Culture shock is a familiar concern among travelers. However, this feeling of uncertainty and anxiety when experiencing a new culture is not strictly limited to tourists. One can observe cultural differences between various communities worldwide, whether or not separated by geographical location. A Glaswegian, for example, often feels a palpable difference when they visit Scotland’s capital, Edinburgh. The same goes for someone from San Antonio, Texas, when they visit San Francisco, California. This concept also holds true in the medical field, given the considerable differences in the standards and practices worldwide.
Perhaps no area of the medical community is more affected by culture shift and shock than optometry — thanks to the myriad of different regulations, standards, and educational requirements that exist worldwide. Some countries demand that an optometrist holds a degree that takes four years to study to practice, whereas other states view a practitioner of optometry as someone akin to a junior technician. In others countries, still, optometrists are highly restricted in what they can practice at all.
Differences Between Eastern and Western Optometry
It might be something of a general statement to say that there are considerable differences between Eastern and Western optometry practices. However, these differences can only provoke debates and new perspectives, ultimately leading to fostering and sharing of new ideas.
The differences and challenges that exist in bridging the gap between these two optometric spheres are a fascinating topic, and one of the best places to examine the issue is the United Kingdom (UK).
Not only is the UK a major destination for Asian optometrists, either for work or training, but the country also hosts a large ethnic minority population of Asians. In the British context, this term mainly applies to those of South-Asian background, i.e., Indians and Pakistanis; whereas East Asian is used to describe people of Japanese and Chinese background, among others. At present, nearly 5 million people in the UK are of this origin, accounting for about 7% of the population.
Education Standards May Differ
One member of this community is self-employed optometrist Ms. Shamina Asif, the founder of Optom Academy. This educational institution was set up specifically to cater to the needs of pre-registration optometry students, many of whom originate from abroad, generally, and South Asia, specifically. Courses are held at the Optegra Eye Clinic at Aston University campus in Birmingham, the UK’s second-largest city. And for Ms. Asif, it’s an endeavor of passion as much as education.
“I always had an element of teaching in me from a young age, so once I felt I had enough knowledge and experience I decided to pursue this passion of mine,” shared Ms. Asif. “The most rewarding part is that I help to contribute to developing great optometrists.”
Ms. Asif has worked with thousands of optometry students. She said the primary challenge one encounters when educating students is understanding the different standards and expectations that exist in different countries. For example, there are different minimum requirements for practice in the UK and the Indian subcontinent.
“The UK is brilliant in terms of regulation of sight testing, as only optometrists can carry out refraction and eye tests. This means you are at a certain standard and qualification before you are allowed to test the eyes of patients,” explained Ms. Asif. “I know this is not the case in many countries, like Pakistan and India.”
“You need to know your subject inside out,” she continued. “I always recommend that prospective students look at the General Optical Council’s website for requirements and exams that they may need to sit. As the way sight-testing might be taught in other Asian countries is not the same standard as the UK, so there’s a possibility that incomers would need to upskill,” she added.
Overcoming Challenges and Keeping a Positive Outlook
Beyond her education projects, Ms. Asif continues to work at an independent practice in the town of Walsall. It has a population of 300,000 that’s notable for its ethnic and cultural diversity. Her specialties include emergency appointments, pre-cataract assessments, as well as post-cat assessments and pediatric sight tests. In her 17 years of experience, she has encountered a variety of challenges.
Of these, two remain important to note for incoming Asian optometrists to the UK, the first being that black and minority ethnicity (BAME) populations are more at risk of experiencing damaging eye conditions, such as glaucoma and diabetic retinopathy.1 In fact, one in 10 people over the age of 65 in this community will experience serious vision loss. Overall, they are less likely to attend primary eye care appointments. There are also socio-economic barriers, such as language difficulties, higher rates of poverty, and higher rates of problem denial.
Secondly and unfortunately, racist attitudes — though rare — do persist in parts of the UK. Four years ago a visitor to an optometry clinic in the town of Lanark told his optometrist, who was of South-Asian ancestry, that he would rather be seen by a ‘white person.’ He was convicted in court of a racist breach of the peace.2
However, Ms. Asif has previously reported that racism is a diminishing issue and that in today’s environment it should not put off Asian optometrists from moving to the UK. In fact, by coming to study and work in the country, they can help drive the change required to make the field more inclusive.
“BAME optometrists make up a large proportion of the workforce in the UK and there are no accessibility issues,” she noted. “The only problem is that you don’t get BAME community in higher board-level positions where policies and strategies are developed,” Ms. Asif shared.
Prepare Well and Plan Long-term
Ms. Asif strongly recommends that optometrists who wish to continue their practice, or those who are yet to begin their education, should consider the UK as an option. The country has a strong healthcare system and high training standards, as exemplified by her work as an educator.
Her final tip for optometrists coming from the East to the West? Consider a long-term plan on how to set up a practice — one that you could own — in the country where you plan to work.
“My team and I bought a practice that was established,” she said. “The owner was retiring, and this was a good opportunity for us. This is a good idea. Try to buy a practice where someone is retiring as you will already have a patient base when you get started,” Ms. Asif added.
“Optometrists save sight and help people to see clearly, giving them a better quality of life. What could be more rewarding?” she concluded.
Editor’s Note: A version of this article was first published in COOKIE magazine Issue 09.
- Eye health care in Wales: Increasing awareness of eye health and primary eye health care to people from at-risk Black and Minority Ethnic communities. Available at: https://media.rnib.org.uk/documents/BME_Eye_Health_Care_in_Wales_-_Poster.pdf. Accessed on October 18, 2022.
- Man refuses treatment from British-Asian optician because ‘Manchester attack was the last straw’. Available at: https://www.independent.co.uk/news/uk/crime/man-refuses-asian-optician-specsaver-manchester-attack-last-straw-a7907261.html. Accessed on October 18, 2022.