Letter of Agreement for Externship

Thank you for agreeing to participate in our fourth year externship program. As you are well aware, it has become increasingly important for students to gain this experience as part of their overall clinical education.

For your information, let me describe for you some of the activities in which our students have been engaged. Throughout their third year, our students have been responsible for a comprehensive primary care examination, including a dilated fundus evaluation. At the completion of the examination, each student must analyze the pertinent information, develop a diagnosis and present a management plan, including the use of therapeutic pharmaceutical agents. Clinical instructors repeat tests where necessary and then discuss the important aspects of the case, critiquing the student's performance. All of these activities should continue during an externship.

Beginning with the second semester of the third year, students are exposed to pediatric, binocular vision and contact lens patients.

Requirements for Externship Site
It is important that you directly supervise the independent work of the student during patient care activities. This will guarantee continuity of educational programming.

As part of their externship, externs are obliged to maintain patient encounter logs and write two comprehensive case reports. These log sheets require your signature for verification. I ask that you assist the externs in the preparation of the case reports by making available relevant reference material at your disposal.

You must also evaluate and grade the extern's performance at the end of the rotation. The extern will also complete a survey of externship experiences. All of the pertinent forms are enclosed for your perusal.

All fourth year externs are assigned an externship counselor from the school faculty whose responsibilities are to monitor, read and evaluate the case reports and assign a rotation grade. They also serve as a liaison between you and the College of Optometry. The externship counselor will be identified by the extern upon arrival.

Throughout the fourth year, including externships, externs are expected to be involved in some form of patient care on a full-time basis. This is equivalent to 32-36 hours/week. Externs should have at least 20 direct patient care experiences per week. Occasionally, externs may request an absence from the externship. The extern must fill out a Leave of Absence form. This form must be signed by you, the Attending Doctor before being submitted to the Chief of Externships. Externs are allowed 1 - Leave of Absence day per rotation. Deviations from the student code of conduct should be reported to the Chief of Externships.

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Alexander Harris, O.D.
Chief of Externships

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Attending Doctor's Signature

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Attending Doctor's Name

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Attending Doctor's Address

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City, State, Zip

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Date