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Job: Ophthalmologist
The role: Ophthalmologists specialize in the management of eye conditions and diseases, including cataracts, glaucoma, and macular degeneration.
“We try to identify people who have eye problems, understand what the problem is, and then solve it,” explains Dr. Phil Hooper, speaking on behalf of the Canadian Ophthalmological Society. Dr. Hooper has practised and taught ophthalmology for more than 30 years.
The majority of ophthalmologists in Canada work in private practice, seeing anywhere from 25 to 50 patients per day, Dr. Hooper says.
“During our day we would often do minor procedures in the office dealing with lumps and bumps on the eyelid and the external eye, or using lasers to deal with things like glaucoma, retinal diseases, and tears,” he says. “You also typically spend one or two days a week in the operating room.”
Beyond seeing and treating patients, ophthalmologists are required to undertake continuing education and research in a lab, hospital, or in the office, depending on the nature of the research.
Ophthalmologists can also pursue additional training to become specialists within the field, such as pediatric ophthalmology, glaucoma, or neuro-ophthalmology,
Salary: Upon completing medical school ophthalmologists typically begin five years of paid training, with a salary that ranges from about $45,000 to $85,000 per year, says Dr. Hooper. Compensation typically increases as candidates advance through their training, and can vary between provinces. “Once you leave training you become a private physician, and as such you bill the provincial authorities for the work that you do,” he says.
Within private practices, earnings often range widely based on specialty, as specializations that require more frequent and intensive surgical procedures commander a higher salary.
“The billings would start out in somewhere of the range of $250,000 [annually] and they go to over $800,000, depending on the type of practice you’re in, and how busy you are,” says Dr. Hooper, adding that overhead costs typically account for 40 to 50 per cent of those billings.
Education: The educational pathway to becoming an ophthalmologist is relatively long, with most completing their training in their late 20s or early 30s. After successfully completing a medical school program of either four or five years, graduates are eligible to begin a five-year residency program in ophthalmology.
“You typically do electives to learn more about the specialty in your third or fourth year of medical school,” says Dr. Hooper. “The declaration is made in fourth year, and you apply to do a residency.”
Following residency, candidates must successfully complete a written and oral exam administered by the Royal College of Physicians and Surgeons. The College also requires an additional 90 hours of educational or training activities following graduation to maintain the credential.
Job prospects: According to a 2018 study conducted by the Conference Board of Canada, demand for ophthalmic interventions is expected to increase 55 per cent between 2018 and 2040 as a result of a growing and aging population.
“There’s an ongoing need in this particular field,” says Dr. Hooper. “We’re roughly keeping pace with retirement, but we’re not doing a good job of keeping ahead of the demand.”
Challenges: One of the biggest challenges ophthalmologists face is the lack of operating space needed to address growing demand.
“There are a finite amount of operating room spaces within hospitals, there’s a crunch from other specialties that need space, and governments across Canada are looking to address how they’re going to cram all of this into the existing infrastructure,” says Dr. Hooper. “That’s one of the factors that limits the extent to which ophthalmologists can practice, and new trainees struggle to find operating facilities in which to do the surgical aspect of their care.”
Why they do it: Dr. Hooper says that there are two factors that make ophthalmology unique from most other medical professions. One is the high degree of patient interaction, and the other is the high degree of technological innovation.
“You really get to know the people, you can see that you’re making a difference in their lives day to day, and it makes for a very nice interaction,” he says. “If you’re a bit of a techy and like high tech things, you get to interact with lasers, you get to interact with microsurgery, you’re doing very precise surgery on very fine structures, and the field is constantly innovating and changing.”
Misconceptions: Since ophthalmologists are known for seeing a high volume of patients, some have the false impression that the practice is repetitive and straightforward.
“We’re viewed as technicians [more so than medical professionals] and that’s all we have to offer,” says Dr. Hooper, adding that many fail to appreciate the challenge associated with diagnosing patients and developing a treatment plan. “If you’re doing a lot of something, the criticism is raised that the thought process for doing it isn’t all that high, and that’s not correct.”
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