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Hey guys, I'm an ophtho-hopeful who failed to match last year and matched this year. I thought I'd write this post to try to encourage some of you who may be down in the dumps today and to try to offer some advice. Feel free to PM me if you have specific questions.
I'm going to start by talking about the route I took, and then I'll try to go over general options. My background: I'm an MD/PhD, went to a mid-tier med school, steps 251/259, middle third of class (no AOA), 3 first author publications at application time last year. Got 20+ interviews, went on 16 (17 if you count Arizona as two), and was sure I was going to match. 1/13/2015 was quite possibly one of the worst days of my life. I know this is super-emo and dramatic to say, but you know how people remember where they were when Kennedy was shot and when 9/11 happened? I remember where I was when I opened up the email and saw "No Match" and it still haunts me! This was the thread I started last year while I was reeling from the news: http://forums.studentdoctor.net/threads/didnt-match-im-horrified.1116127/ -- and I'm sure many of you, unfortunately, know exactly what that feels like
This is how I spent my year: For about 6 hrs I just wandered around in shock. Then I got started asking for advice wherever I could find it. By the end of the day I'd talked to my dept chair, several mentors, and my med school dean, all of whom helped me lay out my options. By the end of the week I'd touched base with all the program directors who'd interviewed me to try to figure out what went wrong and how I could go forward. I chose to do a research year; it made sense for me because of my background, and because I felt it was a good way to beef up my CV over my gap year. I spent a few weeks applying to and interviewing at all the pre-residency fellowships I could find and ended up with offers from all of them. I ultimately chose to go to a less "established" one that was more of a real postdoc -- largely because of my PhD background. Since my last rotation ended in April, I moved immediately afterward and got started. By the time apps went in I had 3 additional publications under review and 3-4 more in the works. I applied extremely broadly, landed something like 25 interviews, and again went on 16 (I physically couldn't handle more than that). I also applied to neurology as a backup, but only 10 programs (got 6 interviews, went on 3 of them -- scheduled the other three for post-match and will be cancelling them); really, all the neuro interviews did for me was make me realize I would rather be an ophthalmologist in Timbuktu than a neurologist anywhere else. Finally, I applied to something like 26 prelim programs -- a good spread of IM prelim and TY. I'm still doing those interviews...and honestly it's an uphill battle because so many prelim PDs are skeptical that I'll be able to do internal medicine after so much time "away".
--
Anyway, that's just a rundown of what I did, individually. As for advice -- and please keep in mind that this is just my personal opinion, and based on my experiences; i.e. YMMV. But there are a few things I want to touch on:
First off: don't give up, and don't do nothing. The worst thing you can do now is wallow in despair and get nothing done. If you want to try again, you'll need to get the wheels spinning immediately. So the first thing you need to do is seriously assess whether or not you want to try again. In doing so, you should consider -- with brutal honesty -- your strength as an applicant. I hate to say this, but if you have a 205 on boards, no honors, and no research, being a reapplicant would probably be the final nail in the coffin. But most people on SDN, and really most people considering ophtho, have the credentials for it -- or at least enough to be salvaged. In that case, start thinking about what you can do to strengthen your application.
As an example -- this is why I think I didn't match last time: I got way too overconfident (due to getting a ton of interviews from great schools), and I'm a pretty bad interviewee. I didn't convey interest at schools that were supposedly "safeties", I blew off my home school's interview, and I talked way too openly about where I wanted to go. I also didn't ask for help from my mentors -- overall I just kinda thought I had it in the bag, and ... I blew it. On top of that, I also talked too much and too fast, and paired with my overconfidence, I probably came off as aggressive. Other factors: med school didn't have a strong ophtho program, I didn't really have a lot of mentors vouching personally for me, no AOA, no actual ophtho research. So I tried to fix all that by doing research, by forging strong relationships, and by really working on my interview skills. I still suck in interviews, but at least I don't talk a million miles an hour anymore
Try to turn the microscope on yourself and be brutal. Pick out every flaw and see if you can fix it. If you can't, forget it. If you can, fix it! It also helped me a lot to ask PDs for advice. Some of them will give you canned answers about tough odds; some will be honest with you, and those are the ones that will help you.
--
So assuming you do want to go on and try again, what can you do to make sure you're in the 50% that makes it? There are a few options, which I'll try to go over in some detail:
1) Go on into internship.
This is sort of the "default" path. You continue on with your prelim interviews and hopefully match somewhere good. Be aware that TY programs may ask you where you matched, and will probably rank you lower when they learn you haven't. But that's okay, because imho if you do an internship, you need to do one that'll allow you to forge connections with ophthalmologists and also -- if worst comes to worst -- train you adequately to go on into internal medicine (because that will be your backup plan).
Pros of doing an internship: you can apply for PGY-2 openings if they pop up (and a couple seem to every year); you probably have a backup in IM if you don't match ophtho a second time, and you won't have wasted any time. Cons of doing an internship: you'll be worked hard, you won't have a lot of time to interview or prepare, and you may not be able to add much to your CV. You may or may not be able to build crucial relationships with people that can help you.
2) Do an "established" pre-residency fellowship.
There's a handful out there, mostly pathology-related. I applied to one at Bascom Palmer (1-2 spots, $30k) and two at Utah (3 spots, $30k, and 1 spot, $20k). I believe there was also one at Iowa (possibly paid?). Honestly, if you're an MD with little research experience, these are amazing and I would highly recommend any or all of them if you can get a spot. Your mentors will be well-known and will go out of their way to help you, as their reputation (and their access to high-quality fellows like yourself) depends on their ability to match you.
Pros of a pre-residency fellowship: a mentor that will really go to bat for you, ability to add meaningfully to your CV, ability to pick up some marketable skills. Cons: it's pretty competitive to get in. The Bascom one interviewed 20+ people for one spot last year. Additionally, don't expect to match to the program you're doing your fellowship at, so you won't have that 'safety net'. Finally, the publications you'll have from this are more likely to be case series and the like.
3) Do a research year.
This will really depend on how proactive you are. I think this route is high risk, but potentially very high reward. I'm going to toot my own horn a bit and say that despite getting accepted to the Bascom fellowship and both Utah fellowships, I chose to do a research year instead. Primarily, I did that because I already had a PhD and was seeking more of a "postdoc" experience than a pathology fellowship, and wanted to continue research similar to what I did as a grad student. I just thought I, personally, would get more out of it -- and I got very lucky in that I found a great, super-productive lab with an awesome mentor, and also had the opportunity to work closely with a bunch of clinical attendings (and get paid to boot). If you have similar leanings, this might be the path for you. But I do have to stress that your mileage may seriously vary. If you do go this route, try to look for some of the following:
- Mentor works with clinical attendings (or is one)
- Mentor works with medical students, preferably ones who matched into ophtho
- Mentor is well known in ophtho
- Lab is productive. No publications are ever guaranteed, but if you get in a lab that pumps high-quality papers out, you'll have a much better chance at publishing quickly
- Lab gives you time to work with clinical attendings, preferably in a shadowing/sub-interning fashion
Pros of a research year: you might get serious research done and publish high-impact paper(s). You might build meaningfully toward an academic career. Depending on mentor and collaborators, you might make some great connections. Cons: you might not get much done; your mentor might not be well known or might not know how to help you; you might not get much out of the year.
In all honesty, I'd probably recommend doing an established fellowship if you can, a research year if you can't, and an internship as a last resort. If you have a strong research background and you have a good idea of what you might want to do research on, consider doing a research year > fellowship >>> internship. But I really do feel that internships will not move you forward very much, and will also leave you strapped for time and thoroughly exhausted during interview season.
OK -- so that was a huge post, and a bit of a braindump, but I hope that helps a little. Above all, keep your chin up... it's hell to not match, but it's not the end of the world. In retrospect, I honestly think this past year has made me a better doctor, a better researcher, and a better person to boot. What doesn't kill you really does make you stronger -- and more humble, grateful, and compassionate
Best of luck to you all. Feel free to reply or PM me if you have specific questions or want to discuss more. If anyone else reapplied successfully, please chime in!
I'm going to start by talking about the route I took, and then I'll try to go over general options. My background: I'm an MD/PhD, went to a mid-tier med school, steps 251/259, middle third of class (no AOA), 3 first author publications at application time last year. Got 20+ interviews, went on 16 (17 if you count Arizona as two), and was sure I was going to match. 1/13/2015 was quite possibly one of the worst days of my life. I know this is super-emo and dramatic to say, but you know how people remember where they were when Kennedy was shot and when 9/11 happened? I remember where I was when I opened up the email and saw "No Match" and it still haunts me! This was the thread I started last year while I was reeling from the news: http://forums.studentdoctor.net/threads/didnt-match-im-horrified.1116127/ -- and I'm sure many of you, unfortunately, know exactly what that feels like
This is how I spent my year: For about 6 hrs I just wandered around in shock. Then I got started asking for advice wherever I could find it. By the end of the day I'd talked to my dept chair, several mentors, and my med school dean, all of whom helped me lay out my options. By the end of the week I'd touched base with all the program directors who'd interviewed me to try to figure out what went wrong and how I could go forward. I chose to do a research year; it made sense for me because of my background, and because I felt it was a good way to beef up my CV over my gap year. I spent a few weeks applying to and interviewing at all the pre-residency fellowships I could find and ended up with offers from all of them. I ultimately chose to go to a less "established" one that was more of a real postdoc -- largely because of my PhD background. Since my last rotation ended in April, I moved immediately afterward and got started. By the time apps went in I had 3 additional publications under review and 3-4 more in the works. I applied extremely broadly, landed something like 25 interviews, and again went on 16 (I physically couldn't handle more than that). I also applied to neurology as a backup, but only 10 programs (got 6 interviews, went on 3 of them -- scheduled the other three for post-match and will be cancelling them); really, all the neuro interviews did for me was make me realize I would rather be an ophthalmologist in Timbuktu than a neurologist anywhere else. Finally, I applied to something like 26 prelim programs -- a good spread of IM prelim and TY. I'm still doing those interviews...and honestly it's an uphill battle because so many prelim PDs are skeptical that I'll be able to do internal medicine after so much time "away".
--
Anyway, that's just a rundown of what I did, individually. As for advice -- and please keep in mind that this is just my personal opinion, and based on my experiences; i.e. YMMV. But there are a few things I want to touch on:
First off: don't give up, and don't do nothing. The worst thing you can do now is wallow in despair and get nothing done. If you want to try again, you'll need to get the wheels spinning immediately. So the first thing you need to do is seriously assess whether or not you want to try again. In doing so, you should consider -- with brutal honesty -- your strength as an applicant. I hate to say this, but if you have a 205 on boards, no honors, and no research, being a reapplicant would probably be the final nail in the coffin. But most people on SDN, and really most people considering ophtho, have the credentials for it -- or at least enough to be salvaged. In that case, start thinking about what you can do to strengthen your application.
As an example -- this is why I think I didn't match last time: I got way too overconfident (due to getting a ton of interviews from great schools), and I'm a pretty bad interviewee. I didn't convey interest at schools that were supposedly "safeties", I blew off my home school's interview, and I talked way too openly about where I wanted to go. I also didn't ask for help from my mentors -- overall I just kinda thought I had it in the bag, and ... I blew it. On top of that, I also talked too much and too fast, and paired with my overconfidence, I probably came off as aggressive. Other factors: med school didn't have a strong ophtho program, I didn't really have a lot of mentors vouching personally for me, no AOA, no actual ophtho research. So I tried to fix all that by doing research, by forging strong relationships, and by really working on my interview skills. I still suck in interviews, but at least I don't talk a million miles an hour anymore
Try to turn the microscope on yourself and be brutal. Pick out every flaw and see if you can fix it. If you can't, forget it. If you can, fix it! It also helped me a lot to ask PDs for advice. Some of them will give you canned answers about tough odds; some will be honest with you, and those are the ones that will help you.
--
So assuming you do want to go on and try again, what can you do to make sure you're in the 50% that makes it? There are a few options, which I'll try to go over in some detail:
1) Go on into internship.
This is sort of the "default" path. You continue on with your prelim interviews and hopefully match somewhere good. Be aware that TY programs may ask you where you matched, and will probably rank you lower when they learn you haven't. But that's okay, because imho if you do an internship, you need to do one that'll allow you to forge connections with ophthalmologists and also -- if worst comes to worst -- train you adequately to go on into internal medicine (because that will be your backup plan).
Pros of doing an internship: you can apply for PGY-2 openings if they pop up (and a couple seem to every year); you probably have a backup in IM if you don't match ophtho a second time, and you won't have wasted any time. Cons of doing an internship: you'll be worked hard, you won't have a lot of time to interview or prepare, and you may not be able to add much to your CV. You may or may not be able to build crucial relationships with people that can help you.
2) Do an "established" pre-residency fellowship.
There's a handful out there, mostly pathology-related. I applied to one at Bascom Palmer (1-2 spots, $30k) and two at Utah (3 spots, $30k, and 1 spot, $20k). I believe there was also one at Iowa (possibly paid?). Honestly, if you're an MD with little research experience, these are amazing and I would highly recommend any or all of them if you can get a spot. Your mentors will be well-known and will go out of their way to help you, as their reputation (and their access to high-quality fellows like yourself) depends on their ability to match you.
Pros of a pre-residency fellowship: a mentor that will really go to bat for you, ability to add meaningfully to your CV, ability to pick up some marketable skills. Cons: it's pretty competitive to get in. The Bascom one interviewed 20+ people for one spot last year. Additionally, don't expect to match to the program you're doing your fellowship at, so you won't have that 'safety net'. Finally, the publications you'll have from this are more likely to be case series and the like.
3) Do a research year.
This will really depend on how proactive you are. I think this route is high risk, but potentially very high reward. I'm going to toot my own horn a bit and say that despite getting accepted to the Bascom fellowship and both Utah fellowships, I chose to do a research year instead. Primarily, I did that because I already had a PhD and was seeking more of a "postdoc" experience than a pathology fellowship, and wanted to continue research similar to what I did as a grad student. I just thought I, personally, would get more out of it -- and I got very lucky in that I found a great, super-productive lab with an awesome mentor, and also had the opportunity to work closely with a bunch of clinical attendings (and get paid to boot). If you have similar leanings, this might be the path for you. But I do have to stress that your mileage may seriously vary. If you do go this route, try to look for some of the following:
- Mentor works with clinical attendings (or is one)
- Mentor works with medical students, preferably ones who matched into ophtho
- Mentor is well known in ophtho
- Lab is productive. No publications are ever guaranteed, but if you get in a lab that pumps high-quality papers out, you'll have a much better chance at publishing quickly
- Lab gives you time to work with clinical attendings, preferably in a shadowing/sub-interning fashion
Pros of a research year: you might get serious research done and publish high-impact paper(s). You might build meaningfully toward an academic career. Depending on mentor and collaborators, you might make some great connections. Cons: you might not get much done; your mentor might not be well known or might not know how to help you; you might not get much out of the year.
In all honesty, I'd probably recommend doing an established fellowship if you can, a research year if you can't, and an internship as a last resort. If you have a strong research background and you have a good idea of what you might want to do research on, consider doing a research year > fellowship >>> internship. But I really do feel that internships will not move you forward very much, and will also leave you strapped for time and thoroughly exhausted during interview season.
OK -- so that was a huge post, and a bit of a braindump, but I hope that helps a little. Above all, keep your chin up... it's hell to not match, but it's not the end of the world. In retrospect, I honestly think this past year has made me a better doctor, a better researcher, and a better person to boot. What doesn't kill you really does make you stronger -- and more humble, grateful, and compassionate
Best of luck to you all. Feel free to reply or PM me if you have specific questions or want to discuss more. If anyone else reapplied successfully, please chime in!
