guttata

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This is what scares me about going into ophtho.

Which fellowship specialty(s) will not have foreseeable drop in surgeries in the future?
I want to go into an ophtho since it's a surgical subspecialty. If it's going to be 90% clinical, I'd rather do something else. So, are any fellowship specialties not heading down this direction?
Pediatrics and plastics.

Or any academic jobs - you will get more than your share of lid lacerations/ruptured globes/etc.
 

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Pediatrics and plastics.

Or any academic jobs - you will get more than your share of lid lacerations/ruptured globes/etc.
And keep in mind there are right around 20 spots per year for oculoplastics. So I wouldn't necessarily go into ophthalmology if you felt like you could only do plastics. In fact I don't really think I'd do any specialty that I wouldn't be happy in without a fellowship, because those aren't guaranteed.

And I completely understand how terrifying the future with coverage for all, further government control, and downtrending of reimbursements while moving to less expensive care providers are - but keep in mind that at this point pretty much every specialty is threatened by a mid-level care provider, APN, cRNA, Optoms, Audiology, the list goes on. Remember when cRNAs took off everyone was sure that Anesthesia was dead. The cRNA didn't do a residency or medical school and has seen only a fraction of the cases and pathology of an Anesthesiologist and doesn't have nearly as thorough knowledge of medicine, but they still provide good care when an Anesthesiologist is available for back up. If we can move toward this direction in eye care it will be better for us all. Other fields have recognized the validity of less-but-still-well trained practitioners and have embraced them within their practices. It is ultimately probably better for our patients.

I think that for the good of us all the Optometrists are going to have to realize that pumping out a mountain of graduates is a bad idea and control their numbers before eye care is completely saturated and unprofitable for everyone. The single biggest barrier to that in my opinion is OD oversupply. Because lets get real here that's the reason for pushing scope of practice expansion. If we have to fight for patients it's too hard to work together. If that isn't addressed then the future is competition, and for what little I know it may be dangerous to go into ophthalmology if you aren't comfortable with having to fight for business. If you believe the 2012 survey then 1/3rd of ophthalmologists are making less than $150,000 which is terrifyingly low for someone with the amount of debt that most of us have with the prospect of long hours after surviving the hellatiousness of medical school and residency.

Any attendings in private practice comprehensive feel free to correct me, but I don't even know if any comprehensive docs get on these forums.
 

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And keep in mind there are right around 20 spots per year for oculoplastics. So I wouldn't necessarily go into ophthalmology if you felt like you could only do plastics. In fact I don't really think I'd do any specialty that I wouldn't be happy in without a fellowship, because those aren't guaranteed.

And I completely understand how terrifying the future with coverage for all, further government control, and downtrending of reimbursements while moving to less expensive care providers are - but keep in mind that at this point pretty much every specialty is threatened by a mid-level care provider, APN, cRNA, Optoms, Audiology, the list goes on. Remember when cRNAs took off everyone was sure that Anesthesia was dead. The cRNA didn't do a residency or medical school and has seen only a fraction of the cases and pathology of an Anesthesiologist and doesn't have nearly as thorough knowledge of medicine, but they still provide good care when an Anesthesiologist is available for back up. If we can move toward this direction in eye care it will be better for us all. Other fields have recognized the validity of less-but-still-well trained practitioners and have embraced them within their practices. It is ultimately probably better for our patients.

I think that for the good of us all the Optometrists are going to have to realize that pumping out a mountain of graduates is a bad idea and control their numbers before eye care is completely saturated and unprofitable for everyone. The single biggest barrier to that in my opinion is OD oversupply. Because lets get real here that's the reason for pushing scope of practice expansion. If we have to fight for patients it's too hard to work together. If that isn't addressed then the future is competition, and for what little I know it may be dangerous to go into ophthalmology if you aren't comfortable with having to fight for business. If you believe the 2012 survey then 1/3rd of ophthalmologists are making less than $150,000 which is terrifyingly low for someone with the amount of debt that most of us have with the prospect of long hours after surviving the hellatiousness of medical school and residency.

Any attendings in private practice comprehensive feel free to correct me, but I don't even know if any comprehensive docs get on these forums.
This is my fear and why I'm reluctant to go into ophtho. I really want to go into it but if the future means few surgeries then forget it haha. The private practice comprehensive ophtho I go to told me you don't make much $$ and just kept stressing how ophtho is only an okay field. Obviously I couldn't actually ask her how much she made haha.
 

WhatNEyeTem

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This is my fear and why I'm reluctant to go into ophtho. I really want to go into it but if the future means few surgeries then forget it haha. The private practice comprehensive ophtho I go to told me you don't make much $$ and just kept stressing how ophtho is only an okay field. Obviously I couldn't actually ask her how much she made haha.
What is with the "haha" 's? If you are this conflicted about ophtho, and care mostly about the $$$ and surgery, then consider something like orthopedics (e.g. spine surgery). You will definitely be operating and make good $$$, though your lifestyle may suffer a bit.
 

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I'm not sure why ever time someone asks a question or displays hesitancy about salary on this forum people tell them they're just in it for the money or to consider a different specialty? It's a valid question. Picking a field ideally should just be about interest but in the real world other factors do matter. Obviously if he wasn't interested in ophtho he wouldn't be on this forum asking these questions.

I used to be all about the surgery too but honestly after ophtho rotations...the specialty is so much more complex than that...it's very hands on and visual and while my heart is still in the or...I'm just as intrigued by indirect and slit lamp exams. Surgical days are icing on the cake... Make sure you can find intrigue in the clinical aspect of ophtho before u choose
 

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What is with the "haha" 's? If you are this conflicted about ophtho, and care mostly about the $$$ and surgery, then consider something like orthopedics (e.g. spine surgery). You will definitely be operating and make good $$$, though your lifestyle may suffer a bit.
Exactly. That's why I was leaning more towards ophtho because of the lifestyle. What's the point in making more $$ if you don't have much time to enjoy it? I just want a good mix of clinical and procedural work without a terrible lifestyle in a science I find very interesting. I really liked the anatomy and physiology behind ophtho when we studied it last year, so I'm looking more into it now and asking important questions.

I have many cardiologists in my family and understand the importance of lifestyle, salary, and clinical vs procedural workload. Cardiology has both lots of clinical and procedural work with a good salary but not the best lifestyle. They work 8-7 Mon-Fri, night call off and on, and weekend call every few weekends. Weekends are even worse than weekdays since they have more emergency procedures during the nights to cover partners. Even tho the field looks awesome, after seeing my family members' lifestyle growing up, that's not something I want for me and my own family regardless of the great salary and extremely interesting clinical+procedural work.

The 8-5 M-F schedule in ophtho seems so ideal, but if there's barely any procedures, then that trumps the good schedule. It's not that I only want to do procedures for more $$. I find procedural work to be more exciting than clinical. I also like clincial, tho, and would not want to do only procedures. If I could do just 1-2 days of procedures per week and the rest clinical, that'd be perfect.
 
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guttata

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Exactly. That's why I was leaning more towards ophtho because of the lifestyle. What's the point in making more $$ if you don't have much time to enjoy it? I just want a good mix of clinical and procedural work without a terrible lifestyle in a science I find very interesting. I really liked the anatomy and physiology behind ophtho when we studied it last year, so I'm looking more into it now and asking important questions.

I have many cardiologists in my family and understand the importance of lifestyle, salary, and clinical vs procedural workload. Cardiology has both lots of clinical and procedural work with a good salary but not the best lifestyle. They work 8-7 Mon-Fri, night call off and on, and weekend call every few weekends. Weekends are even worse than weekdays since they have more emergency procedures during the nights to cover partners. Even tho the field looks awesome, after seeing my family members' lifestyle growing up, that's not something I want for me and my own family regardless of the great salary and extremely interesting clinical+procedural work.

The 8-5 M-F schedule in ophtho seems so ideal, but if there's barely any procedures, then that trumps the good schedule. It's not that I only want to do procedures for more $$. I find procedural work to be more exciting than clinical. I also like clincial, tho, and would not want to do only procedures. If I could do just 1-2 days of procedures per week and the rest clinical, that'd be perfect.
Perhaps you should also consider anesthesia, gastroenterology, emergency medicine, dermatology, otolaryngology, plastic surgery, and urology. But, it sounds like you want a 8-5 M-F general surgery lifestyle.
 

WhatNEyeTem

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Perhaps you should also consider anesthesia, gastroenterology, emergency medicine, dermatology, otolaryngology, plastic surgery, and urology. But, it sounds like you want a 8-5 M-F general surgery lifestyle.
For best mix of lifestyle, surgery, and compensation, I think straight-up plastic surgery is probably the best. But obviously, those residencies are probably the most competitive to obtain.
 

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For best mix of lifestyle, surgery, and compensation, I think straight-up plastic surgery is probably the best. But obviously, those residencies are probably the most competitive to obtain.
Yes but once again it isn't just about compensation. Even though we're talking about money here keep in mind that we all got into medicine because we wanted to help people who needed help for health reasons, not purely cosmetic ones.

I'm pretty sure that nobody is coming onto the Ophtho sub-forum and considering ophthalmology JUST because they heard it's good money either. Like the previous poster most of us are interested in Ophthalmology for two main reasons 1. We like the specialty for what it is - a mixture of clinical and surgical management of patients in an area of medicine that we find interesting and 2. The lifestyle appears to be compatible with our goals in life.

Now, the reason this thread even exists is because we're all deeply in debt and worried that we may not be able to provide a decent life for ourselves or our families. Even if you hate Anesthesia you could work for four years after residency and have your loans paid off, bought a decent house in a suburb, and stop working right there with more money in your bank account at 40 than most people have to retire on at 60. Or you could do emergency medicine and work 36 hour weeks making $220,000. All of those numbers are really easy to find but for Ophthalmology there is a lack of data that make those considering Ophtho nervous when combined with all the fire and brimstone OD posts on here. Nobody here seriously considering ophthalmology is less than a competitive medical student so we all have options. But you've got to stop thinking that we're trying to work 25 hours a week and make $400,000.

I've decided to pursue Ophthalmology because I like the clinic more than the clinic work in any other specialty, and I like the procedures more than the procedures in any other specialty, and I like the surgeries more than the surgeries in any other specialty, and I like the patients more than the patients in any other specialty. However not everyone considering going into Ophthalmology likes everything about Ophthalmology or any specialty for that matter. And furthermore none of us can predict if we will still like anything a decade after doing it every day. Hence the common finding of program directors who spent a decade in private practice and then decided to do academics. If liking everything about a specialty was a pre-requisite then there wouldn't be any Oncologists or Gastroenterologists. However, while cancer and poo are not fun to deal with daily you get paid well and that kind of makes it worth it for those people. They would not be as happy doing that work for $100,000. For I assume most rational, thinking human beings income and lifestyle enter into career decisions and at these levels of compensation they could have just been an engineer or a tech or any number of other jobs and had a lot less stressful academic life and a lot less stressful work life.

Only in medicine do we have this conversation by the way. Every other career in the world is filled with people that work just as hard as many physicians or just as many hours and they aren't pompous arses when people considering entering their field ask about compensation. "If you're worried about money don't be a plumber! Sounds like you really just want plumbing without all the sh**. Maybe you should think about HVAC or Welding." Maybe it's because I come from a family of manual laborers, but sometimes people on here need to get a firm grip on their head and try to pull it out of their rectum. Two page long thread and no "I know of many colleagues making X with lifestyle Y in ophthalmalogy subspecialty Z" posts. Just posts telling people to consider other fields.
 

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Yes but once again it isn't just about compensation. Even though we're talking about money here keep in mind that we all got into medicine because we wanted to help people who needed help for health reasons, not purely cosmetic ones.

I'm pretty sure that nobody is coming onto the Ophtho sub-forum and considering ophthalmology JUST because they heard it's good money either. Like the previous poster most of us are interested in Ophthalmology for two main reasons 1. We like the specialty for what it is - a mixture of clinical and surgical management of patients in an area of medicine that we find interesting and 2. The lifestyle appears to be compatible with our goals in life.

Now, the reason this thread even exists is because we're all deeply in debt and worried that we may not be able to provide a decent life for ourselves or our families. Even if you hate Anesthesia you could work for four years after residency and have your loans paid off, bought a decent house in a suburb, and stop working right there with more money in your bank account at 40 than most people have to retire on at 60. Or you could do emergency medicine and work 36 hour weeks making $220,000. All of those numbers are really easy to find but for Ophthalmology there is a lack of data that make those considering Ophtho nervous when combined with all the fire and brimstone OD posts on here. Nobody here seriously considering ophthalmology is less than a competitive medical student so we all have options. But you've got to stop thinking that we're trying to work 25 hours a week and make $400,000.

I've decided to pursue Ophthalmology because I like the clinic more than the clinic work in any other specialty, and I like the procedures more than the procedures in any other specialty, and I like the surgeries more than the surgeries in any other specialty, and I like the patients more than the patients in any other specialty. However not everyone considering going into Ophthalmology likes everything about Ophthalmology or any specialty for that matter. And furthermore none of us can predict if we will still like anything a decade after doing it every day. Hence the common finding of program directors who spent a decade in private practice and then decided to do academics. If liking everything about a specialty was a pre-requisite then there wouldn't be any Oncologists or Gastroenterologists. However, while cancer and poo are not fun to deal with daily you get paid well and that kind of makes it worth it for those people. They would not be as happy doing that work for $100,000. For I assume most rational, thinking human beings income and lifestyle enter into career decisions and at these levels of compensation they could have just been an engineer or a tech or any number of other jobs and had a lot less stressful academic life and a lot less stressful work life.

Only in medicine do we have this conversation by the way. Every other career in the world is filled with people that work just as hard as many physicians or just as many hours and they aren't pompous arses when people considering entering their field ask about compensation. "If you're worried about money don't be a plumber! Sounds like you really just want plumbing without all the sh**. Maybe you should think about HVAC or Welding." Maybe it's because I come from a family of manual laborers, but sometimes people on here need to get a firm grip on their head and try to pull it out of their rectum. Two page long thread and no "I know of many colleagues making X with lifestyle Y in ophthalmalogy subspecialty Z" posts. Just posts telling people to consider other fields.
The issue regarding the future of ophthalmology has been discussed many time before. Do your homework and search the forum.

To summarize, ophthalmology is saturated and finding a good job in the big city is difficult. Starting salaries are lower than what most medical students think. $150-180K is average for most graduating residents. Salaries after being in practice a few years will vary and depends on partnership, location, subspecialty.

Most ophthalmologists are very satisfied with the amount of clinic/surgery (about 4 days clinic, 1 day surgery and throw in the many office procedures) but realize it is less surgical than other surgical specialties (ENT, ortho, plastics, etc) and the nature of ophthalmic surgery is very different so it is difficult to compare directly.

Bottom line, money is not the greatest, but still very good and job satisfaction makes up for the rest. Decide first if you like the field, then decide if the money is good enough for you.

Worry about getting into residency before worrying about fellowship. All this talk about fellowship when you haven't even done an ophthalmology rotation is silly.
 

KHE

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Obviously, most people are going to put compensation potential way up high and they should. Student loans are absurd. The time and energy spent in getting to the end of that marathon is enormous. Of course people should want to be compensated fairly.

Another issue that people don't consider is that a specialty like ophthalmology is expensive to practice. The diagnostic equipment involved tends to be pricey. It's not like being a GP or a psychiatrist where you can get by with an examining room and not a lot else. Now, I get that GPs and psychiatrists aren't heavy procedure based fields like ophthalmology has the potential to be but the point I'm trying to make is that there's a lot of overhead involved.
 

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Perhaps you should also consider anesthesia, gastroenterology, emergency medicine, dermatology, otolaryngology, plastic surgery, and urology. But, it sounds like you want a 8-5 M-F general surgery lifestyle.
I also mentioned I need to be interested in the science behind it and want to diagnose stuff in clinic. Based on my own interests, that eliminates anesthesia, ER, derm, and plastics. As for GI and urology, ppl have been trying to convince me to do urology but honestly those 2 areas are just not the part of the body I want to work with haha. That just leaves ENT of that group, but based on when we studied all the head and neck stuff last year, I like ophtho way more than ENT.

Two page long thread and no "I know of many colleagues making X with lifestyle Y in ophthalmalogy subspecialty Z" posts. Just posts telling people to consider other fields.
This. This is what this thread should be about and still no posts like he mentioned. So far, this thread has been pretty pointless. I understand if some of the attendings get annoyed when ppl ask about compensation, but you are already in the field and well-established. Especially if you've been working for quite some time, I'm sure your salary is more than adequate because from what I understand it's only been in the last few years that ophtho has taken a big hit. Will someone please provide more specific info?
 

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I think the reason for the attitude you're getting about salaries is because of the stereotype non-ophthalmologist physicians have that we're rolling in bank. In residency I got comments from ER physicians (after they called me in at 3AM), anesthesiologists, etc about how much I'm going to be making once I graduate; the reality is that I'll be making far less than them. When my friends in primary care get newsletters bemoaning the salary gap between primary care and "specialists" the newsletter will use cataract surgery as the example of a specialist making more money with a 4 minute procedure a PCP can make all morning. In reality, ophthalmologists salaries really aren't that much higher than primary care.

I'm sure many med student gravitate towards ophtho because they hear these rumors of "lifestyle" (ie high salary with little work) and we are the by far the most competitive specialty for our salary. Almost all ophtho residents could have easily gone into rads or anesthesia and made literally twice as much starting out. Ophtho is an awesome field but you need to be choosing this specialty for the right reasons.

And the main reason you shouldn't choose a speciality based on the salary is that any of our salaries can be changed at the whim of some government bureaucrat tomorrow. It's already happened to ophtho and can happen to anyone else.
 

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If you're looking for numbers: starting salary 120K - 180K, near a large city but it can vary quite a bit. Or you can start out on your own and make nothing early on but possibly have a higher earning potential in years to come. In ophtho, you need to be able to run and expand a business in order to make more. But there are many others here with more experience who might be able to give you more accurate numbers.
 
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rocketbooster

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And the main reason you shouldn't choose a speciality based on the salary is that any of our salaries can be changed at the whim of some government bureaucrat tomorrow. It's already happened to ophtho and can happen to anyone else.
What govt change hit ophtho hard that didn't also affect other fields? Just curious.
 

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My salary, 61,000 but I am a fellow and I don't think anyone cares what I make

What I have seen and heard: these are all starting
Comprehensive - urban = around 150K. rural closer to 180K. Academics closer to 120K

Retina - starting 250-350K private, 200-250K academics

Other fellowships closer to comprehensive but a little higher, have heard glacuoma getting 180 in urban, peds getting 200 in academics, etc

Salary after 3-5 years is all over the place, less of a ceiling in private. Also for comprehensive if you do refractive and multifocal, or if you co-manage with a lot of OD's and operate a lot your salary can be a lot higher
 

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Just wanted to thank everyone who has replied with information so far.

I apologize if we students appear overly concerned with compensation, but remember we're stressed, terrified about matching, deeply indebted, and feel very uncertain about our futures. Ultimately we love Ophtho patients and that's why we're asking for this information. If it was only about hours and compensation we wouldn't be asking these questions here. We'd be trying to publish papers in Dermatology.
 

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What govt change hit ophtho hard that didn't also affect other fields? Just curious.
Huge cuts in cataract reimbursements. More recently, in retina, there have been cuts in OCT reimbursements.

Moral: as soon as you improve the quality and outcomes for a procedure the govt will cut the reimbursement for it.
 

LightBox

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I make about 300K total, 2 years out of training, but am practicing in a rural environment doing basically everything. I'm an associate and my boss basically will be screwing me, so I'll be moving on eventually.

Though 300K might sound like "alot", trust me... if you are receiving a W-2, the taxes really eat up your take-home salary. Plus, I have no stake in the real-estate, an ASC, or other tax-advantaged entities. That is another reason why owning the business is very important. You can keep your money "hidden away" in the business/real estate and draw a lower salary so that you incur less income taxes. You can still invest in stocks, municipal bonds, etc via your business. How do you think the super-rich only pay a 8-9% realized tax rate? It is because they do not incur high income taxes and keep their money in their businesses. They also deduct everything via their business to lower their tax bill further.

Though my compensation is reasonable, I feel far from "rich" and definitely am not driving around a Benz or living the high-life. But then again, I'm trying to be as frugal as possible given I plan to move on. Hope that helps.
 

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I make about 300K total, 2 years out of training, but am practicing in a rural environment doing basically everything. I'm an associate and my boss basically will be screwing me, so I'll be moving on eventually.

Though 300K might sound like "alot", trust me... if you are receiving a W-2, the taxes really eat up your take-home salary. Plus, I have no stake in the real-estate, an ASC, or other tax-advantaged entities. That is another reason why owning the business is very important. You can keep your money "hidden away" in the business/real estate and draw a lower salary so that you incur less income taxes. You can still invest in stocks, municipal bonds, etc via your business. How do you think the super-rich only pay a 8-9% realized tax rate? It is because they do not incur high income taxes and keep their money in their businesses. They also deduct everything via their business to lower their tax bill further.

Though my compensation is reasonable, I feel far from "rich" and definitely am not driving around a Benz or living the high-life. But then again, I'm trying to be as frugal as possible given I plan to move on. Hope that helps.
Thanks for the response! Is that similar to your colleagues' compensation , are you comprehensive or fellowship trained? Also being where you are could you comment on rural area practice? For instance what kind of hours you spend in clinic, and surgical case load, and the types of things you see on call? I imagine that call might be more interesting being one of few local docs.
 

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Readers should know that your compensation is at the high end of the range, especially for a non-owner. I would place your pay at the top 5% or even top 2% of associate, non-owner compensation.

Most practice owners are not stashing loads of money in their practices or real estate for some expected cashout down he road. Sure, many buy their business office properties and buy shares in or own outright surgery facilities, but revenue streams from those enterprises can vary significantly unless you have a very high volume practice of your own that assures profitability. Remember also that there is also risk, and most of these investments are very expensive. An equipped one-OR surgery center without any fancy gear--like a fs yag or dedicated vitrectomy equipment--is north of $1M. Then you need to house it in either a rented or mortgaged space.

Ophthalmic practice is expensive. Anyone considering the field should know that. And reimbursements have not held up against inflation, even though this coming year we are scheduled to have a 1% increase, there are plenty of other "initiatives" that could reduce the increase by the same amount and more.
 

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Thanks for the response! Is that similar to your colleagues' compensation , are you comprehensive or fellowship trained? Also being where you are could you comment on rural area practice? For instance what kind of hours you spend in clinic, and surgical case load, and the types of things you see on call? I imagine that call might be more interesting being one of few local docs.
Well, according to orbitsurgmd, I guess I am toward the higher end of "average" for an associate. Some of my friends have similar salaries, but they are doing much more refractive surgery than I am. I am comprehensive-trained. I prefer rural area practice for the mere fact that I became busy very quickly. I am not fighting for every last patient here. I also love the low-cost of living and am originally from a small town anyways. I guess I'm not so cultured that I absolutely need museums and fine dining nearby.

I would have to say that I would feel very under-appreciated if I was being paid 150k, doing the same amount of work, but living in a highly-desirable area as a non-partner. We all spend the majority of our time at work, and to feel like you are being screwed all of the time, would not be a situation I would tolerate for very long.

I am in clinic 4 days a week (8 to 5), OR one day a week (full day in ASC -- 15 or so cataracts, blephs, trabs, etc). I don't do tranpslants. I get called into the hospital maybe once every 4-6 months for a ruptured globe. All other ER calls, they just send the patient to my office. Call is 99.99% easier than anything I saw in residency.
 

rocketbooster

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Well, according to orbitsurgmd, I guess I am toward the higher end of "average" for an associate. Some of my friends have similar salaries, but they are doing much more refractive surgery than I am. I am comprehensive-trained. I prefer rural area practice for the mere fact that I became busy very quickly. I am not fighting for every last patient here. I also love the low-cost of living and am originally from a small town anyways. I guess I'm not so cultured that I absolutely need museums and fine dining nearby.

I would have to say that I would feel very under-appreciated if I was being paid 150k, doing the same amount of work, but living in a highly-desirable area as a non-partner. We all spend the majority of our time at work, and to feel like you are being screwed all of the time, would not be a situation I would tolerate for very long.

I am in clinic 4 days a week (8 to 5), OR one day a week (full day in ASC -- 15 or so cataracts, blephs, trabs, etc). I don't do tranpslants. I get called into the hospital maybe once every 4-6 months for a ruptured globe. All other ER calls, they just send the patient to my office. Call is 99.99% easier than anything I saw in residency.
What are you considering rural? Are we talking a small town of a few thousand ppl or suburban?

I noticed ppl on here are only saying urban and rural, never suburban. Would you consider a midwestern town of a few hundred thousand as urban or rural? Just curious why no one has ever mentioned suburban. Would it just be somewhere in the middle I'm assuming or does everyone from huge cities consider suburban as rural? haha
 

LightBox

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There are roughly 150k in my "drawing" area. So I guess this isn't exactly rural, but it's definitely not a big city. I would consider a MidWest town with 100-200k as "rural" too :)
 

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Why money talk is dirty? After all, we are not talking about number of Lamborghinis in our driveways, it is the question of surviving in the future. As for me, I am already deep in it and I can't leave Ophthalmology. May be after training I'll go back home where there is no taxes and America trained doctors are treated as royalties:). Future is very uncertain for all of us here. My observations
1. Ophthalmology is great but do not expect to be millionaires in near future
2. In the future salary will take a huge drop, particularly for the primary care providers (in all fields) and comprehensives
3. A drop in salary means unhealthy competition amongst care providers resulting in very hostile professional environment
4. Do not even think about Rads because in a few years from now I believe more Rads doctors will be consulted from Bombay/Lahore/Nairobi than from here. No primary care can be immune. If you want a millionaire guarantee, go into Neurosurgery/Spine surgery etc which is very training intensive, but life will suck very badly.
You wouldn't believe me, I have only started my Ophthal residency here and I've got a job offer from Abu Dhabi which really pays high (not millions in $$$, but quite high for that part of the world), with free housing (no utility bills either)), free healthcare, no taxes, assured pension plan and free transportation:D. I can't blame you if you don't believe me, but I swear this is true. Too good to be true, but true!!!!!!!!!!!!!! At least that's what they have promised me anyway.
 

MR1

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Agree don't do medicine if you want to be a millionaire.

You are gonna make good money. You will not be rich doing ophtho. But you will always have a job. There is a very low risk of being unemployed. You can easily save 20% towards retirement. You will be able to pay off your loans. Your kids can probably go to private school if you want. You will not be at risk of foreclosure. You will drive a nice car.

How many people outside of medicine can say all those things.

I didn't say you could drive a Porsche or even a Beemer. I didn't say you'd live in a McMansion.

I think we get caught up thinking we deserve all these things bc we sacrificed so much to get here.

Ophtho is a great field. If you love it do it. If you paid me 3x what I'll make but make me do something I hate I wouldn't take you up on that offer any day.
 

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I make about 300K total, 2 years out of training, but am practicing in a rural environment doing basically everything. I'm an associate and my boss basically will be screwing me, so I'll be moving on eventually.
Wow, I agree with orbitsurgMD here. I've never heard of a comprehensive associate making $300k only 2 years out. I don't know your full situation, but while you may think you're being screwed, you'll be hard-pressed to find another similar position making that much in that time frame. Decide carefully.
 

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Agree don't do medicine if you want to be a millionaire.

You are gonna make good money. You will not be rich doing ophtho. But you will always have a job. There is a very low risk of being unemployed. You can easily save 20% towards retirement. You will be able to pay off your loans. Your kids can probably go to private school if you want. You will not be at risk of foreclosure. You will drive a nice car.

How many people outside of medicine can say all those things.

I didn't say you could drive a Porsche or even a Beemer. I didn't say you'd live in a McMansion.

I think we get caught up thinking we deserve all these things bc we sacrificed so much to get here.

Ophtho is a great field. If you love it do it. If you paid me 3x what I'll make but make me do something I hate I wouldn't take you up on that offer any day.
Well-stated.
 

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Oh unfortuantely I know this is true, but I do enjoy the pathology for now. Have you ever heard of a non-busy retina doc outside of NY,SF,etc?

Even if we do less surgery in the future, we still will be in clinic enough and like you said I agree 90% is non-surgical and is where we make the money anyway.
I don't know of any retina docs who aren't busy! As to the second part, I just wanted to make sure you understood that you're money will be in the clinic, not the OR.
 

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Nice perspective from a resident. May not be so acurate though.

In the future salary will take a huge drop, particularly for the primary care providers (in all fields) and comprehensives
No necessarily true. PCPs may actually benefit from Obama care, there is already a huge shortage, even in saturated areas. I don't know what you mean by "comprehensives" but if you mean comprehensive ophthalmology, I think comprehesives are in a better position then sub-specialists. I can taylor my practice to what I want to do. I can do trabs, tubes, lasers, cataracts, plastics and adjust my practice as I see fit. Lets say there is a cut in OCT reimbursement (which just actually took place); retina guys won't stop using OCT because of that.

A drop in salary means unhealthy competition amongst care providers resulting in very hostile professional environment
In ophthalmology, this happened long long time ago. especially in saturated areas.

Do not even think about Rads because in a few years from now I believe more Rads doctors will be consulted from Bombay/Lahore/Nairobi than from here. No primary care can be immune. If you want a millionaire guarantee, go into Neurosurgery/Spine surgery etc which is very training intensive, but life will suck very badly.
Not sure about this one, but probably true.


You wouldn't believe me, I have only started my Ophthal residency here and I've got a job offer from Abu Dhabi which really pays high (not millions in $$$, but quite high for that part of the world), with free housing (no utility bills either)), free healthcare, no taxes, assured pension plan and free transportation:D. I can't blame you if you don't believe me, but I swear this is true. Too good to be true, but true!!!!!!!!!!!!!! At least that's what they have promised me anyway.
I LOLed at this one. Did they also tell you that you will live in a compound and will venture out only with a armored guard? And you can not be jewish to get this gig :)
 

rocketbooster

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I LOLed at this one. Did they also tell you that you will live in a compound and will venture out only with a armored guard? And you can not be jewish to get this gig :)
Abu Dhabi is one of the biggest cities in the UAE. The UAE is loaded. It's not the West Bank. He'll be living a much more lavish life there than us here, I can tell you that. And no, Abu Dhabi is not known to house terrorists if that's what you think. It's one of the most Westernized, well-off cities in the Middle East. Google image it. It looks way better than any of our huge cities.
 

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Abu Dhabi is one of the biggest cities in the UAE. The UAE is loaded. It's not the West Bank. He'll be living a much more lavish life there than us here, I can tell you that. And no, Abu Dhabi is not known to house terrorists if that's what you think. It's one of the most Westernized, well-off cities in the Middle East. Google image it. It looks way better than any of our huge cities.
Thanks for your opinion. Unfortunately, in the real world, you should not have Google drive your major career decisions. I actually considered that route at some point in my carrer and had several offers from various hospitals of UAE. The very first question of their telephone interview was about your religious affiliation. That was a question with only one wrong answer.
 

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I also mentioned I need to be interested in the science behind it and want to diagnose stuff in clinic. Based on my own interests, that eliminates anesthesia, ER, derm, and plastics. As for GI and urology, ppl have been trying to convince me to do urology but honestly those 2 areas are just not the part of the body I want to work with haha. That just leaves ENT of that group, but based on when we studied all the head and neck stuff last year, I like ophtho way more than ENT.


This. This is what this thread should be about and still no posts like he mentioned. So far, this thread has been pretty pointless. I understand if some of the attendings get annoyed when ppl ask about compensation, but you are already in the field and well-established. Especially if you've been working for quite some time, I'm sure your salary is more than adequate because from what I understand it's only been in the last few years that ophtho has taken a big hit. Will someone please provide more specific info?
Rotate through third year and then decide. Two weeks ago, you didn't know the scope of a comprehensive ophthalmologist - so, don't go blindly into third year.

The compensation issue has been discussed numerous times. Please do a forum search. Your salary will depend on how you practice and where you practice, so there is not a good answer to satisfy everyone. Most applicants on here won't be in the job market for another 5-6 years. A lot can change over that time frame.

I will say that the 300k figure (2 years out) for a comprehensive is an anomaly (a good one) - and that doing 15 cataracts per week (two years out from residency) is highly unusual in most markets. Someone mentioned that you can estimate your salary based on the number of cataracts you do a year multipled by a thousand. So 200 cataracts a year = $200,000. For most generalists, you need to see 15-20 patients to generate one cataract surgery. The above poster would do well to have some ASC equity given his/her surgical volume.

Go to the AAO website. Most generalists start around $125-150k, lower near saturated big cities). Ophthalmology salaries start low, but potential for higher salary is good. If you join an HMO, it could be as much as $200k to start, but you cap earlier. If you join a good group, you have 1-2 years of associate work and then purchase into the practice. Buy-in can vary, but most pay it off in 5-7 years.
 

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But you will always have a job. There is a very low risk of being unemployed. You can easily save 20% towards retirement. You will be able to pay off your loans. Your kids can probably go to private school if you want. You will not be at risk of foreclosure.

Ophtho is a great field. If you love it do it. If you paid me 3x what I'll make but make me do something I hate I wouldn't take you up on that offer any day.
Thanks. Ultimately, this type of assurance is what I think most of us are looking for here. It's just hard to actually believe it when there are constant OD vs OMD posts and "Ophtho is dead" or "reimbursement is dropping!" talk.
 

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Thanks for your opinion. Unfortunately, in the real world, you should not have Google drive your major career decisions. I actually considered that route at some point in my carrer and had several offers from various hospitals of UAE. The very first question of their telephone interview was about your religious affiliation. That was a question with only one wrong answer.
Haha, I didn't use google for my source of info. I just specifically told you to google image it to take a look at the city since you gave the impression that you thought the UAE was a third world country. I've been to the Middle East many times, and also would have been able to give them their "correct" answer on religious affiliation. ;)

I know many ppl who get job opportunities over there...they get paid substantially more than here and live a more lavish life, if you want to word it that way. Even though I disagree with your stance on what you think the UAE is, I can still see why you'd have that negative opinion if you are Jewish. The reality is the UAE is as secular as it gets for the Middle East. Go visit and find out for yourself.
 

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Rotate through third year and then decide. Two weeks ago, you didn't know the scope of a comprehensive ophthalmologist - so, don't go blindly into third year.
This is correct. I've learned a crapload about ophtho in the last few weeks. However, I really can't go through all 3rd year before deciding because I need time before next summer to actually do ophtho research if I decide to go that route. As of now, I have research in another field that's technically applicable to ophtho but not specific.

Unfortunately, the ophtho department at my school won't respond to my emails about my ophtho interest and potential shadowing opportunities. A bit frustrating. :scared:

I figure it's only worth my time to shadow the ophthos tied to my school since that will get me to know my school's department and also maybe set me up with some ophtho research. Private practice docs generally lack the university and research ties.
 

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Haha, I didn't use google for my source of info. I just specifically told you to google image it to take a look at the city since you gave the impression that you thought the UAE was a third world country. I've been to the Middle East many times, and also would have been able to give them their "correct" answer on religious affiliation. ;)

I know many ppl who get job opportunities over there...they get paid substantially more than here and live a more lavish life, if you want to word it that way. Even though I disagree with your stance on what you think the UAE is, I can still see why you'd have that negative opinion if you are Jewish. The reality is the UAE is as secular as it gets for the Middle East. Go visit and find out for yourself.
Out of curiosity, why did you assume I was jewish? My point was I would never work in a country where your job prospects so heavily depended on your religious affiliation. And, yeah, it's secular alright. Do women get to drive there yet? :)
 

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Talking to some attendings in medicine in general and other ophthalmologists, the general gist everyone tells me that we'll be fine. We'll be comfortable, but not filthy rich from our profession. There are other fields that can be and are more profitable, but I think the view of this is the "grass is greener" thinking. Most of my friends from college that were netting near 6 figures a year or two after graduation have quit their jobs, changed professions, or were laid off. Even then, they were putting in some heavy hours at times. Many of these guys lament how secure my profession is.
 

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Talking to some attendings in medicine in general and other ophthalmologists, the general gist everyone tells me that we'll be fine. We'll be comfortable, but not filthy rich from our profession.
Good to hear. I also feel like if most people say "comfortable" I will find myself feeling "rich." Perspective matters, as the modern day poet T.I. has versed, "My dad wasn't a doctor and my momma wasn't a lawyer. I ain't neva' had sh!7, congratulations is in order."
 

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Wow, I agree with orbitsurgMD here. I've never heard of a comprehensive associate making $300k only 2 years out. I don't know your full situation, but while you may think you're being screwed, you'll be hard-pressed to find another similar position making that much in that time frame. Decide carefully.
I agree that I shouldn't be complaining about my current overall salary as an associate.

I guess I feel like I will be getting screwed because partnership is a dream that my boss will never consider. In other words, I feel like I will be capped out very soon.

I got busy quickly mainly by word-of-mouth, and I guess I'm a reasonable person with good surgical results compared to the competition in town.
 

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I agree that I shouldn't be complaining about my current overall salary as an associate.

I guess I feel like I will be getting screwed because partnership is a dream that my boss will never consider. In other words, I feel like I will be capped out very soon.

I got busy quickly mainly by word-of-mouth, and I guess I'm a reasonable person with good surgical results compared to the competition in town.
Well, if partnership is off the table, that is a problem.
 

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Nice perspective from a resident. May not be so acurate though.



No necessarily true. PCPs may actually benefit from Obama care, there is already a huge shortage, even in saturated areas. I don't know what you mean by "comprehensives" but if you mean comprehensive ophthalmology, I think comprehesives are in a better position then sub-specialists. I can taylor my practice to what I want to do. I can do trabs, tubes, lasers, cataracts, plastics and adjust my practice as I see fit. Lets say there is a cut in OCT reimbursement (which just actually took place); retina guys won't stop using OCT because of that.



In ophthalmology, this happened long long time ago. especially in saturated areas.



Not sure about this one, but probably true.




I LOLed at this one. Did they also tell you that you will live in a compound and will venture out only with a armored guard? And you can not be jewish to get this gig :)
Nobody can accurately predict what is going to happen in future; we all are speculating at the best. But I still believe that comprehensive Ophthalmology will suffer in the future because an intermediate level of care providers (cheaper alternative for providing universal coverage) will be created/trained from existing groups to provide bulk volume health care.
I don't agree with your opinion on Abu Dhabi. True, you'll not find nude drunken girls on shores of Abu Dhabi/Dubai, but these are like any futuristic modern cities of today. They do not ask about religion as opening conversation, that is not true. In fact most of the doctors there are foreigners, imported mostly from India/Pakistan, and yes, you guessed it..they are not all Muslims! In fact, you can find quite a few British/American/other European doctors working there for tax reasons. Go find out for yourself. Just make one visit, you'll change your mind!
 

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I think ophthalmology has a very bright future. There is going to be a massive influx of patients with eye disease over the next 20 years (baby boomers and patients who now have insurance due to Obamacare) with little growth in the # of practicing ophthalmologists. I'm just finishing my 1st year in retina practice, but I see the comprehensive guys around me doing tons of premium IOLs. This is a giant revenue boost for them and will continue to be the primary revenue driver for comprehensive. I think that once you have an established practice, income is really determined by how efficiently you can see patients. Practice setup certainly influences this, but there is also tremendous variability between doctors. We all had the co-resident who struggled to see 5 pts in a 1/2 day at the VA and the other who could bang through 20 without a sweat. I don't think this changes much when people go into practice. I see comp guys who only see 25-30/day and don't have time for lunch and others in the same practice who see 80/day. They all refer to me and there doesn't seem to be any notable difference in quality of assessment, plan, documentation, ect. I would strongly recommend that current and future residents really push yourself to be as fast as possible in clinic. Don't cut corners, but train yourself to see as many patients as you possibly can per 1/2 day and this will really benefit you when you are in practice. There is going to be a surplus of patients (maybe not in highly saturated areas) and the more you can see, the more successful you will be.
 

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I am glad you are looking forward to career in UAE! Less competition for us :thumbup:

Good luck with your clinical rotations, interviews, match and residency :xf:

Nobody can accurately predict what is going to happen in future; we all are speculating at the best. But I still believe that comprehensive Ophthalmology will suffer in the future because an intermediate level of care providers (cheaper alternative for providing universal coverage) will be created/trained from existing groups to provide bulk volume health care.
I don't agree with your opinion on Abu Dhabi. True, you'll not find nude drunken girls on shores of Abu Dhabi/Dubai, but these are like any futuristic modern cities of today. They do not ask about religion as opening conversation, that is not true. In fact most of the doctors there are foreigners, imported mostly from India/Pakistan, and yes, you guessed it..they are not all Muslims! In fact, you can find quite a few British/American/other European doctors working there for tax reasons. Go find out for yourself. Just make one visit, you'll change your mind!
 

JMK2005

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I think ophthalmology has a very bright future. There is going to be a massive influx of patients with eye disease over the next 20 years (baby boomers and patients who now have insurance due to Obamacare) with little growth in the # of practicing ophthalmologists. I'm just finishing my 1st year in retina practice, but I see the comprehensive guys around me doing tons of premium IOLs. This is a giant revenue boost for them and will continue to be the primary revenue driver for comprehensive. I think that once you have an established practice, income is really determined by how efficiently you can see patients. Practice setup certainly influences this, but there is also tremendous variability between doctors. We all had the co-resident who struggled to see 5 pts in a 1/2 day at the VA and the other who could bang through 20 without a sweat. I don't think this changes much when people go into practice. I see comp guys who only see 25-30/day and don't have time for lunch and others in the same practice who see 80/day. They all refer to me and there doesn't seem to be any notable difference in quality of assessment, plan, documentation, ect. I would strongly recommend that current and future residents really push yourself to be as fast as possible in clinic. Don't cut corners, but train yourself to see as many patients as you possibly can per 1/2 day and this will really benefit you when you are in practice. There is going to be a surplus of patients (maybe not in highly saturated areas) and the more you can see, the more successful you will be.
I wonder what what the magic number of patient's seen per day is. The rate limiting step for me is in the summary at the end and all the questions that need to be addressed. Can you really see 80 patients a day and provide good care?
 

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I wonder what what the magic number of patient's seen per day is. The rate limiting step for me is in the summary at the end and all the questions that need to be addressed. Can you really see 80 patients a day and provide good care?
In my opinion no. Seeing that amount you are going to miss something, if you haven't already. I agree it depends on the person and heavily on the set up. How many techs, the flow, etc.

All specialities are different. My happy number is 40-50 per day as retina. I also like to do my notes as I see patients so things are fresh. You can see more if you do your notes later. I also like\need to eat lunch

Yes some patients do suck massive amounts of time from you and can ruin a day quickly
 

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I wonder what what the magic number of patient's seen per day is. The rate limiting step for me is in the summary at the end and all the questions that need to be addressed. Can you really see 80 patients a day and provide good care?
The "magic number" to break even depends on your overhead (e.g. how many techs you have, your rent, etc). I've heard that every new tech requires you to see at least 2-3 extra patients EVERY DAY to cover their salary.

Sure you can see 80 patients a day. But I agree -- quality is going to suffer. Plus, patients will begin to grumble since their waiting times will be longer and you will likely be spending 1-2 minutes with them.

I don't think I would ever want to see that many patients a day no matter how much money is involved. That sounds like a good way toward burning out. There are other things in life besides running a mill.
 

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I am glad you are looking forward to career in UAE! Less competition for us :thumbup:

Good luck with your clinical rotations, interviews, match and residency :xf:
I hav'n't yet decided about UAE. What do you mean 'less competition for us'? Competition in what? I am just a PGY-2 now; how can I compete with a high and mighty 'attending' already established in practice and making millions?:D