Matching Ophthalmology with No Research

[Undes1]

I posted on the Ophthalmology Forum as well.

My wife is an M3 at a low tier MD School in the southeast.
Step 1: Upper 250s
Step 2: Not yet taken
Clinicals: Honored all Rotations so far.
Lots of volunteering around town and really unique ECs

Her school doesn't have a home Ophtho program and doesn't have any Ophthalmologists as part of the teaching staff. She did her rotation with a local PP ophtho practice but has no other exposure to ophthalmologists through the med school. She absolutely loves the field and was able to get promises for strong LORs from the attendings at the PP clinic.

The problem is that her school is very much primary care minded and don't really have research opportunities available to the students in any of the more competitive specialties.

My wife has pursued a few research projects that we're outside of the school but they didn't pan out. Mainly, COVID cancelled or indefinitely suspended the projects.

Is it possible to match with a great Step 1, great clinical grades, and strong LORs, and unique volunteer and ECs, but with NO ophthalmology research to speak of? Like zero research in the field?

Frankly, as her husband, it's really hard for me to see her so sad and stressed over "trying to find research". I want to help her in every possible way that I can, but I know even less about research than she does.

So I'm posting hoping that y'all maybe have some wisdom or even have some anecdotal stories that it is possible. Do PDs understand her situation with the limited Research and no home program?

EDIT: She matched! It is possible! Woohoo!

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[i-doctor]

Attending here. No research, but I got many interviews and matched several years ago.
Your wife still has a great shot at it. It’s slightly less competitive than 5-10 years ago, as the match rate is nearing 90% for U.S. medical school seniors.
She has valid reasons why she doesn’t have ophtho research experience (including Covid). This should be her narrative: She was blown away by her ophtho experience and is pursuing the field despite no infrastructure or support from her medical school. Make lemonade out of lemons. She’s obviously a TOP performer at her “low-tier” med school. At least one program director will bite!

 

[rtn1]

Is it feasible for her to do a research year at another institution?

 

[Throwaway5129]

I think its in her best interest to try and get a couple publications and/or presentations.
Are there institutions in the same state she can reach out to for reach opportunities? People are more willing to do research completely online now, due to covid? Is there primary care research at her school? I think that would work too.

 

[Undes1]

Attending here. No research, but I got many interviews and matched several years ago.
Your wife still has a great shot at it. It’s slightly less competitive than 5-10 years ago, as the match rate is nearing 90% for U.S. medical school seniors.
She has valid reasons why she doesn’t have ophtho research experience (including Covid). This should be her narrative: She was blown away by her ophtho experience and is pursuing the field despite no infrastructure or support from her medical school. Make lemonade out of lemons. She’s obviously a TOP performer at her “low-tier” med school. At least one program director will bite!

Gosh I hope you're right. She's been reaching out to lots of people about research but still haven't gotten any responses. Maybe they'll get back to her after the holidays.

 

[Undes1]

Is it feasible for her to do a research year at another institution?

That's the great debate we've been having for a long time. But she's gotten mixed responses as to whether she needs to take a research year..

Some folks say there is no chance she'll match without multiple publications, and other folks said that she'd be crazy to take a year given her Step 1 score and LORs.

 

[i-doctor]

I think a research year is not necessary. This isn’t like needing research to get into medical school. Again, 90% of U.S. Med School Seniors (allopathic) match. Admittedly they are a strong group of candidates overall. The odds of matching go way down for every other category.
So if, say, she takes a year off after medical school to do research and then applies, she is now in a different category with a much lower acceptance rate. It is indeed possible that some programs won’t even look at her application and will just ASSUME she didn’t match as a senior…. even before reading it…so it doesn’t even matter what her research is or what her personal statement says. Especially coming from a “low tier” med school.
My opinion is to apply to a lot of programs as a senior and only consider a research year afterwards if she doesn’t match.

 

[Undes1]

I think a research year is not necessary. This isn’t like needing research to get into medical school. Again, 90% of U.S. Med School Seniors (allopathic) match. Admittedly they are a strong group of candidates overall. The odds of matching go way down for every other category.
So if, say, she takes a year off after medical school to do research and then applies, she is now in a different category with a much lower acceptance rate. It is indeed possible that some programs won’t even look at her application and will just ASSUME she didn’t match as a senior…. even before reading it…so it doesn’t even matter what her research is or what her personal statement says. Especially coming from a “low tier” med school.
My opinion is to apply to a lot of programs as a senior and only consider a research year afterwards if she doesn’t match.

Thank you for the response! I believe what you're saying makes a great deal of sense. I've reviewed the SF match data a dozen times but there seems to be a big break between the statistical data and the word of mouth information. So it's cool to hear this coming directly from an attending.

In the military we call the non-data driven, word of mouth/rumor information "gouge". And there seems to be alot of "gouge" out there. Some good, and some really really bad.

Thanks again i-doctor!

 

[ChordaEpiphany]

That's the great debate we've been having for a long time. But she's gotten mixed responses as to whether she needs to take a research year..

Some folks say there is no chance she'll match without multiple publications, and other folks said that she'd be crazy to take a year given her Step 1 score and LORs.

Maybe not the best place to soapbox, but I really hate that the default response is "what about a research year?"

Is it objectively good advice? Sure. It will help the individual applicant most of the time, but I hate that this is now the norm in medicine. Don't have enough of [qualification X] to be competitive? Take more time off and get it! This is just part of the CV arms race that is killing doctors' lifestyles, family time, and incomes more than any sort of corporate takeover or declining reimbursements.

A doctor who trained in the 80s started, on average, at 22 years old, finished med school in 4 years with basically no research and little debt, and then went immediately to residency (with no dedicated research time) and at most one fellowship (with some dedicated research time). A doctor today starts at 24 years old after scraping by for two years with some resume-boosting research/non-profit gig. Then they spend 4 years in med school with a strong possibility of graduating in 5-6 years because many paths now require tons of research or extra degrees. Then they go to residency, where many programs have extended the total training time (e.g., gen surg, now a 7 year residency at many programs), and then to fellowship, heck maybe a second fellowship after that because academic hospitals realized they can make a pretty penny off of attending-level physicians working for $80K/year. Even in MD/PhD, it's now the norm to start at 23-24 and train for 8-9 years and spend several years spinning your wheels as an instructor even after training. When our attendings were med students they started at 22, finished in 6-7 years, did their training, and then started a lab, snagging at R01 on average 10 years earlier than today.

Anyway, when you tally up the total cost of all of this to the trainee it winds up looking like an effective 35% pay cut plus all the stress of many trainees needing to start families in the middle of residency because training has been pushed effectively all the way through the birthing years. Honestly it's completely absurd.

I'm not going to weigh in on OP's situation as I personally have no experience in ophtho matching, but I really hope our generation can get rid of some of this nonsense. Med school should be 4 years, and the best students at the end of those 4 years should get the residencies they want. That will also mean that the best students will sometimes have research and sometimes not have research. Most attendings don't do research anyway. I'm not sure how this absurd trend even started.

I think a research year is not necessary. This isn’t like needing research to get into medical school. Again, 90% of U.S. Med School Seniors (allopathic) match. Admittedly they are a strong group of candidates overall. The odds of matching go way down for every other category.
So if, say, she takes a year off after medical school to do research and then applies, she is now in a different category with a much lower acceptance rate. It is indeed possible that some programs won’t even look at her application and will just ASSUME she didn’t match as a senior…. even before reading it…so it doesn’t even matter what her research is or what her personal statement says. Especially coming from a “low tier” med school.
My opinion is to apply to a lot of programs as a senior and only consider a research year afterwards if she doesn’t match.

Pretty sure OP's wife would do a research year between M3 and M4 given she is a current M3 with plenty of time to push her M4 year (I'm assuming, at my school this would be no problem). So she would still apply as a US senior, but would probably spend a year at another institution in someone else's research group.

 

[Lawpy]

Maybe not the best place to soapbox, but I really hate that the default response is "what about a research year?"

Is it objectively good advice? Sure. It will help the individual applicant most of the time, but I hate that this is now the norm in medicine. Don't have enough of [qualification X] to be competitive? Take more time off and get it! This is just part of the CV arms race that is killing doctors' lifestyles, family time, and incomes more than any sort of corporate takeover or declining reimbursements.

A doctor who trained in the 80s started, on average, at 22 years old, finished med school in 4 years with basically no research and little debt, and then went immediately to residency (with no dedicated research time) and at most one fellowship (with some dedicated research time). A doctor today starts at 24 years old after scraping by for two years with some resume-boosting research/non-profit gig. Then they spend 4 years in med school with a strong possibility of graduating in 5-6 years because many paths now require tons of research or extra degrees. Then they go to residency, where many programs have extended the total training time (e.g., gen surg, now a 7 year residency at many programs), and then to fellowship, heck maybe a second fellowship after that because academic hospitals realized they can make a pretty penny off of attending-level physicians working for $80K/year. Even in MD/PhD, it's now the norm to start at 23-24 and train for 8-9 years and spend several years spinning your wheels as an instructor even after training. When our attendings were med students they started at 22, finished in 6-7 years, did their training, and then started a lab, snagging at R01 on average 10 years earlier than today.

Anyway, when you tally up the total cost of all of this to the trainee it winds up looking like an effective 35% pay cut plus all the stress of many trainees needing to start families in the middle of residency because training has been pushed effectively all the way through the birthing years. Honestly it's completely absurd.

I'm not going to weigh in on OP's situation as I personally have no experience in ophtho matching, but I really hope our generation can get rid of some of this nonsense. Med school should be 4 years, and the best students at the end of those 4 years should get the residencies they want. That will also mean that the best students will sometimes have research and sometimes not have research. Most attendings don't do research anyway. I'm not sure how this absurd trend even started.

Pretty sure OP's wife would do a research year between M3 and M4 given she is a current M3 with plenty of time to push her M4 year (I'm assuming, at my school this would be no problem). So she would still apply as a US senior, but would probably spend a year at another institution in someone else's research group.

The answer to end the arms race is app caps but no one wants to entertain that idea.

If research is required to the level where ophtho programs will screen out someone with a 250+/all honors, there’s a major problem here

 

[ChordaEpiphany]

The answer to end the arms race is app caps but no one wants to entertain that idea.

If research is required to the level where ophtho programs will screen out someone with a 250+/all honors, there’s a major problem here

What we really need is a focus on rate of achievement over cumulative achievement. The issue is that all the top programs feed off of NIH grants, and NIH study sections are full of absurd 50+ year old academics who benefit from suppressing new investigators, elongating post-docs, and demanding more research and more experience. So a 29 year old with a 240/mix of H and HP/10 pubs is a better candidate than a 26 year old with a 250/mostly H/1 pub, because they are more likely to go into academia and then get grants afterwards. Then bottom programs for some reason follow the top programs' priorities (which I still don't understand).

App caps will help, but it doesn't really solve the issue of dragging out training time. People will apply fewer places, but they'll still take the time out of their lives to ensure they are at max competitiveness for those places they apply.

 

[i-doctor]

Pretty sure OP's wife would do a research year between M3 and M4 given she is a current M3 with plenty of time to push her M4 year (I'm assuming, at my school this would be no problem). So she would still apply as a US senior, but would probably spend a year at another institution in someone else's research group.
[/QUOTE]

Between M3 and M4 then is a 50/50 call. Something tells me that her school won’t allow it. Anyway, ophthalmology is a fantastic field. I love going to work every day. There’s a reason why so many of us are still working into their 70’s. Regardless of the income.

 

[rtn1]

anyways, I’m not in optho at all, but I do know that it is a brutal match, with only 74% matching. Anecdotally, I know someone from my school who was AOA and didn’t match.

It really comes down to how risk averse you two are. If I were her I would either plan to apply to a backup speciality (IM?), or take a research year. Seeing how the rest of her app is close to perfect, it seems like a productive research year could give her her pick of programs, while no research might be limiting. Also, how prepared would you two be if she only applies to ophtho and god forbid she doesn’t match? Is she prepared to SOAP? Would the two of you be willing to deal with finding a postgrad position and going through another application cycle if she’s dead set on optho? These are all very personal questions you two should ask yourselves beforehand.

 

[Lawpy]

anyways, I’m not in optho at all, but I do know that it is a brutal match, with only 74% matching. Anecdotally, I know someone from my school who was AOA and didn’t match.

It really comes down to how risk averse you two are. If I were her I would either plan to apply to a backup speciality (IM?), or take a research year. Seeing how the rest of her app is close to perfect, it seems like a productive research year could give her her pick of programs, while no research might be limiting. Also, how prepared would you two be if she only applies to ophtho and god forbid she doesn’t match? Is she prepared to SOAP? Would the two of you be willing to deal with finding a postgrad position and going through another application cycle if she’s dead set on optho? These are all very personal questions you two should ask yourselves beforehand.

Something has gone very wrong in the process if OP’s SO has to think about IM backup just because she couldn’t find ophtho research (and assuming she doesn’t want to do a research year). The system is broken and research years shouldn’t be mandatory even for competitive specialties

 

[Lawpy]

What we really need is a focus on rate of achievement over cumulative achievement. The issue is that all the top programs feed off of NIH grants, and NIH study sections are full of absurd 50+ year old academics who benefit from suppressing new investigators, elongating post-docs, and demanding more research and more experience. So a 29 year old with a 240/mix of H and HP/10 pubs is a better candidate than a 26 year old with a 250/mostly H/1 pub, because they are more likely to go into academia and then get grants afterwards. Then bottom programs for some reason follow the top programs' priorities (which I still don't understand).

App caps will help, but it doesn't really solve the issue of dragging out training time. People will apply fewer places, but they'll still take the time out of their lives to ensure they are at max competitiveness for those places they apply.

I think app caps will pretty drastically reduce the arms race because the main reason contributing to it is overapplication and programs needing to find something/anything to sort through thousands of applications. I don’t think training time will be extended in an app capped world, but that said, I have to agree with your earlier points on the absurd emphasis of research from the senior academics who pretty much are the ones calling the shots here. I just don’t think that’ll be that severe if programs have to look only like few hundred applications as opposed to several thousands

I just find it absurd to see a general expectation of research years in specialties even in low tier programs that actually don’t focus much on research. To think not having research is a red flag where backups need to be considered with a 250+/all clinical Hs AND strong ECs is just completely absurd to me

 

[ChordaEpiphany]

I just find it absurd to see a general expectation of research years in specialties even in low tier programs that actually don’t focus much on research. To think not having research is a red flag where backups need to be considered with a 250+/all clinical Hs AND strong ECs is just completely absurd to me

Absolutely. No one with OP's wife's stats should have to worry about a weak research resume if they want to match a community program. The role of research in a clinician's career is wildly overhyped and unnecessarily emphasized, this coming from an MD/PhD student who strongly believes in maintaining a place for research in clinical practice. Most of the research done by medical students is fluff that no one cites or even reads. The same can be said for most residents.

We're getting absolutely fleeced for almost no benefit for those doing the fleecing, and our generational cohort is somehow cheering it on.

It's so interesting that when threats come from the outside (midlevels, government, private equity) med students rise in unison. When the threat, probably the biggest of all, comes from our mentors and superiors, we bend the knee and beg for more.

The sacrifices made in the name of research or well-roundedness should be in proportion to those sacrifices made by physicians who are currently in their 50s and 60s.

 

[Undes1]

I dont think that my wife has any ambition for research at an academic institution as part of her career. She rotated at a small community PP clinic here that had a mix of all the specialties and she fell in love with Ophthalmology. Of all the years shes been in Med school, the happiest I ever saw her was the 5 week rotation that she did. She would come home and study ophtho material for hours just for fun.. It was a pretty big sign that this was the field she cared about and was truly the most passionate.

She has the sentiment that she'll take any program that is willing to take her. That is to say, she doesn't have a particular program in mind, just the program that fits her best. If that winds up being a community program, then that's just fine with both of us!

But the risk assessment piece (not matching and having to SOAP) is always a consideration. Being a flight instructor its like having a never ending risk assessment computer in mind trying to calculate the next 3 moves, but unfortunately it doesn't translate that well to things as complicated as the Match.

Thanks everyone for the discussion, it has very enlightening for both my wife and I!

 

[i-doctor]

Did she go into the OR much? Surgery is a big part of the field, and is what attracted me the most.

 

[Undes1]

Did she go into the OR much? Surgery is a big part of the field, and is what attracted me the most.

Yes lots of Cataract and Retina surgeries that she was in the OR for and scrubbed in to several. Also I think a MIGS surgery and a few Blephs as well. She loved it and bought a suture practice kit to play with at the house. She really likes hands on medicine and the surgical aspect to Ophthalmology is super attractive to her.

 

[i-doctor]

Excellent. Great exposure. Hats off to the retina surgeons. They are a different breed. I couldn’t do it!

 

[operaman]

ENT attending here so can’t speak directly to Ophtho, but a couple thoughts as someone from a similarly competitive field:

1) is she maximizing her away rotations? Selecting good programs where she has a high chance of matching would be a shrewd move. It sounds from her grades and scores that she is a stellar student and would likely impress on rotation. This might be enough to get faculty to overlook her lack of research. There may also be opportunities to write up a case report or a small series; we occasionally had ambitious rotators (especially those with no home program) who would find ways to bang out a small paper during their rotation, though that was definitely rare.

2) seconding a research year if necessary. Not ideal and may not be necessary, but would make her essentially guaranteed a slot at a good program if she did it. Best between M3-4 if possible.

3) leverage personal connections wherever possible. This means getting the Ophtho attendings she worked with to reach out to any personal connections they have by text/phone/email so let them know about this amazing student. She should ask other attendings if they have any friends at other programs who they could call. I’m not in Ophtho at all, but I know a handful of docs I’ve worked with and who would probably give an app a closer look if I called. You never know who knows who until you ask! I’d email any faculty she connects with and ask if they happen to have any personal contacts.

 

[Throwaway5129]

We've both read of students doing "remote research" but her Dean said that was not a thing at her school. Then again he's not a supportive guy, so maybe he's just being a jerk..

Forgive me if I'm being naive to the situation at her school, but remote research is not something she needs to get permission for or report to the dean (or really anyone). Literally a high student in the middle of a completely different continent could reach out and get remote research opportunities, if the PI at the other institution is willing.
She can just do the research and put it on her ERAS application. No one needs to be informed. If she needs to do onboarding at the location she's doing research at, that's normal, and I don't think she needs approval from anyone at her school to do that.
She just needs email people at other institutions, and let them know she's a student at school X, applying this year to optho, and there's no optho research opportunities at her school so she's reaching out to them, and would like to meet over zoom. She probably just need 1-2 abstracts to be safe, considering the rest of her app.

 

[Undes1]

ENT attending here so can’t speak directly to Ophtho, but a couple thoughts as someone from a similarly competitive field:

1) is she maximizing her away rotations? Selecting good programs where she has a high chance of matching would be a shrewd move. It sounds from her grades and scores that she is a stellar student and would likely impress on rotation. This might be enough to get faculty to overlook her lack of research. There may also be opportunities to write up a case report or a small series; we occasionally had ambitious rotators (especially those with no home program) who would find ways to bang out a small paper during their rotation, though that was definitely rare.

2) seconding a research year if necessary. Not ideal and may not be necessary, but would make her essentially guaranteed a slot at a good program if she did it. Best between M3-4 if possible.

3) leverage personal connections wherever possible. This means getting the Ophtho attendings she worked with to reach out to any personal connections they have by text/phone/email so let them know about this amazing student. She should ask other attendings if they have any friends at other programs who they could call. I’m not in Ophtho at all, but I know a handful of docs I’ve worked with and who would probably give an app a closer look if I called. You never know who knows who until you ask! I’d email any faculty she connects with and ask if they happen to have any personal contacts.

All of those are massively useful suggestions. She spent all day today looking at the away rotation application programs to build a timeline for application submission. I think starting this Monday she's gonna be on the phone and email all day reaching out to potential leads for ongoing research off campus. Hopefully she has some luck!

Thank you for the advice!!!

 

[TelemarketingEnigma]

This advice is probably not helpful for OP given the timeline, but question for people with more ophtho knowledge: if another student found themselves in a similar situation to OP (wanting ophtho at a PC focused school), would there be value in looking for vaguely related research that’s housed within a primary care area (and may therefore be more accessible?) I’m thinking things like vision screening for kids, etc that can be done in a pediatrics/public health setting and doesn’t require ophtho mentorship but still shows interest and research effort.

OP, you sound like a supportive partner and your wife sounds like she would be a great ophthalmologist so I hope everything works out for you both!

 

[i-doctor]

Telemarketing— I believe the answer is yes. Any vision-focused work I believe would be looked upon favorably, especially at a community, non-research program.

( But one thing is certain: you must do an ophthalmology rotation somewhere and be exposed to eye surgery ASAP. I can’t even begin to count the number of med students and nursing students I’ve seen who’ve fainted at watching their first eye surgery, usually right after the initial incision. Out cold. Some were interested in Ophtho beforehand, but not afterwards.)

 

[Matthew9Thirtyfive]

Telemarketing— I believe the answer is yes. Any vision-focused work I believe would be looked upon favorably, especially at a community, non-research program.

( But one thing is certain: you must do an ophthalmology rotation somewhere and be exposed to eye surgery ASAP. I can’t even begin to count the number of med students and nursing students I’ve seen who’ve fainted at watching their first eye surgery, usually right after the initial incision. Out cold. Some were interested in Ophtho beforehand, but not afterwards.)

OP already mentioned his wife has been to the OR for several different types of cases.

 

[i-doctor]

Oh ok, I thought this post was for someone different.

 

[Undes1]

Telemarketing— I believe the answer is yes. Any vision-focused work I believe would be looked upon favorably, especially at a community, non-research program.

( But one thing is certain: you must do an ophthalmology rotation somewhere and be exposed to eye surgery ASAP. I can’t even begin to count the number of med students and nursing students I’ve seen who’ve fainted at watching their first eye surgery, usually right after the initial incision. Out cold. Some were interested in Ophtho beforehand, but not afterwards.)

Yeah she isn't grossed out by the eye at all. Its funny, she'll watch YouTube videos of "CataractCoach" and it makes my stomach churn, but she is all about it. She truly is passionate about eye health and the surgical procedures of Ophtho and her rotation at the PP clinic only confirmed that!

 

[i-doctor]

It’s interesting that you are a flight instructor with a wife who’ll be an ophthalmologist. During residency, I was told that doing cataract surgery as the primary surgeon for the first time is similar to flying a plane for the first time. You don’t really understand what you’re in for until you are in the driver’s seat and are no longer the assistant.
Additionally, doing cataract surgery ALONE without supervision for the first time is like flying a plane alone for the first time. Pretty anxiety-provoking, and the stakes are high.

 

[Undes1]

It’s interesting that you are a flight instructor with a wife who’ll be an ophthalmologist. During residency, I was told that doing cataract surgery as the primary surgeon for the first time is similar to flying a plane for the first time. You don’t really understand what you’re in for until you are in the driver’s seat and are no longer the assistant.
Additionally, doing cataract surgery ALONE without supervision for the first time is like flying a plane alone for the first time. Pretty anxiety-provoking, and the stakes are high.

Yeah the "pipeline" to complete medical school is remarkably similar to that of military flow to get your wings. The aviation community routinely practices what we call "stress inoculation", essentially the instructor crushes you in the plane over and over again so that when the time comes to fly solo, you're ready. I'd imagine that's the same mindset that attendings use. What students perceive as pimping and overly micromanaging is actually inoculating them to the stress of operating without supervision. Demanding more and more precision so that when noone is there to judge them, they demand the same precision of themselves.

 

[Undes1]

Seems like being a DO is better in this scenario. I know of 6 DO ophtho matches last cycle that had 0-2 pubs (more had 0 than not). Former AOA programs, but still crazy when you consider an above average MD like OP would destroy a silly exam like COMLEX

We always joke that her school is pretty close to a DO program in the way that it operates and the style of it's syllabus. Hopefully the statistics that the SF match provides still support the MD match rate in her case!

 

[i-doctor]

Out of curiosity, I’ve done a little searching online on Reddit regarding matching into ophthalmology for someone in your wife’s situation. In regards to away rotations, one commenter cautioned that some Ophtho Program Directors will not write letters of recommendation for visiting medical students. Their “policy” is to write letters for and help only their own medical students. (Perhaps their med school Dean has made this rule). This doesn’t necessarily mean that they won’t rank you highly in the match if they are impressed by you, but it certainly helps your overall chances elsewhere to get a good letter of recommendation from them. So perhaps one of your away rotations should be in a community-based residency program that is NOT directly a department of a different medical school.

 

[hopkinsgal2022]

Speaking as someone with a close friend with similar stats (250s Step 1 and 2, H all but one rotation, lots of volunteering, no red flags) at a low tier US MD school (that doesn't have an ophtho department) *but* who also has a lot of research (multiple pubs, a number of poster presentations) and she is still struggling in this year's ophtho application cycle (<10 ophtho interviews), I would say that unless your wife can find several solid away research electives for this spring/summer that could set her up with several pending manuscripts* by the fall, she should absolutely do a research year if she wants to go into ophthalmology. It sucks and I wish I could give you advice you'd like to hear, but I'll give the brutally honest advice if it helps her not have to experience how demoralizing the cycle would be if she applied with no research.

*Obviously the timeline for publication is somewhat out of one's control, but having manuscripts submitted and pending peer review "counts" on ERAS/SF Match.

 

[Lawpy]

Speaking as someone with a close friend with similar stats (250s Step 1 and 2, H all but one rotation, lots of volunteering, no red flags) at a low tier US MD school (that doesn't have an ophtho department) *but* who also has a lot of research (multiple pubs, a number of poster presentations) and she is still struggling in this year's ophtho application cycle (<10 ophtho interviews), I would say that unless your wife can find several solid away research electives for this spring/summer that could set her up with several pending manuscripts* by the fall, she should absolutely do a research year if she wants to go into ophthalmology. It sucks and I wish I could give you advice you'd like to hear, but I'll give the brutally honest advice if it helps her not have to experience how demoralizing the cycle would be if she applied with no research.

*Obviously the timeline for publication is somewhat out of one's control, but having manuscripts submitted and pending peer review "counts" on ERAS/SF Match.

Yeah… the process is a major mess and completely broken. Thanks for confirming it with this personal anecdote

 

[Lawpy]

Seems like being a DO is better in this scenario. I know of 6 DO ophtho matches last cycle that had 0-2 pubs (more had 0 than not). Former AOA programs, but still crazy when you consider an above average MD like OP would destroy a silly exam like COMLEX

Wait former AOA programs still require COMLEX for all applicants?

 

[MDMechEngr]

It's too bad she does not have a home program. She would certaintly match there as a top student.

 

[i-doctor]

Speaking as someone with a close friend with similar stats (250s Step 1 and 2, H all but one rotation, lots of volunteering, no red flags) at a low tier US MD school (that doesn't have an ophtho department) *but* who also has a lot of research (multiple pubs, a number of poster presentations) and she is still struggling in this year's ophtho application cycle (<10 ophtho interviews), I would say that unless your wife can find several solid away research electives for this spring/summer that could set her up with several pending manuscripts* by the fall, she should absolutely do a research year if she wants to go into ophthalmology. It sucks and I wish I could give you advice you'd like to hear, but I'll give the brutally honest advice if it helps her not have to experience how demoralizing the cycle would be if she applied with no research.

*Obviously the timeline for publication is somewhat out of one's control, but having manuscripts submitted and pending peer review "counts" on ERAS/SF Match.

It depends on how you look at it. Less than 10 interviews (8 or 9?) is pretty strong. Good odds of getting in. Doesn’t really matter whether your friend applied to 20,30, or even 60 programs… although admittedly 8 interviews out, say 60 applications, seems worse somehow!

 

[MDMechEngr]

Less than 10 interviews (8 or 9?) is pretty strong. Good odds of getting in.

Page 4 of the attachment gives us an idea of average # of interviews for optho match and unmatched for the last 3 years.

 

[i-doctor]

Page 4 of the attachment gives us an idea of average # of interviews for optho match and unmatched for the last 3 years.

2021 number of applications per matched individual: 80
Ave number of interviews per matched individual:12

So that “average” matched applicant thinks they are weak and will never match, having gotten only 12 interviews out of 80 applications! That’s what hopkinsgal’s friend thinks…

 

[Undes1]

Out of curiosity, I’ve done a little searching online on Reddit regarding matching into ophthalmology for someone in your wife’s situation. In regards to away rotations, one commenter cautioned that some Ophtho Program Directors will not write letters of recommendation for visiting medical students. Their “policy” is to write letters for and help only their own medical students. (Perhaps their med school Dean has made this rule). This doesn’t necessarily mean that they won’t rank you highly in the match if they are impressed by you, but it certainly helps your overall chances elsewhere to get a good letter of recommendation from them. So perhaps one of your away rotations should be in a community-based residency program that is NOT directly a department of a different medical school.

That's great advice. We built a small list of programs that fit the community model best and maybe we'll be able to determine the LOR eligibility in time. Thanks again for the wisdom!

 

[i-doctor]

One established program that comes to mind which fits this criteria is Henry Ford Hospital in Detroit. 5 residents per year, and not all from T25 med schools.

 

[Lawpy]

I don't want to hijack the thread, but would you give similar advice to someone from a midtier with a 268 Step 1 and no research?

I mean just by going by anecdotes alone like in that post above, it looks like research is necessary

Honestly, i suggest talking to the ophtho faculty/advisers/PD in your school for advice

 

[i-doctor]

I don't want to hijack the thread, but would you give similar advice to someone from a midtier with a 268 Step 1 and no research?

I think the big question is one of strategy. You have a knockout Step1 score. Can one match without research? Should you take a year off for research and then apply as a stronger candidate? OR should you apply first and then only spend a year doing research if you don’t match? The risk of applying first without research is that if you didn’t match at a particular program the first time, they might not even look at your application again the following year and just discard it, despite it being stronger. So it is “safer” to take a research year between MS3 and MS4.
Another strategy is to apply to only half of the programs (40 or so) the first time around if no research, and then if necessary to 80 the second time around with the stronger resume with research experience. That way you are a new applicant to 40 of those programs.
(I think there are about 110 residency programs, but I figure the top 25-30 are out of reach for most people!)

 

[petomed]

Seems like being a DO is better in this scenario. I know of 6 DO ophtho matches last cycle that had 0-2 pubs (more had 0 than not). Former AOA programs, but still crazy when you consider an above average MD like OP would destroy a silly exam like COMLEX

You've got some pretty serious self-confidence issues considering how often you feel compelled to minimize and deride your equals in this profession.

 

[petomed]

You know nothing about me. I am simply stating facts. Every DO friend and colleague of mine will acknowledge that the COMLEX is a silly exam compared to USMLE. There are a few outliers (<5%) who will perform poorly on COMLEX (<490) and good on USMLE (>230) and sing like canaries that COMLEX is "harder" but it is not.

There are thousands of physicians who became licensed through COMLEX only and would not have a career if they were required to take USMLE. Many simply would not have passed. My friends have showed me their DO school Step 1 reports (at one particular school only ~1/3 of the class took USMLE and about 30% of those failed it, then went on to match FM reporting only COMLEX). There is no shame in that.

Also, maybe you should be more concerned with your own career than what others are doing Signing with MD, when is it not ok?

I'm honored you choose to spend your time in my post history. My skin is very thick and frankly, I'm quite happy for any direct or indirect insights you have to offer.

You're quite correct, I don't know you at all. But we all can see the way you choose to present yourself here on SDN. It takes substantial effort to present ourselves differently from who we are, so I'd argue that we have a fairly accurate idea of what you believe based on what you say here.

Here's the latest:
"I am simply stating facts."
"Every DO friend and colleague of mine will acknowledge that the COMLEX is a silly exam compared to USMLE."
"There are thousands of physicians who became licensed through COMLEX only and would not have a career if they were required to take USMLE. Many simply would not have passed."

It may be entirely true that COMLEX is an easier exam than USMLE, I have no idea. But you called it 'silly', not easier. One word devalues while the other strictly compares. Need I say more?

You know for a fact that thousands of physicians who became licensed through COMLEX would not have a career if they were required to take USMLE. Such a requirement would be a paramount change in the game because USMLE is not required right now, nor was it required for those physicians you're referencing. Isn't it possible that if those same physicians had to pass or score high on USMLE instead of it being optional, that they would have prepared differently? Studied a bit more? Further, now DO's would be officially required to endure more licensing than MD's but in the exact same timeline. How can you possibly compare USMLE outcomes in such a scenario when the MD would absolutely have more time to study for the same test? After all, DO's must endure COMLEX exams in order to get their medical degree. Instead of acknowledging such obvious confounders, you choose to post data that supposedly forwards all of your facts.

Please.

We can see exactly how you choose to present yourself.

 

[i-doctor]

Undes1–

I had another thought about choosing where to do away rotations. Look at the residency match lists for a given program— many ophtho programs post profiles of their residents (and which med schools they come from) on their websites. This might give a clue as to where they take some students from…. Also, maybe rotate at a larger program. They may have more ability and leeway to reserve a slot for a great visiting med student. Something like LSU. I think they take 7 residents per year.

No need to beat a dead horse here. Let us know what happens with an update to this thread next year Feb 2023 (ophtho match time) or perhaps Feb 2024. Maybe I’ll remember to check!

 

[Undes1]

@hopkinsgal2022

Sent you a PM!

 

[Undes1]

Undes1–

I had another thought about choosing where to do away rotations. Look at the residency match lists for a given program— many ophtho programs post profiles of their residents (and which med schools they come from) on their websites. This might give a clue as to where they take some students from…. Also, maybe rotate at a larger program. They may have more ability and leeway to reserve a slot for a great visiting med student. Something like LSU. I think they take 7 residents per year.

No need to beat a dead horse here. Let us know what happens with an update to this thread next year Feb 2023 (ophtho match time) or perhaps Feb 2024. Maybe I’ll remember to check!

That's a great idea, we had already weeded out a couple programs that seemed very research heavy using that strategy. Thanks so much for all of your input and support, my wife now has a lead on a potential research project with the PP attendings she worked with, hopefully it can become at least a poster presentation! I'll definitely repost with an update next year!

 

[i-doctor]

Ok, one last post..
Perhaps the most important reason for your wife to do an away rotation at a training institution is to understand what an ophthalmology residency is all about. Far different from just a private practice experience. The residency is hard with a steep learning curve. The field is vast. Neuro, Pediatrics, Glaucoma, Cornea etc. She has only seen a small glimpse into the field.
And then there is the trauma. A lot of terrible things come into the emergency room (especially in big city urban hospitals). Freak accidents. Ruptured globes at midnight. And some emotionally difficult discussions with patients who’ll lose an eye.
She’ll probably fall in love the field even more (as I did), but it is very necessary for her application that she gets this exposure before applying. Just keep in mind that being a resident is way more enjoyable than being a medical student! It can get very boring just looking in from the outside and not doing anything.

 

[Undes1]

@Undes1 do you mind if I PM you?

Of course!