Economical and financial constraints for ophthalmologists during COVID-19 pandemic

Dear Editor,

We read the interesting expedited publication by Edakhlon et al.[1] on the impact of the COVID-19 pandemic on income and opportunities of ophthalmologists in India and we must congratulate the authors for analyzing this burning topic across the country. However, we have a few important observations and suggestions to make which we think will be beneficial for all the ophthalmologists.

First, the article highlights that more women ophthalmologists (438, 78.4%) felt it was unfair to reduce the salary during the pandemic, as compared to men (330, 66.3%); this could be probably attributed to more number of women working in private and trust hospitals where there were definite salary cuts.[2] In a real-world scenario, since men are usually the bread earners of the family, one could have expected more men to find it unfair to reduce salary.

Second, the survey was answered by mostly young ophthalmologists (730, 69.1%) who were the worst hit by the pandemic both financially and training-wise; hence, probably the survey results are more inclined toward young ophthalmologists. It could have been interesting to see the response rate of ophthalmologists above 40 since they have more salaries compared to young ophthalmologists and for them, salary cut may be a small portion of the total amount.

Third, less salary reduction was faced by MD/MS (327, 49.4%) candidates as compared to DO (64, 57.1%) and DNB (178, 62.9%). This could be attributed to more COVID-19 duties done by MD/MS candidates in medical colleges where there were delays in salaries but no reduction as compared to DNB candidates who were mostly attached to private or trust-based ophthalmology dedicated hospitals with minimal or no COVID-19 duties.[3]

Lastly, the survey highlights that a sizable portion of respondents 188 (17.8%) were self-employed. They could have been omitted from the analysis since they were not dependent on salary from any sector. Additionally, the article also highlights that the candidates with no subspecialization had a significantly higher loss of surgical training opportunity (332, 78.1%) when compared to those with specialization (357, 56.5%). This was because only seniors surgeons were operating during the lockdown and pandemic to reduce surgical time and complications as there was a substantial spread of COVID-19 spread through the conjunctival surface.[4]

To conclude, in the predicted 3^rd and 4^th wave, these financial challenges can be reduced and overcome by streamlining the minimum salary benchmark for the frontline ophthalmology COVID-19 warriors or by paying the candidates for the number of work hours allotted.[5] The ministry of health and welfare and the government should also formulate policies for the same shortly.

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Conflicts of interest

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