With forecasted public expenditure cuts in the UK and Europe, declining insurance reimbursements and potentially some form of nationalised healthcare in the US, in addition to the effects of a global recession, many—if not most— ophthalmologists may have at least entertained the idea of obtaining a master of business administration (MBA) degree. Their reasons are varied. For some, an MBA might help them move up the 'corporate ladder'—perhaps to become a department chairperson. Others might be thinking 'career change.' Still, others simply might want more tools to manage their practices.

Whatever the reason, increasing numbers of ophthalmologists are taking the plunge and getting their MBAs. We hope this will help provide guidance through the process.

The decision about whether pursuing an MBA will be worthwhile hinges on what you are doing now and how you envision your ideal future. For example, doctors who specialize in laser vision correction or oculoplastic surgery might realize that because a significant portion of their businesses involve nonmedical decision-making, including how to market their practices, it would make good sense to learn more about the business side by obtaining an MBA.

On the other hand, ophthalmologists who are in other specialties without a significant elective component, such as retina surgeons, might decide that those nonmedical business and marketing decisions are not significant. These physicians' decisions to obtain an MBA might be driven by other desires, such as becoming division chief or chairperson of an academic department or transitioning to industry.

Many physicians argue that having an MBA is becoming increasingly necessary with the changes in medicine. Eric Seaman, MD, a urologist, wrote in October 2004 in the Journal of the National Medical Association that he pursued an MBA because he believed that doctors were (and are) losing control of the ability to shape their destinies.

"Market forces, government initiatives, and certain lobbies continue to place more and more burden onto the shoulders of physicians," he wrote. One solution, according to Dr. Seaman, is for doctors to enhance their business knowledge.

My colleagues in academic medicine are pursuing an MBA in search of career advancement because many universities and other institutions are demanding that upper-level administrators not only have the academic credentials and clinical skills but also a business background (for example, an understanding of how to control costs, increase revenue).

Dr Kelly Hutcheson, associate professor of ophthalmology and pediatrics, Children's National Medical Centre and George Washington University School of Medicine, Washington, DC, decided after a decade in academic medicine that her goal was to become more involved in the administration of the hospital and her department. To increase her professional worth, Dr Hutcheson is obtaining her MBA at George Washington University part-time. As part of the faculty, she receives a discount of up to 50% on her courses.

Yet another category of doctors who would be motivated to obtain an MBA are those who are considering a transition to investment banking (Wall Street), hedge funds, the pharmaceutical industry, or consulting. For example, when I was obtaining my MBA at New York University's (NYU) Leonard N. Stern School of Business as a part-time student from 2000 to 2004, I was considering transitioning to a management consulting firm. This new career offered better hours, a more attractive lifestyle, and higher income potential. To investigate this possibility further, I decided to go through the formal career placement track at NYU and interviewed with top management-consulting firms. I made it to the final round before I withdrew myself because I decided to remain in clinical medicine. The process was extremely useful, however, in providing a more complete picture of what my options outside of clinical medicine could be later in life as a second career.