by: august 8, 2008 young ophthalmologists study #7658

By:

August 8, 2008

Young Young Ophthalmologists Ophthalmologists

StudyStudy

#7658

22

Background

• The American Academy of Ophthalmology is interested in identifying the reasons why young ophthalmologists leave their first job.

Purpose

• By understanding why young ophthalmologists change jobs, the AAO can offer resources for both young ophthalmologists and hiring practices to minimize the amount of time and money lost due to turnover.

Background InformationBackground Information

33

Research Method

• This study was conducted via the Internet.

• An invitation was sent by e-mail to young AAO members asking them to participate.

• Bruno and Ridgway provided survey links to the AAO. The AAO sent the survey invitations and reminders.

Sample

• E-mail invitations were sent to 1,959 AAO members in practice less than 5 years.

• 192 members completed the survey.

• Completion rate was 10%.

Background Information Background Information ~ (~ (continued)continued)

44

Timing

• First invitations were sent on June 20, 2008.

• One reminder e-mail was sent.

• The study closed on July 18, 2008.

Terminology

• Throughout this report, doctors who remain in their first full-time position are referred to as “job retainers” and those who have held two or more positions are referred to as “job switchers.”

Background Information Background Information ~ (~ (continued)continued)

55

Sample DemographicsSample DemographicsFirst Position

Total Retain Switch

(A) (B)

% % %

Primary Practice Focus

Subspecialty ophthalmology (91% or more time in subspecialty) 34 35 31

General ophthalmology/ comprehensive (100% of time) 32 32 31

General ophthalmology with subspecialty (less than 50% time in subspecialty) 20 20 21

Subspecialty ophthalmology (50%-90% time in subspecialty) 14 13 17

Number of Years in Practice

Less than 1 year 19 23B 5

1 year 11 14B -

2-3 years 39 41 31

4-5 years 29 21 57A

6 or more years 2 1 7

Gender

Male 69 71 64

Female 31 29 36

Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42).Q.1/5/8 = Please select which statement below best describes your (personal primary practice focus, years in practice, and gender). (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

66

Sample DemographicsSample Demographics~ (continued)~ (continued)

Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42).Q.2/6/7 = Please select which statement below best describes your (age, number of years in current position, fellowship completed). (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

First Position

Total Retain Switch

(A) (B)

% % %

Age

Under 31 years old 4 4 2

31-35 years old 56 60B 43

36-40 years old 31 29 38

41 years old or older 9 7 17a

Number of Years in Current Position

Less than 1 year 26 23 36a

1 year 15 14 19

2-3 years 42 41 45

4-5 years 17 21B -

6-7 years 1 1 -

Fellowship Completed

Yes 65 65 64

No 35 35 36

77

Sample DemographicsSample Demographics~ (continued)~ (continued)

Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42).Q.9 = Which subspecialty below is your primary subspecialty? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

First Position

Total Retain Switch

(A) (B)

% % %

Primary Subspecialty

Have a Subspecialty 68 68 69

Retina/vitreous 19 20 14

Cornea and external disease 15 15 14

Glaucoma 14 12 19

Oculoplastics and Orbit 8 9 5

Pediatrics and Strabismus 5 5 5

Refractive surgery 4 3 7

Cataract/anterior segment 2 1 2

Neuro-ophthalmology 1 1b -

Uveitis 1 1b -

Miscellaneous subspecialty 1 - 2

88

Key FindingsKey Findings

99

Job Retention and Satisfaction Levels for Young Ophthalmologists

As a group, young ophthalmologists are reasonably satisfied with their

first full-time position.

• Nearly four out of five (78%) ophthalmologists in their first five

years of practice remain with their first full-time position. About

one in five (22%) have held more than one position.

• A majority of young ophthalmologists are satisfied with their first

full-time position, with six in ten (62%) saying they are/were

extremely or very satisfied. As might be expected, job switchers

were much less satisfied with their first position, with only 12%

saying they were extremely/very satisfied.

Key FindingsKey Findings

1010

Important Practice Characteristics When Seeking First Position

Practice aspects rated most important to young ophthalmologists when seeking their first full time position include:

• Opportunities for advancement or partnership

• Location of practice

• Type of practice (private, academic, healthcare)

• Ultimate income potential

• Impression of future colleagues

• Reputation of practice

• Opportunity to practice their subspecialty

Most doctors were relatively satisfied with their first practice’s type and location, its reputation and opportunities to practice their subspecialty.

Key Findings Key Findings – (continued)– (continued)

1111

Key Issues in Job Retention/Satisfaction for Young Ophthalmologists

This study identifies four key issues in job retention/satisfaction among young ophthalmologists:

#1 Opportunities for Advancement or Partnership/Income Potential

While important to Young Ophthalmologists, switchers expressed a lack of satisfaction with their true opportunity to advance, and/or earn appropriate income in their first position:

• Both opportunities for advancement/partnership, and the related issue of ultimate income potential were rated important when seeking a first full-time position.

• Job switchers were much less satisfied with these aspects of their first job experience compared to job retainers, and were less satisfied with their starting income level.


1212

#1 Opportunities for Advancement or Partnership/Income Potential(continued)

• The possibility of partnership was offered to significantly more job retainers than switchers. Further, nearly half of switchers offered the possibility of partnership say they were not made fully aware of the conditions.

• Poor pay and a lack of business were frequently given as reasons for switching jobs.

• Another frequently mentioned reason for switching jobs was inequitable work sharing, which a number of switchers explained as seeing fewer patients because of their status in the practice, or being expected to find their own patients/build their own practice.

• Growth/partnership issues were mentioned by both retainers and switchers when asked about advice they would give to a new ophthalmologist.


1313

#2 Location of Practice

Practice location was also deemed important by Young Ophthalmologists, and was a reason for job switching:

• The importance of practice location was rated second highest among factors considered when seeking a first full-time position.

• One of eight doctors mention the importance of practice location when giving advice for a new doctor.

• Switchers report dissatisfaction with location (by doctor or family) as a reason for leaving first job.

• Nearly half of switchers report their first position’s location as a large metropolitan area. Significantly more job retainers practice in a mid-size city.

• Significantly more job retainers mention location as a reason for wanting to stay in their first job for specified time.


1414

#3 Relationships with Other Doctors/Staff

The issue of relationships seemed to play out in several ways:

• A doctor’s impression of his/her future colleagues was rated highly among issues considered when seeking a first full-time position.

• Job switchers were much less satisfied than retainers with their impression of future colleagues.

• Three in ten job switchers identify relationships with other doctors as a reason for leaving their first job. Relationships with non-MD staff also contributed to job switching.

• Volunteered advice for new doctors included comments which may indicate trust issues – including advice related to practice culture/ethics/trust and the need to get job details upfront/in writing/reviewed by attorney.


1515

#4 Work/Life Balance Issues

While time off and being “on call” were considered very important by less than half of doctors when looking for their first full-time job, work/life balance issues do seem to have a role in job retention among young ophthalmologists:

• Job switchers were much less satisfied than retainers for the amount of time off they received, and for frequency of being on call.

• Job switchers report being on call more frequently than job retainers, both during the week, and on weekends.

• While most doctors – both switchers and retainers – indicate they had enough time off at their first full-time position, job retainers were allowed more days off in their first year, had more days for CME, and indicated actually taking more days off during their first year than doctors who had switched jobs.

• One in six job switchers report work/life balance as a reason for leaving their first position.


1616

Young Ophthalmologists and the AAOE

• Most young ophthalmologists (95%) are aware of the AAOE, though

less than one in ten say they fully understand its role.

• One in ten young ophthalmologists report membership in the AAOE.

More than one in five are unsure if they are members.


1717

Detailed FindingsDetailed Findings

1818

Number of Positions Held Since Residency/Fellowship Number of Positions Held Since Residency/Fellowship TrainingTraining

Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42).Q.3 = Are you currently in your first full-time position after residency/fellowship training?Q.4 = You indicated that you held multiple position since residency/fellowship training. How many positions have you held?(A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

First Position

Total Retain Switch

(A) (B)

% % %

In first full-time position 78 100B -

Two positions 18 - 81A

Three positions 3 - 14A

Four or more positions 1 - 5a

Mean Number 1.3 1.0 2.2

• Nearly four out of five (78%) young ophthalmologists remain in their first full-time position after completing their training. A few (4%) have held three or more positions.

1919

Overall Satisfaction With First Full-Time PositionOverall Satisfaction With First Full-Time Position

Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42).Q.13 = Overall, how satisfied were you with your first full-time position?(A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

First Position

Total Retain Switch

(A) (B)

% % %

Extremely/Very Satisfied 62 75B 12

Extremely satisfied 21 26B 2

Very satisfied 41 49B 10

Somewhat satisfied 23 17 45A

Somewhat/Very Dissatisfied 16 8 43A

Somewhat dissatisfied 9 6 21A

Very dissatisfied 6 2 21A

• A majority of young ophthalmologists are happy with their first full-time position, with six in ten (62%) saying they are/were extremely or very satisfied there. Overall, job switchers were much less satisfied with their first position.

2020

Practice aspects rated most important to young ophthalmologists when seeking their first full-time position include:

• Opportunities for advancement or partnership

• Location of practice or institution

• Type of practice (private, academic, healthcare)

• Ultimate income potential (e.g., as a partner)

• Impression of future colleagues based on interview

• Reputation of practice or institution

• Opportunity to practice their subspecialty

Importance of and Satisfaction With Factors Related to Importance of and Satisfaction With Factors Related to First Full-Time Position First Full-Time Position

2121

• Among these important aspects, most doctors were relatively satisfied with

the type and location of their first practice, its reputation, and of their

opportunities to practice their subspecialty there.

• Job switchers were much less satisfied with its opportunities for

advancement or partnership, their impression of future colleagues, ultimate

income potential, and the reputation of the practice.

• Though these issues are of lesser importance, job switchers were also much

less satisfied with the breadth of training available, the amount of time off,

their frequency of being on call, and the starting income level in their first

practice.

Importance of and Satisfaction With Factors Related to Importance of and Satisfaction With Factors Related to First Full-Time Position – First Full-Time Position – (continued)(continued)

2222

Factors Related to First Full-Time Factors Related to First Full-Time Position-Quadrant AnalysisPosition-Quadrant Analysis(Total Ophthalmologists = 192)(Total Ophthalmologists = 192)

Opportunity to work part time in next 10 years

Employment opportunities for spouse

Frequency of being on call

Amount of annual time off

Size of the community

Starting income level

Breadth of exper./train avail.

Access to cult./leis. time activities

Opp. to practice subspecialty

Reputation of practice

Impression of future colleagues

Ultimate income potential

Type of practice

Location of practice

Opp. for advance. or partner

30%

40%

50%

60%

70%

80%

90%

10% 20% 30% 40% 50% 60% 70% 80% 90%

% Extremely/Very Important

% E

xtre

me

ly/V

ery

Sa

tisfie

d

Important and More Satisfied

Important and Less Satisfied

2323

Factors Related to First Full-Time Factors Related to First Full-Time Position-Quadrant Analysis Position-Quadrant Analysis (First Job Retainers = 150)(First Job Retainers = 150)







Breadth of exper./train. avail.






Type of practice


Opp. for advance. or partner.

30%

40%

50%

60%

70%

80%

90%

10% 20% 30% 40% 50% 60% 70% 80% 90%


% E

xtre

mel

y/V

ery

Sat

isfie

d



2424







Breadth of exper./train. avail.






Type of practice


Opp. for advance. or partner.20%

30%

40%

50%

60%

70%

80%

10% 20% 30% 40% 50% 60% 70% 80% 90%


% E

xtre

me

ly/V

ery

Sa

tisfie

d



Factors Related to Full-Time Factors Related to Full-Time Position - Quadrant AnalysisPosition - Quadrant Analysis(Job Switchers = 42)(Job Switchers = 42)

2525

Reasons for Leaving First Full-Time PositionReasons for Leaving First Full-Time Position

17%

17%

17%

21%

24%

26%

31%

31%

52%

0% 20% 40% 60% 80% 100%

Work-life balance was not as expected

My partner/family was not happy with position location

I was not happy with position location

Could not agree on a partnership agreement

Not enough business in practice or institution

Work not shared equitably in practice or institution

Poor relations with other doctors

Poor pay

Found a better position in another location

Base = Job Switchers (42).

Q.16 = You indicated that you left your first full-time position. Please indicate which factors below were the reason or reasons that you left.

• Poor pay, poor relationships with other doctors, inequitable work sharing, and a lack of business are the specific reasons indicated most frequently for leaving a first position.

2626

Reasons for Leaving First Full-Time PositionReasons for Leaving First Full-Time Position(continued)(continued)

29%

5%

5%

7%

10%

10%

12%

12%

17%

0% 20% 40% 60% 80% 100%

Miscellaneous reasons

Terminated for other reason

Terminated for perceived poor performance

Not offered partnership

Personal issues

Cost of living in position location exceededexpectations

Violations of hiring agreement by practice or institution

Poor relations with staff (all other non-MD personnel)

Left for personal/family reasons not already mentioned

Base = Job Switchers (42).

Q.16 = You indicated that you left your first full-time position. Please indicate which factors below were the reason or reasons that you left

2727

Partnership or Shareholder Offering and Full Partnership or Shareholder Offering and Full Awareness of Conditions to Achieve Partnership in Awareness of Conditions to Achieve Partnership in First Full-Time PositionFirst Full-Time Position

Base = In Private Practice in First Full-time Position and Not Solo Practice (138), Job Retainers (106), Job Switchers (32).Q.17 = Was partnership (shareholder) offered as a possibility in your first full time position?Q.18 = Were you made fully aware of the conditions required to achieve partnership (shareholder) when you were hired into your first full-time position? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

First Position

Total Retain Switch

(A) (B)

% % %

Yes, offered partnership/shareholder as possibility 88 93B 72

Yes, made fully aware of conditions 55 64B 25

No, not made fully aware of conditions 33 28 47A

No, was not offered partnership/shareholder as possibility 12 8 28A

• The possibility of a partnership was offered to significantly more job retainers than switchers. Further, nearly half of switchers offered partnership say they were not made fully aware of the conditions of partnership.

2828

Whether Practice Would Pay to Attend Conferences and, Whether Practice Would Pay to Attend Conferences and, if so, Amount of Reimbursement in First Full-Time if so, Amount of Reimbursement in First Full-Time PositionPosition

Base = Total Ophthalmologists Not in Solo Practice (184), Job Retainers (142), Job Switchers (42).Q.19 = Did your practice/institution in your first full-time position pay to attend conferences, such as the American Academy of Ophthalmology Annual

Meeting?Q.20 =How much were you reimbursed?(A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

First Position

Total Retain Switch

(A) (B)

% % %

Yes, Reimbursed 74 73 76

100% 61 60 64

50% 8 8 7

Miscellaneous amount 5 6 5

No, not reimbursed 26 27 24

• About three-quarters of Young Ophthalmologists report that their first employer reimbursed them for attending conferences, such as the AAO annual meeting. Most were reimbursed 100%.

2929

Whether Respondent Had Enough Personal Time Off in Whether Respondent Had Enough Personal Time Off in First Full-Time PositionFirst Full-Time Position

Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42).Q.21 = Did you feel you had enough personal time off in your first full-time position? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

First Position

Total Retain No

(A) (B)

% % %

Yes, had enough personal time off 82 84 76

No, did not have enough personal time off 18 16 24

• Four out of five ophthalmologists indicate they had enough personal time off at their first full-time position. There is no significant difference among job switchers and job retainers.

3030

Number of Days Allowed to Take Off in First Year of Number of Days Allowed to Take Off in First Year of Full-Time PositionFull-Time Position

Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42).Q.22 = How many days contractually (personal, vacation, sick, holiday) per year could you have taken off in the first year of your first full-time position? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

First Position

Total Retain Switch

(A) (B)

% % %

10-14 days 8 6 17A

15-19 days 17 17 14

20-24 days 34 35 31

25-29 days 11 12 7

30 or more days 8 9 5

No limit 10 10 12

Not specified for position 12 11 14

Mean number of days 20.4 20.8b 19.1

• On average, doctors were allowed about 20 days off in their first year of employment. Job switchers averaged slightly fewer days.

3131

Number of Days Allowed For Continuing Medical Number of Days Allowed For Continuing Medical Education in First Year of Full-Time PositionEducation in First Year of Full-Time Position

Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42).Q.23 =How many days contractually could you have taken off for continuing medical education in the first year of your first full-time position? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

First Position

Total Retain Switch

(A) (B)

% % %

None 6 5 10

1-5 days 28 28 29

6-9 days 14 13 17

10-14 days 7 7 5

15 or more days8

9 5

No limit 18 19 12

Mean number 7.6 8.0B 6.0

Not specified for position 19 18 24

• Doctors whose contracts allowed a specific number of days off for CME in their first year report an average of 7.6 CME days. Job retainers report significantly more CME days (8) than job switchers (6).

3232

Number of Days Actually Taken Off During First Year of Number of Days Actually Taken Off During First Year of Full-Time PositionFull-Time Position

Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42).Q.24 = How many days did you actually take off that first year? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

First Position

Total Retain Switch

(A) (B)

% % %

None 1 - 2

1-4 days 2 3B -

5-9 days 12 9 21A

10-14 days 20 17 29a

15-19 days 28 30 21

20-24 days 25 27b 17

25-29 days 8 9 5

30 or more days 5 5 5


• Job retainers indicate taking more days off (16.9) during their first year than their colleagues who had switched jobs (14.3).

3333

Whether Given a Written List of Work Performance Whether Given a Written List of Work Performance Expectations When Starting First Full-Time PositionExpectations When Starting First Full-Time Position

Base = Total Ophthalmologists Not in Solo Practice (184), Job Retainers (142), Job Switchers (42).Q.25 = Were you given a written list of work performance expectations when you started your first full-time position? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

First Position

Total Retain Switch

(A) (B)

% % %

No, not given a list 76 75 79

Yes, given a list 24 25 21

• Three out of four young ophthalmologists do not recall being given a list of performance expectations when starting their first position. Statistically, there was no difference between job switchers and job retainers.

3434

Frequency With Which Work Performance Formally Frequency With Which Work Performance Formally Evaluated in First Full-Time PositionEvaluated in First Full-Time Position

Base = Total Ophthalmologists Not in Solo Practice (184), Job Retainers (142), Job Switchers (42).Q.26 = How often was your work performance formally evaluated in your first full-time position? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

First Position

Total Yes Switch

(A) (B)

% % %

Received No Regular Performance Reviews (Net) 68 69 64

I received only informal feedback on my performance 55 59B 41

My work performance was not evaluated in any way 10 9 17a

Miscellaneous no regular review comments 3 1 7a

Received Regular Performance Reviews (Net) 32 31 36

I received an annual formal performance review 15 16 12

I received a semi-annual formal performance review 11 11 14

I received performance reviews that were quarterly or more frequently 6 5 10

• About two-thirds of doctors not in solo practice indicate they received no regular formal performance reviews in their first position. Job retainers were more likely to receive informal performance feed-back, while job switchers more frequently report that their performance was not evaluated in any way.

3535

Frequency of Being on Call During Monday to Friday Work Frequency of Being on Call During Monday to Friday Work Week in First Full-Time PositionWeek in First Full-Time Position

Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42).Q.27 = In your first full-time position, how often were you on call during the Monday to Friday work week? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

First Position

Total Retain Switch

(A) (B)

% % %

One Day Every...

1-2 days 21 22 17

3-4 days 21 21 21

5-6 days 22 22 24

7 days or more 28 29 24

Not on call 8 7 14a

Mean number 6.3 6.6b 5.1

• In their first job, young ophthalmologists report being on call one of every 6 days during a regular workweek. Job switchers indicate being on call more frequently (every 5 days) in their first position.

3636

Frequency of Having Weekend Call in First Full-Time Frequency of Having Weekend Call in First Full-Time PositionPosition

Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42).Q.28 = In your first full-time position, how often did you have weekend call? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

First Position

Total Yes Switch

(A) (B)

% % %

One Weekend Every...

1-2 weeks 19 17 24

3-4 weeks 24 25 24

5-6 weeks 24 23 29

7-10 weeks 13 13 12

11 or more weeks 14 17B 2

Not on call 5 5 7


• Overall, job switchers report having weekend call more frequently (on average, every 4.6 weekends) compared to job retainers (who average every 6.2 weekends).

3737

Whether Physician Workload Was Shared Equally in First Whether Physician Workload Was Shared Equally in First Full-Time PositionFull-Time Position

Base = Total Ophthalmologists Not in Solo Practice (184), Job Retainers (142), Job Switchers (42).Q.30a/b =In your first full-time position, did you feel that the physician workload was shared equally? Why do you say that? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

First Position

Total Retain Switch

(A) (B)

% % %

Yes, shared equally 62 67B 45

No, not shared equally 38 33 55B

Reasons Not Shared Equally:

See Fewer Patients (Net) 25 20 38A

Controlled by seniority/partner sees more/I see fewer 8 8 7

Surgical patients/partners had more OR time 4 2 10a

New patients/walk-ins referrals given to other doctors 1 - 5a

Building own practice/expected to find own patients 6 4 14A

See More Patients (Net) 8 9 7

Emergency/walk-ins/hospital patients 3 2 5

• Two-thirds of job retainers feel that the workload was shared equally, while more than half of job switchers believe it was not shared equitably. Job switchers were more likely to say they saw fewer patients, especially surgical patients and new patients, or that they were expected to find their own patients.

3838

Number of Patients Seen per Day on Average in First Number of Patients Seen per Day on Average in First Full-Time PositionFull-Time Position

Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42).Q.29 = In your first full-time position, how many patients on average were you seeing in a day? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

First Position

Total Retain Switch

(A) (B)

% % %

Less than 10 per day 7 5 14A

10-20 30 31 26

21-30 34 35 31

31-40 23 23 24

More than 40 per day 6 7 5

Mean patients per day 25 25 23

• On average, young ophthalmologists see about 25 patients per day.

3939

Whether Respondent Knew Ahead of Time Length of Time Whether Respondent Knew Ahead of Time Length of Time Would Stay at First Full-Time PositionWould Stay at First Full-Time Position

Base = Total Ophthalmologists (192), Job Retainers (50), Job Switchers (42).Q.31a/b =Did you know ahead of time that you wanted to stay in your first full-time position for a specified time? Why do you say that? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

First Position

Total Retain Switch

(A) (B)

% % %

Yes, knew ahead of time 39 43B 21

Long-Term Potential (Net) 21 26B 5

Permanent/life-long/indefinite commitment 8 10B -

Location of practice/not move/live here permanently 6 7b 2

Great practice/like people/partner/staff 5 5 2

Career building/potential/partnership opportunity 4 5B -

Short-Term Potential (Net) 9 7 14

Don’t like location/community 2 1 7a

Plan to stay two years/two years tops 2 1 5

No, did not know a head of time 62 57 79A

• Significantly more job retainers say they wanted to stay in their first position for a specified time. They more frequently mention an intention to stay in the practice or its location for life/indefinitely, and the partnership/career potential there.

4040

Overall Satisfaction With Mix of Patient Cases in First Overall Satisfaction With Mix of Patient Cases in First Full-Time PositionFull-Time Position

Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42).Q.32 = How satisfied were you with your mix of patient cases in your first full-time position? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

First Position

Total Retain Switch

(A) (B)

% % %

Extremely/Very Satisfied 68 71B 57

Extremely satisfied 22 23 19

Very satisfied 46 48 38

Somewhat satisfied 21 19 29a

Somewhat/Very Dissatisfied 11 10 14

Somewhat dissatisfied 6 5 10

Very dissatisfied 5 5 5

• More than two-thirds of young ophthalmologists indicate being extremely or very satisfied with the mix of patient cases in their first job. Job switchers were less satisfied with its patient case mix.

4141

Where Information Was Obtained When Looking for First Where Information Was Obtained When Looking for First Full-Time PositionFull-Time Position

Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42).Q.33 = When you were looking for your first full-time position, where did you get information? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

First Position

Total Retain Switch

(A) (B)

% % %

Physicians known through residency/fellowship program 63 69B 41

AAO 60 60 60

Friends or other trainees 40 43B 29

Recruiters 31 33 26

Other residents/fellows 20 21 19

Online resources 18 21B 10

Family members who are doctors 18 18 17

Miscellaneous source 17 15 24

• When looking for their first full-time position, young ophthalmologists most frequently sought information from physicians known through their residency program, AAO, and friends. Job retainers more frequently consulted physicians known through their residency, friends, and online resources.

4242

Practice Setting in First Full-Time PositionPractice Setting in First Full-Time Position

Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42).Q.10b = In what type of setting was your first full-time position?(A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

First Position

Total Retain Switch

(A) (B)

% % %

Private practice/partnership 76 76 76

Academic 17 17 14

HMO 4 3 5

Miscellaneous setting 4 3 5

• Three out of four young ophthalmologists report that their first full-time position was with a private practice or partnership.

4343

Type of Area for First Full-Time PositionType of Area for First Full-Time Position

Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42).Q.11 = In what type of setting was your first full-time position?(A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

First Position

Total Retain Switch

(A) (B)

% % %

Large metropolitan area 38 35 48a

Mid size city 29 32B 17

Small city 17 17 17

Suburbs 13 13 14

Rural 3 3 5

• Nearly half of job switchers report that their first position was in a large metropolitan area. Significantly more job retainers practice in a mid-size city.

4444

Number of Ophthalmologists in First Full-Number of Ophthalmologists in First Full-Time PositionTime Position

Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42).Q.12 = How many ophthalmologists did your first full-time practice/institution employ, including yourself? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

First Position

Total Retain Switch

(A) (B)

% % %

Started/bought a solo practice 4 5B -

2 to 3 36 33 45a

4 to 5 21 21 21

6 to 10 17 19B 7

11 to 16 9 8 12

17 to 25 7 8B 2

26 or more 7 5 12

• A majority of young ophthalmologists (61%) began their careers in a practice with 1-5 ophthalmologists. Job switchers worked in various sized practices.

4545

Overall Satisfaction With Existing SalaryOverall Satisfaction With Existing Salary

Base = Job Switchers (42).Q.34b = Overall, how satisfied are you with your existing salary? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

Somewhat satisfied

33%

Somewhat/Very Dissatisfied

2%Very Satisfied46%

Extremely satisfied19%

• About two-thirds of job switchers say they are very or extremely satisfied with their existing salary.

Note: Very satisfied actually 45% due to rounding.

4646

Average Number of Patients Seen per DayAverage Number of Patients Seen per Day

Base = Job Switchers (42).Q.29 = In your first full-time position, how many patients on average were you seeing in a day?Q.35 = How many patients on average are you currently seeing per day? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

21-3031%

20 or Less40%

31 or more29%

21-3045%

20 or Less22%

31 or more33%

First Position Current Position

Mean = 23 Mean = 26

• Job switchers report that they are now seeing, on average, about three more patients per day compared to their first position.

Note: 20 or less actually 21% due to rounding.

4747

Satisfaction With Academy Efforts to Meet NeedsSatisfaction With Academy Efforts to Meet Needs

Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42).Q.36 = Now, just a few final questions. How satisfied are you with Academy efforts to meet your unique needs as a Young Ophthalmologist? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

First Position

Total Retain Switch

(A) (B)

% % %

Extremely/Very Satisfied 53 55 45

Extremely satisfied 6 7 5

Very satisfied 46 48 41

Somewhat satisfied 41 40 45

Somewhat/Very Dissatisfied 6 5 10

Somewhat dissatisfied 5 5 7

Very dissatisfied 1 1 2

• More than half of young ophthalmologists (53%) say they are extremely or very satisfied with the Academy’s efforts to meet their unique needs. Only 6% indicate that they are dissatisfied.

4848

Awareness of American Academy of Ophthalmic Awareness of American Academy of Ophthalmic ExecutivesExecutives

Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42).Q.37 = Are you aware of the American Academy of Ophthalmic Executives (AAOE) and do you understand its role? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

First Position

Total Retain Switch

(A) (B)

% % %

I am aware and fully understand the AAOE’s role 9 8 14

I am aware of the AAOE and have a partial understanding of the AAOE’s role 63 62 64

I am aware of the AAOE, but do not understand its role 23 25 17

I am not aware of the AAOE 5 5 5

• While most young ophthalmologists (95%) are aware of the AAOE, less than one in ten say they fully understand its role. Over seven of ten indicate partial or full understanding of its role.

4949

Whether Respondent is a Member of the American Whether Respondent is a Member of the American Academy of Ophthalmic ExecutivesAcademy of Ophthalmic Executives

Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42).Q.38 = Are you a member of the American Academy of Ophthalmic Executives (AAOE)? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

First Position

Total Retain Switch

(A) (B)

% % %

Retain, member of the AAOE 10 11 10

No, not member of the AAOE 68 66 74

Not sure 22 23 17

• One in ten young ophthalmologists report membership in the AAOE. More than one in five are unsure if they are members.

5050

• Much of the advice offered for new ophthalmologists

centered on job seeking issues, such as the

culture/ethics/associates in a potential practice, practice

location, contractual details and review, and

growth/partnership issues. Job switchers more frequently

mention networking with other ophthalmologists, and

understanding expectations.

• Other advice included the values of flexibility/open-

mindedness, working hard, setting limits, being realistic

and patient, and continuing to learn.

Volunteered Advice for New Ophthalmologist Starting Volunteered Advice for New Ophthalmologist Starting First JobFirst Job

5151

Volunteered Advice Would Give to a New Volunteered Advice Would Give to a New Ophthalmologist Starting First JobOphthalmologist Starting First Job

Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42).Q.39 = What advice would you provide to a new ophthalmologist starting their first job? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

First Position

Total Retain Switch

(A) (B)

% % %

Job Seeking (Net) 60 57 69a

Practice Characteristics (subnet) 42 39 52a

Be aware of practice culture/ethnics/associates 14 12 19

Practice location/where you want to live 13 12 17

Evaluate contract/get details/in writing/attorney review 13 12 17

Growth potential/consider partnership issues 8 9 5

Network with ophthalmologists/talk to peers 12 8 24A

Search early/carefully/best not advertised 9 9 7

Know your priorities/find practice that fits 7 8B 2

Know what is expected of you 4 2 10a

5252

Volunteered Advice Would Give to a New Volunteered Advice Would Give to a New Ophthalmologist Starting First Job Ophthalmologist Starting First Job – (continued)– (continued)

Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42).Q.39 = What advice would you provide to a new ophthalmologist starting their first job? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

First Position

Total Retain Switch

(A) (B)

% % %

Personal Values/Characteristics (Net)35

3631

Be open-minded/flexible/open to change jobs 10 9 14

Work ethic/work hard 8 7 12

Be assertive/set limits/don’t be taken advantage of 8 7 10

Be realistic 6 5 10

Be patient/build practice/experience slowly 6 7B -

Keep learning/about practice/keep educating self 9 10 5

by: august 8, 2008 young ophthalmologists study #7658

Documents

years old

number of years

job retainers

job switchers

position totalretainswitch

confidence level

primary subspecialty

continued slide