What is the Future of Optometry Education?

Welcome to our captivating podcast episode, where we explore the future of optometry, including its evolving landscape, educational opportunities, diversity, and future prospects. Our esteemed guest is Dr. Michael Bacigalupi, former Founding Dean of the Kentucky College of Optometry. Dr. Bacigalupi’s journey from the sunny avenues of South Florida to the esteemed corridors of academic leadership personifies inspiration and forward thinking in optometry. Dr. Bacigalupi dives deep into the multifaceted dimensions of optometry, revealing the passion, challenges, and prospects that shape this dynamic field. Dr. Bacigalupi’s experiences, from pivotal moments that steered his career to his significant roles in shaping the next generation of optometrists, offer a profound glimpse into the future of optometry.

Who is Dr. Michael Bacigalupi?

Dr. Darryl Glover:

Today, we delve into topics of education, diversity, and opportunity. The big questions are: Who has the solutions? How can we propel our profession forward? And most importantly, how can we be the catalyst for change? Friends and family, it gives me immense pleasure to introduce a very special guest – the incomparable Dr. Bacigalupi. This evening promises to be enlightening, problem-solving, and absolutely real.

I’m thrilled to have you on the show, Dr. Bacigalupi. Before we dive in, I think it’s important for our audience to get to know you better, though I’m already familiar with your background. So, if you could, please share with us where you’re from, your journey into optometry, and what drives your passion in this field. And let’s not forget a fun fact – everyone loves those. Let’s kick off this exciting conversation, my friend.

What is the future of optometry
Dr. Michael Bacigalupi

Dr. Michael Bacigalupi:

Optometry has been a lifelong passion for me. In fact, in my high school yearbook, under my senior picture, it reads ‘pre-optometry.’ My entire life has been dedicated to this profession, and it’s been incredibly fulfilling and rewarding.

Absolutely, I’m glad to share. I was raised in South Florida, specifically in Fort Lauderdale. As someone who thrives in warm weather, my recent experience with the cold in Kentucky has only reaffirmed my preference for warmth!

Growing up, my father was a mailman who braved the intense South Florida heat, walking miles every day. His hard work and the physical toll it took on him left a lasting impression on me. In contrast, my mother was the office manager for an optometrist, who happened to be a close family friend living nearby.

I vividly recall being around ten years old, playing basketball with my brothers, and watching my father return from work, utterly exhausted and dehydrated. Meanwhile, our family friend, the optometrist, would drive by looking relaxed, still sharp in his suit and tie, and driving a Jaguar. That stark contrast made me realize I should pursue a career in optometry, not just because of the lifestyle it represented but also because of my own nearsightedness and that of my family. It seemed like a sign that optometry was my calling.

While it might not be your typical fun fact, a personal highlight for me is that I married my high school sweetheart. We tied the knot at a young age – I was 20, and she was 19. Now, 37 or 38 years later, we’re still happily married. We have one son, who’s a firefighter paramedic on the West Coast of Florida. Despite my efforts, I couldn’t sway him toward optometry, even with the allure of a Jaguar!

The Path to Academic Leadership in Optometry

Dr. Darryl Glover:
Many people are considering careers in academia, like becoming a professor or a dean, but they’re often unsure about the right path to take. I’d love to hear from you about what sparked your interest in this field and how you navigated your journey.

Dr. Michael Bacigalupi:
Certainly, around the sixth or seventh year of my career, I was appointed to the Board of Directors of the Texas Optometric Association (TOA). This role led me to work with the University of Houston College of Optometry in recruiting pre-optometry students. I found immense joy in visiting universities like Texas A&M, University of Texas, and Baylor and speaking to students about my passion for optometry. This experience was a turning point for me. When the opportunity arose to sell my practice, I took it and joined the faculty at NOVA in South Florida, which felt like coming home.

Initially, I hadn’t envisioned a career in administration. I was content with teaching, finding it an exceptionally healthy and varied way to practice optometry. The mix of teaching, seeing patients, lecturing, and doing service and scholarship work makes each day unique, which I believe is vital for avoiding burnout.

However, my career path took a turn when Dr. Lewis Reich, the assistant dean for student affairs at NOVA, left his position. I was promoted to that role and spent around nine years overseeing admissions, student affairs, and development. During this time, I realized my potential in administrative roles and the significant impact I could have.

Given the limited number of positions nationwide, becoming a dean of an optometry school is a rare opportunity. So when the chance to be a dean in Kentucky presented itself, despite never having considered living there, I knew I had to seize it. My wife has been an incredible support, following me through various career moves. We moved to Kentucky in 2018, and I semi-retired in August.

Reflecting on my career, I find it extremely rewarding. Even now, as I semi-retire and do consulting work, optometry continues to excite and motivate me daily.

The Value of Optometry Residencies

Dr. Darryl Glover:
I’m interested to hear your perspective on residencies, especially since this is a topic you’ve likely discussed with your students. What are your thoughts?

Dr. Michael Bacigalupi:
My standard response is that residencies are incredibly valuable and time well spent. Here’s my spin on it: Completing a residency is like passing the national board exams. Once you’re residency-trained, that distinction stays with you for life. It opens and maintains doors throughout your career that might otherwise be closed. For example, large ophthalmology groups and academic institutions often seek residency-trained optometrists. I firmly believe that completing a residency early in your career offers a significant long-term advantage.

Challenges in the Optometry Applicant Pool

Dr. Darryl Glover:
Today, I’m particularly interested in exploring the topic of the applicant pool for optometry. How have you seen it change over time? I’m eager to peel back the layers and understand your experiences in this area.

Dr. Michael Bacigalupi:
Absolutely, let’s delve into that. I’ll be frank: the state of the applicant pool is a concern, especially considering the health of our profession. It would be a significant worry if I were still involved in admissions. There are 24 optometry schools in the U.S., and the applicant-to-seat ratio is about 1.3 to 1. This ratio is concerning because it suggests that as more schools open – with two new ones emerging rapidly – we may soon reach a 1 to 1 ratio, which isn’t ideal.

The key to sustaining our profession lies in attracting a more diverse, brighter set of students. We need to tell the story of optometry effectively, showcasing why it’s a compelling career choice. Many students are introduced to optometry through personal experiences, but we must broaden that exposure. Optometry is just one of many rewarding healthcare professions that significantly impact patients’ lives.

ASCO (Association of Schools and Colleges of Optometry) has been proactive in addressing this issue. Over the past five years, the schools collectively invested over a million dollars annually in marketing campaigns to bolster the applicant pool. While the growth hasn’t met our ambitious goals, it’s certainly better than the declines seen in fields like pharmacy.

However, it’s disconcerting when some optometrists express concerns about there being too many in the field, yet simultaneously struggle to fill positions in their practices. This contradiction needs addressing. We must work collaboratively – practitioners, AOA, ASCO, and the Academy – to attract talented, diverse young people to optometry. It’s a wonderful profession, and we must ensure its vitality for future generations.

Addressing Misconceptions and Reality of Optometrists’ Demand

Dr. Darryl Glover:
I completely agree with your concerns. There’s a common misconception that there are enough optometrists, but the reality is different. In a recent podcast with Dr. Richard Edlow, we delved deep into the data, which I recommend our listeners check out for factual insights.

Dr. Michael Bacigalupi:
You’re right about that. One challenge I faced was attracting diverse students to my college in Eastern Kentucky. We identified financial barriers as a significant obstacle, particularly in accessing resources for the OAT. Thanks to a generous donation from a local family passionate about diversity in health professions, we established a grant to assist underrepresented and financially challenged students with OAT fees. To date, we’ve funded 65 students, with a diverse representation among them. Thirty of these students are now in optometry school across various institutions, not just in Kentucky. This initiative makes me incredibly proud, as it’s not just about aiding one college but supporting the entire profession.

Priorities for the Future of Optometry

Dr. Darryl Glover:
What changes do you think need to happen in the field?

Dr. Michael Bacigalupi:
My top three concerns start with the applicant pool, which we’ve already discussed. Optometrists should engage with initiatives like ASCO’s eye-opener sessions to inspire future generations. Next, the challenge of faculty recruitment and retention in optometry is significant. The academic sector struggles to keep pace with market salaries, leading to disenchantment among experienced educators who find that newcomers in commercial practices earn comparable wages. We need to restructure optometric salaries in academia to retain top talent.

The third issue is the performance on the NBEO exams. The 2023 class’s first-time pass rates for part one varied significantly, with a national average of only 67%. This is dramatically lower than other health professions, which consistently achieve around 90%. I believe this discrepancy is partly due to the extensive range of content tested, spanning outdated knowledge to contemporary practices. This breadth strains both the curriculum and the students, leading to a disconnect between what’s essential for contemporary practice and what’s being tested. We must reevaluate if memorization is the best metric for assessing competence in optometry.

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