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Health, Education, and Welfare, there are about a dozen Cubans studying optometry at our schools in this country, and I might add that their scholastic standing, despite language difficulties, is high. These refugees from Castroland are needed, and excellent additions, therefore, to our trained manpower pool. In conclusion it is estimated that with

1. The existing severe shortage of licensed optometrists ;

2. The normal attrition rate of about 3 percent per year among practicing optometrists; 3. The expanding U.S. population and the increase in longevity; and

4. The increasing demand for optometrists in industry, research, and

Government service the minimum of 1,000 graduates annually is a most conservative one. The need is there, the supply of qualified students readily available. To meet our country's requirements for optometrists, support for expansion of facilities is needed, and support by way of financial aid to students is a necessity with the long and arduous training program that optometric students must complete.

Thank you.

APPENDIX

Accredited schools and colleges of optometry in the United States, their deans,

and year organized

Name and address of school 1

Name of dean

Year organized

1923.

1952.

1872.

1951.

1904.

School of Optometry, University of California, Meredith W. Morgan, Ph.D

Berkeley, Calif.
University of Houston, College of Optometry, Cul- Chester H. Pheiffer, Ph.D., O.D.

len Blvd, Houston, T'ex.
Mlinois College of Optometry, 3421 South Michigan Alfred A. Rosenbloom, Jr., 0.D..

Ave., Chicago, Ill.
Indiana University, Division of Optometry, Bloom- H. W. Hofstetter, Ph.D., Director..

ington, Ind.
Los Angeles College of Optometry, 950 West Jeffer- Charles A. Abel, 0.D.

son Blvd., Los Angeles, Calif.
Massachusetts College of Optometry, 178 Newbury Ralph A. Green, O.D.-

St., Boston, Mass.
The Ohio State University School of Optometry, Glenn A. Fry, Ph.D., Director..

Columbus, Ohio.
Pacific University, College of Optometry, Forest James F. Wahl, 0.D.

Grove, Oreg.
The Pennsylvania State College of Optometry, 6100 Lawrence Fitch, O.D..

North 12th St., Philadelphia, Pa.
Southern College of Optometry, Memphis, Tenn.--- Spurgeon B. Eure, 0.D..

1894.

1914.

1945.

1919.

1932.

1 All of the above schools and colleges of optometry are accredited by the Council on Optometric Education, the official accrediting agency of the AOA recognized by the National Commission on Accrediting.

Dr. HEATH. I am serving as president of the Association of Schools and Colleges of Optometry. At the same time, I am a professor of optometry at Indiana University. Indiana University's Division of Optometry is 1 of only 10 schools of optometry in the United States. These 10 schools are charged with the responsibility of providing the optometric education for the practitioners who will provide about 70 percent or more of the vision care of the American public. This is a big responsibility.

With the advances in optometric science of recent years, the curriculum has become so full that it has necessitated increasing the length and the depth of the courses to the point where four of the schools presently have had to extend their curriculum to an additional year, making a total of 6 years of college training to accomplish their optometric education.

Now, this includes 2 years of preoptometry. These are general college subjects in mathematics and science courses. And then 4 years of professional courses following that.

Up to this point a 5-year curriculum—2 years preoptometry,

-2 3 years of professional courses—has been the standard.

This increased length of training, and mostly training, of course, poses an additional burden for the student who is contemplating a career in optometry. With these long 5-year programs, very full 5-year programs that we have had, most students have found it completely impossible to do enough part-time work to support themselves while in college.

Our students in a recent study, a study actually being conducted at the present time by the Association of Schools and Colleges and not quite complete, on instructional hours, shows that in many of our schools the students are carrying the equivalent of 21 semester hours of work while the normal college load for a full-time student is 15 semester hours. So it is this sort of thing that has provided the pressure resulting in the increased length of the program.

I should also point out that with 2 years of preoptometry, it is possible to complete an optometric education in 5 or, in the case of some of the schools, 6 years, but over half of the students entering optometry schools have already completed more than 2 years of preoptometric studies, and nearly a third of these entering students already have bachelor's degrees. So they have had 4 years at least of college training before embarking on the additional heavy 3 or 4 years of professional studies in the optometry program.

Now, the student and the school have a load to carry in addition to this heavy curriculum, and that is the financial burden of putting the student through the school. The cost of training an optometry student to the school averages about $2,200 a year judging from estimates received from all of the schools. This is not very far from what it takes to educate any student in a discipline requiring laboratory instruction. If it is lower than that in some other fields, this is undoubtedly due to forced economies and restricted funds, which is not always a good basis on which to attempt to give the highest caliber training. It is often an indication that salary scales for faculty and staff are undesirably low and that available equipment is in short supply, and so on. So these are not good economies if we strike very much below this average cost.

So far as the student is concerned, the tuition charges at these schools range from about $850 to $1,250 per year. So from this we can say that the student pays about half the cost of his instruction, and the rest must be supplied by the schools.

These funds come in part from the income of the optometry training clinics which are maintained at each of the schools as part of their instructional program. Other funds are available from alumni organizations, and in the case of the State universities, of course, there are tax funds, and, also, those schools receive part of the license fees of all the optometrists registered in those States each year.

The heavy course load, as I have pointed out, makes it impossible in general for the optometry students to earn enough or to provide from their own resources for their lengthy optometric training, and consequently, a great number of them have to turn to loans in order to see their way through their total program.

Most of the schools have small loan fund programs. Oftentimes these funds have been supplied by alumni organizations or by local

service groups such as the Lions Club in some cases, but these are small. They are used primarily for acute emergencies. Scholarships are limited in number and limited in amount. They amount to something like $50 to $400 a year as a general rule. The National Defense Education Act, the student loan program in that act, has been inadequate at virtually all of the optometry schools. It has given first choice to student education in languages, et cetera, and, of course, the National Defense Education Act was designed to help primarily the undergraduates who intended to become teachers.

For our purposes, since the cost of optometric education to the student is high, the National Defense Education Act's loan ceiling is not high enough and the repayment provisions are not adequate for our purposes. They have no forgiveness features such as are contained in the Health Profession's Educational Assistance Act for doctors who set up in practice areas which are deficient or critically short of health personnel

Another feature is that this latter act, the Health Profession's Education Assistance Act, is also operated by the health profession's schools, and optometry's exclusion from it, therefore, is a most undesirable disadvantage in our recruitment program. The need, as has been emphasized and will be repeatedly emphasized, for optometrists is critical. There are about 21,000 licensed optometrists but really only about 17,000 of these can be considered to be available for the health care, for the visual care of the American public. This is a ratio of about 1 optometrist to 11,250, while for a minimum of good visual care, a ratio of 1 in 7,000 is considered to be barely adequate.

To put it another way, a nation of 200 million people needs a minimum of 30,000 optometrists to care for its vision needs. This is a conservative figure. Yet to reach it, we will have to graduate a thousand new optometrists a year. At the present time we are not graduating half that number. This last year we had enrollment in the optometry schools of slightly over 550 new students. This is up nearly 200 students since 1958 when we hit the acute postwar lull. But at this present time, lack of funds and lack of space and facilities at the schools are going to increase the number of rejectees that will be necessary in order simply to handle the increased student load.

Next year the problem will be even more acute unless the schools can expand their facilities.

Meanwhile, American optometry, limited in number and funds as it is, is increasingly becoming the instructor to the world. Students from all the continents in the world are coming to the United States for optometric education. Some stay here and practice. We are glad to have them. They increase our number, and they are needed. We are particularly glad that among these foreign students there are about a dozen Cubån refugee optometrists who are presently studying in the schools with the assistance of the Department of Health, Education, and Welfare. These foreign students are doing very well academically in spite of their language difficulties. They are needed. They are excellent additions to our training manpower pool.

Now, in summing up, just let me say that the need for additional manpower is really acute. The supply of qualified students now as a result of recruitment programs is readily available to meet our requirements for optometrists, our Nation's supply of trained practitioners.

a

Thank you.

Support for expansion of optometry schools and facilities is desperately needed, and support by way of financial aid for students is a necessity in view of the long and arduous program that optometry students must complete.

Mr. ROGERS of Florida. Thank you very much, Dr. Heath.

Dr. HEATH. I do have, Mr. Chairman, catalogs of the 10 schools of optometry in this country which spell out the curriculum of each. I would like to give these to the committee for

Mr. ROGERS of Florida. We will be glad to have them and make them a part of our committee file. Congressman Pickle, would you like to introduce our next witness?

Mr. PICKLE. Yes, I would, Mr. Chairman, and thank you for the privilege. This

is almost like old-home week, Mr. Chairman, because the situation easily could be reversed. You could be presenting me today to this group because optometry is very close to my heart. A few years ago I served as the executive secretary for the Texas Optometric Association and served in that capacity for about 4 or 5 years until they moved me on to other pastures.

It was my privilege then to work closely with every member of the Texas Optometric Association, and in that capacity I traveled over the State of Texas into almost every county, visiting in each of the doctors of optometry's offices, learning to know them personally and understanding something about their problems.

This is a great profession and doing tremendous work for the people of the United States in the field of vision. This group deserves support, not only because of the merits of this bill, in my opinion, but in addition I hope that the States themselves will set up more schools. It is wrong that we only have 10 schools of optometry in the country now. This number must be doubled, I would think, or tripled, and this is partially the responsibility of the States. I hope my own State takes more leadership in this field than they are doing.

I was pleased to notice over the years that optometrists have come a long way. Some part of our population still thinks in terms of being in the back of a jewelry store. That day went out with the horse and buggy. That is no more the situation than anything. In Texas I visited offices where an optometrist is in one part of a new stone or brick building, shared by a dentist on one hand, or shared by an M.D. on the other. There is close liaison between the Texas Optometric Association and the Texas Medical Association, and they are learning to work closely together as they should because the two fields are not overlapping in any respect, and I am glad of that development.

While I served as executive secretary, I made many good friends. One of them is here today, Dr. Nelson Waldman is the new presidentelect of the Texas Optometric Association. I have served with him on the board of directors. I listened to him give me some strong instructions at times, and I have given a little advice here and there. We have taken some of the slings, the barbs, and arrows, and some of the credit for the progress made in Texas. I have shared a lot of these experiences and one of the finest men in our State is Nelson Waldman who has been a leader in the optometric field. He is my personal friend, and I am delighted to present him to this group here today.

Dr. Waldman.

Mr. ROGERS of Florida. Thank you very much, Congressman Pickle.

Dr. Waldman, before you begin, I think you should know that the committee receives you with great affection after all of this very fine introduction from our good and close colleague here from Texas whom this committee regards most highly.

STATEMENT OF DR. NELSON F. WALDMAN, 0.D., CHAIRMAN, COM

MITTEE ON VOCATIONAL GUIDANCE, AMERICAN OPTOMETRIC ASSOCIATION

Dr. WALDMAN. Thank you very much. I was unprepared for such a reception. However, if it were possible, I could take much more time than what I am allotted here this morning to tell you some very wonderful and very, very flattering things about Congressman Pickle who, as he indicated, served as our executive secretary in Texas for several years.

Frankly, I think that you people here in Washington are very fortunate to have him.

Mr. ROGERS of Florida. We agree with you 100 percent.

Dr. WALDMAN. I think he will be a tremendous asset to all of you and all of us serving here in Washington. I hope you take advantage of him.

Mr. Chairman, I, too, will attempt to summarize the statement that has been presented to you.

Mr. ROGERS of Florida. That will be fine. Your full statement will be made a part of the record at this point without objection.

(Dr. Waldman's statement in full follows:)

STATEMENT OF NELSON F. WALDMAN, O.D. Mr. Chairman and members of the committee, thank you for the privilege given me today to speak in favor of legislation which can do so much to aid the visual welfare of our Nation.

I am Dr. Nelson Waldman, practicing optometry in Houston, Tex. I am chairman of the American Optometric Association's Committee on Vocational Guidance and president-elect of the Texas Optometric Association.

The American Optometric Association has done a great deal of research in an effort to determine the current and future needs of optometrists in the United States and the prospects for meeting these needs. We have studied ways and means of attracting intelligent young men and women and have devised a program to assist in eliminating the shortage of optometrists which will otherwise become a problem of serious consequences for this great country.

The services of optometrists are essential to the health and well-being of the American people; the missions of the U.S. armed services and of civilian space and other scientific endeavors; the production of vital military and related equipment and materials needed for national defense; and to the development of skills and the improvement of educational techniques among students and workers. However, as the demand for optometric services has expanded—both in civilian and military life the number of optometrists has not been keeping pace, and has, in fact, been declining. Thus, it is imperature that every effort be made to emphasize the need for and the shortage of, men and women trained in this vital professional specialty.

Optometrists devote 5, 6, or more years to college or university education to the purpose that at the conclusion of such education they can make a conscientious measurement of refraction and visual acuity and apply their acquired knowledge to increase the visual performance of both young and old who seek their professional services.

Optometrists fill a public health need which can be met from no other source than by utilization of their services. They presently supply two-thirds of all the vision care to the general public of the United States, and in the Armed Forces this percentage is close to 85 percent.

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