Northeastern State University
Oklahoma College of Optometry

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Educating Optometrists and Caring for Indian People

Dr. George Foster, Muskogee/Creek, Dean [now Dean Emeritus] of Northeastern State University Oklahoma College of Optometry (NSUOCO), is proud of the fact that his school has graduated more than half of the American Indian optometrists who are currently in practice. He is also quick to let you know that the national accrediting body for schools of optometry has judged NSUOCO to be the premier clinical training optometry program in the nation.

Thanks to what Foster describes as a “symbiotic” relationship between NSUOCO, the Cherokee Nation and Oklahoma Higher Education, NSUOCO optometry students have rich opportunities to develop and enhance their skills as they care for patients at W.W. Hastings Indian Medical Center. They also care for patients at the clinic on the NSUOCO campus and in rural clinics of the Cherokee Nation. Together students and their faculty supervisors have more than 40,000 patient visits/encounters each year.

Today all the people in northeastern Oklahoma have access to eye care. In the not too distant past, though, too many of these people suffered greatly from lack of eye care. Foster remembers that when he received his bachelor’s degree from NSU in 1965, the College of Optometry did not exist, and eye care services were scarce. “Many Native Americans in this area, particularly in rural communities, had never had their eyes examined,” he says. “People were going blind from preventable eye diseases, such as glaucoma and diabetic retinopathy. Children needing vision care had trouble in school. Adults needing glasses couldn’t read.”

Fighting for a Much Needed Clinic

In the late 1970s, because of the urgent need for eye care, Chief Ross Swimmer of the Cherokee Nation and Mayor Tony Stockton of Tahlequah decided that an optometry clinic should be included in the new building that was being constructed to replace the W.W. Hastings Indian Health Center in Tahlequah. However, legislators in Washington refused to fund an optometry clinic.

Defeat was not acceptable. Foster recalls, “The day before a congressional committee was due to visit Hastings Hospital, the hospital administrator, Bill Thorne, let word out that any Native American who needed an eye exam should get in line at Hastings Hospital the next day.”

Foster continues, “When the congressional committee drove into Tahlequah and saw a huge long line of people, they asked, ‘What are these people doing?’ The committee was told these people were coming to have their eyes examined. Someone added, ‘You should have been here yesterday. The crowd was even bigger!’ So the committee funded extra space for eye care in the hospital.”

Completed in 1981, the optometry clinic at Hastings Hospital made a positive difference, particularly for people who lived near the hospital. But after the School of Optometry was established in 1979, the faculty and others were aware that too many people in remote areas were still not getting the care they needed.

The Tribes Step In

When the Cherokee Nation realized that access was an issue, they took many steps that resulted in establishing health and eye care programs in all of its rural clinics. Today a NSUOCO faculty person is at each clinic, and third and fourth year students rotate through the clinics on a regular basis. In order to provide the complete scope of eye care for the Cherokee Nation and to educate students, NSUOCO faculty and staff also include an ophthalmologist, opticians and technicians.

Early Patient Care Experiences

Foster describes the curriculum at NSUOCO in this way. “The first two years are primarily classroom-based and the third and fourth years primarily clinical. However, because of our volume of patients and the rich variety of clinical experiences, we can start exposing students to clinical experiences early on.”

After completing an optometric clinical methods course in the first semester, students can begin participating in supervised clinical vision screenings. As they progress in their studies, students, under the supervision of clinical faculty, become increasingly involved in examining patients, diagnosing their problems and developing and carrying out treatment plans. They also perform minor surgical procedures.

Foster says that one of the strengths of the program is that students are exposed to the complete medical record, providing them with a more wholistic view of their patients. The clinics are all part of the Indian Health Service and the Cherokee Nation Health Services, so when students are caring for patients, they aren’t limited to just information about the patients’ eyes.

“Our classes are small, and the atmosphere is nurturing versus competitive,” says Foster. “We don’t sign students up and then try to eliminate 20 percent of them. We emphasize service and teamwork with other health care providers to achieve our goals. We also try to instill in our students the idea that their job is to take care of the visual needs of their patients from infancy through their elder years.”

Foster estimates that roughly 95% of the patients who are cared for by the faculty, students and residents are American Indian. About 20% of the faculty are American Indian, and about 10% of the students are American Indian.

The majority of the 52 American Indian NSUOCO graduates are in private practice providing primary eye care services. Four of the graduates are assistant professors at NSUOCO. Three of these assistant professors care for patients and supervise students in Cherokee Nation health care facilities. Another graduate of NSUOCO is a professor of optometry at Pacific University College of Optometry. Three other graduates provide care with the U.S. Public Health Service. Two care for people in the Choctaw National Health Services facilities.

Residency Program

Northeastern State University Oklahoma College of Optometry also has a one-year postgraduate residency program. Currently there are 13 residents. “We recruit the best and brightest from across the country,” says Foster. “Typically residents want to develop expertise in specialty areas, for example in vision training or in contact lenses.” Depending on their interests, residents work in such settings as veteran administration hospitals and co-management centers where they work with ophthalmologists in the care of patients with complex problems.

For More Information

To learn about all of the certified doctoral optometry programs in the United States visit the website of the Association of Schools and College of Optometry and Resources.

More information about the NSUOCO optometry and residency programs is available at the
NSUOCO website. Note that applicants to the doctoral (O.D.) program are limited to residents of Oklahoma, Texas, New Mexico, Colorado, Kansas, Missouri, Arkansas, Louisiana, and Nebraska.

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This article was originally published in the Summer 2008 issue of Winds of Change. The cover artist, Brent Greenwood, Chicakasaw/Ponca, lives in Edmond, Oklahoma.