My first job - hospital vs community practice

Thinking about your career but not sure which path to take? We asked three newly qualified optometrists to tell us a little about where they work.

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Krupa Mistry MCOptom - hospital clinic

Krupa graduated from the University of Bradford in 2015 and is now working Monday to Friday (9-5) at University Hospitals Coventry and Warwickshire Trusts (UHCW). 

‘Try and get as much hospital experience as possible, maybe over the summer holidays, so you know what you’re getting yourself into. I think a Saturday job or a temporary summer job in private practice is also useful so you can compare the differences. UHCW views previous optical experience in any sector as extremely important.

‘I’m working full time at UHCW and the best word to describe the working environment is busy! The Optometry Department is within the Ophthalmology Department. It is a very large team and there is lots of interaction with all kinds of practitioners including consultants, nurses, orthoptists, junior doctors, medical photographers and healthcare assistants. I mainly do the core services - low vision, paediatrics (including a school screening service), contact lenses, general clinic (which include refractions and bandage contact lens patients) and keratoconic work ups.

‘I am currently training to work in Eye Casualty, which is very exciting. We see a range of different things coming through the doors! I am thinking of taking the IP (independent prescriber) qualification to help me during my work in Eye Casualty. The Trust supports optometrists in gaining their IP qualification by funding the course and giving study time.

‘The pay for hospital optometrists is lower than in private practice. But I think the clinical experience I’m getting is invaluable. Under the NHS pay structure, there is a pay rise each year for the first eight years, during which time the pay increases by £9000, and if I am fortunate enough to be promoted to a more senior role, that role has a higher pay structure again with similar pay increases for the first eight years.

‘I would definitely recommend working as a hospital optometrist – especially the clinical experience, as you see all kinds of weird and wonderful patients. Alongside the clinical experience, you get to work with other clinicians such as orthoptists, which is very useful when it comes to binocular vision (BV).  The best thing about it for me is being able to work with such a large team. You get to interact with all different departments and you are constantly learning.  It builds your confidence in seeing so called ‘tricky’ patients, although I guess you do lose your skills of routine sight testing if you solely work at the hospital.‘

Dan Varcoe MCOptom - community practice

Dan graduated from the University of Bradford in 2013 and works in Boots in St Austell, Cornwall

‘I’m currently working in a practice within a Boots shop, so I work with the optometrist team, as well as having pharmacists and people that work in healthcare and retail around too. I have a mix of patients, from young children, up to the elderly, some NHS and some private patients. I mainly see patients for sight tests, but I also see contact lens patients and some for our local enhanced services such as cataract operation discharge and GAT IOP referral refinement. I also like to get involved with a bit of dispensing when I get chance.

‘I always wanted to work in community practice and chose a multiple practice, because of opportunity to use up-to-date equipment, work other optometrists, and choose the days that are convenient for me. I also have a manager who appreciates the optometrist’s role and often involves us in the way we run the practice as a team. I really enjoy my job, and I think that if there are bad things about work places then they are specific to the individual practice rather than the type of practice.

‘I work four days most weeks, 8.45-5.30. I work alternate Saturdays and one Sunday in four. I sometimes work an extra day if my colleague is off, or if I want to work in another practice if they need cover. There are definitely options for career progression. I am currently helping to ensure that all of our practices in Cornwall are offering enhanced services and supporting the practice teams with this, and am just about to begin supervising a pre-registration optometrist. I am also studying independent prescribing at GCU.

‘I think I am paid a fair amount for a good days work, I see higher salaries offered with recruitment agents, but I enjoy working where I work.  It’s convenient and close to home, and I work with a great team of people. I get a staff discount, both on glasses and within the main shop as well. ‘

Gemma Hill MCOptom - independent community practice

Gemma graduated from Glasgow Caledonian University in 2015 and is now working in an independent opticians in Glasgow, called Forde Opticians.

‘I originally had my heart set on hospital optometry and received an offer for a pre-reg in England. I had also received an offer for a pre-reg in a multiple. I was struggling to decide between the two, when one of my lecturers told me he knew of an independent opticians looking for a pre-reg. He had a feeling that the job was for me and would provide me with the more clinical experience of optometry I was looking for.

He was spot on, it was exactly the type of practice I was looking for but hadn’t known about. It was my interview that really sealed the deal. I was interviewed by the two optometrists who would be my supervisors, one of whom was the owner of the company. I got an instant “good feeling” from both of them that I hadn’t from the other two options. Now I’m working here full time and I can’t see myself working anywhere else, not in the near future anyway.

‘Forde Opticians have a busy practice in Govan with three testing rooms, and a quieter practice in Linwood which has one testing room. I work 9-5.30pm weekdays and every other Saturday. Because of our locations we shut on Sundays and we don’t work any late shifts. I’m probably getting a lower salary than city centre Glasgow could offer, but I have a good bonus system that has been achievable. I also pick up extra days where it’s suited me, and that’s topped up my salary a bit too.

‘One of the disadvantages of working in an independent is the lack of perks and benefits that you could get from working for a bigger company; for example, health insurance or longer or better paid maternity leave. But benefits are often things you can’t quantify. I feel I have a better work/life balance as my hours are so good. I definitely don’t get the Monday blues. When you work with your boss, you feel like you’re listened to when it comes to clinical input, equipment and frame choices. The best part of our particular set-up is that the boss is an optometrist which, after working at different practices before even becoming an optometrist myself, is something I know I much prefer.

‘The patients in both practices are very interesting. They are typical salt-of-the-earth Glaswegians, so friendly and definitely easy to manage and get along with. I have only worked here for two years but I already have patients who I really look forward to seeing. Many patients present with quite advanced pathologies. You can often be dealing with people who don’t necessarily understand, or believe, that things like poor diet, smoking and drinking can have a detrimental effect on their eyes and their health in general. There are also patients who are from more affluent areas that keep coming back because the practice and the staff have been there for so long, so they stay loyal.

‘There isn’t really a clear career pathway within the organisation. If I want to run my own opticians one day I will have to make that leap by myself, and I can’t see that at the moment. However, I definitely do have the flexibility and support to start IP, which I have signed up for next year. After that, I hope to achieve further professional certificates where and whenever possible. Although I can’t see myself running a whole company on my own, I would love to be the senior optometrist in just one practice where I could carve out links with the local schools, pharmacy and GPs surgeries and deliver proper community optometry.

‘The best thing about working in an independent practice is the mutual support between you and your practice owner. They truly want you to do well and be happy and in turn you want the company to do well. The worst is the lack of benefits that you might get from working for a larger company. On the whole, I would more than recommend independent practice.’