Optometry in the Military: Career Profiles

Dr. Burke: Go for it! My time as a Naval Officer and optometrist was a fantastic experience, and one I would highly recommend. You need to understand that you are a military officer first and optometrist second, meaning you’ll have tasks besides refractions to undertake (which is great as it keeps your day to day from being too mundane). You also need to be flexible as even though you have some say over where you’re stationed, the final call is determined by the needs of whatever branch of service you are considering signing on with. With that in mind, and I’m biased of course, I’d say the best option is the Navy in order to up your chances of living seaside!

Dr. Zhang: First of all, the military is a wonderful setting in which to practice primary eye care. I would get your optometry license in a state where your scope is less restrictive. For example, if you get an MA license, you can't manage glaucoma, and if you get a NY license, you can't Rx orals like Valtrex, and that's just tying up your hands unnecessarily. A career path in the military does not equate to eye care every day for the entirety of your career. You are expected to be a primary eye care provider: that is the skill set you bring to the military. However, you are also expected to be a military officer, meaning you will lead by example and you must meet or exceed all military standards (i.e., physical conditioning standards). If you do decide to stay in the military and make it a full career, there are many great pension benefits after 20 years of service. When you do stay that long, you'll be moving up the ranks and should expect your day to day to be less clinical and more military (commanding, managerial, and administrative tasks).

You can be affiliated "full-time," meaning an active duty military member; or "part-time," meaning a national guard or a reservist serving one weekend a month and a 14 day tour a year. Your rank when you first join is dependent on your years of experience as an optometrist. If you are a new grad, you'll enter as a captain, and you can easily look up the base pay of an O-3 officer with 0 years of service. You do not have to commit to a lengthy term of service: it is typical to sign a 3 year active duty tour, and if the military still fits your lifestyle then continue on. If you find other ventures you'd like to pursue, you can separate at the end of your initial commitment.

Talk to a health professions recruiter to find out what sign-on bonuses and loan repayments you can qualify for. If you are still in optometry school, definitely look into the Health Professions Scholarship Program.

Dr. Jones: First, consider the financial goals you have. The decision for me was a financial one. Serving my country is something I am very proud of, but most people joining the military do not do so with the intent of being a true patriot. It is absolutely reasonable to weigh the financial benefit of practicing in the military with the hit you will take in salary if you were to compare working full time in the “civilian world.” It is simple math, but math that you should do before joining. If you can join during school and are selected for the Health Professions Scholarship Program (HPSP), as I did, you will discover very quickly that you made an excellent financial decision.

Second, you should do some research in the different branches of the military to decide which suits you best. I chose the Air Force because that is what my dad (Navy), my uncle (Marine Corps) and my grandfather (Army) told me to do.

Dr. Christman: Understand that you will not be solely an optometrist, but an officer and soldier. You will have administrative and officer duties and training requirements that are challenging and different and take priority over your doctor duties. Physical fitness included. These can add depth and flavor to your career if you embrace them as part of the unique job in the Army. Just remember that even when you feel like you're doing hard, boring or different duties, the pay is the same, so you might as well enjoy being out of the clinic for a while.

Dr. Burke: Not at all. Though some military optometrists have completed a residency, or do one during their time in the service, most officers enter directly out of optometry school.

Dr. Zhang: You do not need a residency prior to joining the military. If you get your fellowship in the American Academy of Optometry, you can get an additional board certification pay monthly. If you do not have prior military experience, you will go through a 5 week officer training program where you'll learn military customs and etiquette. If you are joining in the active duty service, as a new grad you will likely be stationed somewhere where there is another optometrist to guide you on clinical or military questions. You will also learn about military vision standards as well as pilot vision standards. In addition to providing full-scope primary care, you'll have to make sure that members continue to meet vision standards to stay in the service.

The military does get a lot of their optometrists as new grads through the HPSP scholarship program. However, there are quite a few practicing optometrists looking for a change of pace and/or loan forgiveness who join after being out of school for a number of years.

Dr. Jones: I can only speak to the requirements of the Air Force, but I understand there are similar requirements in the other branches. Once you graduate, or decide to join (if already practicing), you will have to complete Officer Training School (OTS). This is where you learn your place in the military. The length of this training can vary, but I went to Montgomery, Alabama for 6 weeks. The common way people describe this is that “it is the best experience you would never do again.” Once this is completed, you will report to your first duty station and start credentials, just like any other optometry job. The Air Force sends its new optometrists to a course in Dayton, Ohio within the first few months of starting practice, to the “Refractive Surgery Course.” The original intent was to standardize co-management of refractive surgery across the Air Force, but it evolved into a sort of “Air Force Optometry Orientation.” We were able to meet a lot of senior optometrists and reunite with many of the newbie ODs we just met at OTS. There are a lot of standards and practices unique to military optometry (depth perception tests, color vision tests, occupational requirements, etc.) which you are introduced to at this course as well. I think it was a week or so long, and it was mostly fun and interesting. There are many other ancillary training sessions that you are eligible to participate in, but not required. I went to a course to become a Night Vision Goggle Instructor, which is as cool as it sounds.

Most new optometrists are recent graduates which are coming off of the HPSP train, but there are also some people who were in practice and wanted to change things up. I believe these people are able to apply for the same loan forgiveness programs that people working in underserved populations are able to apply for.

Dr. Christman: Applications to receive a scholarship should be done as soon as possible as the deadline in Jan 1 of the year previous. But even after you graduate, loan repayment is available. An OD degree is sufficient, but being able to pass a physical fitness test is essential.

Dr. Burke: You get to be part of something bigger than yourself, you get to see a different side of life that most civilians do not, and you get to meet some folks who are literally putting their lives on the line for our country and fellow citizens. My day to day interactions with other service members had a much bigger impact than I ever could have imagined, especially having never set foot on a military base prior to my service. Of course, using the service time to both pay off student loans as well as earn a second advanced degree was a pretty great perk as well.

Dr. Zhang: The most rewarding aspect is the people you work with and the connections you make. The military is full of wonderful people and is much more diverse than one would imagine. From a practitioner standpoint, as a military provider you have the convenience of seeing your patients' full medical history, and you can easily coordinate care with other providers. You can prescribe the most appropriate treatments without worrying about insurance coverage. You usually have an autorefractor, NCT, Topographer, OCTs, HVFs, fundus camera, Pachymeter, and some clinics have an Optos, B-scan, so additional testing is easily obtained. You usually have a trained technician who will do the pretesting as well as run the additional tests for you.

It is also nice to practice in settings where you do not have to "up-sell" your services or products. Your primary focus is to simply take care of your patients and you are well equipped for that. You also do not have to worry about patients being lost to follow-up, because you can always involve the member's leadership to command them to come in. Other benefits of being active duty include a part of your pay is tax-exempt (i.e., your housing and subsistence allowances), you can qualify for VA loans to make home ownership easier, and you can go to conferences like the Academy, SECO, etc. on the government's dime. You can be stationed all over the world and the military pays for your moves.

Dr. Jones: The most rewarding aspect of practicing in the military (for me) has been to witness the ripple effect you have when working for such a giant organization. Instead of the “cog in the machine” feeling, you see how your work positively impacts something bigger than yourself. It’s very special. The people you meet with such different backgrounds have such different roles in this machine, but all are working toward the same goal (“the mission”); it is extremely rewarding.

Once I was called to see a patient early that I was treating for iritis, and I was due to see him for follow-up in a day or two. Our Commander asked me to see him early, because he was the only person on base at the time who could do this particular job which needed to be accomplished. He was not allowed to do this job while on active treatment for a medical condition. His iritis had cleared up after his taper and I cleared him for work. Over the weekend I saw on the news that there was a B2 Stealth Bomber that was flown across the Pacific with the assistance of a refueling plane (KC-10) from Travis AFB (my duty station). The person in the refueling plane who controls the long “boom” to transfer fuel from one plane to another was my iritis patient.

The machine keeps running.

Dr. Christman: I love the extra jobs, abilities, and training available in the Army. Helicopter rappelling, field battle medicine, biochemical weapon training, and lots leadership and management experience. I love the variety and constant moving to a new location.

Dr. Burke: You’ll be joining a government agency, so there will be some bureaucratic headaches coming your way. Maybe it’s just me, but I never had much of a problem with that sort of thing.

Additionally, there is a strict chain of command in the military, one you become a part of the minute you join, and so you’ll be dealing with the demands of your superiors more so than you would be in other practice settings. Your introduction to this starts in the summer before reporting to duty upon arrival at Officer Development School, a six week course that teaches you what to expect during your service time.

Dr. Zhang: You have additional duties. Sometimes you have to stay late after clinic to work on administrative tasks required of being a military officer. There is endless computer-based training to be completed regularly. You are "on call" at your leadership's discretion: for example, during times of crisis like the start of the COVID-19 pandemic shutdowns, everyone had to be ready to report to their unit within a 2 hour notice.

If you are joining as active duty, you may get stationed somewhere you did not pick. If you continue to stay in for your career, you are forced to move every 3 years or so. The military does try to match where you want to go, but ultimately you go where the needs of the military are.

Dr. Jones: I found the biggest challenge was to balance time devoted to clinic against time devoted to “additional duties.” This may be different in other branches, but in the Air Force, in order to promote and progress in your career, you must have a variety of experiences outside of clinic. Often, the people who seem to see the least number of patients have the most impressive performance reports. I was fresh out of school and felt like I should really hone my craft, but felt obligated to seek out opportunities outside of clinic. Those opportunities are the things that stood out to leadership. Ideally, you can do both, but I found this to be difficult.

Dr. Christman: Constant change and uncertainty is a challenge. You can prepare yourself to make a move, deploy, change jobs, do training, and the mission, location, or timeline can change in a moment. You’ve got to be resilient and agile. Especially your family. If we get out it will be because the constant change and uncertainty was too much for my family.

Dr. Burke: You’ll typically see patients 4-4.5 days a week, with the other half or full day dedicated to admin work and military duties. Most commands allow for extended breaks during the day so that you can combine physical activity with your lunch break, as staying physically fit is expected of you as a military officer (you’re tested on running, push-ups, sit-ups, etc from time to time). At most commands, you’ll be seeing not only other service members, but also their families and retired military personnel, which is nice as it mixes things up and keeps your skills sharp.

Dr. Zhang: You are expected to operate 4.5 days a week, and are allowed a half day each week for administrative duties and/or unit fitness (you're getting paid to hit the gym!). Clinic usually opens between 7 and 7:30 AM and closes at 4 or 4:30 PM and you get an hour break for lunch. Patients are usually scheduled 2 or 3 per hour. At least once a month, there is usually a commander's call where everyone reports about their unit (usually 6:30 AM on a Friday).

Patients are usually between 18 and 50 years of age; however, you could be serving dependent children as young as you're comfortable seeing, and retirees (think VA population). Your patients are just a cross-section of the general population. You get a lot of normal routine visits, and you also work up a ton of glaucoma suspects. You get walk-ins every day for FB removals, corneal and conjunctival abrasions, acute red-eyes (mostly lots of Betadine for viral conjunctivitis in Jan and Feb, lots of allergies during spring and summer months, few bacterial throughout the year and with a few HSV/HZV cases as well). You will also see optic neuritis and uveitis patients. These patients will need full work-up, and oftentimes may result in a medical board evaluation if they are found to have underlying autoimmune conditions.

Dr. Jones: Most of the week is just like any other optometry practice. You see patients. You will usually have physical training with your unit once a week during work hours, and will have more meetings than a typical optometry job, but mostly you see patients. The variety in demographics can vary greatly depending on the clinic and base you are assigned to. Some clinics are a “one doc shop,” and you will likely only have time to see Active Duty and their family members. This will be mostly young/healthy exams.

I was stationed at a large multidisciplinary hospital. We had enough capacity to include slots in our schedule for retirees and even retiree family members. This brought in an older demographic which brought in more interesting cases. We had ophthalmology in the hospital, so we co-managed a lot. We also had fourth year students. This kept us busy with lots of interesting cases. This experience is completely different from someone stationed overseas or in a remote part of the country, which I can’t speak to.

Dr. Christman: Depending on the clinic location your day can vary widely. Mostly you start early 6-730 and end early 3-430. Patients every 20-30 minutes plus walk-ins. Most patients are very healthy, with the type and age of patient very specific to your location. My locations have been 50% emerging presbyopes with kids, families, injuries, and light disease. Or my last location was a residency (excellent with equal pay as always) where I did 60% scleral and specialty contact lenses and 30% disease with 10% normal.

Dr. Burke: I’d imagine so, though I can only speak to my experience with the Navy.

Dr. Zhang: I assume it is the same across all branches. The marines do not have optometry, as they are served by Navy optometrists. The vision standards may vary between branches and the physical fitness requirements are different depending on the branch you join.

Dr. Jones: Yes and no. When I left Active Duty, I joined the US Air Force Reserves and I took a job as a contractor (civilian) in an Army Hospital. I was Air Force, my boss was Navy, the hospital was Army, and most of our patients were Marines. I was accustomed to military language and procedures, but it was a big adjustment. Certainly, my practice in the Air Force had set me up to succeed in the setting of an Army Hospital, but it was different in ways I would need a much bigger platform to describe. Throughout these questions, I preface most of what I say with, “in the Air Force we,” for a reason. Each branch is fundamentally different, and this trickles down to some of the most trivial aspects of day to day life in an optometry clinic. All of the branches are great. All of them have their advantages and disadvantages for each individual person or career field. I haven’t met a single military optometrist who regrets the decision they made to join the military, no matter what branch.

Dr. Christman: It varies widely by the location and the mission at that location inside the Army. I’m sure other branches also vary widely.

Optometrists interested in pursuing a career path in the military have the option of starting while still in school, immediately after graduation, or later in their career (although some age restrictions apply). Current optometry students or new grads can talk with recruiters or other colleagues who’ve chosen this path, as well as visit the respective websites for optometry careers in the Navy, Air Force, or Army for more information.

In addition to the financial incentives, practicing in a military setting can be a rewarding experience for many other reasons as well. It can offer the opportunity to travel and see new parts of the world, while also working with a highly diverse group of patients, colleagues and other service members. As the cost of optometric education continues to rise, a growing number of today’s optometry students may likely consider a career path in the military as means to offset the financial burden.