As both patient and physician populations continue to age, the demand for ophthalmologists has continued to rise, thereby providing numerous employment opportunities for those young ophthalmologists on the market for the first time. This job-search process can be both an exciting and daunting one, the outcome of which can define your personal and professional happiness for years to come. As such, there are many factors to keep in mind. Where are the best places to find job opportunities? How do I select a practice that will be a good fit for me? What type of questions do I need to ask when talking with a practice? Sharing from their own job-search experiences, your 2013 YO Info editorial board offers their tips on landing your dream position.
Brian Chan-Kai, MD
Searching for employment was a decidedly different task from seeking a residency or fellowship position, and the mentality that I had coming out of training was not optimally suited towards finding the best employment match. For starters, it was the first opportunity to make a decision based on my (and my family’s) needs, rather than having a match system tell me where the next stop would be. Ultimately, a good relationship with my residency chairman opened the opportunity to return as a faculty member after fellowship concluded. Along the way, a few things become apparent:
- Explore every connection. Talk to everyone you trust; in addition to faculty mentors, community-based clinical adjunct faculty are an excellent resource and offer a different perspective on employment. Former residents and fellows can also be extremely useful.
- Be sure to vet your practice as much as possible. It is important to call as many people as possible who have some knowledge of the prospective practice. The top of the list includes younger associates and people who have left the practice. Other good contacts would be sources in the community who work with the group you are considering. Again, be sure to use residency and fellowship connections. Job interviews are only a snapshot and are not always a great reflection on whether a practice will be a good match for you.
- Financial stability is important. Money can be a taboo topic, but it is important to have some knowledge of the financial health of your future practice. We all have basic bills to pay and, in many cases, debt to repay. Asking for a basic profit/loss statement is reasonable. In addition, a good understanding of a practice’s buy-in structure and your compensation within that framework is, in the long run, much more important than your initial salary figure.
- Know your exit strategies. Like all relationships, things don’t always work out. It is important to understand the ramifications of quitting a job — malpractice tails and noncompete clauses are a couple of potentially difficult issues that may limit your ability to walk away. Ultimately, my family situation led to my leaving my first job. However, planning for that possibility ahead of time allowed us to transition relatively smoothly.
Dr. Chan-Kai is a vitreoretinal specialist at EyeHealth Northwest in Portland, Ore. Dr. Chan-Kai completed his residency at the Cullen Eye Institue/Baylor College of Medicine, where he also served as chief resident. He then trained in vitreoretinal surgery and diseases at the Casey Eye Institute/Oregon Health and Science University. He is a new member of the YO Info editorial board.
James G. Chelnis, MD
Deciding on a specialty and a fellowship is difficult. Residents are encouraged to make long-term decisions within a short window during their training. So how are you supposed to do it? It’s important to explore all of the options and major parameters at play. Do you favor clinical over surgical care? Do you prefer longer, more involved surgical techniques? Would you rather care for patients with chronic diseases? Most importantly, you have to explore whether you are more comfortable as a first-stop, jack of all trades or an expert courting a narrower focus.
I have decided, like the majority of ophthalmology residents, to apply to a fellowship program. If this is a possibility for you, prepare early. Master the factors you can control: read through the Basic and Clinical Science Course texts, prepare for the Ophthalmic Knowledge Assessment Program exams and make sure to explore research opportunities. Editor’s note: Don’t miss YO Info’s tips on preparing for your OKAPs.
When entering the workforce, don’t be shy to contact past graduates from your training program. They have recent memories and insights that will be central to your job search. Additionally, my program is experimenting with offering residents an annual forum with pertinent parties (community specialists and contract lawyers, among others) to prepare residents for, in most cases, their first job search. Ask your program director about offering this type of forum prior to completing your training.
Dr. Chelnis is a resident at the University at Buffalo, where he graduated from medical school and was the school government president. In this role, he helped renegotiate the university’s health insurance terms with their provider to exceed American Medical College Application Service standards. He also championed other causes, such as creating a nationwide student–alumnus network and organizing “Career Day” to place students in direct contact with physicians of all specialties prior to clinical rotations. This is his second year as a member of the YO Info editorial board and he remains eager to infuse a resident’s perspective into the newsletter.
Natasha Herz, MD
Applying for your first professional job is an intimidating task, so I am offering the following tips to get you started:
- Choose a region of the country where you would like to put down roots to start your career and your family. If you do not have a preference, then consider states without income taxes and where the market is not saturated with ophthalmologists. Keep in mind that physician payments from insurance companies are, for the most part, the same regardless of the cost of living in the region in which you choose to live. For example, your standard of living will be much higher if you live in Texas versus Washington, D.C. Since my husband already had his dream job in Washington, D.C., this first question had been definitively answered for my job search. I knew I needed to find a job in that specific area.
- Find the opportunities or make them happen. I started by searching the Academy’s job site and posting my own CV on it. I also used the Academy’s “Find an Eye M.D.” search engine to look for physicians in the Washington, D.C., area who were within 10 years of retirement, and sent them a cover letter with my CV.
- Have an organized plan to follow up the leads that you find in your job search. I followed up with a phone call about 10 days after I mailed the letters. Fortunately, I found some good leads and eventually negotiated a contract with a retiring physician in which I purchased his practice after we worked together for the first three years to help ensure a smooth transition. The first two years were challenging, but I am now successfully into my sixth year of practice and quite happy that my first job has worked out so well.
Dr. Herz is a cataract, corneal and refractive surgeon who works as a solo practitioner at Kensington Eye Center in the Washington, D.C., metropolitan area. She completed her residency and fellowship at the Cullen Eye Institute at Baylor College of Medicine in Houston. Local peers selected her to appear in Washingtonian magazine’s Top Doctors of 2012. She also serves on the Academy’s Young Ophthalmologist Committee and is the chair of the young physician committee for her local medical society. She has served as a member of the YO Info editorial board since 2008 and became the chair in August 2011.
Edward Hu, MD, PhD
There is no perfect practice opportunity. Any career decision is complex and many personal and professional variables help shape it. For me, I relied heavily upon a professional practice management consultant for career guidance. I am currently practicing with Eye Surgeons Associates, a large multispecialty ophthalmology practice in the Midwest, as a refractive cataract surgeon. My greatest pearls for finding the best job fit are prioritizing the aspects of a practice that are most important to you (location, scope of practice, financials, technology, autonomy, etc.) and understanding that your current practice environment is just a starting point. Your ability to influence the direction of your future practice is only limited by your will and patience to do so.
Dr. Hu is a cataract specialist practicing in Iowa’s Quad Cities. After graduating from the Massachusetts Institute of Technology, he received both his MD and a PhD in retinal electrophysiology from the New York University School of Medicine. He completed his residency at the University of Iowa Hospitals and Clinics, perennially ranked one of the top three training programs in the country. Locally, Dr. Hu is very active in the medical community as a member of the Quad Cities, Scott County and Rock Island medical societies, where he is the current secretary and treasurer.
Janice C. Law, MD
Toward the end of residency as a chief resident, I knew that I wanted to continue affecting change in the medical field through education. I recognized that teaching and developing curriculum for ophthalmology residencies would influence the future of our field and this could be my contribution.
To address my surgical and clinical interests, I chose a fellowship in vitreoretinal diseases and surgery with excellent mentors to guide me in my training and job search. In the middle of fellowship, I sought academic positions for residency directors in need of a retina specialist. I wrote to several department chairs inquiring about opportunities for a blend of both positions. This paired position was difficult to find; most programs were looking for either one or the other. Few were looking for both, and those that were had limited resources for education program improvements. I was fortunate to have an offer that suited my career goals from Vanderbilt Eye Institute – I would work with the program director as the associate director and have a teaching opportunity at the Veterans Administration hospital while having a retina practice. I was also attracted to the position by the many faculty development opportunities and resources available through Vanderbilt’s School of Medicine Office for Teaching and Learning in Medicine and Vanderbilt University’s Center for Teaching that would help develop me as an educator.
Tips for your first job search:
- Narrow down your geographic needs early.
- Identify your specific job requirements (especially if unique) and start inquiring about positions one to two years in advance of training completion.
- If interested in an academic job, start with www.AUPO.org for posted faculty openings.
- When choosing a department to work for, try to get a sense of how the department is run. Like any practice, the leadership is important. Is the department respected in the medical center or university?
Dr. Law is an assistant professor at the Vanderbilt Eye Institute in Nashville. She received her ophthalmology training at the Kresge Eye Institute in Detroit, where she also served as chief resident. After a two-year medical and surgical retina fellowship at the Vanderbilt Eye Institute, Dr. Law joined the retina faculty as assistant professor in vitreoretinal diseases and surgery. Dr. Law is also the associate program director for residency education in ophthalmology and plays a very active role in developing curricula and assessing teaching and learning within ophthalmic education.
David E. Vollman, MD, MBA
What happens when you want to stay where you trained? Sometimes that can be a hard proposition, depending on the job market. I knew I enjoyed academics and wanted to continue training residents. My family enjoyed where we were living and we were not anxious to move. So, during my residency, I started to explore options to stay in my department. I found that a good way to determine if a job will potentially exist for you is to use your mentors and be open with the administration about your desire to stay. Some departments are looking several years down the road in planning, so the sooner you voice your interest, the better — especially if you are going to practice comprehensive ophthalmology and want to start right after residency. Also, consider hybrid positions where you practice at multiple locations. For example, I work at both the university as well as the local VA hospital. Finally, allow for flexibility early in your career. Your dream job may not exist right away, so start in a position where you think you can flourish and that has room for growth.
Dr. Vollman is a clinical instructor in the department of ophthalmology and visual sciences at the Washington University School of Medicine and a staff ophthalmologist at the John Cochran VA Medical Center in St. Louis. After completing an MD/MBA dual-degree program at the Ohio State University College of Medicine, he completed his ophthalmology residency at the Washington University/Barnes-Jewish Hospital/St. Louis Children’s Hospital Consortium Program. Subsequently, he served as chief resident at Washington University, helping to direct the inpatient consult service and resident education.
Elizabeth Yeu Lin, MD
I have been a full-time faculty member at the Baylor College of Medicine since my fellowship. Being in academia can be very fulfilling for various reasons, including the collegiality with brilliant minds, the teaching opportunities and the exposure to complex patient management. When considering a university-based academic position, you need to consider your aspirations. As you know, there are three arms in academia: clinical practice, research and/or teaching. The goals for your academic career should fall in line with the department's own goal for you, both in your concentration of where your time is spent as well as what your practice design will be like. If you are joining a faculty with several others within your specialty, find out if there is a niche they have in mind for you and how they plan to develop you as a member of the section. Also, find out early on what the tenure track is, in order to determine if you want to follow a tenure or non-tenure track. Lastly, be sure to ascertain what type of young faculty development and support is available to you (i.e., mentorships, research funds or travel support).
Dr. Yeu is an assistant professor at the Cullen Eye Institute/Baylor College of Medicine in Houston. She received her MD through an accelerated undergraduate studies and medical school program from the University of Florida College of Medicine in 2003. She completed an ophthalmology residency at the Rush University Medical Center in Chicago and a fellowship in cornea, anterior segment and refractive surgery at the Cullen Eye Institute. Dr. Yeu currently serves as an examiner for the American Board of Ophthalmology and serves as an editor for the Academy’s Ophthalmic News and Education (ONE) Network refractive surgery subcommittee. She is also an appointed member of several national committees, including the Young Physicians and Residents’ Committee of the American Society of Cataract and Refractive Surgery and the Academy’s refractive surgery Annual Meeting subcommittee.
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