Primary Eye Care - Crownpoint IHS '02-'03

• Briefly describe the patient population and types of disorders that routinely present at your clinic. Also, provide the typical number of patient encounters you have in a day.
  • Navajo population of all ages. See high refractive errors, ambyopia, diabetic and other vascular pathology, trauma, foreign bodies, iritis, and lots of cataracts!
    Typically see 8-10 pts/day, most (80%) are dilated exams.

• Describe other activities that you are available to participate in besides direct patient care. (i.e. Grand rounds, internal lectures, interaction with other health professionals, staffing of student interns).
  • On-call to hospital ER staff, staff student interns, quarterly journal club with other IHS residents in area

• Briefly describe the setting of the clinic and the surrounding area.
  • Crownpoint is a small desert community on an Indian reservation. We are surrounded by mesa tops and canyons. The next closest town is Thoreau, about 25 miles away. Thoreau is next to Interstate 1-40, but is really a very small town; it has two gas stations, a trading post, a restaurant, and several other small businesses. Gallup is 50 miles away, and has a Super Walmart (we all like to shop there!), restaurants, and a mall. Albuquerque is 130 miles away, and has everything.

• What are some strengths of the program and what areas do you feel need improvement.
  • Friendly, tight-knit community and hospital staff, independence, relaxed schedule, housing.

• Briefly describe the geographic location/area of your residency program (what should one expect).
  • Crownpoint is about 50 miles from the nearest metropolitan area, so it is somewhat isolated. Crownpoint is pretty self-contained however; it has a grocery store, a police station, post office, general store, gas stations, laundromat, schools (kindergarten through college), and of course a hospital. We are in the middle of a southwestern desert at an elevation of 8,000 ft. Temperatures can vary widely; in the summer the temps can get up to 90 degrees, then drop to 30 degrees at nightfall. The snow in the winter can keep up until April ( as it did this year). We are prone to high winds and thunderstorms. The spring and fall are beautiful though (wildflowers everywhere). But keep in mind, this is a desert and the general color here is tan, and the weather is mostly dry.
  • Crownpoint is a very small community, two miles square. There are local Navajos and a very large population of hospital staff that live here. Most hospital staff live about two miles away in what’s called “old PHS housing”, which in blunt terms is a collection of trailers under a mesa. Families live here, as well as interns and residents rotating through. It’s usually quite and very dark out here (nice for viewing stars). The community is quite safe, and almost everyone knows everyone else. There are lots of get-togethers at each others houses (mostly an excuse to share food).
  • There is no “night-life” here, unless you consider the monthly rug auction/art & crafts fair at the elementary school, which can go to 1 or 2 am, as night life. There is only one restaurant in Crownpoint – Taco Bell. There are no entertainment venues. If you are very much a city person, this place is not for you. You need a certain amount of independence, sense of adventure, and autonomous nature if you want to live here. You can’t be afraid of the dark, or of quiet, or of your trailer making sounds as it expands and contracts with changing temperature.
  • If you are an outdoors person, this place is great for you, and there’s lots to do. You can visit nearby pueblos, and ancient ruins, go backpacking, hiking or camping on canyon trails. There are ruins literally everywhere here. The closest is Tall House ruins right here in Crownpoint. There are many state parks nearby. Red Rock National Park is 30 mins away. The Grand Canyon is a few hours away, as is skiing in Colorado if you prefer.

• Has your residency thus far been what you expected?
  • Yes, pretty much. I knew I would see vascular pathology and high refractive errors. I didn’t expect all the trauma-related cases. I appreciate the patient load and the diversity of cases, but mostly what I’ve learned is confidence, and comfort in managing cases.
  • At first the geographic isolation (having to drive an hour to get anywhere!) was daunting, but the community is tight-knit and self-sustaining for the most part. I now consider the “big city” (i.e. Gallup, Albuquerque), as rather cold and impersonal.

• What were your reasons for applying for a residency and have they been addressed?
  • I applied for the residency mostly because I didn’t feel as confident in my clinical and diagnostic skills as I wanted, and so yes, this has most definitely been addressed here in Crownpoint.