I just graduated from optometry school…now what?

Unless optometry students are very fortunate or extremely organized, they will be faced with major life and career decisions right before or immediately after graduating. This is where being a planner or being very proactive can be extremely beneficial.

Where to practice
If students already know that they want to live in a specific state after graduation or-even better-a specific town, start looking for opportunities while still in school.

While I was in optometry school, I took several trips back to my home state of North Carolina to meet with ODs who might want to bring in an associate or potentially sell their practice.

Each state’s optometric association can be a valuable resource for potential or new graduates. Contact the association to learn about classifieds that ODs have posted. This will give you points of contact and potential leads to follow.

Previously by Dr. Sikes: Educate, don't sell to patients

The state(s) where new grads want to get licensed should be the first target. Some states require only that ODs pass the National Boards, while others have a separate law test or specific oral, written, or procedural state boards with which to contend. Know the licensing requirements for the states in which you want to practice.

Another recommendation includes becoming licensed in a few states-especially if new grads are not 100 percent set on where they want to live and/or practice. It can sometimes be much easier to get licensed right out of school when everything is still fresh on your mind from boards.

For the states in which new ODs want to practice, research their scopes of practice as well. Desire to practice full-scope optometry, including lasers and minor surgical procedures, means crossing some states off the list. All ODs hope that future grads will have more state choices because optometry scope expansion is growing across the United States.

Related: What happened in Oklahoma: Expanding scope of practice and protecting what has been earned

Waiting for boards
Once new ODs have figured out where they want to practice, they should find something to do with themselves while waiting in limbo to take the individual state boards. For most ODs, this simply involves finding a practice (hopefully one where they intend to work later) in which the current ODs act as the attending doctor.

Once new grads have passed their state board(s), they are all set now, right?

Well, sort of.

Also by Dr. Sikes: Why my passion for pediatrics stays personal

Mode of practice
As I see it, several questions still need to be addressed:
• What mode of practice is preferred?
• Do new grads like the corporate or commercial side of optometry?

For example, new ODs should ask themselves if they would like to be able to make decisions for their offices and change things as they see fit to suit their practice styles. Or would they prefer to see patients without worrying about managing the office?

Speaking from personal experience, working in a corporate style of practice immediately out of optometry school was a good transition for me. It let me focus solely on the patients and not have to worry about running the business side of the practice.

Yet, it wasn’t what I wanted long term. I wanted to be able to make changes to my schedule, adjust office policies, and customize the way I practice. That is why private practice was ultimately my goal.

However, I found that jumping immediately into private practice proved to be more difficult than finding a corporate position. I wanted to find a private practice where I could buy into the practice and eventually buy out the current OD upon retirement. As you can imagine, those kinds of opportunities don’t come along very frequently-especially if you want to relocate to a specific area.

Because the bills don’t stop coming, this is another reason that having an opportunity to practice somewhere else is beneficial while waiting for the right opportunity to present itself.

Related: How to overcome barriers when buying or selling a practice

Details matter
When accepting an offer to work for anyone at any office, be deliberate and attentive to agreements or contracts that you sign.

Pay attention to the length of term for the contract and, even more importantly, to the covenant not to compete clause. If new ODs have intentions of private practice or even working at a different location within the next few years, then the covenant not to compete clause can make life difficult and even hinder future success.

I have not  seen it in any contracts that I have read, but ODs hear stories about a practice that has a five- or 10-mile radius for a covenant not to compete. That in and of itself doesn’t seem too bad, but reading more closely may illuminate other language that states the distance is from any office location or any office where the OD has practiced.

Such language could significantly increase the restricted area of practice, potentially even keeping the OD out of a city or even an entire county until the covenant expires, which is generally a year or more after the last day of employment.

Related: Optometry must change with the times

One very valuable piece of information that has been passed down to me through the years:  If someone says he is going to do something, then he should be able to produce it in writing. If he won’t produce it in writing, then he likely has no intention of honoring the verbal commitment in the first place.

If new grads find something in the proposed contract that doesn’t seem right or they don’t agree with it, then they should address it with the future employer/partner before proceeding. It is much easier to iron out misunderstandings before getting into a business relationship than after you are already in it.

In addition-and I can’t stress this enough-all ODs should get a lawyer whom they trust to read through all documents before signing them. As a side note, even with a lawyer reading through everything, ODs should read the documents even more intensely to make sure they sound correct.

Lawyers are extremely knowledgeable, but they may not know questions to ask or what to look for as it relates to optometry in general or a new OD’s specific situation.

Related: 5 reasons I went back to school as an OD

For example, a new grad may have verbally agreed to a specific salary or covenant not to compete clause, but it may be written differently in the contract. The lawyer would not necessarily know that it is different unless the new grad provided the lawyer with specifics to look for ahead of time. The lawyer may advise that the contract is valid even though it is not what the new grad agreed to in the negotiations. In short, you are your best advocate.

Gaining perspective
Clearly, there are many decisions to be made around the time of graduation. The best advice I can offer is to think about things from every angle and perspective. If a new OD is considering making one decision, try to think about the cascade of effects that may occur based on that one decision.

Don’t forget to ask for help. Even though new doctors may have tried to think of all the potential benefits and downfalls, they may have missed something. Always talk to a trusted classmate, mentor, or family member before making big decisions.

Finally, new grads must remember they are never stuck in one position. Some of the best parts of being a licensed optometrist is the ability to gain licensure in multiple states or to get a license in a new state if desired and to practice the way that they want.

Remember: Do what you love and love what you do.

Read more by Dr. Sikes