Current job market

[teeter]

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To: those ophthalmology residents who are looking for jobs, or private practitioners who have already gone through the process.... what is the current status of the ophtho job market? Last year I spoke to a newly graduated ophthalmologist, and he said that the job market is dismal in large and medium-sized cities.(unless of course you go to a rural area). And, he said, because of the competition for jobs, the practices you can join offer relatively poor compensation. How true is this?

And, if this is the case, any thoughts as to the reason? (i.e. sharing of some procedures with optometrists? Decline in compensation for lasik-type surgeries?)

 

[yagmd]

I have not started ophtho residency, but the stats I've seen are very concerning. If you look at the postings on the AAO web site for jobs, the vast majority of the offers are starting in the $95 - $105K range. I've heard from people who took offers starting as low as $80K. From what I hear, junior faculty at Wilmer start below $100K.

That's really terrible. It's really tough to support a family in a large metro area on that kind of salary (particularly when many of us will still have student loans to pay off). The ophtho starting salaries are even lower than fields like Family Practice, General Internal Medicine, etc. Starting salaries in other fields, are dramatically better. Radiology job offers easily start in the $250-$500K range. Many other fields (particularly surgical fields) start at least in the $150-$200K range.

Some other examples for comparison:
Physician Assistants - $80 - $100K
Average Optometrist Salary - $120K
ICU Nurse - $80K
Corporate Lawyer (1st year out of law school, no residency) - $120K

Do any of the current residents / fellows / faculty know if the job offers are any better for sub-specialist ophthalmologists? Most of the job postings I've seen are for general ophtho, and from what I've heard a lot of the people completing fellowships are having to do part-time general ophtho if they go into private practice.

 

[JennyW]

I have not started ophtho residency, but the stats I've seen are very concerning. If you look at the postings on the AAO web site for jobs, the vast majority of the offers are starting in the $95 - $105K range. I've heard from people who took offers starting as low as $80K. From what I hear, junior faculty at Wilmer start below $100K.

That's really terrible. It's really tough to support a family in a large metro area on that kind of salary (particularly when many of us will still have student loans to pay off). The ophtho starting salaries are even lower than fields like Family Practice, General Internal Medicine, etc. Starting salaries in other fields, are dramatically better. Radiology job offers easily start in the $250-$500K range. Many other fields (particularly surgical fields) start at least in the $150-$200K range.

Some other examples for comparison:
Physician Assistants - $80 - $100K
Average Optometrist Salary - $120K
ICU Nurse - $80K
Corporate Lawyer (1st year out of law school, no residency) - $120K

Do any of the current residents / fellows / faculty know if the job offers are any better for sub-specialist ophthalmologists? Most of the job postings I've seen are for general ophtho, and from what I've heard a lot of the people completing fellowships are having to do part-time general ophtho if they go into private practice.

Let me point out that the average salary for an optometrist quoted here is NOT for a new graduate. It is for an experienced practitioner who owns their practice.

And I wouldn't be too discouraged about the low faculty salary. Most faculty positions are essentially a vow of poverty anyways. No one gets rich working at a university except the administrators. 😀

And while a starting salary may be lower in a field like optho, your salary will likely rise up quickly, and surpass those in other surgical fields in short order. Outside of large urban areas, the demand for a fellowship trained subspecialist is likely low, so doing part time "general oph" should probably be expected. I don't know if there are a lot of corneal transplants going on in Grand Forks, ND.

You are right about large urban areas though. Most, if not all large cities are saturated with eye care providers. You should consider a less urban location.

Jenny (an OD)

 

[yagmd]

Jenny,

Good points. I agree with most of what you said, except for 2 things:

1) "while a starting salary may be lower in a field like optho, your salary will likely rise up quickly, and surpass those in other surgical fields in short order"

-- based on all the data I've seen, the average salaries for ophthalmologists (after several years in practice) are the lowest of any of the surgical sub-specialties in medicine, except for perhaps OB-GYN. All of the other surgical specialties (orthopedics, ENT, urology, gen surg, plastic surg, neurosurg, etc) are significantly higher. Ophtho used to be one of the best paid surgical fields about 10-15 years ago, but incomes have declined significantly after medicare slashed the reimbursement for cataract surgery.

2) "outside of large urban areas, the demand for a fellowship trained subspecialist is likely low"

-- the few job postings I've see that offer good starting salaries ($150-$200K) are for sub-specialists in remote areas. If you want a good salary, it looks like your best bet is to be the only retina, oculoplastics, cornea, etc guy in town in a remote area. It's just basic economics of supply and demand. The vast majority of physicians want to be in mid to large-size cities (note that that's where almost all the medical schools and residency programs are).

 

[JennyW]

Jenny,

Good points. I agree with most of what you said, except for 2 things:

1) "while a starting salary may be lower in a field like optho, your salary will likely rise up quickly, and surpass those in other surgical fields in short order"

-- based on all the data I've seen, the average salaries for ophthalmologists (after several years in practice) are the lowest of any of the surgical sub-specialties in medicine, except for perhaps OB-GYN. All of the other surgical specialties (orthopedics, ENT, urology, gen surg, plastic surg, neurosurg, etc) are significantly higher. Ophtho used to be one of the best paid surgical fields about 10-15 years ago, but incomes have declined significantly after medicare slashed the reimbursement for cataract surgery.

2) "outside of large urban areas, the demand for a fellowship trained subspecialist is likely low"

-- the few job postings I've see that offer good starting salaries ($150-$200K) are for sub-specialists in remote areas. If you want a good salary, it looks like your best bet is to be the only retina, oculoplastics, cornea, etc guy in town in a remote area. It's just basic economics of supply and demand. The vast majority of physicians want to be in mid to large-size cities (note that that's where almost all the medical schools and residency programs are).

Remote towns are likely to be small and are not likely to support a full time sub specialist. The point that I was making was not that subspecialists shouldn't go to a small town or aren't needed, but that they may not be able to have a full 5 day schedule in their sub-specialty in a small town and therefore, may end up practicing "general" for a day or two a week. To have that full schedule, they may practice a couple days a week in small town A, and a couple days a week in small town B 50-100 miles down the road.

Jenny

 

[medduck]

I have not started ophtho residency, but the stats I've seen are very concerning. If you look at the postings on the AAO web site for jobs, the vast majority of the offers are starting in the $95 - $105K range. I've heard from people who took offers starting as low as $80K. From what I hear, junior faculty at Wilmer start below $100K.

That's really terrible. It's really tough to support a family in a large metro area on that kind of salary (particularly when many of us will still have student loans to pay off). The ophtho starting salaries are even lower than fields like Family Practice, General Internal Medicine, etc. Starting salaries in other fields, are dramatically better. Radiology job offers easily start in the $250-$500K range. Many other fields (particularly surgical fields) start at least in the $150-$200K range.

Some other examples for comparison:
Physician Assistants - $80 - $100K
Average Optometrist Salary - $120K
ICU Nurse - $80K
Corporate Lawyer (1st year out of law school, no residency) - $120K

Do any of the current residents / fellows / faculty know if the job offers are any better for sub-specialist ophthalmologists? Most of the job postings I've seen are for general ophtho, and from what I've heard a lot of the people completing fellowships are having to do part-time general ophtho if they go into private practice.

I don't think that ophtho job prospects are quite so bleak. Most of the jobs on the AAO site quote salaries in the 125-175 range and do not include incentive bonuses. With incentives, I think first year out for general will make at least 150-175. Unless it's an academic position, most jobs will lead to partnership within 2 years. At that point, I think you can add 100k to the average. According to ophthalmology times survey in 2002, the average non-salaried ophthalmologist made 320k, similar to ENT, ob-gyn, g-surg.

I know someone who just finished a cornea fellowship and will start in southern cal at 180k. I also know an otolaryngologist who started at 140k in southern cal. You probably can't salaries that are much lower than in southern California. Obviously these salaries will go up once they make partner.

I met a resident at Iowa who said they would make 400k as partner within 2 years of starting a general ophtho job- in a smaller town though. I've heard the ophthalmologist in my home town makes 800k, however that's if you want to live in Alaska.

To answer your question about subspecialists, I know 2 retina fellows who finished a couple years ago that started in the 250k range in the suburbs of Chicago.

It's hard to know how supply and demand will affect ophtho in the future. True, it's not as hot as rads and gas right now, but who knows how things will be in 10 years. I agree it's a little concerning after all this investment in education... but you have to go with what you love to do everyday.

 

[JennyW]

It's hard to know how supply and demand will affect ophtho in the future. True, it's not as hot as rads and gas right now, but who knows how things will be in 10 years. I agree it's a little concerning after all this investment in education... but you have to go with what you love to do everyday.

I would imagine that the chances of massive breakthroughs that will lead to a huge increase in demand is a lot higher in ophthalmology than in many other specialties, particularly with respect to retina and refractive patients. If there is a breakthrough in anesthesiology that leads to easier and safer anesthesia, will that lead to a significant increase in the demand for any surgical procedure?

Ophthalmologists who do refractive care can learn a lesson from the mistakes that ODs have made in the past with respect to spectacles and contact lenses. STOP TRYING TO UNDERCUT EACH OTHER ON ELECTIVE PROCEDURES!

Jenny

 

[Visioncam]

I met a resident at Iowa who said they would make 400k as partner within 2 years of starting a general ophtho job- in a smaller town though. I've heard the ophthalmologist in my home town makes 800k, however that's if you want to live in Alaska..

Don't be too critical of Alaska! Anchorage is not as cold as people think. It is warmer than Minneapolis or Milwaukee.

Alaska as huge areas of the state where there are no ophthalmologist. I don't think there are any ophthalmologists north, west, or southwest of Fairbanks.

Alaska has no state income tax which compares favorably to some states, which have tax rates over 10%. Alaska has a Permanent Dividend Fund where every person gets a check of between $1-2k. A family of four would get a check of possibly $8,000 a year.

In my opinion, Alaska is in the top third of best states to live.

 

[medduck]

Don't be too critical of Alaska! Anchorage is not as cold as people think. It is warmer than Minneapolis or Milwaukee.

Alaska as huge areas of the state where there are no ophthalmologist. I don't think there are any ophthalmologists north, west, or southwest of Fairbanks.

Alaska has no state income tax which compares favorably to some states, which have tax rates over 10%. Alaska has a Permanent Dividend Fund where every person gets a check of between $1-2k. A family of four would get a check of possibly $8,000 a year.

In my opinion, Alaska is in the top third of best states to live.

I'm not being critical of Alaska. I lived in Fairbanks for 18 years, through one span of two weeks where the high was always below -40 degrees. The northern lights are amazing in the winter and it's cool having 22 hours of daylight in the sumer. Downsides are the cold and darkness for a solid 4-5 months.

I agree Anchorage would be a great place to live, milder climate than Fairbanks, more snow and better mountains for skiing. The Permanent Dividend Fund is nice but a lot of it is wiped out by higher costs for groceries, cars, electric and heating oil bills in the winter.

I agree Alaska is top third of states to live.

 

[smiegal]

Visioncam,

I agree that Anchorage is a great city, I was there this summer and loved it. Great access to the Kenai river King salmon runs! You're wrong about the temperature, though 👎 . Here are the average high temperatures (F) in December, March, July, and October, respectively:

Anchorage: 24, 34, 65, and 40
Milwaukee: 33, 43, 81, and 60
Minneapolis: 26, 41, 83, and 48

 

[Andrew_Doan]

Consider this discussion here:

http://forums.studentdoctor.net/showthread.php?t=105824

 

[Visioncam]

Visioncam,

I agree that Anchorage is a great city, I was there this summer and loved it. Great access to the Kenai river King salmon runs! You're wrong about the temperature, though 👎 . Here are the average high temperatures (F) in December, March, July, and October, respectively:

Anchorage: 24, 34, 65, and 40
Milwaukee: 33, 43, 81, and 60
Minneapolis: 26, 41, 83, and 48

I won't argue with your statistics. However, even your statistics almost proves my point. Anchorage is only a few degrees colder than Minneapolis. During the coldest month, it is only 2 degrees colder. It's not -40 as some people imagine. Funny that Milwaukee is not colder than Minneapolis. Maybe it's the wind in Milwaukee or else I'm an idiot.