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Graduated but Unlicensed: The Potential Financial Impact on ODs

Dr. Vittorio Mena graduation pass rates, tuition and retake fees

Dr. Vittorio Mena with his parents at his graduation from Pennsylvania College of Optometry. Photo courtesy of Dr. Vittorio Mena.

A data-driven look at how NBEO pass rates, tuition and retake fees affect earnings

By Vittorio Mena, OD, MS

March 20, 2026

Getting that first paycheck after optometry school graduation is such a gratifying experience. The reward is great after all the years of hard work and dedication, many sleepless nights and your brain running on caffeine. But what about the students who never pass boards and are not able to practice optometry to their full extent?

Many of these unlicensed doctors are considered super technicians, working in practices until they can pass their national board exams. According to ZipRecruiter as of February 2026, “the average optometric technician makes $41,294 a year which is about $19.85 per hour”.¹ For optometrists, it is $150,279 a year, which is about $72.25 per hour”.²

That is a difference of $52.40 an hour for not being able to achieve that optometric license. However, let’s assume they get paid at least half and get $36 per hour—a difference of $36.25 per hour in pay.

FROM DEGREE TO LICENSE

While getting your degree is important, what can stand in the way is the overall license. This is why it is important for anyone entering any medical profession to understand how each institution is performing nationwide when it comes to pass rates as well as tuition rates. As of publication, The Ohio State University has taken the number one spot for the fourth straight year in a row (an entire graduation period) when it comes to passing Part 1 of NBEO boards. This is considered the hardest of the three exams needed to pass in order to get a license.

Overall, throughout the country in back-to-back years, about every 2-out-of-3 students are passing Part 1 on their very first attempt. Out of the 24 schools, 12 of them have passing rates of under 70%. Also, 4-out-of-5 students have an ultimate pass rate for all three parts of boards on first attempt. This means that 20% of students may have graduated with a degree in optometry without being able to practice immediately right after graduation which causes a massive economic burden to them and their families.

Since I do not have the data for doctors who end up never passing at all, we can only assume anywhere between 0-19% will never have passed all three parts after six attempts. I can only assume that less than 3% never pass nationwide.

UPCOMING CHANGES AND IMPACT OF TUITION AND RETAKE FEES

Starting in August of 2026, each part of NBEO will cost students/doctors $1,490 for each exam. If they pass two out of three on the first attempt and take six attempts to pass the one remaining, it will cost $11,920 in potential exam fees.

If they make $36 per hour, it would take them 331 hours of working (that’s 8.2 weeks or two months full time) to be able to pay for their exam fees. That is not including taking taxes out, so at 25% taxes, it would take 441 hours or 11 weeks to pay it all off. In addition, many of these students and new doctors are also working to pay back student loan debt and are paying rent and have other living costs and bills.

According to the Association of Schools and Colleges of Optometry (ASCO), The Ohio State University College of Optometry tuition rate for residents is $31,746 and $52,802 for nonresidents per year (2025-2026). The school has an overall pass rate for all three exams on the first attempt of 98.33%.

Western University of Health Sciences College of Optometry has the lowest overall pass rate on first attempt 47.37%. Tuition rate (resident or nonresident) costs $48,618 per year (2025-2026). Note that this does not include room and board and other miscellaneous expenses for either institution.

Southern College of Optometry tuition (resident or nonresident) costs $45,902 per year (2025-2026). Inter American University of Puerto Rico School of Optometry costs $31,000 if a resident and $33,000 for nonresidents (2025-2026).

SCHOOL RANKINGS OF PASS RATES

Here are the top three schools for Part 1 pass rates (first attempt):

The Ohio State University College of Optometry (95% pass rate)
Southern College of Optometry (86.72% pass rate)
The University of Alabama at Birmingham School of Optometry (76.36% pass rate)

Here are the bottom three schools for Part 1 pass rates (first attempt):

Inter American University of Puerto Rico School of Optometry (25% pass rate)
Western University of Health Sciences College of Optometry (29.82% pass rate)
Indiana University School of Optometry (51.95% pass rate)

These schools have the most candidates taking the exam:

Pennsylvania College of Optometry at Drexel University (130 students)
Southern College of Optometry (128 students)
New England College of Optometry (116 students)

These optometry schools require students to pass Part 1 in order to graduate:

Inter American University of Puerto Rico School of Optometry
Southern College of Optometry

22 other schools do not need to pass in order to graduate.

START FINANCIAL CONSIDERATIONS EARLY

I chose to take a closer look at these financial impacts to shed light and spread awareness into a very important topic that can impact mental health. Students and young ODs should be prepared as debt can add up quickly when the plan for passing and getting a license doesn’t go as planned.

Consider sharing this information with incoming students or those who are shadowing you in practice and want to potentially become an optometrist. Each school has their uniqueness, strengths and weaknesses. Having a heads up can lead to better success in their futures.

If you never pass? It doesn’t mean you are doomed. If you are up for the challenge, you can still run an optometric practice and become a business owner or become an optician, which will require some additional education. Or maybe you have another skill set you are passionate about—the sky is the limit!

References

Vittorio Mena, OD, MS, is the sports vision director with Optical Academy. Dr. Mena is also an optometric financial coach/fiduciary with Series 6 and 63 investment licenses and Series 2-14 life and variable annuity licenses. To contact him: menavitt@gmail.com