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Residents And Fellow | Jan 2015

Congratulations! You Have Completed Your Training. Now What?

Real-world advice on choosing the right practice setting for your career as an ophthalmologist.

In almost every interview for residency, the question arises: Where do you see yourself in 5 to 10 years? Most trainees often change their mind as to what their ideal practice type is as they progress through residency. This month's installment of “Residents and Fellows” raises important questions you should ask yourself prior to looking for your first job after training. The key is to be honest with yourself to determine the best fit for you.

—Section Editor Sumit “Sam” Garg, MD

Industry analysts agree that an estimated 60% of physicians will change employers during the first 3 years into their first job. Although some of these moves are dictated by changing personal circumstances, most are the result of insufficient research before selecting an initial practice environment. With so many options available (private practice, group/solo practice, academic, hospital, Veterans Administration, etc.), it has become difficult to know where to start and how to find the knowledge needed to make the best choice for your professional longevity. Following are some best practices and pitfalls from established and successful ophthalmologists who once stood at the career crossroads—just like you.


There are many factors that will influence your decision. A fondness for research and teaching may steer you toward academics. A business background and entrepreneurial spirit may encourage you to start your own practice or become a partner in an existing and growing practice. Financial considerations may guide you to salaried positions within a group practice. All of these influences are important, but most established and successful physicians agree that focusing on your personal passion will almost always guide you to the best decision. Passion for your craft means everything. Do you love being in the OR? Do you enjoy writing and mentoring? Do you see yourself traveling and working with charitable organizations? What are you passionate about?

Of course, location, cost of living, hospital systems in the area, and the availability of technology should all be carefully considered. Equally important is having open communication with your family. If your spouse has strong desires or dislikes with regard to a particular location or practice setting, this will help you to narrow the search. Your spouse will be nearly as involved in this process as you are, and ultimately, his or her happiness will translate into your overall satisfaction with your new position.


The world of ophthalmology is continuously evolving, and it is important to note that integrated practices are becoming much more common. Heeral Shah, MD, a retina specialist with Ramesh R. Shah, MD, in Joplin, Missouri, offers this advice: “There are many factors to consider when deciding between an academic position and private practice. Some include research interests, enthusiasm in training residents and fellows, and the level of ‘teamwork' that you look for in your day-to-day work life. Having had experience in both worlds, I can say it is rare, but not impossible, to find a private practice where interesting cases and treatment ideas are routinely discussed among the specialists in the practice. That said, the field of ophthalmology has changed drastically in the past decade. Where once private practice ophthalmologists were uninvolved in research and lecturing, a good percentage of clinical trial sites are now within private clinics, and the same is true for speakers around the country.”


Lastly, one of the most important decisions you can make in the search process is to get help! There are people out there who are qualified to help you figure out what is available and what the best direction for you may be. From finding vacancies to helping you negotiate your new contract, most specialties have recruitment and consulting firms that are willing to assist you along the way.n

Section Editor Sumit “Sam“ Garg, MD
• medical director, vice chair of clinical ophthalmology, and an assistant professor of ophthalmology at the Gavin Herbert Eye Institute at the University of California, Irvine, School of Medicine
• serves on the ASCRS Young Physicians and Residents Clinical Committee and is involved in residents' and fellows' education

Jessie Wilson
• director of business operations at Brighter Bay, St. Petersburg, Florida, specializing in career placement in the eye care community
jwilson@brighterbay.com; Twitter @brighterbay; (813) 708-1230; www.brighterbay.com

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