MS4: Too late to consider ophthalmology?

[Rocket3004]

Hey All

So I'm a 4th year student, and have been setting myself up for a career in ENT or Rad Onc, as those were two fields I was interested in. I did a rotation in both earlier, and although I liked different aspects of each it was kind of equivocal.

I have had cold feet committing to either field, particularly ENT. The more time I spend on the service, the more I think it isn't for me. I also am interested in research and I don't think being a full time surgeon would really allow for that (something I understood, but thought I would overcome).

After thinking about what I like and dislike about medicine in general, and speaking to friends/other doctors, it seems ophthalmology might be a great fit. I spent a day or two shadowing a resident before, but to be honest, haven't done a rotation or spent quite enough time to think that it is definitely my field.

I would seriously consider applying, and in general, I have a strong application for most specialties. I have a board score where I could apply to ENT or Rad onc, would be elected AOA, top 5% in my class, and have done a pretty significant amount of research in cancer biology (5-6 publications, 1-2 book chapters, 4-5 oral presentations, 5 abstracts, etc. etc.)

I'm really getting very anxious. I tried to set myself as a competitive applicant for whatever field I want to go into, and have a strong interest in academics, but I feel like it is all starting to unravel now. I haven't felt this unsure of myself or my future in my life. I feel like all the sacrifice I made is for nothing now.

So - would it be insane to apply to ophthalmology now??? (assuming I can get some kind of rotation in) I would guess that is an emphatic YES, but I put it out for you all to decide. Especially since I would want to go to a program that has strong basic science (i.e. probably also very competitive).

Thank you for your time.

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[JMK2005]

though you are late, there is still time. you should get in touch with your home school ophth department. get a rotation ASAP. since you are competitive applicant in general, you will be attractive to many programs despite the late start.

 

[Slide]

Different opinion here, and lots of others may disagree as well, but I'll say it anyway.

I assume that this month you're not on an ophthalmology rotation because of your previous statement. The earliest you'll be able to do a rotation is September. Considering that you probably won't get a letter of recommendation until mid-September, and you likely won't have you application complete and submitted till late Sept/early October, your window of opportunity will be slim. By the time your application is submitted to the programs of your choosing, you'll miss half of the programs due to deadlines, and will be forced to compete for an ever shrinking list of interviews.

Your research is great, and will look great to many programs with strong basic science departments. However, for ophthalmology, most interviewers are more interested in ophthalmology-related research. Your current research would be excellent for programs that have ophthalmic oncology attendings, but that is a pretty niche field. Also keep in mind, yes you are a strong applicant, but there are a surprising amount of similarly-strong candidates. Ophthalmology recently has drawn stellar applicants, and each year, it seems the applicants just get stronger and stronger. I'm not saying your chances are impossible, but what I'm saying is that if you want to get into a program with a strong basic science department integrated with the program, the stars will have to align just right for you to get an interview in these highly competitive programs. A lot of these programs tend to take a fair number from their own school, and other accepted applicants usually have a well-known attending vouch for their behalf. Even if you make it, you'll be asked about your recent switch into ophthalmology, and even if you have a great argument, it may not impress people nonetheless (attendings are still like other people with emotions and biases).

Really, if you want to increase your chances, one thing to consider is to do a research year fellowship or a pre-residency fellowship; ophthalmic pathology may be a good fit for you, given your cancer research). It will greatly increase your chances the upcoming year (second-year applicants have a tough time matching, historically) and also give you a break from the chaos of medical school and residency. Anecdoctally, I've met other residents and applicants as both a medical student and resident, and these guys typically do very well once they apply.

 

[TheLesPaul]

I took my ophtho rotation is August. I was all set to apply to IM until then (had rec letters done and everything), and then I decided to apply at the last minute. It worked out, although I didn't get as many interviews as I would have had I had more time to plan (and esp. do ophtho-related research, which is key for the top 10).

I ended up staying at my home school (which was my 1st choice), but had I wanted to leave I think switching at the last minute definitely would have hurt me. Slide is right -- there are a number of very similarly-strong applicants on the trail and unless you published in Nature, it's hard to distinguish from the pack. The key is that it's a really small field so rec letters count for a lot. If you want to stay at home, the faculty can reasonably know you, so it's okay. For outside programs, they will not necessarily be impressed. But it can turn out okay! I am definitely glad I switched and am also glad I didn't take a year off to do it. Just make sure you click submit on SFMatch by 9/1 if you want to do it this year. Good luck!

 

[mydodger]

Regardless of what the very next year of your life will look like you need to do things now to make sure you're setting yourself up for the right long term goals. Do an ophthalmology elective right now and start putting your details into the sfmatch. You're late for the application cycle at this point and you'll need to be okay with having not the best set of letters - maybe just get one ophtho letter and two other strong letters from different fields. Applying this year won't hurt you, but you should have a backup.

However all of that is small stuff compared to knowing whether or not you really want to do Ophthalmology. It doesn't sound like you've really had much experience with the field, and that matters a whole whole lot. Don't set yourself up for disappointment, explore the field before you commit to it.

 

[linevasel]

I echo the others. Your best shot is really at your home institution. if your home institution is particularly strong, then you may end up becoming one of the unfortunate 30% (approx) that don't match. What it really comes down to is how quickly you can get an ophtho letter. Even if you did a rotation in September, you would have already missed the September 1st deadline (of course spots are still open, but you won't have as many interviews as you would have liked). So you need to talk to your chair program director as soon as possible so that you are on their radar (also need to make sure you have a solid story as to your late ophtho interest).

I have heard of people who have switched even later than you and still matched, but basically they had attendings willing to write them a letter on good faith (not an impossible task, but certainly a challenge to decorum). Having said that, I knew one person who submitted their app in the 2nd week of October and still got 2 interviews. (That individual did not match, but he had other issues). So.... it can still be done.

Alternately, you could just take your time, fill out your ENT app, and do your optho rotation. if you love it, give it a go. If you don't match, you can just do intern year or an ocular path/onc year. With your stats, you have a good chance of matching - if you can get programs to actually look at your app. But Ophtho is a very particular world. You need to make sure you love it. Once you go Ophtho, you effectively leave the house of medicine (my Uveitis colleagues may disagree- but you get the drift). You need to make sure it is for you!
Good Luck

 

[mydodger]

you may end up becoming one of the unfortunate 30% (approx) that don't match

Woah woah woah. It's 23% that didn't match last year. Don't round that up to 30 I need all the chances I can get! I have a feeling that the number is better for US senior applicants too but since they never report the number of applicants from each subset it's impossible to know. The number is trending down as the number of applicants trends down as well. It appears our field will not remain a "hot" competitive field for too much longer.