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Clinical Skills: What Owners Expect From a New Grad OD

Practice owners plan for the learning curve that comes with a first position. They don’t expect a new grad OD to practice like an associate with ten years of experience. Most start you with fewer patients per hour and build up the schedule as you get comfortable.

Starting a new role also means learning the office’s diagnostic equipment, patient flow, and day-to-day operations. The adjustment that most often catches a new grad OD off guard is pace. In a busy office, techs handle pre-testing so the schedule keeps moving, and learning to rely on them takes some getting used to.

Clinical exposure depends a lot on your rotations. Some new grads have done plenty of surgical co-management, specialty lens fits, myopia management, or advanced dry eye treatment, while others have barely touched those areas. Owners know this going in. What matters to them is that you’re patient with yourself, willing to learn, and comfortable asking questions. That mindset is the best way to set yourself up for success clinically.

Where residency fits

Most optometry jobs don’t require a residency, but it can help in certain situations. In saturated markets like Los Angeles, Chicago, or New York City, residency training helps your CV stand out, and many medically focused practices and MD/OD groups prefer or require it. It’s also a smart move if you want to focus on a specialty like pediatrics, specialty contact lenses, vision therapy, or neuro-optometric care.

Outside of those situations, plenty of busy practices hire straight out of school and provide mentorship that feels a lot like residency while you earn a full salary. Weigh the cost of another year of training against where you plan to live and the type of practice you want to join.

Beyond Clinical Skills

Clinical skills show that you’re qualified for a role, but interpersonal skills are often what decide who gets hired. Every practice is different, but when owners describe their ideal optometrist, these traits come up most: communication, a team-player mentality, bedside manner, and drive.

Communication

The way you communicate while interviewing gives owners a preview of how you’ll communicate on the job. Reply to calls, emails, and texts promptly. After an interview or visit, send a thank-you note and ask about next steps, and don’t be shy about following up if you haven’t heard back.

The biggest mistake we see is going silent. ETS Vision recruiter Sheri Beveridge once presented a standout OD to a practice that was a perfect fit for both the OD and the practice. The practice reached out, but the OD didn’t respond for two weeks. By the time the OD decided to accept the offer, the practice had already hired someone else.

If a position isn’t right for you, let the practice know, and if it is, act on it. Ghosting an owner leaves a lasting impression, and optometry is a small world.

Team player

Finding a doctor who fits the practice culture and wants the whole team to succeed is a top priority for owners.

A successful practice takes more than a great optometrist. Assistants, technicians, and administrative staff are what allow ODs to work efficiently and give patients a smooth experience. Owners value associates who take an interest in the practice as a whole rather than seeing their role as limited to their own patients.

In practice, that could mean stepping up when a coworker is out sick, covering at another location, mentoring technicians and newer ODs, helping the team stay on track during a hectic day, or pitching in when something falls outside your usual responsibilities. It works both ways, too. When you show up for your team, you can trust them to show up for you when something comes up on your end.

Bedside manner

Many owners have spent years building their reputation and treat their patients like family. Once you join, you carry that reputation into every exam room. Patients remember how you made them feel, so take time to get to know them and listen.

Drive

Owners want an associate who is motivated, and you can start showing that drive during the interview process. Arrive having researched the practice and ready with your own questions. Once you’re in the role, keep taking on new skills and have a clear sense of where you want your career to go, whether that’s a specialty, partnership, or ownership. The associates who stand out most want the practice to grow along with them, starting with building a loyal patient base of their own.

Understanding the business side

Owners also notice new grads who show an interest in the business side. If you understand what keeps a practice profitable, like supporting the optical and handling a full schedule, you’ll stand out, particularly if partnership or ownership is on your radar down the road.

Our recruiters see this as the biggest knowledge gap between school and real-world practice. Understanding the numbers that keep a practice running is essential to a successful career, and for many ODs, the first position is an eye-opener.

Compensation

A lot of new grads leave school expecting a starting salary that doesn’t match what practices can offer, and the difference almost always comes down to production. Your pay is tied to the revenue you bring in, which depends heavily on patient volume. An associate seeing two patients an hour brings in far less than one seeing four to six, and the practice can only pay what the numbers support.

That’s why many offers pair a base salary with production pay or bonuses. The base gives you stability while you build speed and a patient base, and production lets your earnings grow as you get busier.

When an offer comes in, ask how production or bonuses are calculated, when they kick in, what current associates are actually producing, and whether there’s a cap.

How to Think About Your First Position

Where your career goes depends on your goals and whatever life throws at you along the way.

If you’re moving home or already know where you want to settle, take your time searching for something that could be a long-term fit, ideally with solid mentorship and a path to partnership if that’s your goal.

If you’re not sure yet, it’s fine to treat your first job as a stepping stone. The first couple of years come with a steep learning curve, and ODs should use that time to build clinical confidence and pay down loans while they figure out what they want in an employer. In some areas, openings are limited enough that a first job ends up being a stepping stone either way.

Don’t put too much pressure on yourself to find the ‘perfect’ job immediately after graduation. If the ideal long-term opportunity isn’t available yet, your first position can still be incredibly valuable.” – Katie Mares, Western U.S. Optometry Recruiter

We often see ODs reassess around three to four years out and look for a position that better fits their evolving priorities. That might mean more autonomy, a different patient population, specialty care, stronger leadership support, a new location, or a culture that better matches their values.

Whichever way you lean, read your restrictive covenant closely. Non-compete rules vary widely by state. If you expect to move on eventually, know exactly what the non-compete covers. And if the practice is near your hometown, make sure you wouldn’t be blocked from working there if you and the practice part ways.

Finding the Right Practice for You

The best opportunity is the one where the practice’s goals and the OD’s goals line up. Every doctor and every practice weighs things differently, so the first step is figuring out what matters most to you. Finding that alignment is what our recruiters aim for on every search, and it’s a big reason two-thirds of our business is repeat business.

Set your priorities with CLAMPS

Our recruiters use a framework called CLAMPS to help candidates sort out what they want:

• Challenge: Clinical autonomy, continuing education, and room to learn new skills. How stimulating is the work?
• Location: A specific place or type of place, whether metro or rural. Rural can mean a full schedule and a strong patient base. Is it somewhere you want to live?
• Advancement: Title, equity, and partnership or ownership tracks.
• Money: Base salary, commission, benefits, bonuses, and guarantees. Look at total compensation, whether the schedule will be full, and your ability to pay off loans.
• People: Office culture, who you’ll work for and with, and who you’ll serve.
• Schedule: Patient flow, work-life balance, and whether evenings or weekends are required.

Knowing what you want in each area and ranking them by importance gives you a simple way to weigh one opportunity against another. It also helps you protect your non-negotiables without writing off a good opportunity over something lower on your list.

Evaluate each practice on its own

Private practices, group practices, and PE-backed practices can all be good places to start. Two offices with the same ownership model can feel completely different, so talk with a few types before ruling anything out.

Private practices often let you work closely with the owner and become deeply involved in how the office runs. Larger groups can offer more resources, infrastructure, and room to grow, along with other ODs to learn from early on. PE-backed groups vary considerably, and policies sometimes change after an acquisition, so look beyond the label and ask about the specific group’s leadership, expectations, compensation model, and opportunities for advancement.

Whatever the setting, find out how much clinical autonomy you’ll have and what the practice expects from you in your first year. If you can, visit or shadow before accepting. Pay attention to how the team works together and whether you can see yourself there every day.

When a New Grad OD Should Start the Job Search

Earlier than most students expect. We recommend getting serious in the second half of third year and actively talking with recruiters and practices 6 to 12 months before graduation. If you have your heart set on a specific city, give yourself even more runway, since a narrower search takes longer.

You don’t need to be ready to sign that early. Use the time to see what’s out there and get a feel for different markets. Just start when you have the bandwidth to respond to practices quickly, because a slow reply can cost you an opportunity.

Start Your Search With ETS Vision

Your first job sets the tone for your early career, and you don’t have to navigate the search alone. Our recruiters can help you get a feel for the markets you’re considering and the practices hiring there. Send your resume today. There is never any fee to candidates.

Ready to explore your options? Search current openings for optometrists at ETSvision.com/jobs.