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Summer 2024

Why an ICO Education Matters


Sheila Quirke

It is an objective fact, widely recognized within the field, that a degree from Illinois College of Optometry (ICO) has status and value. The oldest school of optometry in the nation with the largest alumni network (eight thousand living graduates and growing), ICO has earned its well-deserved reputation as one of the top OD programs in the country. Stating that in this forum, though, is a bit like preaching to the choir, as readers of this article — the alumni of ICO — already know it well. 

Stephanie Messner, OD, ICO Dean and Vice President of Academic Affairs knows it too, “ICO is a legacy institution that is successful because of its ability to adapt, change, and grow. We have a very strong curriculum and are constantly evolving to improve.” Dean Messner is in a unique position to speak with authority on this topic, as she recently served as Chair of the Accreditation Council of Optometric Education (ACOE) and sat as a member of the Council for over five years prior to chairing it.

“We have a robust training ground at the IEI. Our patient population tends to be higher in rigor and quantity than other programs.”  
Geoffrey Goodfellow, OD ’01

Those who are still learning about the value and significance of an ICO education are the prospective college students looking for an OD program. With a growing number of optometry programs (24 in the US now, with two more in Canada) and a stable number of student prospects, competition is on the rise among programs. “With the applicant pool growing at a pace slower than the expansion of available seats, it can feel like an arms race for schools to attract the best candidates,” noted Dean Messner.

A common resource that prospective students use when searching for a program is the scores of the National Board of Examiners in Optometry, widely known as the NBEO. Published annually by the Association of Schools and Colleges of Optometry (ASCO), the NBEO’s Yearly Performance Report is a well-regarded metric consulted by college students looking for OD programs. 

Sarah DeVries, OD, is a current resident at ICO and relied on the NBEO scores as part of her decision-making process for choosing an OD program, “You put so much time and effort into your education. If you’re going to do it,” she reasoned, “do it big. That will provide you with the bigger gain.” 

It stands to reason that a program’s higher score on the NBEO may correlate to a higher quality program overall, but the reality is more nuanced. “There is not a complete transparency of information. Prospective students,” says Dean Messner, “must be savvy enough to extrapolate those results.” That data extrapolation requires a series of steps pulling from different sources.

Publicly available information sheds light on this issue. Data published on ASCO’s website is provided for each graduating cohort, but some programs require students to pass one or more parts of NBEO to graduate. Under these circumstances, when a student doesn’t pass a part of the exam by the time they would otherwise graduate, their data is excluded. This practice can artificially inflate pass rates for each individual exam section as well as for the ultimate pass rate. 

When programs follow this practice, the best way for a prospective student to see how much impact this may have on their reported data is to look at published attrition and retention data on an individual program’s website. If a program lists a considerable number of students as having completed all curricular requirements but not met other graduation requirements, that indicates a significant number of students did not pass boards and therefore did not graduate. 


These students in effect are erased and not included in the calculation of pass rates. If they had been, the calculated pass rates would have been significantly lower. “I have seen instances where nearly 25% of a cohort of students who successfully completed the curriculum were unable to graduate because they didn’t pass a part of the board series,” states Dean Messner, “Clearly, this will have a major impact on their reported pass rates.”

ICO does not impose any mandates to pass any part of the NBEO to successfully graduate from its program. Data for all students who have successfully completed the curriculum are included in the graduation cohort and accurately and transparently reflects ICO’s student performance on the exam series. 

Dean Messner explains the rationale behind that choice, “At one time we considered adding the requirement to pass one or more parts of NBEO as a condition of graduation. This would put us on a level playing field with other institutions who have such requirements when it comes to reporting NBEO pass rates. But we decided against this for two reasons — first, we want to be transparent regarding our academic outcomes. Our NBEO performance is solid, and we have nothing to hide. In addition, we don’t want to withhold the OD credential from students who completed the curriculum as it might limit their employment prospects as they are working toward passage of the NBEO series. While graduates who have not passed boards may not be able to practice optometry, they potentially can work in the eyecare field in other capacities. Why would we want to preclude them from doing so?”

A score of 100% on the NBEO would suggest the best to most people, but that is a metric that cannot account for, as Geoffrey Goodfellow, OD ’01, ICO faculty member and the Associate Dean for Academic Assessment says, “the depth and breadth” of any given curriculum. “The NBEO is an important common metric and ICO has a long history of performing well above the national average, but we do more here.” 

For Dean Messner, it goes beyond preparing students to pass an examination. “At ICO, we take a holistic approach to what success looks like. Our students will become life-long learners. They are leaders within the exam room and among their teams. Knowledge is king, but we also try to ensure that our graduates are great communicators with the ability to engage others. They have people skills that result in developing relationships with patients and other professionals that can span decades.” 

The ICO approach to holistically trained optometrists is singular and reliant on a set of intentional building blocks that differentiate it from other OD programs: 

The Complex Patient Base Difference

ICO students train at the Illinois Eye Institute (IEI), a world-renowned clinic that clocks over 85,000 patient visits annually. Even first-year students are given patient access, as clinical shadowing begins in the initial year of training. “We have a robust training ground at the IEI,” says Dr. Goodfellow, “Our patient population tends to be higher in rigor and quantity than other programs.” The patients are diverse in age, race, class, and medical presentations, leading to rich and challenging exposures for students.

“Perhaps a better metric for assessing program quality is one used by ACOE that requires each optometry program to demonstrate that at least 80% of their matriculants achieve licensure or are license- eligible (passed all parts of NBEO) within six years of matriculation."
Stephanie Messner, OD 

The Faculty Difference

ICO has one of the largest faculties amongst national OD programs. Dean Messner thinks of them as less ‘sage on the stage’ and more focused on active and experiential learning. “We have a mix of veteran educators and researchers and new expert recruits who trade knowledge and ideas. It’s a dynamic exchange that benefits our students,” says Dr. Messner.

The Alumni Network Difference

With thousands of engaged graduates and a proud history of shaping optometrists who specialize in both clinical skills and industry innovations, ICO has worked hard to cultivate a network to help support and mentor new graduates. Scott Jens, OD ’91, ICO’s current chair of the Board of Trustees, sees the difference a committed alumni network makes, “They provide an extra presence and stability for new graduates. Our network is a powerful platform for this next generation of practitioners.”


The Student Base Difference

Dean Messner has seen a change in ICO students over the years, “Our recent students tend to be more service minded and less concerned with grades. They’ve got the intellectual horsepower necessary for academic achievement but bring more to the table than just grades.” She has also seen a culture shift among students, “They are less competitive with one another. Student support and helping each other along the way is more important to them.”


The Tech Integration and NBEO Readiness Difference

“ICO is leveraged for ‘surround sound’ with technology,” says Dr. Jens, “We continued to embrace the use of tech after the pandemic. These students have so much more to learn now in a four-year window and tech helps with that.” Advancements include an online archive of lectures, a lecture capture system, enhanced imaging, and animations.

Dr. Goodfellow and other faculty have worked to help prepare students for their NBEO boards so they feel confident and accomplished on test days, “The NBEO rubric and learning objectives are baked into our curriculum,” he says, “ICO also provides space for readiness courses on campus to aid in board reviews and our academic calendar is curated to provide built-in time to study for board exams.”

The Organizational Structure Difference

One of only three stand-alone OD programs left in the country, or “all optometry all the time” as Dean Messner likes to think of it, ICO is in a strategic position to fully prepare competent and well-prepared optometrists. “We are more agile,” says Dean Messner. “Not competing with other disciplines ensures we maximize available resources. And there is a streamlined chain of command, unlike a university setting. We can make changes quickly in response to needs.” Dr. Goodfellow agrees, “Optometry is not a side gig or competing for resources at ICO. All our classes are taught with that emphasis on optometry.”


Reflecting on the role of NBEO results in choosing an OD program, Dean Messner states, “Perhaps a better metric for assessing program quality is one used by ACOE that requires each optometry program to demonstrate that at least 80% of their matriculants achieve licensure or are license- eligible (passed all parts of NBEO) within six years of matriculation. The metric looks at each student who started the program, not just those who graduated. Even though a student may leave a program for academic or personal reasons and never graduate, they still are included in this calculation. Basically, the metric is a reflection of the quality of the admissions process for a program as well as of the quality of the education provided. It also reflects the ability to ultimately pass NBEO (or alternately the Canadian boards) since that is a requirement for licensure. The calculation requires a six-year look-back, so the most recent data available is for students who started the program in 2017.” 

“It is generally high achieving students who choose a residency and I always try to be the attending that I wanted, but I have learned more in this one year than my four-year program combined.” 
Sarah DeVries, OD  


At ICO, over 92% of the students who matriculated in 2017 went on to licensure, far exceeding the ACOE requirement. “I am very proud of this rate of success for our ICO students,” says Dean Messner, “After all, this is what our mission is all about.”

On the cusp of wrapping up her one-year residency at ICO, Dr. DeVries has seen and felt the difference an ICO education makes, “It is generally high-achieving students who choose a residency, and I always try to be the attending that I wanted, but I have learned more in this one year than my four-year program combined,” she says. “My confidence has grown and I am also amazed at what the ICO students already know and their competence. We see patients from all over the world with different backgrounds and from all walks of life. My inter-professional communication has improved and the volume of patients I see with challenging ‘once-in-a-lifetime’ conditions started on day one.”


And that, right there, is the ICO difference that will never be seen on a metric.

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