Scared before even applying!!!

[boondocksaint]

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So I've already done a month rotation in ophtho, and loved it! Even though I've found that ophtho isn't exactly the cush residency everyone makes it out to be. The learning curve is ridiculous!!! That doesn't bother me though. What bothers and scares me is the fact that nearly EVERY last year resident, and even the fellows, tell me that the job market in ophtho is dismal. Fellows are telling me they received like 3 job offers. Residents are doing fellowships because the job offers for comprehensive are terrible, and the salary is like $120K. I've had a few fellows who did a year or two of private practice tell me that they had to bust to make 120-150K in their first year of practice, and that the outlook for being a partner isn't what they had expected. And don't get ANY of them started on the whole optometrist thing. I thought that was just crap on the message boards, but NOOOOOO. Every resident is scared to death, and angry as all hell that they're gonna lose the bread and butter of laser and cataract surgery (basically everything that doesn't usually require suturing) to the ODs.

Any private practice guys who read this, and who maybe have been reluctant to talk about this kinda stuff, please reply. Is this for real? Last year residents' and fellows' opinions would be appreciated too (basically anyone who has a feel for the job market). I am in love in ophtho, and have put a LOT of effort into becoming marketable for this field. But medicine is a job, and when people are downright depressed about their job outlook, it makes me seriously second-guess if I am doing the rational thing continuing in ophtho. Yes, doing what you love is important, but so is being able to support a family, and wife who hopefully will be able to stay home and raise the kids (daycare is no replacement for parents). I don't mind medicine. I don't love it as much as ophtho, but perhaps the medical subspecialites have a brighter future. I would appreciate all views on this, and soon, as it's down to the wire!!!

By the way, I'm in the Northeast.

 

[ucophtho01]

I have many friends in Ophthalmology. I have two friends, former Ophthalmology fellows who took positions for 80,000 and 110,000 respectively. I can't say that the market is dismal but it is definitely competitive. If your trying to go to a saturated market, you won't have much luck finding a great starting salary simply because practicing ophthalmologists can't risk losing their income. Reimbursements are down. You'll find that a lot of contracts will have a "no compete" clause which leaves little room for error should you leave the practice.

If you are worried about money, you could go for a retina fellowship but once again it's competitive. And don't forget, maintaining a private practice is difficult (maintaining office staff, having patients, insurance). You'll find that maybe an academic setting would be more appropriate. But once again, your salary may not be as much.

Just think what's gonna happen in 10 years. Either way, make the decision to do Ophthalmology because you want to do it everyday.

 

[xaelia]

You also have to think about starting salaries in the sense that, at least from what I've seen, the practicing efficiency of a recent graduate vs. someone who's been established in their practice is profound. I've seen an experienced clinician with 70 patients on their schedule each day and booked for surgery for months in advance, while a recent graduate simply won't be that polished. I imagine after a few years in practice the income differential will start to fade.

 

[boondocksaint]

xaelia,

I hear what you say about busy ophtho practices. I saw that during my rotation. They were all booked weeks, if not months in advance. And they would often do 10 cases on their OR day. However, the overhead in ophtho is very high, and reimbursements are down. Doesn't it make you think that if they're still making tons of money, they would be hiring at higher salaries? Plus, none of the ophthos I worked with drove even remotely expensive cars, or wore expensive clothes. Subarus, Jettas, ect were the norm. Now, I don't really care about driving a porshe (too flashy) or living in a mansion, but I do care about driving a car such as said subaru, jetta, ect, and having enough bedrooms so that each of my kids will have their own. And if the current guys are doing just well enough for that to happen, it doesn't bode well for our future.

Or is my view skewed by the fact that all the practices I rotated through were private but still university-affiliated? Will the income differential truley fade? I'm not greedy, but I thinking asking for a 250-300K salary once established isn't asking too much. And I'm not so sure even the newer (5-10yrs) established guys are making that. Thus my concern.

 

[xaelia]

I can't tell the future, and I'm barely qualified to comment on the present.
I did hear from one of our fellows that the other three graduates from UCSF this year all went to Kaiser for about $200k.

 

[Mustafa]

do ophthalmology only because you think you'll love it. don't depend on the $300K salaries. the cost of overhead is high. as xaelia pointed, you have to be prepared to become a machine to do an assembly line of 40-60pts a day. Do people really enjoy handling that kind of volume? I highly doubt it, and the reasons do revolve around $$$. As reimbursements decrease, overheads increase, is a 40-60pt/day load good for either the patients or the ophthalmologists? again, i doubt it. is it worth ultra-marketing schemes in saturated locales to convince otherwise healthy 30 year-olds to play with their vision by undergoing LASIK in order to make that $300K? i think you have to do ophtho b/c you think you'll love it.

in my opinion, there are few high pay, low hours, LOW VOLUME specialties, if any. Derm is high volume. The one exception may be Radiation Oncology. Think, most don't do a fellowship, starting salaries at $225-250K (even at some academic places) for an 8-5 job, advanced toys, few emergencies, free weekends, low overhead (hospital covers), maybe a fourth or fifth of ophthalmology's patient load. All that in 5 years! I don't think any other specialty is reimbursed on a per patient per hour as that one. If these reasons are important to you, and you don't mind dealing with cancer and high patient mortality, consider this field, or one like it.

 

[GuP]

I wonder if there are practicing ophthalmologists on this board. I would love to hear their opinion on this whole issue.