Medical retina as a specialty?

[eyedoctobe]

Current PGY-2 resident considering subspecialties. What is the job market and compensation for medical retina look like? I realize I have very little experience being primary surgeon, but not convinced I would miss the OR, and avoiding post-op complications also sounds tempting.

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[mjohnsonets]

Compensation wise you should see strong support for $300K+ starting salaries in private practices, more in rural areas. The highest I've placed someone with was a $450K base in a rural midwest, physician-owned practice. You can eventually make high 6 figures, maybe 7 if you're a partner and have a very busy clinic.

Jobs can be a little harder to find:
You've indicated you would likely want to stop doing cataract surgery. In my opinion, that's the best option if you choose to go medical retina. You can be 100% retina and focus solely on that. You should be open-minded about seeing some comprehensive/routine patients in the clinic starting out if you're not in a retina-only group. If you do decide you want to do surgery, this can create a tricky practice pattern. If you're willing to go to a rural/semi-rural area, this pattern can actually work great. If you're in a large metro, you'll likely need to join a large multi-specialty practice that can feed you retina patients internally. It will be harder to get retina patients from other ophthalmologists given you do cataract surgery as well.

If you do decide to do retina-only, you can seek out retina-only groups. This will be hit or miss, some retina-only groups love having a med. retina doc to ease the patient load. Some do not because you cannot fully be on the call schedule due to not doing surgery. I've seen this be a non-starter with retina groups. However, again, if you're willing to go rural/semi-rural these groups generally don't care.

If you have an interest in retina, I would encourage you to do a surgical retina fellowship. However, I realize these two specialties can have vastly different lifestyles. From a job market perspective, there are many more jobs, base pay is higher, and total career income will likely be higher due to an ability to buy into a surgery center.

Happy to have a more in-depth discussion with you sometime.

 

[eyeeye_captain]

Excellent information above. I get the feeling you’re thinking private practice, but you could consider academics if you want a more desirable area and are ok with a lower salary. A uveitis focus can help. Not my game, but an option

 

[RetinaDude]

My group is retina only. All of us are surgical. I’d welcome a med retina person but not sure we could ever consider the person for equal partnership because of the inability to provide surgical/call coverage. I’m sure other retina only groups have different considerations, but when you are busy surgically (like we are), a medical retina doc doesn’t do much to help us out with the management of this volume.

Some would say “well a med retina person opens up the door for you to do more surgery”. True, but on a per hour basis, you earn more in the office seeing pts and doing procedures than performing vits and buckles all day long. Surgery is where a lot of the true call burden comes from. This has to be shared among partners or you are not truly in an equal partnership

 

[MstaKing10]

My group is retina only. All of us are surgical. I’d welcome a med retina person but not sure we could ever consider the person for equal partnership because of the inability to provide surgical/call coverage. I’m sure other retina only groups have different considerations, but when you are busy surgically (like we are), a medical retina doc doesn’t do much to help us out with the management of this volume.

Some would say “well a med retina person opens up the door for you to do more surgery”. True, but on a per hour basis, you earn more in the office seeing pts and doing procedures than performing vits and buckles all day long. Surgery is where a lot of the true call burden comes from. This has to be shared among partners or you are not truly in an equal partnership

We are an all retina group and had one medical retina for a long time. There was a "correction factor" in the compensation for this physician which reduced their partner's share by a predetermined amount. They had to find coverage for surgical call when they were on call. They would send us all surgical cases and distributed them among the group. It worked well. They left due to personal reasons but we were quite happy with the arrangement.

That said, we are always looking for new doctors and all things equal, the surgical retina candidate would get the job hands down over a medical retina candidate.

As doctors age/come to retirement age I have noticed most slow down surgically first, well before they roll back their clinic volume. So we have one or two docs who are essentially medical retina and hand off cases to their partners from time to time.

 

[Slide]

Current PGY-2 resident considering subspecialties. What is the job market and compensation for medical retina look like? I realize I have very little experience being primary surgeon, but not convinced I would miss the OR, and avoiding post-op complications also sounds tempting.

One thing to add in addition to the other posters; as full time medical retina it will help with referrals to not be in the OR because they won’t be afraid you’ll poach their cataracts down the road. To be really beneficial for an all retina practice, it may help to have a certain niche that is medically focused. The primary niches that come to mind are uveitis, inherited retinal dystrophies, and ROP. Having someone in a retina only practice that can absorb these patients is a win for everyone because the other surgical staff would like be happy offloading these patients to you.