The process of seeking a new ophthalmology position can be stressful, and we often don’t get much guidance during formal training about preparing for our first attending position. This article will provide practical advice on identifying the right ophthalmology job, finding that opportunity, landing the job
, and setting yourself up for first-year career success.
Here are some tips I picked up on during my experience looking for my first job out of fellowship
How to find ophthalmology opportunities
If you are looking in a specific location, don’t be afraid to cold call offices in the area and speak with the administration. Often there are jobs that are not actively promoted and may become available soon; it can’t hurt to ask. National meetings such as AAO
or ASCRS Annual Meeting
are great networking opportunities to help you land your first job. Also, connecting with previous residency
or fellowship graduates may provide resources for job opportunities. I would also recommend checking out websites like LinkedIn
12 months before graduation
- Make a list of your priorities for your next position. That list could include geographical location, autonomy, work/life balance, compensation, or specific clinical interests.
- Begin networking with colleagues, check AAO (or subspeciality) job listings, and cold-call offices.
- Interview with different types of practices. Most places offer virtual interviews, which could be helpful while you are in training.
6 months before graduation
- Narrow it down to one-two top choices and complete final interviews.
- Craft a letter of intent and begin contract negotiations.
- Have the contract reviewed by the contract lawyer.
- Sign the contract and begin the credentialing process, which can take several months depending on your location and how many hospitals or clinics with which you will be affiliated.
Questions to assess the right ophthalmology job for you
- What does a typical week look like?
- How many ophthalmology patients am I expected to see in a day or per week?
- Who makes my schedule?
- What type of support staff will be available to me?
- Will there be scribes? And will they be designated for me, or will I share them with other doctors?
- Are there other subspecialties around that I can refer to if needed?
- Where will my patients come from? Is someone retiring, and will I be getting their caseload?
- What are the patient payer types, and how are they divided between the group?
- Will I be required to market myself to local optometrists and other specialties? Will I be supported in these marketing efforts?
- Will I be in a satellite office or the main office?
- Will there be an EMR/phone/clinic flow training session?
- When are my surgery days? Are they in a hospital or ambulatory surgery center? Will this day be set, or can it change at a moment’s notice?
- Note: Ensure you get enough OR time initially, and don’t let them tell you to “work your way up towards more.” Most academic centers don’t have much extra OR time, so make sure the department can support a new faculty member’s addition to the OR.
If you have an ownership interest. inquire about future ownership such as the buy-in and/or partnership track. Some practices may not be able to provide exact details, but it is important to ask, so you are educated before jumping into the practice. Cover what percentage of ownership you could be offered and when you would be eligible. Ask to speak with any recent physicians who have bought into the practice.
- Ask questions to understand and set expectations
- Show willingness to be a team player
- Be respectful of the administration and physicians’ time and effort during the interview process
- Send a thank you email after the interview
Red flags to look for with potential employers
- Never getting direct answers or receiving different answers from different people
- Physicians speaking negatively about other physicians in the group
- Not being given an opportunity to speak with other physicians before signing
Negotiating a contract
Try to pick the most important couple of aspects you would like to change. For academic jobs, don’t expect to change much in your contract. Most are hospital-specific and can’t be modified too much. Don’t take this personally–it’s just how the academic world operates.
Employment agreements are often up to 20-30 pages long. Read every word yourself but also have it reviewed by your contract lawyer. Some contract lawyers provide their services for a discount if you are a new graduate. Ask your fellow co-residents or past graduates if they have contract lawyers they recommend.
Key items of the employment agreement
- Compensation and bonus structure: Given the global pandemic and the possibility of a recession, the compensation package may not be as robust as in prior years. Think carefully about asking for changes in compensation as this may adjust your bonus structure.
- Medical Insurance: See if insurance is provided for dependents.
- Retirement plan
- Vacation: Starts at 3-4 weeks plus CME.
- CME: Most contracts permit attendance at one national meeting and a stipend of about $3000
- Relocation expenses
- Signing bonus: if offered, anywhere from 10-50K
- Expenses: medical licensing, malpractice, technology
- Call schedules are often not included in the contract. Make sure to discuss this prior and ask for a written summary. Also, be sure to discuss cross-coverage when a doctor is on vacation.
- Non-Compete. Also known as the Restrictive Covenant. Can vary from 1 year up to 10+ years, and mileage differs between rural and urban settings.
- Tail Insurance. Most contracts require the terminating doctor to pay, but this can be negotiated. Make sure it is detailed in your contract.
Keys to success in your first ophthalmology job
- Meet with partners and administration to discuss expectations on both sides before starting.
- Write your bio for the practice to use in marketing and social media.
- Observe other physicians in the clinic and surgery if able. Learn from their experience and get to know them. Schedule time with staff members to get training for EMR or coding, or clinic flow.
- Meet with referring doctors and primary care physicians to develop relationships and establish a referral system. Remember to return the patient to their optometrist once their treatment with you is complete. Send a detailed note regarding their care to the optometrist's office.
- Be active in your role and show the other partners that you are dedicated. At the same time, don’t let others walk all over you just because you are the new physician in the department. Expectations should be closely monitored as you develop your practice.
And lastly, enjoy yourself! Spend time with your friends and family, and maybe even take an extended trip before you start practicing. You have gone through countless years of training and have a bright future!
- American Medical Association (2022). Joining physician-led integrated systems: A guide to better decision making.
- Nabity, J. (2022). Preparing for Job Search Post Residency. Physicians Thrive.