Most ophthalmologists practice a mixture of medicine and surgery, ranging from lens prescription and standard medical treatment to the most delicate and precise surgical manipulations. The average American general ophthalmologist spends approximately four days per week in the office performing primarily medical ophthalmic functions and one day in the operating room. In a typical workweek, the ophthalmologist will see more than 100 patients and perform three or more major surgical procedures. Cataract removal is the most commonly performed ophthalmic surgical operation.
In addition to managing local ocular disease, the ophthalmologist interacts with other physicians. Many systemic diseases have ocular manifestations, and the ophthalmologist may be prominently involved in both the diagnosis and management of these conditions.
A prospective ophthalmologist should keep in mind that a typical ophthalmic practice involves the treatment of patients with vision-threatening diseases. These patients often believe (correctly or incorrectly) that they are going blind. Dealing with the prospect of vision reduction or loss presents a unique challenge that can be highly stressful and frustrating for both physician and patient. The ophthalmologist must be prepared to offer the patient compassion and understanding as well as clinical expertise.
Those considering the field should also be aware that certain visual and motor abilities are necessary for effective clinical and surgical practice. Ideally, an ophthalmologist will have good fine motor skills, depth perception and color vision. Impairment of these abilities may interfere with the effective use of essential ophthalmic instruments, such as the indirect ophthalmoscope and the operating microscope.
Like many other specialties, ophthalmology has undergone considerable subspecialization. At first glance, the proliferation of subspecialties dealing with such a small sensory organ may seem excessive. However, the development of many highly sophisticated methods of diagnosis and therapy has resulted in the establishment of important discrete areas of interest. Although most ophthalmologists choose to practice general ophthalmology, many decide to pursue a subspecialty area. Many residents who are interested in working in an academic center choose to take additional post residency training (i.e., a fellowship) in a subspecialty area. Others choose to do so either because it fits with the community needs where they hope to practice, or purely out of a passion for the subspecialty field.
The Job Market
Future demand for ophthalmology, as for the other specialties, will depend on the advances of medicine and how fast new procedures and techniques can be made available to meet the needs of the public. Ophthalmology has enjoyed more than its share of scientific and technological breakthroughs in medicine. As such, there are locations throughout the country with relative shortages and others with relative surpluses of comprehensive (general) ophthalmologists and ophthalmologic subspecialists. Overall, from a manpower perspective, ophthalmology continues to be an attractive field of medicine with great opportunities.