Concluding Opinions:
1. There was already indication of surplus supply at D = 12.8 in 2012. Considerable anecdotal evidence suggests recent optometry graduates can not find full time positions and find it necessary to piece together multiple part time arrangements. About 30% of optometrists now practice at 2 or more locations part-time.
2. The peak density 15-17 will arrive in about 35 years and not until 23 years later will population growth bring density down to the 1997 level of 11.5.
3. Before this 63-year cycle is complete, student applications will likely decline as it seems unrealistic to predict the US health system will require these record high future D values. As is now happening for overpopulated training programs in law and veterinarian medicine, schools may be forced to choose between lowering enrollments or lowering admission standards.
4. The failure to accurately portray these impending surpluses has encouraged universities with health or medical programs to believe there is a need for more optometrists which has led to more schools of optometry and impending surpluses.
5. The profession has not stepped forward to recommend appropriate density levels or to correct misleading information encouraging additional schools.
6. The Accreditation Council on Optometric Education (ACOE) sets the standards new schools must meet for accreditation but these have few, if any, quantifiable requirements for clinical training comparable to those for dental and medical schools. Two proposed schools of optometry are in rural counties with as few as 1,200 people and over 80 miles to the nearest metropolitan center. Uniform standards do not exist to insure students examine specified numbers of patients of required types in various settings prior to graduation.
Enrollment “bubbles” are present in other undergraduate and graduate training programs since universities do not believe it is their responsibility to worry about the numbers they graduate and leave it to the “market place” to correct surpluses. [Footnote 2]
But the market place is unfeeling, as graduates find once they receive their degree and attempt to earn a living, care for their family and repay student debt.
In essence, vested interests and individuals are benefiting, or hope to benefit, from the increase in optometry enrollments since 1997 and they can not be expected to question the effects being produced. Surpluses will continue to grow until they become so obvious the best and brightest decline to choose optometry.
The author published a study 40 years ago that argued optometry enrollments were too low as D had declined to about 10 [Bibliography #3]. Now, facts seem just as compelling that enrollments are too high, D will reach unsustainable high levels and applicants per seat will continue to decline.
One must ask why the profession continues to issue what appear to the author as overly optimistic projections of future employment opportunities.
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