Should I continue with Optometry?

[MedWizz]

Hello all,
For context, I am currently 23 years old (single with no dependents) and have been accepted by the optometry schools I have applied to (ICO and UMSL). I currently live and work in North Carolina, so I would have to pay out-of-state tuition. I have already turned down my offer from UMSL and plan to attend ICO this Fall. I have an undergraduate degree in exercise science and have completed almost all pre-medical courses (biochemistry and the second semester of organic chemistry). I have a 3.94 GPA with around 1200 clinical hours as an ophthalmic assistant. I originally planned to pursue PA school, as I have struggled with a commitment to a particular area, but working as an ophthalmic assistant got me into optometry (yes, we have an optometrist I shadowed).

Next, I'm going to go over my current financial situation and tuition calculations with offers:
I currently have $21,000 in undergraduate loans, which are, on average, at a fixed 4% interest rate.

UMSL
Direct expenses-->$236,908*
Indirect expenses (4 years included)-->$130,000
Total expenses-->$366,908
Adjusted total expenses-->$298,908 (with a $17,000/year scholarship)
*I have spoke to financial aid, in which they stated "you will lose your scholarship offer if you apply for resident tuition after a year of residency"

ICO
Direct expenses-->$210,418
Indirect expenses-->$94,850 (I am not sure how this is lower than UMSL, but it was calculated using the cost sheet)
Total expenses-->$305,268
Adjusted total expenses-->$275,268 (with a $7,500/year scholarship)

Current thoughts/future job projections:
I feel that most comments will advise continuing, but I want to clarify that I have a passion for optometry. I think I would like to eventually move back close to my hometown (rural part of NC) and possibly work with the VA as I am interested in ocular disease and have no interest in working with kids (although I would not mind it). The company I currently work for (private practice for profit) is looking for an OD with a base salary of $120,000-$160,000, so I could estimate that my area would pay roughly $140,000 a year in a private setting.

I understand that there are many opportunities for repayment, including working for corporations, PSLF (VA included), and even some private practices that will help repay some loans. I took working for the military out of the option, as I had previously tried to join the Air Force but was turned down by MEPS due to childhood asthma. I feel I would be best off working for the VA while working towards PSLF after 10 years, so I decided to do some more calculations.

After using the FAFSA calculator, I determined that I would make around $2,000 in monthly payments toward student loans using an income-driven repayment plan. If I continued working towards the PSLF after ten years, I would have paid roughly $240,000 in debt before the rest of my loans were forgiven. The standard 10-year repayment plan would be $4232 a month, which is not plausible.

I am not considering ophthalmology due to its extended length (7-8 years at least) and the chance that you will not match into an ophthalmology residency. I am still tossing up the idea of other careers, such as PA school, but even those schools can have upwards of $200,000 in school debt. The ophthalmologist I work for has repeatedly stated not to worry about tuition costs and to go for it, as all medical professionals will have extended debt. I have a hard time considering that, as ophthalmology has doubled to triple the returns of optometry.

Final thoughts:
I am very passionate about optometry and the difference the field has made in the community. I want to step into a similar role; however, I do not want to put myself into a hole I will never climb out of. Unfortunately, it seems that most healthcare professionals will go into extensive debt, but most can get by just fine. I grew up with parents who, to this day, are living paycheck to paycheck, so financial situations have always worried me.

Any responses will be considered, and I appreciate you taking the time to help guide me.

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[percyeye]

All medical training whether it is Optometry, Dental, Medical School, PA etc etc is extremely expensive right now and only getting worse. So I wouldn't base the rest of my life on tuition cost and would do what you are interested in.

PA has a cap of about $100-$140K they can make and employed Optometry is pretty similar but if you are an owner the ceiling on income can be much higher.

I'd recommend do what you are passionate about because everything gets boring and a little mundane after a while.

 

[MedWizz]

All medical training whether it is Optometry, Dental, Medical School, PA etc etc is extremely expensive right now and only getting worse. So I wouldn't base the rest of my life on tuition cost and would do what you are interested in.

PA has a cap of about $100-$140K they can make and employed Optometry is pretty similar but if you are an owner the ceiling on income can be much higher.

I'd recommend do what you are passionate about because everything gets boring and a little mundane after a while.

Thanks for your reply!
I agree that all professional schools in healthcare are excessively expensive. I totally agree that I should just commit, it's just hard to when you know you will struggle to pay off the debt.

As far as attending PA school, they do typically make less; however, I have heard some talk about phasing out optometry with the advancement of newer technology. At the same time, I've heard that they needed more now than ever so I am unsure of what to think.

I will most likely just attend regardless, and deal with the possible consequences later. I do want to do something that I enjoy, which I guess makes it worthwhile in the end.

 

[preoptstudent3]

Have you considered applying to cheaper optometry schools? My tuition will not exceed $125k at UHCO (students receive scholarship money based on their incoming GPA + scholarships each semester based on their opto school gpa). At UAB, I was offered a $100k scholarship and my tuition would’ve been $94k if I accepted their offer. You have a great gpa and a lot of experience… just something to consider if costs are worrying you.

 

[FinnMac]

Hello all,
For context, I am currently 23 years old (single with no dependents) and have been accepted by the optometry schools I have applied to (ICO and UMSL). I currently live and work in North Carolina, so I would have to pay out-of-state tuition. I have already turned down my offer from UMSL and plan to attend ICO this Fall. I have an undergraduate degree in exercise science and have completed almost all pre-medical courses (biochemistry and the second semester of organic chemistry). I have a 3.94 GPA with around 1200 clinical hours as an ophthalmic assistant. I originally planned to pursue PA school, as I have struggled with a commitment to a particular area, but working as an ophthalmic assistant got me into optometry (yes, we have an optometrist I shadowed).

Next, I'm going to go over my current financial situation and tuition calculations with offers:
I currently have $21,000 in undergraduate loans, which are, on average, at a fixed 4% interest rate.

UMSL
Direct expenses-->$236,908*
Indirect expenses (4 years included)-->$130,000
Total expenses-->$366,908
Adjusted total expenses-->$298,908 (with a $17,000/year scholarship)
*I have spoke to financial aid, in which they stated "you will lose your scholarship offer if you apply for resident tuition after a year of residency"

ICO
Direct expenses-->$210,418
Indirect expenses-->$94,850 (I am not sure how this is lower than UMSL, but it was calculated using the cost sheet)
Total expenses-->$305,268
Adjusted total expenses-->$275,268 (with a $7,500/year scholarship)

Current thoughts/future job projections:
I feel that most comments will advise continuing, but I want to clarify that I have a passion for optometry. I think I would like to eventually move back close to my hometown (rural part of NC) and possibly work with the VA as I am interested in ocular disease and have no interest in working with kids (although I would not mind it). The company I currently work for (private practice for profit) is looking for an OD with a base salary of $120,000-$160,000, so I could estimate that my area would pay roughly $140,000 a year in a private setting.

I understand that there are many opportunities for repayment, including working for corporations, PSLF (VA included), and even some private practices that will help repay some loans. I took working for the military out of the option, as I had previously tried to join the Air Force but was turned down by MEPS due to childhood asthma. I feel I would be best off working for the VA while working towards PSLF after 10 years, so I decided to do some more calculations.

After using the FAFSA calculator, I determined that I would make around $2,000 in monthly payments toward student loans using an income-driven repayment plan. If I continued working towards the PSLF after ten years, I would have paid roughly $240,000 in debt before the rest of my loans were forgiven. The standard 10-year repayment plan would be $4232 a month, which is not plausible.

I am not considering ophthalmology due to its extended length (7-8 years at least) and the chance that you will not match into an ophthalmology residency. I am still tossing up the idea of other careers, such as PA school, but even those schools can have upwards of $200,000 in school debt. The ophthalmologist I work for has repeatedly stated not to worry about tuition costs and to go for it, as all medical professionals will have extended debt. I have a hard time considering that, as ophthalmology has doubled to triple the returns of optometry.

Final thoughts:
I am very passionate about optometry and the difference the field has made in the community. I want to step into a similar role; however, I do not want to put myself into a hole I will never climb out of. Unfortunately, it seems that most healthcare professionals will go into extensive debt, but most can get by just fine. I grew up with parents who, to this day, are living paycheck to paycheck, so financial situations have always worried me.

Any responses will be considered, and I appreciate you taking the time to help guide me.

My daughter graduates in 1 week from NSUOCO. She bought a house in Tahlequah, and she's selling it for a 60k profit. She's HPSP Airforce but it was buying the house that was the game changer.

 

[Optometry Master]

I beg you- Do NOT do Optometry. With a $300,000 debt, you will be an indentured servant for most of your professional life. You will be stuck at a refracting commercial mill (Walmart, Lenscrafters, EyeWorks, etc...) with a 99% burnout rate in 2 years. Do dentistry. You will not regret it. Optometry has too many competitors- OMDs, Opticians, Big commercial, internet, etc....

The only good job in optometry is owning a private practice where at least you can call the shots. But it's gotten harder and harder to make a profit. You have to be very creative.

Optometry's heyday was in the 1970's and '80's. Back then they'd do a $25 eye exam and sell some $300-400 glasses because there was nowhere else to buy your glasses. You needed glasses, you went to an optometrist (OMDs were 'too ethical' to sell glasses back then...but now most all OMDs have opticals to supplement their loss of surgical income). With the advent of the internet, glasses sales are becoming almost insignificant for ODs. 75% of your patients will want their glasses Rx to shop elsewhere. They will shop your optical to try on frames and take a picture of the info and go and order them on-line. And you are required by law to give them their spec and CL rx's.......before you even get paid by insurance. And if they don't pay you, you are out of luck. Good luck chasing down patients for money. You'd have more luck playing the lottery. You will have to spend $800 in small claims court to try to collect the $200 the pt owes you. OD used to make $200 selling CLs. Now, pts can buy them from 1-800 contacts (and others) cheaper than an OD can buy them wholesale. So I can't even blame them for buying on-line. So, in a nutshell, the material profit is GONE in optometry except for a few niche markets. So...the experts said, "Go medical".

So we all went medical. But the reimbursement for medical is about $175 per pt vs $400 for a glasses patient. So, you have to see 2 to 3 x more patients. You have to become a cattle driver. You need a bigger space and more exam rooms for all these $30 glaucoma checks all day long.

I'm in NC (one of the better states for Optometry, I believe). Avg pay in 1999 was $130,000. Avg pay today is about $140,000. That says it all right there. You will take home, after taxes & insurance & misc., about $6,000 month, if you are lucky. After paying back your loans, you might have $3,000/month to live on. In 2024, a house and car payment and monthly food will eat that up completely (pun intended). Certainly doable. But you won't be living the 'doctor lifestyle' many think of.

Dentistry, while getting a little more commercial over the past decade, does not have a competitor 'Tooth-MD'. They are the be-all, end-all with teeth. And they have done a great job at keeping out crooked insurances, in general. General MDs (Family docs) will refer happily to dentists. Primary MDs are the #1 referral source to OMDs--NOT to ODs. They automatically (by training/bias) refer eye problems to ophthalmologists.

I graduated in the late 90's. My debt was $130,000. High.....but doable back then. Now-- No way would I do optometry. The return on investment just isn't there. No way I'd go to optometry school now for $300,000. In my 25 years, not one insurance company has increased their reimbursement for than $3 dollars. Do you think expenses and overhead have risen more than that in the last 25 years? You bet they did. 30% just in the last 5 years.

P.S. I just noticed your interest in working at the VA. I just quit the VA after selling my private office of 20+ years. The VA is the absolute worst place in the world to work. It's a giant welfare clinic (and I am a military vet myself). My job was to look in the slit lamp and BIO after the tech refracted and dilated. Then for the next 40 minutes, type a book on them in an antiquated (CPRS) computer system to give those welfare people their free progressive/x'tra active Transitions/AR glasses and THEN give them a year supply of artificial tears (they might as well just have a big crate of art tears for everyone to just reach into and grab a handful). I was clicking the mouse 430 per pt or 6,000 times a day (I counted)...so much I had bruises on the pads of my fingers (and I've used a computer since they got popular in the 1980's and EMRs for 20 yrs). Everyone KNOWS the charting system (it's from 1997) is horrible and they've spent BILLIONS to get a new system but it was even worse so they trashed it.

The VA is a top-heavy, horrible run, bureaucratic gov't job where ignorant high school graduates boss the doctors around non-stop. In fact, MOST of the employees are NOT providers but pencil-pushers that could not hack a job in the real world. NO ONE ever gets fired no matter how bad they are. So you will be working with the dumbest of the dumb. You will have the most ignorant people as your bosses. My hospital wants to keep 6 ODs employed but they can't keep more than 2 at any one time. They just quit faster than they can hire. It sucks THAT bad. They can't even find an ophthalmologist for $300,000/yr with a big sign-on bonus. Been looking for 3 + yrs now. Our boss was an orthopedic MD (that knew zero about eyecare).

I just mention this because I thought like you. Thought I could just go there and treat medical eye problems without having to hassle with insurance and the like involved with owning a private practice. But I found I STILL had to code everything and they have inexperienced H.S. grads (or dropouts) that are 'chart reviewers' that will go behind your back and change your charting or hassle you to change it. Totally unethical and probably illegal....but it's the gov't so they don't have to answer to anyone. In other words, it's not a clean and simple as you think (or I thought) at the VA.

I'm in the process of opening a new private office. It's the only way. The least of all the worst.