Eyeworld

EW NEWS & OPINION 20 December 2016 by Liz Hillman EyeWorld Staff Writer Ophthalmologists from different practice settings share their personal job hunt stories and advice for landing the perfect position T he job hunt for anyone can be daunting, but for oph- thalmologists the choices of where and how to practice medicine further compli- cate the search. There are academic, private, multispecialty, and solo practices. There are subspecialty-focused prac- tices and comprehensive practices, Where do you want to live? Do you want to be part of a surgically heavy practice, a focused practice? If you're joining a larger, multispecial- ty or academic practice, will there be enough patients, and are they planning on helping you embrace a certain field? Are you taking over someone else's practice or creating an entirely new one on your own? "These are all important consid- erations," Dr. Yeu said. While starting salary is an important factor, Dr. Yeu said young ophthalmologists need to remember potential for earning in the field can be much higher, so she doesn't label it a main consideration. "What is going to be your role in that group? Where will you be practicing? What are you going to be taking over? All of these compo- nents are the intangibles beyond sal- ary," Dr. Yeu said. "Also look at the comradery and interaction among the physicians and the staff. All of those components are very telling." Large multispecialty practice During his second year of residency, Robert Melendez, MD, Albuquer- que, New Mexico, wasn't thinking about where he'd be moving onto the next year. Then his mentor Frank Mares, MD, invited him to interview at Eye Associates of New Mexico, where he had volunteered in college. Dr. Melendez was also invited to interview at another Albuquerque practice after they were impressed with the consult note he sent along with his father-in-law for an ap- pointment. He ended up choosing Eye Associates of New Mexico, which has more than four dozen providers. "Make those connections early," Dr. Melendez said. "Ophthalmology is such a small field that you will benefit from that." A 2008 survey Dr. Melendez conducted with the American Academy of Ophthalmology (AAO) revealed that 78% of ophthalmolo- gists in their first 5 years of practice stayed at that first position. The 22% who changed positions within their first 5 years cited reasons like poor pay, issues with colleagues, and a lack of work equity. Those who took the survey recommended job seekers trust their instincts, make an effort to get to know their future colleagues, and make sure they want to live in the selected area. Dr. Melendez has stuck with this first practice, and perhaps that's in part because he took the time to understand what he really wanted of his career. Throughout residency, he thought he would focus on retina in an academic setting. After speaking with his mentor, weighing the pros and cons, he decided comprehensive ophthalmology in a private setting was a better fit. He maintains an academic side as a volunteer faculty member at the University of New Mexico. Once you've narrowed it down to positions you're interested in based on your career goals and location preferences, ask questions that drill into the atmosphere of the practice, Dr. Melendez said. "Ask people in the community [about the practice]. Find out why they really need you—is someone retiring or is demand high? Or are they hiring because they're a little busy and want someone to pick up the slack?" Solo private practice Before opening his own private practice—Goldman Eye—David Goldman, MD, Palm Beach Gar- dens, Florida, was assistant professor of clinical ophthalmology at Bascom Palmer Eye Institute. "Coming out of training, I was very confused by all the options … at the end, I felt most comfortable staying where I had trained, and at the time, an amazing opportunity opened up for me there," he said. When he decided to leave academia, he didn't feel any of the offers he received were fair and de- cided to start his own practice. "I think young physicians leaving training programs who think they can be successful on their own should go for it. Although there are significant start-up costs involved, at the end of the day, you either pay it up front or you pay it later in the form of a buy-in or buy-out of senior partners," Dr. Goldman said, adding that he finds private practice allows him flexibility and more of the op- portunity to work with industry. Starting the search: What you need to know about finding a job in ophthalmology P hysicians are used to being told where to go, as the match pro- cess vividly illustrates. There is no transparency, so only egregious errors such as the 2005 urology match are ever exposed. Additionally, participants must accept a contract without the opportunity to see the terms or negotiate. Unsurprisingly, an antitrust lawsuit against the match was succeeding before lobbying efforts resulted in an antitrust exemption being tucked into a 2004 bill on pensions. As they complete training, physicians face a different challenge—entering a wide-open job market and negotiating on their own behalf. This month, four ophthal- mologists in different settings discuss what they like about their practice environment and how they got there. Next month, we'll address the interview process. Start networking early because you never know where your job will come from. I first met David Chang, MD, when I picked him up at the airport as a third-year resident. Four years later, he offered me my current job. Job setting, location, and personal- ity fit all matter, but the best advice I've received came from Basil Morgan, MD: Figure out what you want to do when you're 50. Choose the lifestyle you want first, then figure out what specialty gives you that lifestyle instead of picking the specialty and trying to fit your lifestyle around it. You'll be happier and more fulfilled that way. Bryan Lee, MD, YES Connect co-editor continued on page 22 YES Connect practices with a strong research portfolio and those focused solely on patient care. Each comes with its own pros and cons. There are also many different ways to find a position: through mentors, connections, online, and ophthalmology headhunters. Here, four ophthalmologists share how they got to where they are today and provide their insights for young ophthalmologists starting their job search. Private practice When Elizabeth Yeu, MD, Norfolk, Virginia, received an offer from Douglas Koch, MD, Houston, to remain on the faculty at Baylor College of Medicine and the Cullen Eye Institute after her fellowship, she didn't even blink an eye before saying yes. Six years later with two young children and in consideration of her husband's career as a general surgeon, Dr. Yeu and her husband decided to at least be open to the opportunity for other positions that might take them to the mid-Atlantic region where they had family. "It was a tough decision to make but a mutual one where we decided if an opportunity were to arise where [my husband] could be [employed by a hospital] and there was a private practice, we would look into it," Dr. Yeu said. By chance, Dr. Yeu learned of an opportunity at Virginia Eye Con- sultants, Norfolk, Virginia, from a friend. "My role now is very different. What I was surprised most about was the clinical research I do now is easily five times more than I did be- fore," she said, noting that some of the red tape in an academic setting can, at times, limit research. "I could not have asked for a better opportu- nity than to have been where I was, and now that I'm closer to family, I'm so thankful for where I am." Dr. Yeu said there are resourc- es provided by organizations like ASCRS•ASOA to make the job hunt more informed, but she added that seeking out an ophthalmology head- hunter can be helpful. "They're knowledgeable about all the different kinds of practices and what might suit your personali- ty and your goals," Dr. Yeu said.

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