Ophthalmology as a career?

I’m a junior in high school (Texas) and I want to be an Ophthalmologist when I’m older.
So I have a few questions about both the profession and the road to become to one.

  1. What do you do after the four years of undergraduate? Can you go to Optometry School or do you have to go to medical school? (I ask this because I know of an Ophthalmologist who went to an Optometry School rather than a medical school)
  2. Follow-up question to #1, if I have to go to medical school, would an accelerated medical program (7/8 year programs like UTD Pact) be helpful or not?
  3. What is a fellowship? (I've heard of this but have no idea what it means)
  4. How competitive is it to be an Ophthalmologist?
  5. I've heard that you can become an Ophthalmologist and not have to perform any surgeries. Is this true or not, as I would have thought that was what an Optometrist did...
  6. What other things other than shadowing and volunteering can I do now that will help me later on?

Thanks in advance!

Ophthalmologists are MDs. They go to medical school. I am pretty sure you can’t get there without med school. An optometrist is not an MD. I assume opthamologists have the option of what they want to specialize in, and may choose to specialize in an area where surgical treatment is not required. You may still need to do surgical rotations during training, though.

Ophthalmologists and Optometrists are two different things.

  1. Ophthalmologists go to medical school (either MD or DO, usually MD) after undergraduate. They then do a preliminary year training in either medicine, surgery, pediatrics, or a transitional year (a combo of medicine and surgery) after graduating from medical school and then enter into their optho residency for 3 more years. These are medical doctors who deal with issues relating to the eye. Optometrists can do some primary care eye drop prescribing but are basically just the people who deal with determining what type of contact lens or glasses you need. Certainly in a city, people will exclusively go to MDs for diagnosis and treatment of anything eye related. It sounds like in more suburban/rural areas that an OD (not to be confused with the DO I mentioned above) is kind of like an NP or a PA but for the eye: you can treat the very basic stuff on your own, but if things start to get remotely complicated you will be over your head and have to refer the patient to someone with more training.
  2. Personally I'm against accelerated programs. I think cutting that year out of undergrad or having to give up your summers for classes (how these programs usually operate) is detrimental. An 8 year program is ok if you 100% know you want to be a doctor but these programs are equally, if not more competitive than the top schools in the country, so if in the future you were staring down (for example) a Duke undergrad and UTD 8 year program invitation and the only reason you're considering UTD is the 8 year program, I'd say go to Duke.
  3. Fellowships are further, more specialized training after a residency. In optho for example, you can do retina, glaucoma, ocular pathology, neuro-optho, optho plastics/orbital reconstructive, uveitis, and pediatrics. Fellowships often involve a research component (but not always).
  4. It's pretty competitive. In the most recent application cycle, 11% of US medical school 4th years failed to land a position as an ophthalmologist (the average among all programs in all specialties is <5%). The people who do land positions usually score in the top 15% of US medical students on the standardized medical licensing exam (that's the average, so about half are in the top 15%). The average applicant applies to 60 programs in order to get a spot.
  5. You definitely are going to have to do some amount of ocular surgery during your training, but for your career you could end up doing essentially none post residency.
  6. Get good grades and a good SAT score so that you can have more choices of schools and merit offers.

iwannabe_Brown, how long does a fellowship typically last? Also, what are the “60 programs” that you talk about in number 4?

Optho fellowships are usually 1-2 years.

Medical students must apply to residency programs (similarly to applying to college or medical school). The different programs refer to different teaching hospitals or hospital systems. Thankfully the application process is centralized and it’s one application that goes out to all the programs (although you do pay fees per school above a certain amount that’s included in the initial application fee).

From that average of 60 programs they will get a certain number of interviews at each of these programs and then after the interviews are over students rank the programs they interviewed at and programs rank the students they interview and then a computer algorithm sorts through the lists and matches students with the highest ranked (according to them) program they can get into. In other words, unlike college or medical school, residents get one acceptance and one acceptance only into the program they ranked the highest that they could get into (sororities and a capella groups often use the same system just on a much smaller scale). According to WUSTL, there are 116 programs across the nation with a combined 465 spots: https://residency.wustl.edu/Choosing/SpecDesc/Pages/Ophthalmology.aspx

Don’t worry too much about how matching works. The American Academy of Optho says “The average applicant applies to 30 to 40 programs, resulting in an average of seven or eight interviews,” which is in contrast to the actual match data. My guess is that those numbers correspond to the US medical school 4th years, the most competitive group in the data set. Foreign medical school graduates and DO graduates probably apply to 100+ programs and pull the average up to 60. Optho is part of a special match outside of the other specialties, and unfortunately they don’t provide as much data about applicants as the main match does.

oh okay, thanks for the clarification!

This is not accurate.

An optometrist is a eye-care professional who deals (almost) exclusively with vision care. An optometry school is a four-year program after undergrad. An optometrist is most definitely NOT like a PA or nurse practitioner. An optometrist is an independent professional, but limited to vision care (with some exceptions). In some states, optometrists can prescribe medicines.

And the suburban/urban thing stated above is completely inaccurate. Optometrists practice everywhere. People go to them for vision care. They work in retail stores like Pearl Vision and LensCrafters and they have private practices.

An optometrist does not do surgery or diagnose/treat diseases of the eye (with some exceptions).

If you do not want to do surgery, you should not be an ophthalmologist. An ophthalmology residency is a surgical residency.

My mistake. I’ve never actually heard/known of anyone going to an optometrist for anything other than getting lenses though. I was surprised when I looked around online to see they actually have the training/privileges to do anything beyond that and figured maybe that’s something more common in suburban/rural areas since I’ve only lived in cities with relatively high densities of medical professionals.

@iwannabe_Brown I don’t know what cities you’ve lived in, but I was born and raised in NYC, and there’s an optometrist on every block. An optometrist IS a medical professional, just not an MD. An optometrist gives you an eye exam with all the regular machinery. I have no particular affiliation with optometrists and have no investment in them, but I am just setting the record straight.

Perhaps you are thinking of an optician. That is the trained professional who fabricates the prescription lenses that go into eyeglass frames. Some of them also fit contact lenses.

@CodenameMonocle

If you are certain you want to become a doctor, UT-PACT with UT Dallas and UT Southwestern is your best option. It is a phenomenal program that places you into a top-tier medical school with minimal effort and requirement when you compare it to a traditional route. Whoever said that BS/MD programs aren’t “worth it” or they “rob” you out of a traditional education has no clue what he/she is talking about. I’ll tell you why.

Admissions to medical school aren’t a joke. A respectable medical school will have under a 5 or 6 percent acceptance rate. UT Southwestern specifically has a 5.6 percent acceptance rate. Despite this being a large acceptance rate for a medical school, don’t let the numbers fool you. They accept approximately 200 students every year with 90% being in-state which means that the out of state acceptance rate is less than one percent. UTSW is a phenomenal school with one of the lowest tuition rates in the country in addition to a top 20 medical school ranking. Couple that with the fact that rank is continuing to go up over the years and you’ve got yourself a perfect medical school. Additionally, UTSW is a research and clinical titan and has abundant opportunities. You can’t go wrong with UT-PACT. Don’t let people persuade you differently.

Regardless of speciality, BS/MD programs are a blessing.

@brantly I grew up in NYC. Maybe optician was the source of my confusion. All I know is if someone thought something was wrong with their eye, they went to an ophthalmologist, not an optometrist. It’s also very possible that the people around me didn’t know the difference and said they were going to an ophthalmologist when in fact they went to an optometrist.

@TheBruceWayne BS/MD programs are extremely competitive. Odds are if you are competitive enough as a high schooler to get into medical school you will be able to get into medical school later on. Should they choose not to do medicine (as a not insignificant number do) students are often now at an undergraduate institution they would not have chosen without the BS/MD. If the BS/MD is a perk, not the main factor for choosing the school, then obviously that’s different. Also, not all “guaranteed admission” is created equal. I have seen at least one program - not UTD- with an MCAT/GPA requirement of 30/3.5. That’s basically the national average for medical students. That’s not really a generous offer from the medical school. Notice also that I separated 8 year programs from accelerated programs. @kristin5792 doesn’t post anymore, but back in 2012, she wrote the following (emphasis mine)

http://talk.collegeconfidential.com/discussion/comment/15096353#Comment_15096353

Unfortunately @iwannabe_Brown

That’s simply not true. You can not compare the acceptance into a BS/MD program to an acceptance to medical school. The MCAT is extremely difficult and to get into a medical school like UTSW from undergrad is not the same thing as getting into a BS/MD program. If you want to make it into a good medical school, you can’t just have a “MCAT/GPA requirement” of 30/3.5. You’re going to need a bunch of extra-curriculars (research, shadowing, volunteering, etc.) along with promising essays. Therefore, just because you may have the MCAT/GPA requirement at your program, it will still be easier than attempting to apply to medical school on your own, potentially taking gap years to study for the MCAT or do research, etc.

You getting this @CodenameMonocle

Yes, I know how medical school admissions works. I’m an MSTP student (https://en.wikipedia.org/wiki/Medical_Scientist_Training_Program). Getting admitted to a BS/MD program requires a large amount extracurricular work (often research) and quality essays too. To do that as a high schooler is much harder than to do that as a college student. If you are qualified enough as a high schooler to get in to medical school, you are not the average pre-medical student. Notice I didn’t say I’m against 8 year programs in general. I’m against doing them at an undergrad you would never have attended otherwise. I am against accelerated programs because they put you in a worse position for your career come medical school and I don’t think it’s worth risking your entire career arc to shave a year or two off your training. Honestly, if the only reason you’re doing research or other ECs in college is for medical school acceptance then you probably shouldn’t be thinking about medical school anyway.

I think that it is clear that Monocle does not understand Ophthalmology or Optometry. I would recommend that some experience following an Optometrist for a half a day and an Ophthalmologist for a half a day in clinic plus some time in surgery. This would be very helpful in gaining some knowledge of two possible career paths. A more important issue is whether to pursue a career in medicine. Choice of specialty in medicine does not have to be made until the later stages of medical school and often changes from with clinical exposure. Ophthalmology is a surgical residency and while one does not have to do surgery after training it makes little sense in most cases to do a Ophthalmolgy if one does not want to do surgery.

As a HS junior, you are not in any position to pick your future medical specialty.

One day at a time is much better planning. Do you best every single day, at HS, at college and then see where you are at some point of time in you junior year at COLLEGE. If you have enough of what it takes to apply to medical school. then go ahead, you did your job very well every day! Then during clinical years while at medical school, you will rotate at different specialties. You may be very disappointed with what you imagine right now as a good match for you. You do not know exactly what is involved and various volunteering and shadowing experiences do not let you know the whole picture. Medical students get frustrated with specialties that were attractive to them prior to rotations.

Then sometime in 3rd year of medical school you will take your Step 1. The score of Step 1 is the most important factor (along with many others) when applying to selective specialty. In addition, it cannot be re-taken, you can re-take Step 1 only if you fail. If you receive a low score that would cut you off from certain specialty, you are simply cut off from this specialty, period.
So, I would focus on each day in your life. If something did not go as you plan on that day, ask yourself why and make immediate adjustments. Forget about medical school at this point, focus on doing your best.

@TheBruceWayne I’m sorry that I couldn’t respond, but yes I did get what you said.
@mjscal I do understand a bit of both ophthalmology and optometry. I have shadowed an optometrist during the summer, and most of the time (at least where I live) she saw clients for routine eye checks. It isn’t often that they get something other than a “check-up”. I am very interested in the medical field and was just looking to see what possibilities there are. I understand that over time my interests may or may not change, but I am just asking questions and nothing is set in stone. And yes, I’m trying to shadow an ophthalmologist in the future.
@MiamiDAP I will agree with you that I am in no position to pick any occupation. However, as I’ve said above, I’m just looking to see what I could be.

Anyways, I also have a question regarding credit. By the end of senior year, I’ll have about 57 credits that I can transfer to any public college (in Texas), meaning I’ll be able to “skip” freshman and sophomore year and graduate two years earlier. However, if I get accepted into UTD Pact, there is a very low chance that any of my math and science credits will transfer. Basically, I’ll have to spend seven years if I go the UTD Pact route and about six years if I don’t go to Pact (only including college and med school, no residency). Also, Pact only requires you to take a practice MCAT and will let you continue to UT Southwestern (only if you meet their academic standards, of course). In terms of credit, is it really worth it to take/not take that extra year?

Optometrist is NOT an MD. Optometrist did not graduate from a medical school. They graduate from Optometry schools, which I heard may be more competitive to get accepted than medical schools. I do not think that optometrist can perform a surgical procedures (I am not 100% sure though, maybe they can). I also do not think that somebody with diabetes who go to check the eyes on the regular basis and whose claims are submitted to the Medical insurance, not Vision insurance, I do not think that such a patient go to Optometrist, they go to Ophthalmologist, the person with the MD attached to his name. I do not believe that the Optometrist can submit a medical claim to the Medical insurance, I believe that they can submit a claim only to Vision insurance.

As I said, an optometrist is a vision-care professional. The degree is OD, doctor of optometry. It requires four years of post-graduate study at a school of optometry. An ophthalmologist is an eye surgeon. The degree is MD. It requires four years of post-grad study at a medical school, followed by a one-year internship and three years of surgical residency in ophthalmology.