**4. Discussion**

Reassuringly, undergraduate optometry students unequivocally view themselves as proto-professionals. They clearly identity as professionals at the beginning of a learning career in healthcare practice.

Undergraduate Optometry students largely view qualified optometrists within the 'Professional' category of the Place Model which would sugges<sup>t</sup> that they, as individuals, aspire to the role of the 'Ideal Optometrist'. However, somewhat worryingly, there seems to be some evidence to sugges<sup>t</sup> that there is a small number of qualified practitioners in existence who have become disillusioned with their profession. Whilst this evidence from undergraduate students is subjective and anecdotal in nature it does back up evidence from the Association of Optometrists' Optometric Workforce survey that there is a growing shift towards de-professionalization. More work needs to be done in order to explore this further, and the Place Model may be a useful tool in order to facilitate this.

The Association of Optometrists published a report on 'recruitment, retention and career aspirations of the optometric workforce' in 2018 [12]. The main findings from the report sugges<sup>t</sup> that the direction of the profession is changing to a more female dominated profession with a high proportion of locums with flexible work patterns. The report also suggested that Optometrists feel that, the profession is feeling devalued with other health professions and the general public not being aware of the Optometrists' scope of practice. They reported that Optometrists feel under pressure to sell spectacles with the situation being exacerbated by the low NHS fee for sight tests. In contrast, a workforce survey by The College of Optometrists revealed that the majority of respondents (80%) rated their job satisfaction as either 5, 6, or 7 on a 1–7 scale (with 7 being the highest level of satisfaction) [13]. The findings of the survey suggested that clinical appraisals are key to maintaining and developing clinical practice [13]. This may be di fficult to implement in smaller or independent practices, and particularly with part-time or locum Optometrists. This highlights the importance of continuing professional development (CPD) in order to maintain a secure professional position in terms of the Place Model. The General Optical Council (GOC), the regulatory body for the optical profession, launched the Education Strategic Review (ESR), a consultation on optometric education standards and learning outcomes in 2017. The review's primary objectives are that the regulator is able to clearly identify the major risks within the sector; there is clarification of the role of the optometric professional and there is a clear understanding of how healthcare is delivered across all UK regions [14]. This consultation-led review received 539 responses from individual registrants (Optometrists and Dispensing Opticians), universities, professional bodies and other relevant stakeholders [14]. Following on from the consultation exercise, the GOC described five key steers all of which point towards the 'Ideal Optometrist' most notably the fourth steer of 'increasing emphasis on professionalism'.
