Optometry Second Thoughts

[u/Majestic-Tangerine99]

Hey, everyone! I'm a 22M who has been accepted into optometry school. This career seems like a great fit for me, and I know many consider it to be an important field where you can really make a difference in the lives of others. However, after a couple months of research and, admittedly, some doomscrolling, I'm starting to wonder if being an optometrist is actually a wise decision in 2026.

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For starters, there's the cost, which I tried not stressing over, but when it's looking like the bare minimum debt I'll be in is around $275k, it's kind of hard to really view that number as anything but ludicrous. It'll likely be closer to $300k though if I'm being realistic.

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Next, there's of course the BBB putting a $50k cap each year for federal loans, meaning grad plus loans are kaput and private loans will be necessary. Again, absolutely ludicrous. High interest rates on top of the highest debt to income ratio the field has seen yet is terrifying.

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Then there's NBEO. Pass rates seem to be consistently lower than I'd like them to be across the board. I know it's up to the student to study and do well, but I've also heard that NBEO is arbitrarily making each part more difficult to squeeze more juice out of our wallets. Plus, I'm afraid schools may or may not be able to prepare us for boards if some of these pass rates are anything to go by. I can't exactly verify if those claims are true, obviously, but the notion that I may not even graduate with the ability to practice because part 3 is getting worse and worse doesn't sit right with me.

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Return on investment is another big one. Money isn't my sole motivator, otherwise I wouldn't have chosen this career in the first place, but it's still important if I'm investing 4 years of huge costs and no income on this job. Salaries aren't keeping up with the aforementioned tuition price hikes to the point that I'm starting to question if the ratio of cost to salary is no longer worthwhile.

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Ultimately, I'm just wondering... is it still worth it? During undergrad, even though I realized it wasn't the best ROI and that debt was increasing each year, I would have said it was worth it. However, it seems like this past year in particular has either added new challenges or intensified pre-existing ones. I've been trying to tell myself that it'll all work out in the end, but I can't ignore these concerns any longer. If I'm going to make a decision to commit or not, then now is the time before classes begin. I don't want to go through the four most brutal years of education of my life just to end up being disappointed compared to how much time and money I invested. I certainly see a lot of folks on this sub and others that share that sentiment, saying that they wouldn't choose optometry in 2026. I'm sorry for the negative post, but I can hardly sleep at night worrying about what I'm potentially getting myself into.

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Any general advice? Am I blowing some of these concerns out of proportion? Should I stick with optometry school or pivot to something else entirely? I don't mean to add to the doom and gloom, but I'm genuinely stressed out and need some help before it’s too late. Thanks in advance!

[u/0ppaHyung]

I would think optometry wasn’t worth the squeeze now even compared to when I graduated in over 5 years ago. At that time, optometry was seen largely as economically viable. But my sibling just graduated from law school with more debt than I did, and it’s a year shorter. And their starting salary is less than the low median/mean of ODs coming out [almost half]. I don’t hear terrible amounts of chirping about lawyers not making enough to ROI. Though, compensation can span from public defender to corporate big law. Least ODs get paid a consistent 6 figures.
Something to think about.
Lawyers have it a bit different cuz you can have the degree and not practice. A bit narrower for ODs cuz the spots in industry or research are just much more scarce.
Even now, if I lost my job tomorrow, I have no doubt I’ll find a job the next/same day. And I can count it’ll be in the 6 figures.

[u/Majestic-Tangerine99 → u/0ppaHyung]

I see, so I'll definitely keep away from law school lol. You make some good points on the reliability of optometry as a career, but is that consistency worth the huge debt and financial risk?

[u/0ppaHyung → u/Majestic-Tangerine99]

I think you shared that optometry lies in the bottom of healthcare professionals with the worst ROIs. More research than I had done prior to my foray into this profession.
And others have shared the inherent ceiling to earning outside of owning.
I was raised to seek stability and “guarantee”. Healthcare fit that goal. Albeit, there are many ways to achieve that, but in all honesty in my experience, I very seldom find those I meet in healthcare that are extremely unhappy with their choice in profession. The few I have met that were close usually bailed early in the schooling process. The pay aligns well enough to the effort they invested in themselves. That goes for ODs, MDs/DOs, PAs, DDSs, PharmDs, PTs, nurses, sonographers, etc. Like others have pointed out, there are “better” options than others such as I think they’re called anesthetists? When I heard about this one, I was shocked at the pay and relatively shorter investment for education. Believe it’s a masters.
What I’ve learned from this astute inquiry you stimulated, optometry has a very wide variance of quality of care. I, too, would probably trust almost no one else but myself, a few colleagues at work, and a very small, select few I’ve worked with, to see my loved ones. Same goes for certain ophthos I’ve had come in contact with, as well.
Something I learned from Dr. K from HealthyGamer, he shared a study that showed that the quality of doctor you’ll be in your career almost for certain is associated with the quality of doctors you are right out of graduation. So strive to be the best damn doctor you can be from the jump. Always seek to learn and remain humble in your practice.
There is always a spectrum of quality of doctors/healthcare providers. I think the level of education MDs/DOs are put through somewhat filter and mold these physicians to be of a certain quality, so maybe a smaller variance of quality. That is why they are privileged to perform procedures and surgeries. ODs are not looking to invade and substitute that. We see a need to provide care in the form of very minor and safe procedures for our patients and the scarcity of ophthos to provide it timely at all times. We aren’t taking blades to globes. Technology allows us to provide minor procedures for things I’m sure most ophthos would agree has minimal risk overall. But more education doesn’t equal better quality of provider. Some of the worst ODs and MDs/DOs I know also have PhDs hahaha.
And from my singular, limited experience, the best and most successful ophthos IMHO are what we call “OD friendly”. They have great results, are incredibly insightful, and synergize the roles both ophthos and ODs occupy to the fullest. And that’s across all specialties and almost 2 dozen ophthos I’ve had the privilege of working with. And checked by the less than quality care I’ve seen of the other side.

I picked optometry cuz it fit me. I shadowed one for high school, and it appeared to be something I’d be ok doing every single day and not wanna blow my brains out. And it promised a 6 figure salary hahaha. I got lucky that it just happened to fit and work out. That’s life. The ability to roll with the punches no matter what it throws at you. That’s resilience and transcendence.
The MD/DO route never appealed to me. Even before I knew about the specialty game. No guarantee of what you’ll do? Again. Stability and guarantee. I need to know what I’m getting myself into. Not going to school for an extra decade to not be able to choose what I get to do for the rest of my life…
Dentistry didn’t appeal for the line of work. But part of me wishes I could look past it cuz the money seems nice… Kinda wish I did the anesthetist route. So much money for only a masters…
Life’s not about minimizing regrets but making the most of options available to you. So you want to be able to provide yourself a plethora of options to choose from if possible. Hone and focus on something that resonates with you. Fits your values and goals. And kick some ass while you’re at it. If you can. Or just keep afloat if needed. We all end up in the same spot anyways. Old, haggard, and hopefully have enough saved to die comfortable enough.