Confused: Optometry or MD?

[Tyra]

OK, now i'm really confused. I've been fascinated by the eyes since i was probably about 11 yrs old (i had numerous eye and vision problems). And once when the ophthalmologist let me look at another patients eyes through an instrument, i was hooked. I knew that I either wanted to be an optometrist or an ophthalmologist. When my kids got a little older, i went back to school last summer to begin my journey to being an optometrist (I'll now be a jr this summer at UIC). But here's the problem: My chem professor from last semester--she hired me this semester as a chem tutor--doesn't think being an optometrist will be fulfilling to me. She now insists that i shadow other doctors besides optometrists. I called my uncle for advice (he's a MD) and he agrees. He says obviously my professor sees more in me than I see in myself and if i don't pursue this i'll be always wondering what if. So, since the prereqs for medicine and optometry are the same, he wants me to take the MCAT and the OAT. When asked why he doesn't feel I'll be satisfied, he said because i'm always talking about disease and surgery and optometrists are very limited. I did inform him that optometrists can now diagnose and treat various ocular diseases and even write prescriptions---but he still thinks i won't be challenged in the long run. I did have some ambivalence concerning the optometry/opthalmology path, but now it has magnified much more. HAS ANYBODY ELSE GONE THROUGH/GOING THROUGH THIS???? PLEASE--ANY ADVICE WILL BE HELPFUL--I'M GOING OUT OF MY MIND!!! (p.s.--i do want honest opionions even if yall think my feelings will be hurt--i'm a tough girl)

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[rpames]

I understand exactly what you are going through. I had been going through it for 4 years. We don't need to go into what an OD can do, because we all know. You need to look at what you want out of life.

First I want to address you chem prof. and uncle. Honestly, they don't know what optometry is. They just assume it is a lesser doctor. No, you can't remove catarcts...no, you can't re-attach a retina...but there is more. You still utilize medical knowledge and treat patients.

What I finally looked at was this, what do I want out of life? Do I want a job where I will be on call all the time at the hospital? Or do I want a job where I can come home at night and watch my kid play soccer? Do I want to arrange my life around when I can find another doc to cover my patients and my 'on call times', or do I want to run my own life?

I know plenty of MDs, they all work long hours for the hospital. Those who are surgeons (one who I worked for), would have to leave for surgery before his kids got up, and would not get home until they were asleep.

My dad was there every morning when I was growing up and home every night to help me with my homework, he came to every soccer game I had, he had time to be my cub scout den master. No, he did not do surgery...no, he did not make 350k/year. But by him being an OD, we had more time together than the MD families I knew, and we had plenty of money.

As far as not being challanged in optometry, BULL! My father says he is challanged everyday. I was talking to him a week or so ago and he said he had 1 patient come in with something he had only read about, and 3 with pathology so rare, he had only seen them a few times in his life. That was all in one day. Optometry is more than the, "1 or 2..."

If you go and work for ShopKo, you won't see a lot of neat stuff, but if you go private/group/hospital, you will be challanged.

I finally decide that my family life and time spent outside the office means more to me than an MD/DO.

 

[Spinola]

rpames,

I think that, with the possible exception of George W Bush, you're the only person who can understand your last post. Could you translate it into English?

 

[cpw]

I thought rpames post made perfect sense. I chose optometry for the same reasons, rpames. Although I was trying to decide between OD school and vet school (not med school.. I had NO interest in med school). And initially I wanted to go to pharmacy school (worked in it long enough to realize that wasn't what I wanted in life).

 

[rpames]

Spinola,

I corrected be spelling error in the second sentance, maybe you can read it now.

 

[TAL]

I just want to make sure everyone recognizes that Spinola, as usual, was the first to person make an instigating comment on this thread.

Tyra, it is obvious that your professor doesn't know anything about optometry or optometry school. You will be challenged. I have 11 finals. That is challenging. I'll stack up my 1st year coursework next to that of any 1st year med student. Don't take too much stock in uninformed opinions about optometry. Do whatever it is that will satisfy what you want to get out of life.

 

[TomOD]

Tyra,

I would like to give you an opinion from a practicing OD. Of course, the ultimate decision is yours. You have made it halfway there by decided that the eye intrigues you and you think working with eyes and eyesight will be a great career. I agree.

If the question is: Are you going to be fullfilled? Well, no one can answer that for you. There are a few OD's that want to be Ophthalmologists. Most, I would venture to guess, are perfectly happy practicing Optometry. There is enough work to do without doing surgery.

As other's have hinted , Optometry is a split profession. By nature, those working at commercial stores do not see the variety, or treat the variety of patient's that those in progressive private practices (or VA or group or OD/OMD practice) do. (Please no one whine that I am bashing commerical optometry because I AM, but that's another topic).

Personally I have experienced a few different modes of practice and have started my own practice emphasizing ocular disease. It is extremely gratifying and might I add, lucritive. I am in a very good state for practicing Optometry. Not all states grant the broad authority that NC does. I am able to practice to the full extent of my training treating everything medically and many things classified as "minor" surgery. The comanagement realationships I have are top-notch. I refer for surgery when necessary and I see my patients back very soon afterwards.

Given all that, Optometry is, by defination, and training, a limited profession. But realistically, most health professions are. With the exception of general Ophthalmologists (which are becoming rare in my community), most speciality Ophthalmologists limit their practice to a specific area.........cornea/anterior seg, retina, glaucoma, cataract/refractive, neuro, etc......... These are definately challenging areas, no doubt. You will see the cases that OD's and general Ophthalmologists can't or won't treat.

Absolutely go and visit some different docs. Ask around who the most "progressive" OD is and which OD's treats the most eye disease (everyone knows) and shadow him/her. If you don't think it would be challeging enough for you, visit a general OMD and a few speciality OMD's.

You have time. You can't go wrong going the Ophthalmology route.........it just takes alot more time to do only a little more (in my opinion).

 

[Tyra]

TomOD---thanks for the input, it actually helped. i never thought of shadowing an OD that treats a lot of ocular diseases. I'm gonna look into that on Monday--maybe Wednesday since Easter's Sunday. Thanks!

 

[medstud721]

OPHTHO--MD AND SURGICAL SUBSPECIALIST
OPTOM--OD

OPHTHO--WORK ON AVERAGE 40 HRS/WK--SECOND ONLY TO DERMATOLOGY IN THE FIELD OF MEDICINE--THIS IS VERIFYABLE BY AMA POLLS
OPTOM- APPROXIMATELY THE SAME

OPHTHO--4 YEARS MED SCHOOL GET PAID AROUND 50K/YEAR AS A RESIDENT(NOT MUCH LESS THAN STARTING OPTOM), THEN MAKE ON AVERAGE 300K

OPTOM--4 YEAR COLLEGE--START AROUND 50-60K, END UP AROUND 100K. MOST OPTOMS DON'T REALIZE THAT BOTH GROUPS START TO GET PAID AT THE SAME TIME--4 YRS AFTER COLLEGE

TO PUT IT SIMPLY, OPHTHOS ARE SURGEONS THAT ARE MOST GRATIFIED BY HELPING PEOPLE THROUGH MEDICAL KNOWLDEGE AND MANUAL(SURGICAL) SKILL--IT'S PRECISION MICROSURGERY

OPTOMS MOST ENJOY HELPING PEOPLE BY GIVING THEM A PAIR OF SPECS--THATS WHAT DEFINES THE CAREER TO THE PUBLIC

HOPE THIS HELPS

 

[rpames]

Why medstud...why? You did not make a single point in you POST. No one is comparing getting into med school over OD school. There are many of us on this forum who could get into med school if we wanted to. This forum is not one where we are going to fall into your trap of fighting. We all know your feeling, we don't want to read them again.

 

[abs1]

rpames,

do you know what those "rare" pathologies your dad saw recently were? just curious. as i sit here and study disease after disease after disease its always interesting to know which ones actually DO appear in optometric offices. thanks!

 

[rpames]

I don't know off the top of my head, but I will ask the next time I speak with him. I'm sure TomOD could tell you some cool pathology he has seen better than I can relay info. I'll stil ask though.

 

[TomOD]

I recently completed some case reports for membership in the American Academy of Optometry. Reports were on: 1) The Differential Diagnosis of Glaucoma in a Patient with Pan-Retinal Photocoagulation Secondary to Proliferative Diabetic Retinopathy, 2) Clinical Findings and Management of Non-Arteritic Ischemic Opitc Neuropathy (comangaged with retinal OMD) 3) Clinical Implications of An Anterior-Chamber Intraocular Lens Implantation in a Long-term Aphakic Eye (sx performed by OMD, of course), 4) Incidental Finding of Open-Angle of Glaucoma in a 12 year-old Kid with Unilateral, Spontaneous, Idiopathic Uveitis, 5) Diagnosis and Management of Thygeson's Superfical Keratitis.

This week, I have treated 17 glaucoma patients (not exactly sure if these are considered "cool" cases). I have a lady that I am juggling back and forth with a corneal Ophthalmologist with unusual keratitis, 5 folks with background diabetic retinopathy (one with proliferative changes requiring PRP by the retinal specialist). Today I saw a guy with a history of a BB gun wound to the left eye. What was interesting about this was that he has an iris wound that allows for retroillumination showed a perfect view of the edge of his crystalline lens and zonules (I got a nice picture).

Yesterday I sent a lady for an MRI with headaches, bitemporal field loss and bilateral optic disc edema. If there is a problem (tumor), she will go to an neuro-surgeon.

I also treated a lady with a peripherial corneal ulcer induced from contact lens abuse. Today I also had a 75 y.o. guy that had uneventful cataract surgery (I comanaged him) last summer. He had a subconjunctival hemorrhage in the right eye (he says he has had 2-3 others in the past month). Turns out he had by-pass surgery in November and his Internist is trying to regulate his Coumadin (causing his bleeds). No specific treatment other than to notify the Internist. Another guy came for a Kenalog Chalazion injection today.

In between these (and more I don't recall now), I did some refractions and some contact lens fits.

I find my job very stimulating.

 

[Tyra]

nice TomOD.... has it always been this interesting or did u have to build up a patient basis to include diagnosing/treating ocular disease?

 

[Brill]

I think it would also be wise to consider that opthamology is one of the most competitive residencies to get, so if you weren't able to match into one out of med school you'd probably end up doing something besides working with eyes.

 

[vtrain]

I was in a similar position to yourself when I first entered OD school. I had the option of attending both med and od school, and chose the later - without any regrets thus far. I have come to realize that the general public doesn't really know what an OD is and if surveyed, probably couldn't tell you the difference between an optom/ophth/optician. This is for various reasons (lack of effort to educate the public by the AOA, small profession size, etc.). The point is, when your chem prof/uncle says you won't be challenged, take that with a grain of salt. I encountered the same statements when I made my choice and this worried me initially as well. Shadowing ODs/MDs, as mentioned, is the best way to debunk any myths about either profession. Most ODs that I came across were thrilled when I asked to shadow them and you will probably find the same. Shadowing an MD ophtho is a little more tricky - if you have connections, it will come in handy here. I was only able to shadow an MD, through a friend who was a really good friend of an MD. In terms of being challenged, you will be challenged as an OD - it just depends on where /how you want to practice. If you choose Walmart and decide to churn out 40 refractions a day, you probably won't be as challenged as say, working at a VA Hospital, or in a private practice. Granted, to find the more challenging postitions, it might take more luck/time/effort to find these positions, but they are out there. If you feel you won't be challenged, academia is another alternative. I can name at least one optom/prof at our school who teaches, works part time in a priv. practice and is writing a book on the side. Tell me that's not a challenge! There are so many facets to optometry, that to think you won't be challenged in silly. However, that's not to say you won't ever get bored of the profession, because you will. In fact, I think any profession can become mundane. The ophtho that I shadowed does cataract surgeries day after day and he told me that he gets bored but that's his "bread and butter" trade and that's how he makes the $$ to put food on the table/send the kids to college. Likewise, as an optom, your bread and butter will be rxing glasses/refractions - and that will get mundane as well. Through experience thus far in this profession, I'm gonna make a generalized statement and say that those who fight boredom the best, and are challenged the most in this profession, are those who continually educate themselves/who practice at a high level/are diverse in the way they practice optometry.Hope this helps.

 

[TomOD]

I am a private practitioner who started a "cold" practice about 3 years ago. I may not be "typical" but there are quite a few Optometry practices like mine. There really is a WIDE range of Optometrists out there..........from basic refractionist (they are dying off) to full-scope OD's ultilizing both medical and traditional optometric skills.

 

[JG777]

Hi Tyra,

i understand what you are going through and it all comes down to what you want out of life.

i work for an OMD. it's long long hours, average 60 patients a day, makes a lot of money, very prestigous, and of course you do more for your patients in regards to surgery and what not. however he's a retina specialist. so he obviously has more flavor than a general OMD.

i volunteer for an OD. hours are short, average 10-12 patients a day, mostly glasses and contact lens stuff, i don't see as much "respectful" attitude towards the OD as much as i see it for the OMD. i also talked to 3 OD's and that's the number one downside of the profession - their patients don't see them as "real" doctors (i guess). the fact that i only see glasses and contact lens makes me realize that i dont' want to be doing just glasses or contact lens all the time - it can get boring.

it really depends on what you want, and if your true interest lies in maintaining the quality of vision in people then of course OD or OMD is the route- but really think of the time and how much work you want to put into it. i honestly feel as an OMD your work becomes your life. also think about debt. i know an optometrist who is neck down in debt.

it's a tough one to make, i know. but if you are still unsure...i'd take the OAT and MCAT. see how well you do on them. shadow shadow shadow. and qualitatively think about what it is that you really want out of your life.

much luck to you....

 

[mpp]

I was in the same boat a few years ago and I chose the MD path. I'm happy where I am now but probably would be happy in OD school too. Keep shadowing and see what interests you. Now that I am in medical school, although I do still find eyes interesting, I also find other things interesting.

Another good idea is to try an envision what you want your life to be like in 15 years...the midpoint of your career. Think about all aspects of your life. Ask many practioners in both realms about these future goals and see which career path will best help you reach those goals. Good luck deciding...I don't think you'll go wrong either way as long as you always make the best situation out of your position.

 

[docwatson]

So that we have another opinion...

OMD--Physician (ophthalmologist), primary aim is medications, surgery
OD--Optometrist, primary aim is glasses, contacts, medical therapy/medications

OMD--40/hrs week (from previous post). 5 days per week or less. Don't usually work weekends.
OD- 40-50 hours/week, 5 days per week unless you work commercial (not recommended). Saturdays are typical unless you are in private practice.

OMD--4 years undergraduate, 4 Years medical school, 4 years residency/fellowship. 12 years total.
OD--4 years undergraduate, 4 years optometry school. Residency is optional. Optometry school is just as difficult as medical school. Optometry school is considered professional/doctoral level education. 8 years total.

OMD--Average salary $250,000. Can make far more.
OD--Start out making $60-$100K, and the sky is the limit. You can make just as much as an ophthalmologist if you wanted to but most optometrists are not that ambitious. You can make $500,000 but it's rare.

OMD--More stress. Sees the most difficult cases (gets referrals from ODs). Much higher liability insurance rates.
OD--Less stress. Sees more routine cases. Lower insurance rates.

OMD--On call. Must be available 24 hours a day, 7 days a week. For surgery cases, you may be up in the middle of the night. Having another doctor cover for you can get you out of this responsibility at times.
OD--Many states require 24/7 coverage but normally most people do not call in since we handle mostly routine cases.

OMD--Higher overhead, larger staffs usually.
OD--Smaller offices usually. May have less office conflict because of this. Tighter control over overhead.

OOMD--Satisfied with helping people through medications and surgery.
OD--Satisfied with helping people through vision correction and sometimes medications if necessary.

ODs are generally more satisfied overall than OMDs in their profession. This despite commercial optometry making big advances in recent years.

 

[Reality check]

Keith,
"Optometry school is just as difficult as Medical School" How do you know this? Did you ever attend Medical School to compare it to Optometry School? OD's can make just as much as ophthalmologists if they wanted to? Absolutely not! Unless you are an owner/ doctor of a successful optical retail business you'll never make as much as OMD's. Salaried OD's can make 70K to 135- 150K a year and they'll work there butt off 6 probably 7 days a week for that kind of money. "OD's are generally more satisfied overall than OMD's in there profession." Where did you get this information from? Quote the article or give me factual info regarding your statement. You talk about commercial optometry like it's the plague "not recommended." Why? State your case. Do you believe all optometrists working in private practice/ clinics/ and or VA Hospitals are clinically more competent than commercial OD's? You'd be surprised. What do you do that's any different than an OD working at Pearl with every instrumentation you have in your office and practicing rights?

 

[rpames]

It is a amazing, as soon as someone even suggests that OD school may be as difficult as medical school, people get all bent out of shape. So many med students like to think they are some kind of god because they go to the great med school.

THIS FORUM IS NOT GOING TO TURN INTO A COCK FIGHT.

RealityCheck, if you have comments apposed to Dr. Watson's, please post them, not just questions. But do it with respect. Do not start a fight! I for one am sick of that type of posting everytime the OD v. OMD thing comes up.

P.S.
My father does quite a bit better then the salaries you posted, and he does not work on the weekend. The other private ODs is town also do better than those numbers. It is all in how you treat your patients and how you run your practice.

 

[r_salis]

Originally posted by Reality check
"Optometry school is just as difficult as Medical School"...

Troll.

Troll troll troll troll troll troll troll.

 

[LSUMED2006]

Tyra,

If you get a chance, check your inbox, as I sent you a PM.

Jason

 

[JasonDO]

Originally posted by rpames
I understand exactly what you are going through. I had been going through it for 4 years. We don't need to go into what an OD can do, because we all know. You need to look at what you want out of life.

First I want to address you chem prof. and uncle. Honestly, they don't know what optometry is. They just assume it is a lesser doctor. No, you can't remove catarcts...no, you can't re-attach a retina...but there is more. You still utilize medical knowledge and treat patients.

What I finally looked at was this, what do I want out of life? Do I want a job where I will be on call all the time at the hospital? Or do I want a job where I can come home at night and watch my kid play soccer? Do I want to arrange my life around when I can find another doc to cover my patients and my 'on call times', or do I want to run my own life?

I know plenty of MDs, they all work long hours for the hospital. Those who are surgeons (one who I worked for), would have to leave for surgery before his kids got up, and would not get home until they were asleep.

My dad was there every morning when I was growing up and home every night to help me with my homework, he came to every soccer game I had, he had time to be my cub scout den master. No, he did not do surgery...no, he did not make 350k/year. But by him being an OD, we had more time together than the MD families I knew, and we had plenty of money.

As far as not being challanged in optometry, BULL! My father says he is challanged everyday. I was talking to him a week or so ago and he said he had 1 patient come in with something he had only read about, and 3 with pathology so rare, he had only seen them a few times in his life. That was all in one day. Optometry is more than the, "1 or 2..."

If you go and work for ShopKo, you won't see a lot of neat stuff, but if you go private/group/hospital, you will be challanged.

I finally decide that my family life and time spent outside the office means more to me than an MD/DO.

as an ophthalmologist I will have a similar schedule as yours...on surgery days I'll play a round of golf and still be home before you if I decide to do a fellowship in occuloplastics or retina that will obviously change...however, the majority of general ophthos who practice a mixture of med/surgery have extremely flexible lifestyles and loads of free time