• Optometry as a Career Choice

    Optometry as a Career Choice

    You will graduate college this year. You have a high grade point average and are strong in sciences. You enjoy dealing with people and helping them. You decide to explore the health professions that lead to a doctorate.

    Your GPA will allow you to consider Medicine, Dentistry, Podiatry or Optometry. You rule out medicine, because you do not wish to have the stress of life and death decisions combined with unpredictable hours. Dentistry is unappealing because you have never enjoyed working with your hands and suspect you are a bit clumsy.

    That leaves Podiatry or Optometry. You learn that Podiatry has a low glamor rating but high income potential. Optometry has a median salary that is $88,000 versus Podiatry at $124,000. For more on glamor versus income visit ...http://netscape.salary.com/articles/...ce.asp?atc=544

    You feel eyes and vision have a greater “glamor factor” than feet and ankles and are willing to sacrifice the potential income difference for what you perceive is a satisfying profession. What are your perceptions of optometry? You gain your knowledge from sources such as the Center for Advising and Student Achievement whose description...

    The Perception of Optometry

    “Optometrists are independent, primary health care providers who examine, diagnose and treat disease and disorders of the eye and visual system. This includes measurement and prescription for glasses and contacts, diagnosis and treatment of eye coordination and focusing issues, treatment of eye diseases such as glaucoma, and detection of systemic diseases such as diabetes and high blood pressure. Optometrist also perform non-invasive surgical procedures. Areas of sub-specialty include low vision rehabilitation, pediatric or geriatric eye care, vision therapy, sports vision, and ocular disease.”

    It is an accurate description. You feel this is the right fit. You will sacrifice four difficult and expensive years of education and training to achieve a Doctor of Optometry (OD) degree. You perceive this will allow you to either open a new practice, become an associate leading to a partnership in an established practice or have other attractive opportunities if you do not wish to become self employed.

    You could work for the government. Opportunities exist for a career in the military. This means being commissioned as captain in the army, air force or as a naval officer lieutenant in the Medical Service Corps. For those who enjoy rural locations, there are also opportunities in the Indian Health Service. Closer to home, you can be employed by the Veteran's Administration

    What you really like best are these multiple choices, that would allow you to have very flexible hours, good income with enough free time to meet family obligations. Although tuition is extremely high there are generous student loans. Funding your professional education will not be a problem. These may be your perceptions for a rewarding future career in optometry. All based on solid research.

    You decide on the appropriate optometry college... (http://www.aoa.org/x2664.xml). If you are a resident in one of the states with a college of optometry as part of the public university system, there is considerable tuition reduction, over private optometry colleges. All this is reviewed by visiting (http://www.opted.org/info_faq.cfm)

    The Reality of Optometry

    Optometric education and training is demanding and exciting. After one free summer between the first and second year, there is no free time. Outside employment to supplement income is out of the question for most. By the end of the fourth year student loan debt can range from a low of $100,000, to for many who graduate from private colleges $200,000. A formidable debt!

    This not an impossible debt however, because of long term, low interest repayment provided there are professional opportunities with adequate remuneration. Some students delay loan repayment by electing to take a residency.(http://www.opted.org/residencies_faq.cfm) . They sacrifice a years higher earnings for proficiency and improved future hiring opportunities.

    Now the problem...

    There is an excess of optometric graduates. Optometry colleges have been unwilling to cut back on enrollment. As a result the vast number of graduates cannot be absorbed into private practice, as associates leading to partnerships. Those ODs who receive offers, do so at a lower salary than they expected. This makes paying off the student debt very difficult.

    ODs who wish to open a new practice find receiving bank loans difficult to impossible because of their student debt and no financial track record. For many this closes the door to becoming their own boss.

    Some recent graduates elect working for the government either in the military or Indian Health service if they don't mind being far from home or the Veteran's Administration when there are openings.

    A lucky few, are hired as associates in an Ophthalmologic practice where they can utilize their training to the fullest extent and maintain doctor prestige and that “glamor factor”. Starting salaries in MD practices are better than in an optometric associate situation. The down side is that there is no equity in the practice. The OD will remain an employee, always subservient to the MD.

    The Commercial Alternative

    At present, the majority of optometric graduates are forced into situations that they did not expect when they selected optometry as a career choice. They are forced into commercial, corporate optometry. The pay scale is better but the “glamor factor” of optometry is gone. They may work in a mall with undesirable hours. That means possibly evenings and week ends. These ODs might receive a prestigious title, but make no mistake, they are employees of a corporation. Employees can be terminated at any time if the employer is displeased. Equity and patient loyalty cannot be built in that commercial environment.

    The question to ask... Would working in Wal Mart or a similar company, in a small dark room eight hours or more each day, something that would be acceptable as a career? This may not happen, but it is a sad reality to many recent optometry graduates.

    Optometry can be a rewarding and gratifying career. Be certain that you review your positive perceptions and that the optometry college admission committees will reinforce, but understand the realities. Certainly visiting with practicing optometrists in both professional and commercial locations will allow a well rounded picture for future career decision making.

    If you decide on optometry and are accepted in an optometry college, our website welcomes you.

    Paul Farkas,M.S.,O.D.,F.A.A.O.
    Web site administrator

    This article was originally published in forum thread: Optometry as a Career Choice started by Paul Farkas View original post
    Comments 3 Comments
    1. Dominick Maino's Avatar
      Dominick Maino -
      Hi Paul...

      Just want to make a couple of comments about what you've written:

      "That leaves Podiatry or Optometry." All professions have their own unique challenges and advantages. Podiatry really shot itself in its foot (pun intended) when they mandated that all graduates had to do a residency and then did not provide enough residencies for graduates. This mandatory residency also extended the time it took to get into practice as well...changing a 4 year program post undergrad to a 5 year program.

      Income for an optometrist can vary...however the AOA notes that: "The American Optometric Association (AOA) lists the median net income for optometrists in private practice between $115,000 to $120, 000 (2000)." and that was back in 2000. Even with the economy's downturn, optometrists still make a pretty good living. The average income in 2009 as $114,410 and median income as according to the Review of Optometry $93,000. (http://www.revoptom.com/content/c/22520/). Again this was after the recession....one thing you can count on is that these numbers will probably go up as our economy improves.

      "Although tuition is extremely high there are generous student loans" Tuition at the schools and colleges of optometry can also vary. Optometry schools' tuition is comparable to any other independent health care profession and in some cases less. Education is never cheap....but often it has value beyond its monetary cost.

      "By the end of the fourth year student loan debt can range from a low of $100,000, to for many who graduate from private colleges $200,000. " While this is true for many students, please note than the schools and colleges of optometry are aware of this debt burden. The Illinois College of Optometry has been recognized for making sure our students have a high level of Financial Knowledge....we assist them thru the student loan maze and always have assistance available. We also show them how to manage debt as well.

      "There is an excess of optometric graduates." This has been said since I graduated from optometry school at he dawn of time! How do you measure this? One way is to assess if graduates are working. I know that for many years now, ICO grads have managed to pay their school loans and not default on what they owe. This only occurs if the graduate is working. If jobs are available....and they are...this would seem to indicate no excess of ODs at this time. Is this a possible problem in the future...yes...as more schools and colleges come online...you may see a significant increase. However their are many factors at play that now would seem to indicate that the pool of possible undergrads who will apply to optometry school may be decreasing soon. These indications include fewer males going to college, new medical schools opening, new dental schools opening....and other options for undergrad students in business, law, etc.

      "ODs who wish to open a new practice find receiving bank loans difficult to impossible..." It can be difficult to open a new practice....but certainly it is not impossible. I see ICO graduates do this all the time. Most of us who have been in optometry for a while remember the way it was to set up a practice...and not the way it currently is...there are many different forces now that were not a part of the equation when you and I graduated. The fact that 50-60% of our graduates are now women results in a paradigm shift that alters many of our pass perceptions in a yet to be determined manner.

      "At present, the majority of optometric graduates are forced into situations that they did not expect when they selected optometry as a career choice." While this may be true for many graduates of optometry programs....it should be noted that most new optometrists will work in up to 5 practice situations before they choose a more permanent practice choice. These graduates will use the initial higher salaries in corporate positions to put aside a nest-egg or to pay down debt so they can open a private practice.

      "Be certain that you review your positive perceptions and that the optometry college admission committees will reinforce, but understand the realities." I do not know what other schools and colleges do in this area...but when our applicants interview...one of the places they stop at is our financial affairs office....and they start the teaching process of the fiscal realities right then and there with the applicant. We do not want our students surprised about the cost and how to manage debt...

      Optometry remains a highly attractive and fiscally rewarding career. Is it easy? No. Will you encounter significant debt? Yes, as you would with any health profession educational program. Are there distinct advantages to being an optometrist? Yes. These advantages are many...but many of my students like the significant life style advantages optometry offers.

      The future:
      Any time you think you can predict the future...well, you are probably wrong...but that never stops anyone from trying..so here are some of my predictions for optometry.

      At the last American Academy of Optometry meeting where I presented a poster, a fellow next to me from MIT was presenting information about a device that hooks up to a cell phone. It determines your prescription and then sends it off to a lab to be fabricated. Although this device was meant for 3rd world countries where eye care is minimal. You can bet that once perfected it will be used by the general population. You might think this would be a major problem for optometry. I predict that when this occurs, it will actually make "refraction" a true specialty in the profession. Most of those in their late teens to 39 yrs of age could probably use this device well. Those younger and older will need the expertise of the optometrist. Those will high refractive errors will need the optometrist (how often do you think that first time corrected hyperope will be able to adust to their glasses without problems?) Those with binocular vision problems of any age will need the optometrist (can you say "3D Vision Syndrome?). Those with various medical eye problems will need the optometrist. Can you imagine actually charging an appropriate fee for performing a refraction? I think all the specialty areas of optometry will keep us alive and well....and prospering for some time to come.

      Women in the profession.
      The fact that many health care professions have a significant number of women graduates is going to change all these professions in ... as of yet ... unpredictable ways. I do not think we will have an over supply of optometrists for some time. This is because the practice patterns of women will be and are different than that of men. I predict that women who are new graduates will practice for several years once out of optometry school, then reduce their hours working as an optometrist significantly while raising a family...and then re-enter the profession later on. Once there is a critical mass of women doing this within the profession...only then might the actual supply of optometrists be affected.

      Medicine and Optometry
      We will be on the opposite sides of many issues for years to come. At some point the government will step in if we can't solve the issues ourselves....this will be bad for all. This will be true for medicine and podiatry, medicine and nurse practitioners, and medicine and just about anyone else involved in health care. Whoever can give the highest quality care at the least cost will probably come out the winner.

      The far future
      When I am but dust....and many mountains worn down to bumps upon the earth....no optometrists will be needed. There will be bionic eyes.....and in general, many six-million dollar men and women (a joining of the flesh with technology) who live very extended lives. I wish I could hang on till then....it would be interesting to see what optometry would morph into to serve this new group of cyber-digital-computerized-human-computer integrated person!

      Dominick M. Maino, Od, MEd, FAAO, FCOVD-A
    1. Norman Shedlo's Avatar
      Norman Shedlo -
      Read this excellent article on medical school debt.

      July 28, 2011, 12:01 amThe Hidden Costs of Medical Student Debt

      By PAULINE W. CHEN, M.D.He was a senior surgeon many of us in training wanted to emulate — smart, busy and beloved by patients and staff. But we loved him most because he could have been any one of us. He had slogged through the same training program some 15 years earlier, and he had survived. . .

    1. David Burgett's Avatar
      David Burgett -
      Paul, this is a great article because you accurately cover the general conditions and realities of the profession from a relatively unbiased perspective. From a student's position, Optometry as a profession is over-glamorized, for both the "doctor" status and the financial expectation, albeit the same exists for most advanced-degree health professions, simply because a college student envisions themselves as doctor earning good moneyand having "reached the rainbow", so to speak. They can not truly appreciate the "side effects" and other limitations since they have not worked for a living, and have not experienced the life consequences (fulfillment, gratification, etc. or lack thereof) that comes with the career conditions you describe. In general, though, all professions have their downsides and you hit the nail on the head when you ask if working "
      in a small dark room eight hours or more each day (is) something that would be acceptable as a career," referring to only a commercial setting; however, is this not the case in 90% of optometry settings?

      The bottom line is, as an optometrist, we sit in a jail cell-sized, dark room with no windows, performing mainly the same tasks repeatedly for eight hours or more each day, regardless of where or for whom we are working (for the most part). And this is what over-idealizing, glamour-seeking, prestige($)-driven students should consider more seriously, by way of shadowing doctors in different settings for an entire day or more, to get the feel of what the job truly consists of. It does not cut it to work as the receptionist or technician, since you still believe that "being the doctor" will not be the same.

      As a college student, I shadowed a doctor in their private practice for a few hours a day, during a few days each week, and I always left the office thinking, "wow, all that stuff is really cool, and it seems like a relaxed, comfortable environment - I would love to do that and make $100k!". But I probably would have felt differently had I spent 3 full straight days sitting in the exam room.

      Optometry schools, of course, will understandably not want to thwart or dissuade any potentially "good" candidates; also, it is not to be expected that schools would or should make sure the students know about these less glamorous sides of the profession. It seems the best place to encourage and offer this "complete" and "thorough" consideration of Optometry as a career choice should be the 4-year college career office and counselor. What can be done to ensure that students get more than, “Optometrists are independent, primary health care providers who examine, diagnose and treat disease and disorders..." as a description of what they will be doing all day? "Go speak with as many optometrists as possible about their experience," and hope that they will get a straight, well-balanced and true picture of the profession, without getting an inflated impression of prestige and authority from the "doctor", when asked by the dreamy-eyed student in search of glamour, fortune and status.

      In summary, thanks, Paul, for touching on an important issue that is frequently under valued and minimized to aspiring optometry students, which is the importance of REALLY knowing what the options are for optometrists, the nature and reality of the work, and the financial burden that will exist.

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