Opthalmology vs. Optometry? Please Help!!

[frubeak]

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I am an undergrad who is considering medical school vs. optometry school. I read in the forum that the major difference (besides the degree) between the two is that opthalmologists can perform surgery whereas optometrists can't. So, I am wondering in a day of an opthalmologist, what portion is spent giving eye exams, and other stuff that an optometrist would also be doing, and what portion of the day do you practice "M.D. only" stuff?

also, what were the factors that influenced you to become more interested in medical school instead of optometry?

 

[frubeak]

anyone? Please?

 

[Jokestr]

Difficult question to answer briefly...I suggest you do some research on optometry school versus medical school first off and ask your advisors in undergrad which might better fit with your personality/grades/and aspirations.

As you may or may not know, ophthalmologists are MD's first, and THEN become ophthalmologists. Most(not all) ophthalmologist probably went to medical school not knowing what they wanted to specialize in. Most people apply to medical school because they want to become physicians...and have the ability and knowledge to treat multiple medical conditions and problems. Usually(once again, not always) sometime in medical school people discover what area of medicine they would like to pursue. Going to medical school is a LONG, HARD process, yet very fun and rewarding and the same can be said of the residency to follow. But, ophthalmologists are then prepared to do multiple types of surgeries(see specialties for example Retina, Oculoplastics, Cornea, Pediatric/Strabismus, Glaucoma) and multiple types of disease processes causing the need for these surgeries such as diabetes, hypertension, trauma, infection etc.
Optometrists on the other hand have completely different training. I will try not to comment too much on optometrists at the risk of offending anyone based on my own personal ignorance. However, optometrists are generally speaking trained more strictly based on eye issues. Schooling is shorter, somewhat easier to get accepted. The training is not as wholistic(for example in optometry school you will never be delivering a baby, or dealing with a gunshot wound to the chest as a patient is dying right in front of you). Optometrists do not have the same opportunity to perform surgeries, however may be better trained than some ophthalmologists in the area of optics and physics.
This is only a brief comparison and lacks MANY MANY key points. I do not think this answer can be given in any brief manner and I appreciate any additional comments from an optometrists point of view on the matter.
However, I once again suggest you do some research and introspection to determine what area you would be most interested in.
Coming from an MD's point of view, I have loved my experiences and would definitely choose to do it over again even knowing how hard and substantial the work would be.
Good luck on a very big life decision,

 

[frubeak]

Thanks for the reply. I have a really high GPA, a good MCAT score, and good extracurriculars, and research experience. I know I could get into optometry easily, but if I were to go to med school, I wouldn't get to guarantee that I could get accepted into opthalmology. I guess that's kind of where my problem lies.

 

[Haptic]

frubeak-

90% of US seniors who apply for ophtho get in. It's not insanely hard to get into...if you can get into a good US med school, and with your stated stats you should, then getting into ophtho isn't bad

I didn't choose ophtho until 4th year and i'd say most people don't choose until 3rd year.

 

[Mirror Form]

I am an undergrad who is considering medical school vs. optometry school. I read in the forum that the major difference (besides the degree) between the two is that opthalmologists can perform surgery whereas optometrists can't.

Yeah, that's what every optometrist says. I used to believe it until I started ophtho residency. Optoms refer patients to us all the time for non-surgical issues. Frequently they're not even complicated issues. Obviously some optoms are better than others. But to say that the only difference is surgery is definitely not the case.

 

[qwopty99]

my understanding is that u can't really "plan" to become an ophthalmologist - at least that's the impression i have going through the canadian system.

i think in canada there's only 16 residency positions available in the country per year for ophth. as such, it works out (roughly of course) to only one student per medical school graduating class a year. that's it. as such, u may end up going to medical school, and end up matching in something else. of course, u may of course end up matching into ophth. a poster above said 90% of applicants match into ophth (presumably in the states). i can't confirm, but it does seem awfully high to me (not that i'm doubting it per se).

if u want to tackle disease - and make treating disease your primary task day-to-day with virtually every patient u see, then u want to be an ophthalomologist. disease itself can be interesting, and its treatment ongoing. if u basically want to go to work in a suit and tie every day, keep your hands clean, and not deal with sick patients, then optometry is for u. doing optometry is different in the sense that the vast majority of patients can be adequately dealt with in the 20-25 min span that u have working with them. the patient presents with a problem, and by the end of u 25 mins with them, they are on their way. there is "some" level of depth required in analysis, but typically, it's not terribly deep. u seldom have to go home wondering if ur patient will need additional treatment. consider how this is different with a patient who has glaucoma. ur going to see them probably every 2 months for the rest of their lives trying to maintain an acceptable IOP.

i'm an OD. i was competitive for medical school but i chose optometry because i felt i'd find myself at age 28 and midway through residency (i envisioned 100 hours/week in the hospital), and seriously regretting why i didn't choose the "easier" path of optometry. i like that optom school allowed me to finish in 4 years. that said, now that i'm out, i have to admit that optometry isn't nearly as lucrative as i expected it to be (we all think we'll gross 100K when we get out - but that's the AVERAGE salary - which includes salaries of those who've worked for many years. its more like 60-65K your first year out - of course this varies on geography and other things), and certainly no where as financially rewarding as medicine (i'm not trying to make ODs sound like mercenaries, but it's a bit disconcerting to pull in a starting OD salary, when ur MD resident friends are all "certainly" going to start at 150K and in a few years pull well over 300K). of course, if u go into ophthalmology, then issues like malpractice worries, and those (da-mn) optometrists start making life less ideal.

no profession is perfect unfortunately, and that includes both optometry and opthalmology.

 

[Ophth_06]

"90% match" statistic is misleading, keep in mind this is a self selected applicant group who have all done well in med school, hence the avg USMLE of 230.

It goes without saying that 90% of all med students dont score a 230.

 

[salmonella]

I think ophthalmology education should be restructured into a system similar to dental school. Dentistry and ophthalmology are similar in that both fields have some clinical medicine, and both are surgically oriented, highly specialized areas dependent on cutting edge technology. The ideal way is, go through 4 years of basic biomedical sciences and medical eye care training, and if students desire to do eye surgery, they can continue with fellowship/residency (much like how dentists further specialize in orthodontics or oral surgery). Why waste four years of medical school studying heart, lungs, renal physiology, etc, that have no direct impact on the eyes? It's true that some medical diseases have ocular manifestations, but these can be easily learned without 4 years of med school and 1 year of medicine prelim. Dentists don't go through med school or prelim medicine, yet they routinely prescribe antibiotics for gum/throat infections, perform complicated procedures even in patients with significant medical history.

 

[rubensan]

Why waste four years of medical school studying heart, lungs, renal physiology, etc, that have no direct impact on the eyes? It's true that some medical diseases have ocular manifestations, but these can be easily learned without 4 years of med school and 1 year of medicine prelim. Dentists don't go through med school or prelim medicine, yet they routinely prescribe antibiotics for gum/throat infections, perform complicated procedures even in patients with significant medical history.

i would be very careful with this logic.

it is a long road, but if i had to do medical school and internship over again i would because i believe that it has made me a better health care provider. i think allopathic medical training is shifting focus and has less to do with memorizing facts and more to do with teaching a set of skills that will enable future M.Ds to become life long learners. a good general medicine internship still requires endless insulin sliding scales, EKG and CXR interpretation, but more than that i believe that it creates and environment where an M.D. gets used to taking care of a large volume of patients, applying evidence based medicine into practice and frankly learning how to be a doctor. i would not underestimate the value in any of this.

 

[Olddog1]

I am an undergrad who is considering medical school vs. optometry school. I read in the forum that the major difference (besides the degree) between the two is that opthalmologists can perform surgery whereas optometrists can't. So, I am wondering in a day of an opthalmologist, what portion is spent giving eye exams, and other stuff that an optometrist would also be doing, and what portion of the day do you practice "M.D. only" stuff?

also, what were the factors that influenced you to become more interested in medical school instead of optometry?

Rarely do people enter medical school and say I am going to be an ophthalmologist. I know 2 people that did, they were both ODs first. Most people enter medical school knowing they want to be an MD and things fall into place from there. Medical school is a huge time commmitment so make sure it is the direction you want to take. The only way to find out it by seeing what practice is like. I would recommend volunteering at ERs (great for the variety), following a family MD around for a few days, get a part time job at a hospital, and/or contact some optoms to see if any would let you shadow them as well.

 

[VA Hopeful Dr]

Yeah, that's what every optometrist says. I used to believe it until I started ophtho residency. Optoms refer patients to us all the time for non-surgical issues. Frequently they're not even complicated issues. Obviously some optoms are better than others. But to say that the only difference is surgery is definitely not the case.

I think, as you said, this depends greatly on the individual OD. I, too, have seen some that will refer out every red eye that walks in their door. Conversely, I have seen ODs that will handle everything that their scope allows, only referring out when patients need things they can't do (surgery, oral meds, injections).

My advice to the OP: go to medical school. If, later on, you decide that you'd rather be an OD, the New England College of Optometry has a speed-degree. If you already possess an MD/DO/PhD in the sciences, you can get your OD in 2-3 years instead of 4.

 

[eyerepairman]

my understanding is that u can't really "plan" to become an ophthalmologist - at least that's the impression i have going through the canadian system.

i think in canada there's only 16 residency positions available in the country per year for ophth. as such, it works out .

Canadians, as well as DO's, historically have taken advantage of Americans (and MD's, respectively). Canadians take away residency spots from Americans. The same with jobs, in general, as well as ophthalmologists who want to practice there. DO ophthalmology residencies take only DO but residencies at MD medical schools don't ban DO's.

This is not to imply that Canada is an evil country, only that they take advantage of the US in many ways, discriminate against Americans, and quite a few of them secretly (or not so secretly) have extremely anti-American feelings. I don't know of any Americans who are anti-Canadian.

 

[eyerepairman]

The optometry students that I've talked with generally say that they didn't want to work so hard to get through medical school and residency. Some expressed no interest in surgery.

Optometrist will always be seen by some as second class so prospective optometrists need to be comfortable with that happening. Ophthalmologists also have to realize that many people don't know that there's a difference between ophthalmologists, optometrists, opticians, or even obstetrician s(once a lady thought that that an ophthalmologist delivered babies!), so ophthalmologists have to be prepared that people will get confused to what they do and even if they are MD's!

The same decision process is experienced by ophthalmology residents. They have to decide if they want to be general ophthalmologist or go into retina, oculoplastics, etc.

 

[WhiteDots]

I completely agree with rubensan about it being good to have an MD and intern year. For those of you who think it's not necessary, I honestly think you're missing out the point of ophthalmology. Ophthalmology isn't simply about cataract surgery, lasik, and managing solely eye problems. I think medicine has shifted so much to the point where, if it's not what I specialize in.. I shouldn't take care of it-- which is a shame. Look at the prelim/TY previous posts to see what others have said is the value of a solid internal medicine training-- which can come through either TY or a prelim medicine year.

Histo, toxoplasma and cara, endocarditis, sarcoid, lupus, preeclampsia, diabetes are just a few of the many types of medical problems that you can find in the eye. And, if you plan on doing a uveitis/ocular cancer fellowships-- those guys wind up prescribing chemotherapeutic drugs and DMARDs! I would argue you better have an MD before you start playing with those drugs-- or even before you start prescribing high dose steroids-- an MD would be invaluable.

For anyone who says medicine isn't necessary to be a great ophthalmologist-- is just kidding yourself (or at least-- i definitley wouldn't want you to be my ophthalmologist). If you're just going into ophthalmology because you want make money, have an easy life, just do cataracts and refractive stuff... and not do anything else, I think you're missing the point of what ophthalmology is all about (and have alot more to learn about what ophthalmology really is)-- and yes for those who just care only about this-- you probably don't need to do 4 years of medical school and an intern year.

Just my 2 cents worth.

 

[qwopty99]

Optometrist will always be seen by some as second class so prospective optometrists need to be comfortable with that happening.

while i understand ur gist, i think that such a perception really exists in narrow circles. opticians (in canada anyways) CERTAINLY view optometrists as 2nd class citizens. ophthos conceivably could view optoms in such a manner, but (in canada anyways) i don't think they do. the reason, is that given that the OD has so relatively little education (from the perspective of the ophtho), and yet the OD has a very big scope (again, from the perspective of the OMD), the OD is definitely a legislative force that has to be reckoned with. i don't think any OMD will discount the lobbying force of the OD, where it has come, where it intends to go, for them to take them lightly. that said, some OMDs may view the OD as a second class citizen with regards to eye knowledge etc, and that must be mentioned as well.

as for the general public, i for the most part have to "disagree" with what ur statement above. the reason is included in your own post:

Ophthalmologists also have to realize that many people don't know that there's a difference between ophthalmologists, optometrists, opticians,

while it IS true that u'll get the occasional patient walk into an OMD office, and basically say that they'll never visit an OD again (for whatever reason), and that they're supporters of OMDs, out of the general population (those that visit OMDs and those that don't), the number of such people are very very small.

as such, the OD to many people, is the only "eye doctor" they are aware of. as such, the OD in many instances, has the "prestige" of what an OMD really "should" have. you mention some people don't even know OMDs graduated from med school. i can tell u some people don't know that ODs DIDN'T graduate from med school.

just my OD 0.02.