A bit late to the fun, but as a VA optometrist providing on call services at our VA hospital at 1:30 AM a couple of days back while seeing someone on the floor as an inpatient, I must wholeheartedly disagree that optometry does not have a hospital presence. Or an ER presence. Prior to the VA I did 23 years of private practice as a solo practictioner with an occasional associate. I respect those doctors whom have gone and acquired additional credentials, but I have had years of practice experience working with doctors equally competent that have not done any of these nor or board certified. My view of Board Certification is simply are we asking the doctor to have a higher level of competency through skills gained outside normal optometric practice versus just a rehash of prior attempts at giving one doctor a paid for leverage using their "board certification " to distance themselves from other practictioners. I do not have a Residency, ABO certification or a Fellowship. My credentials prior to working at the VA were simply BS, OD and a Honorable Discharge from the USA while serving as an NCO. Sorry to refute several of the general inquiries and misconceptions in this thread. Residencies are an important part of this profession. When comparing those young doctors in the residency program that I have been involved in as an attending doctor, I have concluded that practical experience from providing general optometry in a smaller community has many of the same attributes in making it an equal learning enviroment. Many of these doctors gain little from adding any of the credentials we are discussing as a means of enhancing their standing in the community they serve. Nothing like being miles away from your friendly ophthalmologist and having to think on how best to treat the patient in your exam chair on Friday night with acute NAG whom cannot travel due to lack of transportation. We have a wonderful profession. Attitude is essential in any profession. If you choose optometry to get rich then be ready to face an uncertain future. A new doctor will successful in optometry by being the best eye care provider possible in whatever choice of practice setting that makes them happy. In your career you'll enjoy outstanding work hours, great standard of living and be given the ability to freely determine your own future by working smarter not harder. Always be ready to educate yourself on new trends, equipment, materials and services. I enjoyed being a trendsetter by utilizing the latest instrumentation and ophthalmic materials that gave my patients a great eye care experience...... but as I quickly learned that came by serving THEIR needs.