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Too Many Optometry Schools?

Updated: Nov 1, 2023

In 2014, I wrote a column for the magazine Optometric Management. At that time, I addressed this issue. I think it is time to do it again! Here is the column from 2014:

First, any organized attempt by optometry to block a new school would be met by a long line of lawyers ready to file anti-trust and restraint-of-trade claims. At board meetings of the Texas Optometric Association, the attorney would say, “We are half way to an anti-trust lawsuit just by having you all in the same room together.”

Schools/entities show interest in starting optometry schools for two obvious reasons. First, a U.S. Bureau of Labor Statistics (BLS) 2012 report (see concludes optometry is expected to grow “much faster than average” until 2020.

Second, optometry “rounds out” the school’s health professions portfolio. Specifically, it fits nicely with an interdisciplinary learning environment, which is cost effective and a great model for an integrated healthcare team of the future.

A college might plan to supply more O.D.s because, based on BLS numbers, it sees optometry as a profession “in demand.” But, what they are failing to look at is the supply and demand in optometric education. For the past five years, the number of seats available in the schools, 1,800+/- annually, has risen, due not only to the formation of four new schools, but also to an increase in the class size at several established schools. Yet the number of applicants remains flat at 2,500+/-. With this low 1.4 applicant-to-seat ratio, schools may face trouble in filling their classes unless they lower admissions’ standards.

Low standards are bad, but the national board exams and state licensing requirements help us hold a consistent standard of training prior to entering practice. If a new school can train a low-quality applicant thoroughly enough to allow him or her to meet the national standards, should we worry?

The 2014 AOA/ASCO “Eye Care Workforce Study” predicts that at current levels of capacity, there are enough O.D.s. Does this survey contradict the BLS prediction? I think it does. The 2012 BLS report forecasts good prospects for O.D.s “because the number of optometrists is limited by the number of accredited optometry schools.” Since 2012, a new school opened, schools increased class size, and two more schools plan to open in 2016. Perhaps we are at the “tipping point.”

The BLS also stated “a large number of … optometrists are expected to retire over the coming decade, creating opportunities.” But the Workforce Study showed that male O.D.s are working until age 68.1. Considering these factors, it makes it hard to point the finger at any one group for our current situation. Is it new schools? Increased class size? O.D.s who won’t retire? Organized optometry? Honestly, it is probably a combination of these and many other factors.

Obviously, people need eye care, and schools/entities see this business opportunity. If all stays the same with the current number of optometry graduates, we will be in a state of equilibrium, but if not, we may be at that “tipping point.”

If I was asked to write this column again, I'd keep a lot of the information the same. First, it is still true that no one controls the formation of optometry schools. The majority of schools/colleges of optometry are private institutions. It would be anti-trust to gang-up on any school to prevent them from starting a new school. That has not changed at all. My second point in the column was that optometry appears attractive to Universities because it is a professional program with fairly high tuition. In a world where most undergraduate tuitions are discounted over 50%, a professional program that charges full tuition seems attractive as a way to grow their income. Third, we still struggle with the applicant pool. We hover around a 1.4 to 1.0 ratio of applicants to available seats. This isn't good. The schools and colleges of optometry have worked hard and spent really dollars to try to improve this ratio, but only small gains have been made.

Where my column today would differ significantly from 2014 is in the job demands. The Bureau of Labor Statistics could have never imagined the growth in the demand for OD's across the country. We have heard from big industry that they cannot find OD's to fill many of their offices across the country. I once heard Reade Fahs (National Vision) tell a group that he would hire every graduating optometry student in the country if he could. The explosive growth of companies like NVI, Essilor-Luxottica, VSP, etc. have driven the demand for OD's through the roof. The great thing for new graduates is that they are almost guaranteed a job upon licensure, but they may have to work for a major corporation. This sentence alone will spawn my next two blogs about the challenges of private practices and the changes in OD salaries across the industry. But, like I wrapped up that column almost 10 years ago...these are interesting times and we have to watch for a tipping point.

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