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Fortress

Ophthalmology job market

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Hey everyone. I have a question about the ophthalmology job market. How difficult it is for a recent graduate to find a job? I am under the assumption that since ophtho surgeries are primarily outpatient based, it shouldn't be hard to find a job just like any other outpatient specialty. Does the concept of "surgeons fighting for OR time" hold true in ophthalmology? Isn't it true that in ophtho you could do your surgeries outside of the hospital system?

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1 hour ago, Fortress said:

Hey everyone. I have a question about the ophthalmology job market. How difficult it is for a recent graduate to find a job? I am under the assumption that since ophtho surgeries are primarily outpatient based, it shouldn't be hard to find a job just like any other outpatient specialty. Does the concept of "surgeons fighting for OR time" hold true in ophthalmology? Isn't it true that in ophtho you could do your surgeries outside of the hospital system?

yeah if you have an OR with those special pivoting microscope things outside of the hospital

 

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3 hours ago, Fortress said:

Hey everyone. I have a question about the ophthalmology job market. How difficult it is for a recent graduate to find a job? I am under the assumption that since ophtho surgeries are primarily outpatient based, it shouldn't be hard to find a job just like any other outpatient specialty. Does the concept of "surgeons fighting for OR time" hold true in ophthalmology? Isn't it true that in ophtho you could do your surgeries outside of the hospital system?

The overhead costs in Ophthalmology are very high, similar to other surgical specialties. Without the hospital to fund some of the equipment and nursing staff, government-paid fees (i.e. OHIP or MSP) alone may not make it financially feasible to work. So to answer your question: Yes, Ophthalmologists are also fighting for OR time and the recent graduates have difficulties obtaining a decent amount of OR time. 

Of course, if one were to practice in an entirely private system and charge fees beyond government-paid rates, then this would be feasible. Think LASIK, rhinoplasty and breast augmentation. 

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13 hours ago, ArchEnemy said:

The overhead costs in Ophthalmology are very high, similar to other surgical specialties. Without the hospital to fund some of the equipment and nursing staff, government-paid fees (i.e. OHIP or MSP) alone may not make it financially feasible to work. So to answer your question: Yes, Ophthalmologists are also fighting for OR time and the recent graduates have difficulties obtaining a decent amount of OR time. 

Of course, if one were to practice in an entirely private system and charge fees beyond government-paid rates, then this would be feasible. Think LASIK, rhinoplasty and breast augmentation. 

Okay. But what about those 4-storey eye care centers where there is a certain floor reserved for cataract surgeries and the rest of the building is clinics. Of course such a center is run by a group of ophthalmologists who share OR time, but I mean this model is not tied to the hospital in any way, right? And if a recent graduate cannot find a job in a hospital or in one of those eye care centers, then perhaps a group of recent grads can come together and open up such a center.

Please point me to where I am wrong.

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33 minutes ago, Fortress said:

Okay. But what about those 4-storey eye care centers where there is a certain floor reserved for cataract surgeries and the rest of the building is clinics. Of course such a center is run by a group of ophthalmologists who share OR time, but I mean this model is not tied to the hospital in any way, right? And if a recent graduate cannot find a job in a hospital or in one of those eye care centers, then perhaps a group of recent grads can come together and open up such a center.

Please point me to where I am wrong.

You could but the overhead will still be super expensive unless you get more and more ophthalmologists in your group but then you also get less OR time.

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1 hour ago, Fortress said:

Okay. But what about those 4-storey eye care centers where there is a certain floor reserved for cataract surgeries and the rest of the building is clinics. Of course such a center is run by a group of ophthalmologists who share OR time, but I mean this model is not tied to the hospital in any way, right? And if a recent graduate cannot find a job in a hospital or in one of those eye care centers, then perhaps a group of recent grads can come together and open up such a center.

Please point me to where I am wrong.

You're right. But recent graduates often have some debt and are not able to take out multi-million dollar loans to build such centers.

It is also extremely complex to coordinate and requires a high degree of trust among the recent graduates. And like i previously mentioned, the OHIP rates may not make such models financially feasible outside of a hospital setting. 

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17 minutes ago, ArchEnemy said:

You're right. But recent graduates often have some debt and are not able to take out multi-million dollar loans to build such centers.

It is also extremely complex to coordinate and requires a high degree of trust among the recent graduates. And like i previously mentioned, the OHIP rates may not make such models financially feasible outside of a hospital setting. 

Actually this is not accurate with respect to Ophthalmology. 

Ophthalmology can set up a medical practice or a surgical practice. It is pretty straightforward to set up a medical practice in a city of your choosing and operate without any OR privileges. Caveat being Intra-vitreal injections in which you need to be approved by the Retina association to be able to provide these injections.

With regards to a Surgical Practice, the main limitation is not the “OR time” but the Cataract Allocation for the jurisdiction. There is a certain amount of Cataract Surgery funded by the government per jurisdiction. The Ophthalmologist in the jurisdiction then distribute them amongst themselves. Furthermore, in order to be able to operate in a certain jurisdiction, you must have OR privileges even if you are operating in your own OR. The medical community therefore can limit how many Ophthalmologist operate in a certain area by limiting OR privileges. Different provinces have different set ups for private OR. There are certain OR in which you offer exclusively private care (patient pays out of pocket) in which case they would pay the fee for the OR to function. Other OR’s are publicly funded and privately operated. This means that the government pays a net fee to the OR facility per procedure to cover overhead etc. The surgeon then operates and bills the government for the procedure. In both cases, you must have OR privileges offered by the government/jurisdiction to operate in your own private OR. What people seem to misunderstand is that the limitation to OR time is not the physical OR (there are many private OR just sitting there not being used to capacity) but the funding to run the OR. Because  most Ophthalmology procedures are elective, there are caps on the amount of certain surgeries that can be performed which limit the job market. 

TL;DR

Job prospects for Surgical Ophthalmology are limited, similar to other surgical specialties, purely because of healthcare budget limitations. Medical Ophthalmology can be set up pretty much anywhere.

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On 3/1/2020 at 3:38 PM, Aetherus said:

It is pretty straightforward to set up a medical practice in a city of your choosing and operate without any OR privileges.

Can you please clarify what you mean by medical ophthalmology? My understanding is that it means clinic only and no OR time. Yet you are saying you can operate without OR privileges?

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17 hours ago, Fortress said:

Can you please clarify what you mean by medical ophthalmology? My understanding is that it means clinic only and no OR time. Yet you are saying you can operate without OR privileges?

Sorry, misuse of the word operate. I am using it as operate=run a practice. So what I’m saying is that it is easy to set up a practice with only clinic days and no OR.

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