Ophthalmologists M.D.

What Ophthalmologists Do

When it comes to eye care, the most completely trained professions for the field are ophthalmologists, because they are physicians that have specialized in vision care, allowing them to handle everything from simple medical exams to surgical needs. Ophthalmologists can handle basic eye care situations including eye exams, providing prescriptions for eye wear, and diagnosis and testing for visual disorders. They have more training and education in eye disorders, diseases that affect vision, neuro-pathways, and plenty of other areas that makes them more capable at handling issues such as cataracts, corneal diseases, retinal detachment, and many surgical procedures. Their medical knowledge of the entire body also gives them additional skills in diagnosis and treatment of conditions that originate in another place, but affect vision. However, because they are busy with more complicated issues, the majority of patients visit an optometrist for their basic eye care, and is usually referred to an ophthalmologist for issues that can’t be handled by the optometrist.

Ophthalmologists will see patients of all ages and a wide range of conditions, but some will specialize in one or several areas that allow them to work in certain environments. Pediatric ophthalmologists are trained in pediatrics and can focus their work on children and infant vision. Lasik surgeons can be ophthalmologists who have specialized training in the cornea, retina, and refractive surgery. Neuro-ophthalmologists can have training in neurology, optic pathways, and trauma. There are plenty of subspecialty areas such as the ones mentioned, which allow ophthalmologists to refine their skill and even job structure regarding patients they handle.

Ophthalmology Education and Schools

Those that become ophthalmologists can either become Doctors of Medicine or Doctors of Osteopathic Medicine, but the majority has an M.D. degree. This requires entry into a 4-four year program of Doctors of Medicine, which has more than 125 program accredited choices, whereas for Doctors of Osteopathic Medicine, there are 26, 4-year programs to choose from.

Medical schools are extremely competitive to get accepted into and each has its own requirements including official school transcripts, letters of recommendation, and of course the Medical College Admission Test or MCAT. Training during medical school will vary depending on each school, but students can expect meticulous coursework and labs with a minimal learning curve, and usually no grading by the curve. The final 2 years of medical school generally focus on hands on training and experience by following a physician, who is also a teacher, and through clinical rotations at participating hospitals, clinics, and private offices that offer a vast amount of field experience. They receive training in all aspects of medical treatment including internal medicine, pediatrics, cardiology, and ophthalmology.

After completion of medical school, students are required to enter a residency for graduate medical education, accredited by the Accreditation Council for Graduate Medical Education. For those interested in becoming an ophthalmologist, the minimum length of the residency is 3 years, and applicants must have completed an internship or PGY-1 prior to acceptance. Ophthalmology residencies vary on training areas and some provide more emphasis on special areas such as cataracts, pathology, or refractive surgery. Ophthalmologists who wish to specialize in certain subjects can start with residencies that offer more training in these areas.

After residency, ophthalmologists can become licensed and join the work force, or continue with subspecialty training through a fellowship that can range from one to three additional years, depending on the specialty and program structure. Ophthalmologists gain hands on training in specific areas and gain valuable surgical experience. Both residency and fellowships can be matched through http://www.sfmatch.org.

Ophthalmologist License and Certification

Ophthalmologists can become licensed through each state or territory medical board by passing a written, oral, or practical exam, and meeting the specific requirements. Requirements will vary from state to state, but there are rules that are followed by the majority of medical boards. These include passing a medical test like the United States Medical Licensing Examination (USMLE) or other testing organization, submitting a self-query from the National Practitioner Data Bank and Health Integrity and Protection Data Bank, pass local jurisprudence tests, and completion of a graduate medical training program. They can also become board certified by passing written and oral exams conducted by either the American Osteopathic Board of Ophthalmology, Otolaryngology (AOBOO) for D.O.s, or the American Board of Ophthalmology (ABO) for M.D.s.

Board certification has different requirements for M.D.s and D.O.s, but both require 3 years in a residency focused on ophthalmology and approved by the boards. Renewal of both licenses and certification requires a certain amount of continuing medical education or CME.

Ophthalmologist Salary and Work Environment

Ophthalmologists can work in different work environments, depending on area of expertise, but the majority work in either private practice or for a health organization such as hospitals, surgical centers, and others. Those that are in private practice will often see patients needing everything from basic eye examinations, to those requiring cataract or glaucoma treatment. Those working in hospitals may see trauma patients, while those in surgical centers may perform Lasik or other refractive procedures. Also, those who have specialties may setup their own offices and see only patients with conditions needing an expert in that area. For example, a neuro-ophthamologist may see only a few patients, but will see a high degree of those with vision problems relating to neurology.

The work area, specialty, and experience of the ophthalmologist also determines how much money they make as well. All physicians make some of the highest paying salaries among all professions, and those that specialize can make even more. Ophthalmologists working in private practice will make more than salaried ones at other facilities, but will have more paperwork to handle and a staff to deal with. Specialists in areas such as retina, surgery, and pediatrics will often make high end salaries compared to other ophthalmologists because of their need during specific problems. Lasik surgeons, pediatric ophthalmologists, and retinal ophthalmologists can make more because of the eye conditions they are treating. According to the Medical Group Management Association, the 2006 median salary was $297,486, with the top percentile making around $375,000. According to salary.com, the median salary was $255,438 and the high end topped over $300,000 for 2009. These median salaries depend on who is surveyed but tend to be between $250K to $290K every year for the past few years.


Pediatric Ophthalmology

Pediatric ophthalmology is an important subspecialty area, as it affects vision of infants and young children, including development, conditions and diseases, routine exams, visual learning disorders, and plenty of others. Just like with adults, there can be many conditions that affect the vision of young children including strabismus, amblyopia, eye movement disorders, cataracts, glaucoma, and a multitude of other binocular vision problems. Many of these conditions and diseases will affect these individuals for the rest of their lives if untreated, and can result in academic difficulties, low confidence, and emotional scars. Early detection and treatment of vision problems at an early age can help avoid many of these issues, which is why pediatric ophthalmology is vital. Pediatric ophthalmology involves many professions, but the main ones involved are pediatric optometrists, orthoptists, and pediatric ophthalmologists. The orthoptist and optometrist sections explain more about these professions.

Pediatric Ophthalmologists

There is no certificate or license specifically for pediatric ophthalmologists (only certificates for residencies and fellowships), so having the title of ophthalmologist does not necessarily make a physician the most capable person in vision care for infants and young children. Even though they may be trained in many aspects including pediatric vision, the medical doctors that can truly serve as pediatric ophthalmologists to their fullest, are those trained through residencies and fellowships, with core training in pediatric vision care that includes hands-on experience in diagnosis, treating, and surgical procedures. They will be more apt at handling pediatric vision problems than an ophthalmologist with no training in pediatric vision

Ophthalmologists who want to focus on pediatric vision care should find residencies with strong training in pediatrics. Residencies that offer clinical experience in pediatric departments or have ophthalmology departments with a children’s clinic, are two examples of pediatric ophthalmology training where an ophthalmologist can learn more on proper diagnosis of vision care problems that affect children, see more cases involving children and infants, and possibly perform surgical care such as removing cataracts.

The most qualified pediatric ophthalmologists also have continued training and experience through fellowships, which are designed to enhance and fine tune skills and clinical judgment. Unlike residencies which may rotate between different medical areas that affect different age ranges, fellowships focus on specific tasks for the entire length of the program. This means for a pediatric ophthalmology fellowship, an extra 1 to 3 years in training, specifically dealing with vision problems for infants and children. Ophthalmologists in pediatric ophthalmology fellowships will work in the pediatric departments and spend their days in rotation, examine children for strabismus, help kids in outpatient care with eye training, help with removal of cataracts in surgical rounds, and other educational training requirements as deemed by the specific fellowship.

A career as a pediatric ophthalmologist is not for everyone and many ophthalmologists go towards other subspecialties. There are many reasons for this that all focus on dealing with children. Many medical doctors do not deal with children as well as others, and some are not comfortable seeing children and infants with visual disorder from birth defects, trauma, or other causes. Pediatric ophthalmologists have to be able to handle children in all conditions, including those that are unruly or have mental disorders, and assist them through the vision care regimen. For ophthalmologists who love working with children and take pride in treatment of them, the pediatric subspecialty is definitely a possibility.

When Pediatric Ophthalmology Begins

Pediatric ophthalmology starts at the neonatal stage, as vision develops and detection of certain diseases. After birth, infants are usually checked by a pediatrician for visual functions, but parents can also take them to see optometrist or pediatric ophthalmologist for a more thorough examine. Recommendations from InfantSEE®, a public health program designed in early detection of eye problems in infants and children, include an exam at 6 months to 12 months, 2 years, 4 years, and at regular intervals. This is extremely important, as early detection and treatment before grade school begins can help young children adapt much quicker. For parents who have grade school students that have difficulty learning, this may be caused by an eye disorder that needs to be examined and treated by a pediatric ophthalmologist.