Article: Optometry as a Career Choice

[Paul Farkas]

You can view the page at http://www.odwire.org/forum/content/...-Career-Choice

[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
dmaino@ico.edu

[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. . .



http://well.blogs.nytimes.com/2011/0...-student-debt/

[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.