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[brophtho]

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[Dantes]

From what I understand salary starts low but rises relatively quickly. Otherwise it's a surgical field with a good culture, good hours, generally good outcomes, and you get to sit for your procedures. If I was ok dealing with just the eye and I were more competitive, I would have considered it.

 

[Datypicalpremed]

Kinda surprised and disappointed OP didn’t include one of the biggest draws of going into Optho.






You get a Jonathan.

 

[Angus Avagadro]

I'm surprised optho has taken such a hit over the years. God used to borrow from them on Fri when he was short on cash. Applicants to residencies all used to be AOA. I guess lense replacement reimbursement took a big hit over the years.

 

[srirachamayonnaise]

I was considering ophtho for a bit. But the fact that I would only work with a tiny organ for the rest of my career makes me question why I go to medical school to begin with. It feels like dentistry and ophtho can be learned basically without going to medical school at all.

 

[CyrilFiggis]

Everything is supply and demand. Ophtho is still a limit number residency making it naturally competitive. Also, while compensation may have changed, lifestyle is still great. Banker’s hours and 300k salary is nothing to sneeze at. We have this habit of comparing specialties to one another, but never against non-medical careers. In the grand scheme, ophtho is a great career/lifestyle.

 

[ace_inhibitor111]

I was considering ophtho for a bit. But the fact that I would only work with a tiny organ for the rest of my career makes me question why I go to medical school to begin with. It feels like dentistry and ophtho can be learned basically without going to medical school at all.

That’s true for a lot of specialties unfortunately

 

[brophtho]

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[VA Hopeful Dr]

So academic salaries aren't really what you want to focus on unless you are hell bent on staying in academics.

PP ophthalmologists make way more than the numbers you're throwing out. Sure they may start low, but they don't stay there.

 

[brophtho]

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[VA Hopeful Dr]

They only reserve I have about PP is not only the constant grind of clinic and cataract surgery but the lack of guarantee your salary will balloon. Yeah after 3-4 years you can become partner. But partner is not guaranteed, and I’m sure not everyone ends up receiving partnership. I also hear more of the shady business practices older attendings using to attract freshly minted attendings without any true intention of partnership at all, more so than other specialties as well. Additionally it seems like the buy-in for partner is much, much higher in ophtho than other specialties like ortho. With the state of private equity gobbling everything up, I’m not sure PP is where I want to be, but of course that may change.

Then start your own. It's still a very viable option. Or find a group that has some younger partners.

 

[painballer27]

Private practice ophthalmologists can make a lot. Their pay is not low. Also it is a truly gratifying field. Normal hours for the most part which is a very important piece. Also it can be nice just focusing on one thing and not having to manage a ton of issues. I kind of wish I had gone for it honestly. Have the scores, just not the research and other things you need for a highly competitive field.

 

[operaman]

Yeah don’t look too hard at academic starting salaries in any field without looking at the details. Also some schools are known for paying like crap (cough cough Partners cough) while others pay quite well. The averages are much lower than PP but don’t pass judgement based on limited data points.

Just for an example, as an ent recently on the job hunt I saw academic positions as low as $150, most in the $250-300 range, and one at $700 and a few others scattered in between. Even those varied widely - $700 sounds good but that was straight salary while another at $350+Generous Rvu Bonus and no cap could potentially give you more than the $700 with a reasonably busy practice. Pull up public salary data for ucla and you’ll see low base salaries under $200 but comp with rvu bonus well over 1million for many of their docs.

So for Ophtho I think it’s popular because it hits a nice balance of lifestyle and salary, similar to derm. You get a nice variety of surgery, all can be done seated, and call outside of academia can be pretty chill.

 

[Trefoil]

They only reserve I have about PP is not only the constant grind of clinic and cataract surgery but the lack of guarantee your salary will balloon. Yeah after 3-4 years you can become partner. But partner is not guaranteed, and I’m sure not everyone ends up receiving partnership. I also hear more of the shady business practices older attendings using to attract freshly minted attendings without any true intention of partnership at all, more so than other specialties as well. Additionally it seems like the buy-in for partner is much, much higher in ophtho than other specialties like ortho. With the state of private equity gobbling everything up, I’m not sure PP is where I want to be, but of course that may change.

MGMA data is correct but it is averaging PP and academic salaries. If you don’t like either of those options, there is a third. You can work as an employee of a hospital system like Kaiser. Ultimately, I think some people do like being employees, and it allows you to start at a higher salary, but the ceiling is also much lower.

Most people go into ophthalmology because they enjoy medicine and surgery, but they also have a robust world outside of medicine. Most of my colleagues have really interesting hobbies or really big families. This actually does matter because you enter into a culture, and I would say that the ophthalmology culture is very work/life balanced. We aren’t the type of people that invest 100% of our life and time into work typically.

Retina fellowship is actually pretty obtainable, and even though the fellowship hours are hard, the work life balance can be good thereafter. It’s probably one of the few surgical fields where you can make $500-$700K with a relatively nice work life balance.

Another advantage of ophthalmology is that we are a mature field that has been guarding our residencies for a long time. What does that mean? Well, you aren’t going to see residency inflation like you are with emergency medicine or radiation oncology.

The surgery will only feel real to you once you know what you are looking at. This isn’t meant as an insult, but we spend and inordinate amount of time in residency reading out BCSC series, and most medical students have no idea what they are looking at. I know because I remember being a medical student and not really understanding the procedures all that well despite reading a lot.

Finally, to those who don’t think there is a lot of medicine, that is definitely not the case. You can incorporate as much medicine as you want which is really nice. Uveitis is actually a sub specialty that can be approached from the medicine or ophthalmology side, which makes for really interesting perspectives. The medicine trained uveitis specialist will be very focused on what kind of systemic medications can manage the disease process, while the ophthalmology trained specialist might be focused on surgical interventions that are needed.

Anyway, ophthalmology is a bit more of a leap of faith than other fields as the exposure to it as a medical student is so small. Generally, people who enjoy ophthalmology like procedures, like clinic, dislike inpatient care, and want worklife balance. Patient gratitude is also very high which keeps work rewarding outside of financial compensation. The tendency as a medical student is to gravitate towards academics and internal medicine as that is what you know the most about, but when you look hard, you can find all sorts of hidden gems. Good luck in whatever field you choose!

 

[eyeguyhopeful]

MGMA data is correct but it is averaging PP and academic salaries. If you don’t like either of those options, there is a third. You can work as an employee of a hospital system like Kaiser. Ultimately, I think some people do like being employees, and it allows you to start at a higher salary, but the ceiling is also much lower.

Most people go into ophthalmology because they enjoy medicine and surgery, but they also have a robust world outside of medicine. Most of my colleagues have really interesting hobbies or really big families. This actually does matter because you enter into a culture, and I would say that the ophthalmology culture is very work/life balanced. We aren’t the type of people that invest 100% of our life and time into work typically.

Retina fellowship is actually pretty obtainable, and even though the fellowship hours are hard, the work life balance can be good thereafter. It’s probably one of the few surgical fields where you can make $500-$700K with a relatively nice work life balance.

Another advantage of ophthalmology is that we are a mature field that has been guarding our residencies for a long time. What does that mean? Well, you aren’t going to see residency inflation like you are with emergency medicine or radiation oncology.

The surgery will only feel real to you once you know what you are looking at. This isn’t meant as an insult, but we spend and inordinate amount of time in residency reading out BCSC series, and most medical students have no idea what they are looking at. I know because I remember being a medical student and not really understanding the procedures all that well despite reading a lot.

Finally, to those who don’t think there is a lot of medicine, that is definitely not the case. You can incorporate as much medicine as you want which is really nice. Uveitis is actually a sub specialty that can be approached from the medicine or ophthalmology side, which makes for really interesting perspectives. The medicine trained uveitis specialist will be very focused on what kind of systemic medications can manage the disease process, while the ophthalmology trained specialist might be focused on surgical interventions that are needed.

Anyway, ophthalmology is a bit more of a leap of faith than other fields as the exposure to it as a medical student is so small. Generally, people who enjoy ophthalmology like procedures, like clinic, dislike inpatient care, and want worklife balance. Patient gratitude is also very high which keeps work rewarding outside of financial compensation. The tendency as a medical student is to gravitate towards academics and internal medicine as that is what you know the most about, but when you look hard, you can find all sorts of hidden gems. Good luck in whatever field you choose!

Very well said.

As a PGY4 in ophthalmology and on the job hunt, I would echo that ophthalmology is a very, very well reimbursed specialty. My perspective is from a comprehensive ophthalmology/cataract surgeon.

The starting salary is low in ophthalmology naturally because you don't have an established patient base or surgical volume your first year. If you join a hospital system - I have seen offers of 350-400k easily with production bonus as well. My ortho friend's starting salary in PP was 225k (and now he makes 650k after 3 years). But a few of my ophtho friends make more than my ortho and anesthesia friends.

Private practice ophthalmology can be a very lifestyle friendly specialty and most usually make >500k after 3-4 years (I have been looking at big cities in the southeast, midwest and some southwest). And it's not unheard of to be making close to 7 figures if you want to work a little harder. This takes time ofc (5-7 years after residency) - this is while working 4.5 days a week with no weekends (8-5).

Both cataract/refractive/anterior segment surgeons and retina surgeons are usually top earners in the field. If you like blood and guts maybe oculoplastics would be a better fit. But it's hard to appreciate the surgeries we do since you have no idea what you're looking at as a medical student and can't really appreciate the finer anatomy.

In my personal opinion, cataract surgery is very fun and incredibly rewarding with super happy patients. There is so much demand in the field too since as the above posters have alluded to - we have kept our residency spots limited.

It's always been insanely competitive and perhaps last year was more competitive than before.

 

[painballer27]

Very well said.

As a PGY4 in ophthalmology and on the job hunt, I would echo that ophthalmology is a very, very well reimbursed specialty. My perspective is from a comprehensive ophthalmology/cataract surgeon.

The starting salary is low in ophthalmology naturally because you don't have an established patient base or surgical volume your first year. If you join a hospital system - I have seen offers of 350-400k easily with production bonus as well. My ortho friend's starting salary in PP was 225k (and now he makes 650k after 3 years). But a few of my ophtho friends make more than my ortho and anesthesia friends.

Private practice ophthalmology can be a very lifestyle friendly specialty and most usually make >500k after 3-4 years (I have been looking at big cities in the southeast, midwest and some southwest). And it's not unheard of to be making close to 7 figures if you want to work a little harder. This takes time ofc (5-7 years after residency) - this is while working 4.5 days a week with no weekends (8-5).

Both cataract/refractive/anterior segment surgeons and retina surgeons are usually top earners in the field. If you like blood and guts maybe oculoplastics would be a better fit. But it's hard to appreciate the surgeries we do since you have no idea what you're looking at as a medical student and can't really appreciate the finer anatomy.

In my personal opinion, cataract surgery is very fun and incredibly rewarding with super happy patients. There is so much demand in the field too since as the above posters have alluded to - we have kept our residency spots limited.

It's always been insanely competitive and perhaps last year was more competitive than before.

Yeah, I should have done ophtho

 

[Darrow O'Lykos]

Generally, people who enjoy ophthalmology like procedures, like clinic, dislike inpatient care, and want worklife balance. Patient gratitude is also very high which keeps work rewarding outside of financial compensation.

The bolded just backhanded me across the face 4 times because these are all very high on my list of what I want in a speciality. Ortho and cards are piquing my interests but both of those are more of a Panera Pick-2 situation instead of getting all 4 of the above.

Both cataract/refractive/anterior segment surgeons and retina surgeons are usually top earners in the field. If you like blood and guts maybe oculoplastics would be a better fit. But it's hard to appreciate the surgeries we do since you have no idea what you're looking at as a medical student and can't really appreciate the finer anatomy.

What would you say is the best way for a medical student to try and grasp some of those more nuanced aspects of the field? I get it's a bit of a catch-22 from this side of residency, but any insight/advice on a more accurate exposure is appreciated.

 

[Obnoxious Dad]

According to the Bureau of Labor Statistics the average annual income of ophthalmologists was $270,090 in May 2021. This is based on a 40 hour week.

Ophthalmologists, Except Pediatric

www.bls.gov

 

[Trefoil]

According to the Bureau of Labor Statistics the average annual income of ophthalmologists was $270,090 in May 2021. This is based on a 40 hour week.

Ophthalmologists, Except Pediatric

www.bls.gov

Eh, they also have orthopedics listed as $307,000, so these numbers are not particularly accurate. If you look at Medscape, I believe the number is generally $370,000-$380,000 which is much closer. The problem with any broad swath data is that they will incorporate erroneous data like trainees, fellows, and part timer workers. These data sets are usually too large to reflect what is happening on the granular level.

The $370,000 is also misleading because it doesn’t reflect a variety of preferences. For instance, some people indicated a preference of academics…the pay will be lower. In private practice it will start lower and increase after a couple of years. If you work in a city, there will be more business competition, so you will be less likely to make very large sums of money, but if you are willing to move further away from cities into an underserved area, the sky is the limit. Some people are willing to take a pay cut to live in NYC. Others would never want to live in NYC. Fellowships change that dynamic as well. In any case, in ophthalmology, the niche matters a lot, and you can find a large variety of practice types and incomes. The only place you find the medscape $370,000 starting is by large hospital based systems that use this data to set your salary.

Edit: I’ll also add that I have anecdotally heard stories of ophthalmologists who work employed by large refractive practices that do PRK and LASIK all day. They often can make $400,000 working 3 days a week. I don’t know how hard those jobs are to land, and personally, I would not want to work in one because I like variety, but this just illustrates how a variety of job opportunities are available.

 

[VA Hopeful Dr]

Eh, they also have orthopedics listed as $307,000, so these numbers are not particularly accurate. If you look at Medscape, I believe the number is generally $370,000-$380,000 which is much closer. The problem with any broad swath data is that they will incorporate erroneous data like trainees, fellows, and part timer workers. These data sets are usually too large to reflect what is happening on the granular level.

The $370,000 is also misleading because it doesn’t reflect a variety of preferences. For instance, some people indicated a preference of academics…the pay will be lower. In private practice it will start lower and increase after a couple of years. If you work in a city, there will be more business competition, so you will be less likely to make very large sums of money, but if you are willing to move further away from cities into an underserved area, the sky is the limit. Some people are willing to take a pay cut to live in NYC. Others would never want to live in NYC. Fellowships change that dynamic as well. In any case, in ophthalmology, the niche matters a lot, and you can find a large variety of practice types and incomes. The only place you find the medscape $370,000 starting is by large hospital based systems that use this data to set your salary.

Edit: I’ll also add that I have anecdotally heard stories of ophthalmologists who work employed by large refractive practices that do PRK and LASIK all day. They often can make $400,000 working 3 days a week. I don’t know how hard those jobs are to land, and personally, I would not want to work in one because I like variety, but this just illustrates how a variety of job opportunities are available.

I think ophthalmology often flies under the radar as a "good money with real control over your schedule" specialty. I was a tech for an ophthalmologist before med school. He had clinic 9-5 Monday, Tuesday was a cataract day, usually did around 15 or so, out by 4. Wednesday AM was clinic, Wednesday PM was laser day (out by 4ish generally). Thursday was more cataracts. Friday was a half day, mainly cataract post op and any in-office procedures that needed to be done. He owned his own surgery center. Since he didn't use the hospital to operate, he had call only for his patients and those calls were very very rare.

I have no idea how much he made but with that set up I'd be shocked if he didn't make at least 7 figures. I know when he retired he sold the surgery center to a hospital for upper 7/low 8 figures.

 

[Darrow O'Lykos]

I think ophthalmology often flies under the radar as a "good money with real control over your schedule" specialty. I was a tech for an ophthalmologist before med school. He had clinic 9-5 Monday, Tuesday was a cataract day, usually did around 15 or so, out by 4. Wednesday AM was clinic, Wednesday PM was laser day (out by 4ish generally). Thursday was more cataracts. Friday was a half day, mainly cataract post op and any in-office procedures that needed to be done. He owned his own surgery center. Since he didn't use the hospital to operate, he had call only for his patients and those calls were very very rare.

I have no idea how much he made but with that set up I'd be shocked if he didn't make at least 7 figures. I know when he retired he sold the surgery center to a hospital for upper 7/low 8 figures.

I've heard that opthos in particular often under-report their income to keep mum the word on how good their setup can be, especially if they own their own or have partial ownership in a surgical center like you're describing.

This may not be the norm, but I've got a feeling that such a setup is more doable in ophthalmology than in other fields.

 

[operaman]

I've heard that opthos in particular often under-report their income to keep mum the word on how good their setup can be, especially if they own their own or have partial ownership in a surgical center like you're describing.

This may not be the norm, but I've got a feeling that such a setup is more doable in ophthalmology than in other fields.

I’ve heard the same thing. You see this in many fields. The sad fact is that the way CMS decides pay per rvu will often penalize highly used codes, so if you have a great setup you have a big financial incentive to keep it quiet. Even if you don’t face direct competition in your own market, other people adopting your models can lead to declining pay over 5-10 years.

I think any field with the potential to do a lot of clinic procedures, especially if some or all of it can be done by ancillary staff can do very well. Same goes for short OR procedures with no overnight stay and no global. Ophtho checks all these boxes and then some.

Gotta say though- maybe the best kept secret in Ophtho would be veterinary Ophtho. I knew a guy I sang with a couple times and he specialized in cash only dog lasik and was busy and made close to 7 figs with a Cush lifestyle.

 

[anesussy]

The problem with any broad swath data is that they will incorporate erroneous data like trainees, fellows, and part timer workers. These data sets are usually too large to reflect what is happening on the granular level.

So fellows aren't trainees?

 

[VA Hopeful Dr]

I’ve heard the same thing. You see this in many fields. The sad fact is that the way CMS decides pay per rvu will often penalize highly used codes, so if you have a great setup you have a big financial incentive to keep it quiet. Even if you don’t face direct competition in your own market, other people adopting your models can lead to declining pay over 5-10 years.

I think any field with the potential to do a lot of clinic procedures, especially if some or all of it can be done by ancillary staff can do very well. Same goes for short OR procedures with no overnight stay and no global. Ophtho checks all these boxes and then some.

Gotta say though- maybe the best kept secret in Ophtho would be veterinary Ophtho. I knew a guy I sang with a couple times and he specialized in cash only dog lasik and was busy and made close to 7 figs with a Cush lifestyle.

Vet Lasik? That is just stupid. There's a vet ophtho in Charlotte I'm familiar with but he does things like cataracts which I'd consider if I had a youngish dog with congenital cataracts or some such. But Lasik? What, did the dog fail the eye exam part of their driving test?

 

[collegestud2013]

I guess if we are comparing against non-medical careers, my friends in tech must win out everytime. One works for Facebook and makes 300k+ a year at age 25 working very normal hours. He gets treated amazing at work with perks out the ass and very much creative freedom. Meanwhile residents are treated like dog poop in the hospital. We got a free sandwich during noon lecture today! Hallelujah! When I catch up with my college friends, it’s so astonishing how differently our employers treat us, despite being in intellectually-driven fields.

The tech vs medicine career has been debated ad nauseum around here, but the short answer is that people like to use exceptions as the example than what the typical tech employee's situation is like. There are a smaller proportion of people in tech that do really well but getting into the big name tech companies that pay well and offer the best work conditions is very competitive; not everyone is going to be making $500-800k at Google, Facebook, etc... More typical pay to count on is more around $100-200k for most employees and with much less job stability than in medicine; it's very easy to get laid off the next day when tech companies don't do as well and decide to downsize overnight. It is easier to get into tech and with a lot less educational debt (so while it may be attractive for younger employees than taking on loans to go to med school) but this also makes tech more prone to international and domestic competition. Unless you can continue to innovate and develop a set of unique skills throughout your career, there are foreign tech employees (or even younger domestic employees) that are always trying to copy the work you do but will be willing to do it at a lower cost.

 

[Trefoil]

So fellows aren't trainees?

They aren’t residents. Residents can’t practice independently whereas fellows can and are often board certified. Fellows are often responsible for training residents, so they are training, but they also are educators.

 

[anesussy]

They aren’t residents. Residents can’t practice independently whereas fellows can and are often board certified. Fellows are often responsible for training residents, so they are training, but they also are educators.

Resident physicians can practice independently after their PGY1 year.

PGY2+ often have educational/supervisional duties as well.

What an ignorant statement.

 

[VA Hopeful Dr]

Resident physicians can practice independently after their PGY1 year.

PGY2+ often have educational/supervisional duties as well.

What an ignorant statement.

Ehhh, kinda?

Fellows can practice independently in their field to a much greater extent than residents.

Fellows can supervise residents solo since they have completed residency and are often board certified in their primary specialty.

 

[operaman]

Vet Lasik? That is just stupid. There's a vet ophtho in Charlotte I'm familiar with but he does things like cataracts which I'd consider if I had a youngish dog with congenital cataracts or some such. But Lasik? What, did the dog fail the eye exam part of their driving test?

Yeah I might be remembering it wrong - cataracts definitely makes more sense! Whatever it was he was sure busy!

 

[Trefoil]

Resident physicians can practice independently after their PGY1 year.

PGY2+ often have educational/supervisional duties as well.

What an ignorant statement.

Not sure where the animosity is coming from? Fellows can be fully independent within their trained field.

I’m going to start a fellowship next year, but I’ll have been practicing in my field as an attending for three years before that happens. The resident can practice general medicine somewhat independently, but honestly I would have been out of my element in most things after just an intern year.

It’s not meant to be personal, but I’ve already passed my boards and had to do everything on my own for years.

 

[deleted1064759]

The successor to the 'Fauci effect' -- The Glaucomflocken Effect

 

[RetinaDude]

I've heard that opthos in particular often under-report their income to keep mum the word on how good their setup can be, especially if they own their own or have partial ownership in a surgical center like you're describing.

This may not be the norm, but I've got a feeling that such a setup is more doable in ophthalmology than in other fields.

Bingo!!! We have never reported our income. Through the years, we've received many "salary surveys" and we always throw them in the trash. Why in the world would we want to let the rest of the medical world in on our little secret. Never, ever believe those stupid MedScape surveys, or really any other online survey. To date, I have never seen one that is anywhere near accurate. Also, if you are looking at academics, you should be doing it out of the goodness of your heart and not because you hope to make a lot of money.

As my name implies, I am retina, but I have a lot of very good friends in general ophthalmology. Everyone is doing well. I don't know a single cataract doc making less than $500k, working 4 days per week, and usually done by 4:00. The only ones not doing well have chosen that path, are in academics, or live in a large city (such as SF) where there's too much competition.

Retina is on a different level. Read through some of my posts about retina money and lifestyle. You will see why ophthalmology is still a golden field to pursue.

 

[ChordaEpiphany]

Ophtho is one of the most competitive specialties, but why? This is not meant as a dig at all -- I'm simply a medical student trying to make a more informed choice. I hope this does not rub someone the wrong way.

Compensation is SO low. I used to believe MGMA/national data, but after having talks with several attendings and residents who signed new contracts, the average is simply NOT 350k. In academic positions (which is what I’m leaning right now), most comprehensive attendings at my institution start at 150. Fellowship trained don’t make that much more starting either, maybe at most 200k. It’s not just the starting salary either: senior cornea attendings pull 300k max at age 60. Retina is high earning, with some attendings pulling 600k+; however it is only 1 subspecialty and happens to be the most competitive (outside plastics which ironically has a low starting salary as well).

Of course it is not about the money: the eye is very fascinating. Looking through a slit lamp always piques my interest. But is the eye cool enough to sacrifice about HALF of what I’d make in other surgical specialties? (ortho, plastics, etc.). To me, if it were really “die-hard” cool, ophtho should also have a lot more of the “ophtho or bust” mentality like ortho/neurosurgery do, but it’s simply not the case.

I have seen quite a few ophtho surgeries as well, and they just don’t feel quite SURGICAL to me. At the end of the case, gloves are clean and tidy. You wear an apron to maintain sterility, not to protect you from bodily fluids. A patient may lose 1 cc the whole case. I loved it when my apron was smeared with blood and gloves were drenched during my general surgery rotation — it felt like I was really doing surgery. The brevity of cases and the minimal exposure makes ophtho feel “procedural” and not “surgical” to me.

The biggest advantage of ophthalmology I can think of is the lifestyle. However, plenty of other specialties offer compensation similar to ophtho with still a great life (PM&R, FM, psych, etc.). However, ophthalmology is really the only specialty that allows you to perform surgery while still maintaining a great life in residency and beyond. But once again, is it worth sacrificing HALF of my salary in other surgical specialties for just a lighter schedule? Hell, your CRNA is going to be pulling more than you.

OP, not sure where these numbers are coming from, but the attendings at your institution are either getting boned or you are misunderstanding their compensation structure. You might be hearing about guaranteed salary, and they may have production bonuses after that based on RVUs.

I'm not going to point to any specific physicians, but it's very easy to look up salaries of public employees in CA.

Of the recently hired assistant professors (2015-present), almost all started at ~$100-150K guaranteed for their first full year, but wound up netting in the range of $250K-350K total pay, with an additional $50K of benefits (I assume health insurance and retirement match). I saw a few people who made ~$150K for a year or so but jumped to $300K+ after that. The big difference is that most of them seem to top out at ~$400-500K, but you can make a lot more than that in PP.

Also, FWIW, ophtho is one of the absolute worst for academic vs. community pay ratio. I only have data from 2017 (collected 2016, so 6 years old), but community ophthos make ~60% more than academic. The only specialties worse than that are cards (60-100%), allergy/immuno (70%), GI (70%), Heme-Onc (60%), Pulm/CC (60%), and most of pathology.

They're making $300-500K while working 8-5 with a relatively short residency. In PP they're making more than that. Compare this to general surgery where you literally give up your life for 5-7 years (+1-3 years fellowship), and then work crazy hours as an attending for the same pay. It's obvious why ophtho is competitive.

 

[deleted1064759]

Bingo!!! We have never reported our income. Through the years, we've received many "salary surveys" and we always throw them in the trash. Why in the world would we want to let the rest of the medical world in on our little secret. Never, ever believe those stupid MedScape surveys, or really any other online survey. To date, I have never seen one that is anywhere near accurate. Also, if you are looking at academics, you should be doing it out of the goodness of your heart and not because you hope to make a lot of money.

As my name implies, I am retina, but I have a lot of very good friends in general ophthalmology. Everyone is doing well. I don't know a single cataract doc making less than $500k, working 4 days per week, and usually done by 4:00. The only ones not doing well have chosen that path, are in academics, or live in a large city (such as SF) where there's too much competition.

Retina is on a different level. Read through some of my posts about retina money and lifestyle. You will see why ophthalmology is still a golden field to pursue.

Any suggestions on how to ask attendings their compensation without coming across as too abrasive?

If anything, I think MGMA gives us a frame of reference of the relativity of compensation, which is still pretty useful, but, as you said, there could be some significant selection bias.

 

[RetinaDude]

Any suggestions on how to ask attendings their compensation without coming across as too abrasive?

If anything, I think MGMA gives us a frame of reference of the relativity of compensation, which is still pretty useful, but, as you said, there could be some significant selection bias.

I have no idea how I would approach an attending that question. If they work for a public university, I believe their salary info is usually online (public info).

Yeah, I wouldn’t even trust MGMA. For specialties employed by hospitals more, it may be closer to accurate. For ophthalmology, I’d still view the info with a skeptical eye

 

[Obnoxious Dad]

Eh, they also have orthopedics listed as $307,000, so these numbers are not particularly accurate. If you look at Medscape, I believe the number is generally $370,000-$380,000 which is much closer. The problem with any broad swath data is that they will incorporate erroneous data like trainees, fellows, and part timer workers. These data sets are usually too large to reflect what is happening on the granular level.

The $370,000 is also misleading because it doesn’t reflect a variety of preferences. For instance, some people indicated a preference of academics…the pay will be lower. In private practice it will start lower and increase after a couple of years. If you work in a city, there will be more business competition, so you will be less likely to make very large sums of money, but if you are willing to move further away from cities into an underserved area, the sky is the limit. Some people are willing to take a pay cut to live in NYC. Others would never want to live in NYC. Fellowships change that dynamic as well. In any case, in ophthalmology, the niche matters a lot, and you can find a large variety of practice types and incomes. The only place you find the medscape $370,000 starting is by large hospital based systems that use this data to set your salary.

Edit: I’ll also add that I have anecdotally heard stories of ophthalmologists who work employed by large refractive practices that do PRK and LASIK all day. They often can make $400,000 working 3 days a week. I don’t know how hard those jobs are to land, and personally, I would not want to work in one because I like variety, but this just illustrates how a variety of job opportunities are available.

I think the problem with BLS data is that the BLS focuses exclusively on physicians who are paid a salary and ignores physicians who are self-employed or partners in a group practice.

 

[ChordaEpiphany]

Any suggestions on how to ask attendings their compensation without coming across as too abrasive?

If anything, I think MGMA gives us a frame of reference of the relativity of compensation, which is still pretty useful, but, as you said, there could be some significant selection bias.

Tbh I don't think there is a way to ask this without seeming abrasive. Either they tell you or you never find out. A much better question would be, "in your specialty, how does compensation work?" followed by questions like, "How big is the gap between academic and community?" "What are the opportunities in private practice vs. employed vs. academic?" These questions actually make sense because you are looking for information that isn't readily available. For instance, looking at Medscape or MGMA data for a field like radiology might not actually make sense due to trends in PE takeover that make things less favorable for young physicians.

Keep in mind a lot of academic physicians are pretty clueless when it comes to these things. Many didn't even field offers from non-academic institutions.

Never ask their personal compensation. That would be insanely tone deaf.

 

[Splenda88]

I have no idea how I would approach an attending that question. If they work for a public university, I believe their salary info is usually online (public info).

Yeah, I wouldn’t even trust MGMA. For specialties employed by hospitals more, it may be closer to accurate. For ophthalmology, I’d still view the info with a skeptical eye

I am glad someone else finally says that.

Do NOT let these employers fool you with these salary surveys.

 

[FluffyCat1212]

Sorry, I have to piggy back on this question. I recently spoke with an ophthalmologist who said that a fellowship is pretty much a "must" if you want to practice in a more urban or desirable area. Could anybody in the know let me know if it's correct? I'm considering ophthalmology as a potential specialty, but I'm a little put off by the idea that a fellowship is so necessary.

 

[RetinaDude]

Sorry, I have to piggy back on this question. I recently spoke with an ophthalmologist who said that a fellowship is pretty much a "must" if you want to practice in a more urban or desirable area. Could anybody in the know let me know if it's correct? I'm considering ophthalmology as a potential specialty, but I'm a little put off by the idea that a fellowship is so necessary.

Look on the AAO Professional Choices site for listed jobs. You can search by state and many also list the city (or at least the vicinity). You can then view the perspective of hiring practices, in various locations, to see what they are looking for in new hires

 

[FluffyCat1212]

Look on the AAO Professional Choices site for listed jobs. You can search by state and many also list the city (or at least the vicinity). You can then view the perspective of hiring practices, in various locations, to see what they are looking for in new hires

Great tip! Thanks!