Ophtho as a field- I need help with this picture

[jmillski]

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Hello all- I'm a third year and have a few quick questions- I've been interested in ophtho for as long as I can remember (retina in specific). I have quite a few extracurriculars in ophtho (though most were in undergrad), great board score, and pretty good grades coming in.

1. Exactly how saturated is the field becoming? Is there no theory that this will all work out when baby boomers get to cataract/glaucoma/retinopathy age?

2. Exactly how much better is the lifestyle than other surgical subspecialties? I am also considering ortho, but I will be gauging how much I enjoy life by how much time I have to see my family, watch kids grow up, fly, fish, watch birds. On a side note, I'm considering ortho ENT because I'm afraid of how little OR time you get with ophtho.

3. Is retina obtainable by most residencies? If that answer is no, I would consider taking a year off for research.

Thank you guys much. I've just blindly been following ophtho then all of the sudden got hit with the optometry issue, unfairly declining reimbursements compared to other specialties, etc, etc, etc when looking more into the application process for next year.

 

[Ophtho222]

All these questions were just answered in another thread like yesterday. Do a search!

 

[OphthoQuestions]

Hello all- I'm a third year and have a few quick questions- I've been interested in ophtho for as long as I can remember (retina in specific). I have quite a few extracurriculars in ophtho (though most were in undergrad), great board score, and pretty good grades coming in.

1. Exactly how saturated is the field becoming? Is there no theory that this will all work out when baby boomers get to cataract/glaucoma/retinopathy age?

2. Exactly how much better is the lifestyle than other surgical subspecialties? I am also considering ortho, but I will be gauging how much I enjoy life by how much time I have to see my family, watch kids grow up, fly, fish, watch birds. On a side note, I'm considering ortho ENT because I'm afraid of how little OR time you get with ophtho.

3. Is retina obtainable by most residencies? If that answer is no, I would consider taking a year off for research.

Thank you guys much. I've just blindly been following ophtho then all of the sudden got hit with the optometry issue, unfairly declining reimbursements compared to other specialties, etc, etc, etc when looking more into the application process for next year.

1. All attractive/urban areas are saturated for surgical subspecialities. On average, you will make less money (or work harder) in these areas unless you are one of the "top dogs." That's not saying you can't still be rather well-off in these areas. I know many people who are doing just fine in supersaturated areas. It is just more competitive.

2. The quality of life is much better in Ophtho, but that comes with the price of lower, average (at least starting) salaries. With ENT or Ortho (especially Ortho), you will work significantly harder during your residency and fellowship. But your starting salaries will be much better especially with Ortho (and especially Spine). You can still do financially very well with Ophtho, but since it is typically more elective-type procedures (e.g. LASIK, premium lenses, etc), you need to be a better salesman/businessman.

3. Yes, any resident can get a Retina fellowship. As always however, the better "name" will open more doors for fellowship all other things being equal. I am not sure you should spend another year of your life doing research if you are already a strong applicant (unless of course you have a sincere interest in academics/research).

-OQ

 

[FunnyCurrent]

Hello all- I'm a third year and have a few quick questions- I've been interested in ophtho for as long as I can remember (retina in specific). I have quite a few extracurriculars in ophtho (though most were in undergrad), great board score, and pretty good grades coming in.

1. Exactly how saturated is the field becoming? Is there no theory that this will all work out when baby boomers get to cataract/glaucoma/retinopathy age?

2. Exactly how much better is the lifestyle than other surgical subspecialties? I am also considering ortho, but I will be gauging how much I enjoy life by how much time I have to see my family, watch kids grow up, fly, fish, watch birds. On a side note, I'm considering ortho ENT because I'm afraid of how little OR time you get with ophtho.

3. Is retina obtainable by most residencies? If that answer is no, I would consider taking a year off for research.

Thank you guys much. I've just blindly been following ophtho then all of the sudden got hit with the optometry issue, unfairly declining reimbursements compared to other specialties, etc, etc, etc when looking more into the application process for next year.

I'm in the same boat... 3 ophtho/patho pubs as an undergrad. Due to the doom and gloom I'm now wondering if I should continue doing research in this field.

What's the starting salary like in Ophtho. Everyone says 120K but that seems a bit low for a surgical subspecialty.

Also, how does saturation affect the suburbs of big cities. I'm a californian. What if I want to live SF-adjacent or LA-adjacent. Still saturated? How far will I have to go to make an excellent living? Nebraska?

 

[DrMassacre]

. What if I want to live SF-adjacent or LA-adjacent. Still saturated?

very.

 

[golfman]

What's the starting salary like in Ophtho. Everyone says 120K but that seems a bit low for a surgical subspecialty.

120k is about right. Buddy of mine just took a starting job (western region) in a decent sized city and started at 150k. Had several offers below 150k.

 

[FunnyCurrent]

nvm

 

[Andrew_Doan]

I have another theory for you all to consider. The demographics of the field is changing quickly. Twenty years ago, the field was primarily all males. The AAO data now shows that the field is 50%/50% male/female.

Because of my positions in the field, I have spoken to hundreds of young ophthalmologists. Many women are looking for part-time opportunities after they have children. This is not a sexist thing to say, it's just the fact that after being a mom, women want to spend more time with their kids. I have met many, many women, and men, seeking part-time opportunities because one parent wants to spend more time raising kids. I think raising a family is one of the most honorable jobs as this is the future of our world. I am not making judgment, so please do not take this as being sexist. It's just what I have observed.

Consider my family, my wife is one of the most liberal women on earth. She even tattooed a woman's symbol on her ankle in college. She was highly motivated for a nurse practitioner degree and NEVER wanted to stay home with the kids. After we had Nick and Kate, she "retired" from nursing when I was in medical school (eBay income allowed her to quit nursing - praise God) and has thrived as being the CEO of our home ever since. In this day in age, it's becoming more difficult to have both parents work. There are many times I wished she was the eye surgeon so I could be with the kids because I miss out on sooooo much: award ceremonies, games, joys, growth, and so on so on. I live and experience my own kids' lives through my wife's texts and images she sends to me. I love being an eye surgeon and starting companies. My wife loves being the CEO of the home. It's a perfect partnership, and we accomplish a ton together!

Ophthalmology only trains about ~460 new eye surgeons every year. This number is fixed, the number of elderly are increasing quickly, we are like "eye dentists" because everyone needs cataract surgery if they live long enough, BUT the work force is changing to one that a significant number of eye surgeons want to be part-time.

One thing I have understood well is business. There is a huge disparity in supply of full-time eye surgeons and demand for eye surgery in the future.

 

[Visionary]

I have another theory for you all to consider. The demographics of the field is changing quickly. Twenty years ago, the field was primarily all males. The AAO data now shows that the field is 50%/50% male/female.

Because of my positions in the field, I have spoken to hundreds of young ophthalmologists. Many women are looking for part-time opportunities after they have children. This is not a sexist thing to say, it's just the fact that after being a mom, women want to spend more time with their kids. I have met many, many women, and men, seeking part-time opportunities because one parent wants to spend more time raising kids. I think raising a family is one of the most honorable jobs as this is the future of our world. I am not making judgment, so please do not take this as being sexist. It's just what I have observed.

Andrew, this is indeed true, and it's affecting all of medicine. Several years ago, there was a push for gender equality in medical schools. Now, as you say, it's about 50/50. The fact is that women, to a much greater extent than men, choose either part time work or retire early altogether. One of my med school classmates never even started work after residency. She's her kids' private pediatrician. Now, everyone is definitely entitled to make their own career decisions, but this trend actually results in a relative decline in physician workforce despite an already projected shortage. Should be interesting.

 

[Visionary]

Also, how does saturation affect the suburbs of big cities. I'm a californian. What if I want to live SF-adjacent or LA-adjacent. Still saturated? How far will I have to go to make an excellent living? Nebraska?

You'll have trouble in these areas regardless of the medical specialty you choose. Fact is, too many people want to live there, and supply and demand holds for medicine, just as any other business.

 

[Visionary]

120k is about right. Buddy of mine just took a starting job (western region) in a decent sized city and started at 150k. Had several offers below 150k.

Keep in mind that starting salary, while not appealing, is typically less than half of true earning potential once you make partner in 2-3 years.

 

[Andrew_Doan]

Andrew, this is indeed true, and it's affecting all of medicine. Several years ago, there was a push for gender equality in medical schools. Now, as you say, it's about 50/50. The fact is that women, to a much greater extent than men, choose either part time work or retire early altogether. One of my med school classmates never even started work after residency. She's her kids' private pediatrician. Now, everyone is definitely entitled to make their own career decisions, but this trend actually results in a relative decline in physician workforce despite an already projected shortage. Should be interesting.

I have known at least one woman who decided to dropout out of ophthalmology because she wanted to start a family. She took one spot from someone else and then dropped out.

I know several men and women who were booted out of residency, another lost resource as our workforce is reduced by that number.

 

[Shnurek]

Similar trends have happened in opto as well. Women make up ~65% of matriculants to optometry schools. As a male I am in a small minority in my school for example. I view this as an advantage however. I have less (male to male) competition and let's face it, most Americans are still embedded with the picture of the "successful white male" even though Asian-Americans have surpassed the average income of White Americans for example. Also, many older practicing docs do not necessarily enjoy the changing demographics of the profession. All this might change however depending on how trends go.

Anecdotally, in my school's clinic a few weeks ago a patient asked for a "male intern". There was no male intern available and the patient left.

Optometry schools located in less constraining scope of practice states tend to have a higher male:female ratio.

Dr. Doan, I think this partially stems from the fact that many males nowadays are addicted to the internet and computer gaming as you have stated. And it also stems from the fact that Affirmative Action actually slightly hinders certain racial groups and genders from gaining admission to higher education. Many white males are filing "reverse discrimination" lawsuits and people of Asian descent also file suits against institutions for discrimination. States are slowly being forced to ban Affirmative Action.

These issues are in many places taboo and difficult to discuss but they are real. I hope my contribution was somewhat useful and I learned very much from your website, Dr. Doan.

 

[Dusn]

Keep in mind that starting salary, while not appealing, is typically less than half of true earning potential once you make partner in 2-3 years.

Thanks for that reminder. The job market right now, at least in more saturated regions, is not encouraging.

That may be true that there are more women working part-time. But at the same time, the amount of time needed to perform a surgery -- take cataract surgery for example-- has decreased significantly from the past. In addition, the amount of time spent per patient visit has also probably decreased significantly, to the point where I see some attendings seeing 80+ patient's per day (and not just in retina). So that the more experienced surgeon with a large referral source will be able to handle a larger patient and surgical volume, essential keeping the newcomers out of their market and keeping the demand for more ophthalmic surgeons low.

 

[Andrew_Doan]

Dr. Doan, I think this partially stems from the fact that many males nowadays are addicted to the internet and computer gaming as you have stated. And it also stems from the fact that Affirmative Action actually slightly hinders certain racial groups and genders from gaining admission to higher education. Many white males are filing "reverse discrimination" lawsuits and people of Asian descent also file suits against institutions for discrimination. States are slowly being forced to ban Affirmative Action.

These issues are in many places taboo and difficult to discuss but they are real. I hope my contribution was somewhat useful and I learned very much from your website, Dr. Doan.

Thanks for your nice comments!

Consider this:
Philip Zimbardo: The demise of guys?
http://www.ted.com/talks/zimchallenge.html