The eye surgeon. Cataracts, glaucoma, retina, lasers. One of the highest paid and most competitive specialties in Canada, with better hours than most surgery.
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What you earn and what it costs to get there.
Typical net
$600,000
New or part-time
$350,000
High-volume cataract or retina
$850,000
Net income after overhead, which is high because you own expensive lasers and imaging machines. Cataract surgeons bill per case and do many a day. Pay varies by province and billing model. Job Bank puts the median for all surgeons at about $419,000 a year, with a top end near $767,000.
$65,000 to $95,000
Salary as a resident, rising each of the 5 years
Residents are paid employees. Quebec pays the least. Call is lighter than in other surgical programs, but eye emergencies still come in at night.
About $900,000 gross
Average gross clinical payment for ophthalmology in 2023 to 2024, the highest of any specialty, per CIHI (Canadian Institute for Health Information)
The reason is volume: a cataract takes 15 to 20 minutes and a surgeon can do 15 or more in a day. Overhead of 35 to 45% brings net pay down to the range above.
Tuition, fees, exams and kit. Not rent, food or travel
The low end is a three year undergraduate degree and a three year medical school at the cheaper end of Canadian tuition, plus the MCAT (medical school admission test), the MCCQE (the national medical licensing exam) and the Royal College certification exam. The high end is four years of each at the priciest schools with the full range of fees. Residency and the usual one or two fellowship years are paid at roughly resident wages, so they add no tuition. The hundreds of thousands of dollars of lasers and imaging gear quoted for a clinic is a business cost you take on later, with a business loan, not a cost of qualifying.
Typical debt at the end of medical school is $80,000 to $150,000. Fellowships add 1 to 2 years at roughly resident pay.
No employer pension
Most ophthalmologists are self-employed and save through a professional corporation.
Private-pay work
Laser vision correction and premium lenses are paid by the patient, outside the provincial plan.
Predictable hours
Mostly daytime clinic and scheduled surgery, with lighter call than other surgeons.
Malpractice coverage
Through the CMPA (Canadian Medical Protective Association), in a lower fee band than most surgery.
The exact path from high school to qualified.
Same road as every surgeon, and one of the hardest matches to win.
High school
Grades 11 and 12
Top marks in biology, chemistry, math and English. A very high average is the entry ticket.
Bachelor's degree
3 to 4 years
Any major, usually life sciences. High GPA, research, volunteering. Write the MCAT (medical school admission test).
Medical school, the MD (doctor of medicine)
3 to 4 years
Acceptance rates are 5 to 15%. Ophthalmology electives and research in your final year decide the match.
Ophthalmology residency
5 years
Matched through CaRMS (the residency matching service). Paid, supervised. Clinic, lasers, then hundreds of cataract operations under supervision.
Royal College exam, licence, often a fellowship
1 to 2 years
Pass the Royal College of Physicians and Surgeons of Canada exam, register with your provincial College of Physicians and Surgeons. Many add a 1 to 2 year fellowship.
Biology and chemistry
Required for nearly every pre-med path.
Physics
Optics is physics. Lenses, lasers and light are the whole job.
Calculus and functions
English
Tested on the MCAT (medical school admission test), and you will explain a lot to worried patients.
You need a licence from your provincial College of Physicians and Surgeons to practise, and specialist certification from the Royal College of Physicians and Surgeons of Canada to work as an ophthalmologist. Optometrists test vision and prescribe glasses after a 4-year optometry degree; only ophthalmologists are medical doctors who operate. Licences transfer between provinces with paperwork and fees.
Things you don't need, but that help.
Retina
Injections and surgery for diabetes and macular degeneration. Very busy, very well paid.
Glaucoma
Pressure in the eye. Lasers, drops and drainage surgery.
Cornea and refractive
Corneal transplants and laser vision correction, often private-pay.
Oculoplastics
Eyelids, tear ducts and the eye socket. Some cosmetic work.
Pediatric
Lazy eye and crossed eyes in children.
Ophthalmology electives and research in med school
With few spots, reference letters from eye surgeons decide the match.
Steady hands
Cataract surgery happens inside an eye 2.5 centimetres across, under a microscope.
Comfort with technology
Lasers, imaging and surgical machines change every few years.
Business sense
Most ophthalmologists own or share a clinic with expensive equipment.
Laser eye surgery to remove the need for glasses is not covered by provincial health plans, so patients pay thousands of dollars an eye. A few ophthalmologists build entire practices around it. The work is fast and predictable, but you compete with chains on marketing and price, and the reconstruction and disease work is gone.
Day to day, pros and cons, where you'd work.
Surgery days: 8:00 a.m. to mid-afternoon in the operating room (OR), 12 to 20 cataract operations at about 15 minutes each, patients awake with numbing drops. Clinic days: 40 to 60 patients, eye exams, injections for retina disease, laser treatments in the office. Call is a few nights a month, mostly for eye injuries and sudden vision loss that can wait until morning to fix.
The good
The hard parts
Things people don't tell you.
Cataract surgery is performed hundreds of thousands of times a year in Canada, more than any other operation. The cloudy lens is broken up with ultrasound and replaced with a plastic one, usually in about 15 minutes.
Most cataract operations use numbing drops and a light sedative. The patient sees light and colours during the operation and walks out within an hour.
Surgeons operate through incisions of 2 to 3 millimetres, using instruments and a microscope. Retina surgery works on tissue thinner than a sheet of paper at the back of the eye.
Ophthalmologist has two h's and most people miss the first one. It comes from the Greek ophthalmos, meaning eye. Optometrist and optician are different jobs and different training.
Last checked September 2026. Pay figures are typical full-time annual amounts in Canadian dollars, based on Government of Canada Job Bank wage data and published salary grids. They vary by province, employer and experience. Tuition is for domestic students.