primary Care Section:

1. Is a seasoned practitioner with clinical experience well beyond regular Fellowship status
2. Is committed to assuming greater responsibility for total patient care, over the entire area of eye/vision care and associated areas of eye-related health care
3. Is committed to practicing to the full extent of his/her training and state licensure, incorporating state-of-the-art techniques and patient care philosophies into his/her practice
4. Is committed to and highly skilled in providing ongoing care for patients of all ages
5. Is committed to and provides patient education that is highly effective due to the experience, communication skill and sensitivity of the practitioner
6. Is a caring practitioner who recognizes the individuality of each patient
7. Actively participates in co-managed patient care by delivering the primary aspects of the care at the highest possible level
8. Assumes a high level of responsibility in coordinating necessary visual, ocular and related care of the patient with other professionals
9. Demonstrates aggressive acquisition of new knowledge through available avenues
10. Actively contributes to the advancement and success of the profession of optometry

Requirements for Diplomate of the Primary Care Section Status

Diplomate of the Primary Care Section Status will be granted only following successful completion of Parts I through VI. No "grandfathering" of Academy Fellows into active Diplomate of the Primary Care Section Status will occur.


PART I REQUIREMENTS FOR REGULAR DIPLOMATE STATUS

A prospective applicant for the Diplomate Program must be:

1. A Fellow in good standing of the American Academy of Optometry
2. A practitioner who has had a minimum of 5 years of practice experience

PART II APPLICANT STATUS

1. Application Form

The Fellow should complete the application form and return it to:

Diplomate Application for Primary Care Section
American Academy of Optometry
6110 Executive Boulevard; Suite 506
Rockville, MD 20852

2. Curriculum Vitae

The completed application form shall be accompanied by a current Curriculum Vitae. The Curriculum Vitae should be as complete as possible and should include information on educational background, professional experience, publications, speaking activities, optometry organizations, honors, and certifications.


3. Scope of Practice Profile (included in Candidate's Guide)

The Scope of Practice Profile is utilized by the Committee to learn about the Applicant, including his/her patient care philosophies, activities, range of services, and the setting(s) in which they are delivered. The completed Scope of Practice Profile serves as a basis for the Candidate Interview process and taken together with the results of the Case Reports, Interview and Examination, provides an evaluative tool to assess the overall qualifications of the Applicant for the Diplomate Program of the Primary Care Section. An additional intent of the Scope of Practice Profile is to provide a self-assessment tool for the applicant proceeding through the Diplomate Program.

4. Application Fee

The completed application should be accompanied by a $100 application fee.

The materials described in #1 through #3 will be administratively reviewed for completeness, and additional information will be requested as needed. Favorable review of these materials by the Diplomate Program Committee will result in the assignment of Candidacy Status to the applicant. The Candidate has five years from the time of granting of Candidacy Status to complete Parts III through VI. It is anticipated that the entire Distinguished Fellow of the Primary Care Section process will take 2-3 years to complete. If the five-year period lapses without successful attainment of Diplomate of the Primary Care Section Status, the application process, including payment of the current application fee, must be re-initiated.

PART III CANDIDATE STATUS AND CASE REPORTS

Each Candidate will complete ten (10) written case reports selected from the case category/topic listing that follows. Each case report must represent a patient directly examined and managed by the Candidate and must be separate and different from any of the cases that were previously submitted for the Fellowship process. The quality and depth of each completed case report should clearly be appropriate to the level of Diplomate of the Primary Care Section Status and should be well above the complexity of cases prepared for Academy Fellowships.

The Candidate should note that a minimum number of case topics are required within most categories (number noted in parentheses). The additional cases needed to reach the total of ten are then selected by the Candidate from the remaining topics. No duplications of category/topic are allowed.

Category A (minimum of 1)

A1. Routine pediatric examination: a patient under the age of 12

A2. Binocular vision/accommodative dysfunction case

A3. Visual perceptual problem/learning disorder

Category B (minimum of 1)

B1. Routine geriatric examination: a patient over the age of 65 years

B2. Unusual refractive case/refractive surgery case

B3. Low vision/visual rehabilitation case

Category C (both must be completed)

C1. Coordinated care: a patient for whom you obtained consultation/ coordinated care from an ophthalmic practitioner. Include copies of all correspondence.

C2. Coordinated care: a patient for whom you obtained consultation/ coordinated care from a general physician, family practice physician or internist for a systemic problem. Include copies of all correspondence.

Category D (minimum of 1)

D1. Contact lens care: a patient you fit with contact lenses and managed over at least a 6-month period.

Category E (minimum of 2)

E1. Anterior segment problem

E2. Posterior segment or neuro-ophthalmic problem

E3. Cataract management: describe a patient with significant cataract formation for whom you diagnosed the cataract and coordinated the consultation, surgery and post-operative management. Describe your co-management of the patient. Include copies of all correspondence.

E4. Glaucoma case: describe a patient whom you diagnosed as having glaucoma. Include discussion of your management/co-management.

Category F (no minimum)

F1. Occupational/sports vision case

CASE REPORT INSTRUCTIONS FOR DIPLOMATE CANDIDATES

I. Title Page

Full title, each author's name, highest academic degree and affiliation and department and institution where case study was performed

II. Abstract

Include a structured abstract (100 words or less) with the following four headings:

A. Introduction
B. Case Report
C. Discussion
D. Conclusion

III. Text

Number the pages of the report consecutively. The report should be double-spaced. Restrict abbreviations to those that are widely used and understood (i.e. avoid abbreviations that have meaning only within the context of the specific manuscript). Introduce each abbreviation in parentheses after the first appearance of the expanded term. Abbreviations of standard measure used with number quantities (mm, Hg, cm, and ml) are used without initial expansion. Each major section does not need to start on a new page. The text of the case reports should be no longer than 10 double-spaced pages (or 2500 words), and should contain no more than 10 references and 4 figures and/or tables.

IV. References

References should be indicated in the text by consecutive numbers and shown as superscript numbers in the text. If there are more than six authors, write "et al." after the third name. You are responsible for the accuracy of your references.

A. Journal references should include:

1. Author(s)
2. Title
3. Journal name (as abbreviated in Index Medicus)
4. Year
5. Volume Number
6. Inclusive Page Numbers

Example: 

Achiron LR. Postinfectious hepatitis B optic neuritis. Optom Vis Sci 1994;71:53-56.

B. Book references should include:

1. Author(s)
2. Chapter title (if applicable)
3. Editor(s) (if applicable)
4. Book title
5. City of Publication
6. Publisher
7. Year
8. Inclusive page numbers

Example:

Lambert HM, Aaberg TM Sr. Surgical excision of subfoveal neovascular membranes. In: Franklin RM, ed. Retina and Vitreous. New York, Kugler Publications; 1993:31-34.

V. Tables

Data that can be give in the text in one or two sentences should not be presented in table format. Each table should have a brief, self- contained title understandable without reference to the text. Assign a short heading to each column in the table.

VI. Legends for Figures and Illustrations

Figure Legends should be double- spaced and numbered consecutively.

VII. Case Report submissions must include an original plus three additional copies.

Published articles in refereed journals may be substituted for up to three of the written case reports. The article must describe the specific patient topics for which the paper is being submitted, should indicate the candidate as the primary author, and should have been published within 10 years of the date when all 10 case reports are submitted.

Submit completed case reports (original plus three copies of each) to:

Case Reports for Primary Care Diplomate Section
American Academy of Optometry
6110 Executive Boulevard
Suite 506
Rockville, MD 20852

Two of the Case Reports should be submitted no later than October 1 of the year preceding that in which the Candidate plans to take the Written Examination (Part IV) and Interview (Part V) at the American Academy of Optometry Annual Meeting. Each case report will be reviewed by three referees, who may request additional information. The Candidate is encouraged to wait for approval of the first two Case Reports before proceeding with the remaining 8 to ensure that his/her efforts are directed appropriately.

All 10 Case Reports must be submitted to the Diplomate Case Report Chairman by July 15 of the year in which the Candidate plans to complete the Written Examination (Part IV) and Interview (Part V). Submission of individual case reports is encouraged as each is completed. All Case Reports must be accepted for the Candidate to be eligible for the Examination and Interview sessions held during the Annual Meeting.

PART IV: WRITTEN EXAMINATION

Following successful completion of Parts I through III, the Candidate will be notified for scheduling of the Written Examination during the Annual Meeting. The primary purpose of the Examination is to assess the Candidate's skills in clinical diagnosis, data analysis, and patient management/ co-management.

The Written Examination will be constructed to determine if the Candidate practices Primary Care Optometry beyond the entry level and at a level of excellence consistent with Diplomate Status. The format of the written portion of the Examination will be that of multiple choice questions, including clusters of questions pertaining to individual Patient Cases. Computerized presentation of data, supplemental videotape and/or slide presentation will be incorporated. The range of patient types to be covered by the examination questions will correspond to the patient categories described in the section on Case Reports. 

The general structure of each item format will be as follows:

I. Patient scenario: including demographic data, history, initial data results
II. Examination questions: pertaining to additional test findings, differential diagnoses, treatment and management/co-management
III. Comment: the Candidate may comment on the nature of his/her responses to the exam questions

The complexity level of each patient scenario and each scenario component will determine the expected level of performance. Factors such as the scope of care allowed by licensure in the Candidate's own state will be taken into consideration when scoring the test results. However, practitioners are expected to understand and to coordinate, in the best interest of their patients, management plans that may be technically beyond their current scope of direct care as allowed by state law. In addition to the patient scenario questions, multiple choice questions pertaining to state-of-the-art information for the primary care practitioner will be included.

PART V: INTERVIEW

At such time as is deemed appropriate by the Diplomate committee, the Candidate will be interviewed by 3-5 members designated by the Diplomate Interview Committee. The interview is a two-step process.

First, an "entrance" interview is scheduled. The entrance interview will usually be scheduled during the same Annual Meeting at which the written examination was taken. The primary purposes of the entrance interview are:

1. To provide an opportunity to meet the Candidate personally
2. To review interesting aspects of the case reports
3. To review the Scope of Practice Profile

The second portion of the interview process comes after all of the other steps have been completed. Usually, this is done during the same Annual Meeting at which the practical examination was taken. This "exit" interview provides the candidate and the Diplomate Committee members a chance to briefly review the entire process. This interview is meant to be more informative rather than an examination. The committee will discuss with the Candidate his/her strong and weak points on all parts of the Diplomate process, including the practical examination.

PART VI: PRACTICAL EXAMINATION

Following successful completion of Parts I through V, the Candidate will be scheduled to take the practical examination. The practical examination will be given during the Annual Meeting of the Academy, and is normally given at a local optometric office or clinic. The practical examination is designed to assess the Candidate's skill levels in procedures integral to Primary Care Optometry. The Candidate will be asked to examine patients, and often to arrive at a diagnosis and/or formulate a treatment plan or plans for the patient. The Candidate may be asked questions regarding the patient or about related conditions or situations involving some aspect of that patient. An examining proctor designated by the Diplomate Committee will sit in with the Candidate to observe, and to discuss or question as noted above. The practical examination will be divided into stations, with the Candidate rotating through the stations, from patient to patient. The Practical Examination may not be offered at every Annual Meeting, depending on demand.

DIPLOMATE STATUS

The Candidate will be notified as to whether or not Diplomate Status has been achieved either during the exit interview, or shortly thereafter. New Diplomates will be formally recognized and introduced at the Annual Banquet. Diplomate Status will take immediate effect and will remain active for five calendar years, ending on December 31 of the fifth year.

Renewal of Regular Diplomate Status

A Diplomate of the Primary Care Section must complete the requirements for Renewal of Regular Distinguished Fellow of the Primary Care Section Status every five years in order for this status to remain in effect. These requirements include:

1. An updated Curriculum Vitae
2. A completed Scope of Practice Profile pertaining to the pervious five year period
3. A $25.00 renewal fee
4. Demonstration of continued professional activity within the profession and the Academy through accumulation of Activity Points. A minimum of 25 points must be achieved in the 5 year period; at least 5 points must accrue in each of 3 years.

The Activity Points are assigned as follows:

Materials documenting fulfillment of these four requirements should be submitted by July 15 of every fifth year of Distinguished Fellow of the Primary Care Section Status to:

Diplomate Program Renewal Chair
American Academy of Optometry
6110 Executive Boulevard
Suite 506
Rockville, MD 20852

An interview with 3-5 members designated by the Distinguished Fellow of the Primary Care Section Renewal Committee will be conducted during the Annual Meeting of the fifth year of Distinguished Fellow of the Primary Care Section Status. A Candidate will be notified as to whether or not Distinguished Fellow of the Primary Care Section Status has been renewed by the day following the Interview. Renewal of Distinguished Fellow of the Primary Care Section Status will be formally announced at the Annual Banquet. Renewed Status will be immediately in effect and will remain current for another five (5) calendar years, ending on December 31 of the fifth year.

Inactive Diplomate Status

Inactive Status applies to the Diplomate who is, for good reason, in a state of hiatus from his/her full time clinical activity. Reactivation of Regular Status will occur when full time practice resumes, subject to fulfillment of all other requirements. A written request for Inactive Status must be made to the Diplomate Program Chair.

Emeritus Diplomate Status

Emeritus Status applies to the earned Regular Diplomate who permanently retires from patient care activities and is otherwise entitled to Regular Status. To be eligible for Emeritus Diplomate Status, a Diplomate must first be eligible for and become an Emeritus Fellow in the Academy. A written request for Emeritus Diplomate Status must be made to the Diplomate Program Chair.