Question about away rotation strategy

[eyemedstudent]

Hey everyone, I was hoping some of you could give your insight into my situation. I am a third year med student who is hoping to match into ophtho next year. I am extremely worried about matching as I did lower than expected on step 1 (235). I have an alright CV bc I was active in research/orgs/volunteering/other ECs starting 1st year and a lot of them were in ophtho, though nothing too big. I have made some connections in the field now that may be able to help as well.

My issue is that my school doesn't offer elective rotations before 4th year, meaning the only elective I would get before applications are due is in August. I was thinking of studying and taking step 2 before that to try and improve and make up for my step 1 score before this first possible elective.

My question is, during this month, do I try to get a rotation at a really good institution in order to get a big letter of rec (even though I'm pretty sure I have zero chance at going there), or do I try to go to a lower-tier program that I have a better chance of getting into? I was thinking about doing electives during Aug/Sept/Oct in ophtho to hopefully try and bolster my chances at getting interviews but I was unsure if it was worth going for a big letter in Aug for my application.

Currently I have 1 ophtho letter from research, I could get another from a small private practice guy who I've spent a bit amount of time with and likes me, and I would probably get one from my IM rotation or some other core. I am unsure of how big of an impact big letters play, especially for a very below avg student like me, versus going to a place I can get into and work my butt off and try to show them that I would fit well there.

Sorry for the long post, I'm just really scared I'm not going to match even though I really love the field!

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[DrZeke]

Hey everyone, I was hoping some of you could give your insight into my situation. I am a third year med student who is hoping to match into ophtho next year. I am extremely worried about matching as I did lower than expected on step 1 (235). I have an alright CV bc I was active in research/orgs/volunteering/other ECs starting 1st year and a lot of them were in ophtho, though nothing too big. I have made some connections in the field now that may be able to help as well.

My issue is that my school doesn't offer elective rotations before 4th year, meaning the only elective I would get before applications are due is in August. I was thinking of studying and taking step 2 before that to try and improve and make up for my step 1 score before this first possible elective.

My question is, during this month, do I try to get a rotation at a really good institution in order to get a big letter of rec (even though I'm pretty sure I have zero chance at going there), or do I try to go to a lower-tier program that I have a better chance of getting into? I was thinking about doing electives during Aug/Sept/Oct in ophtho to hopefully try and bolster my chances at getting interviews but I was unsure if it was worth going for a big letter in Aug for my application.

Currently I have 1 ophtho letter from research, I could get another from a small private practice guy who I've spent a bit amount of time with and likes me, and I would probably get one from my IM rotation or some other core. I am unsure of how big of an impact big letters play, especially for a very below avg student like me, versus going to a place I can get into and work my butt off and try to show them that I would fit well there.

Sorry for the long post, I'm just really scared I'm not going to match even though I really love the field!

Disorganized thoughts :

You will get interviews with a 235. You are below average but not VERY below average. VERY below average is <220-225. And some of those people will still March.

It's hard to get a meaningful letter from a big wig in 1 month. I feel like most of the people who have big letters that are well written got them from people they worked with throughout medical school. I could be wrong but having attended med school with a top 5 eye program, it's my opinion.

So, perhaps a range of middle tier/sleeper programs that interest you? I don't think your letter will be in on time if you do an August elective. You could try and let them know you need a letter early on, but sometimes it's tough. Even if you don't get a letter try and form relationships. I had one faculty at an away rotation email a program for me. But ultimately it was the people I had known for a while that went to bat for me that really helped me out.

So maybe do electives at places you are very interested in that are not top 10-20. People with sub your score match to good institutions (even top 20). I know some of them well, some of it is about who you know and some of it is about away rotations and relationships formed.

Also you haven't mentioned, does your home program have an ophthalmology program? Are there opportunities for you to volunteer or even shadow when you have time? Those relationships should not go underestimated. You don't need a formal elective to have someone back you... That's how I might try and get an ophtho letter in time. If not - you can use the private guy, tho it needs to be incredible.

Basically I would do the rotations at middle tier programs you are interested in. If you want to try for a big letter at a big place it's fine. imho, nothing is really a waste. Believe in yourself and apply broadly. Your score is what it is, and it's not that bad. Also remember programs want to match people that want to be there. I got a lot of regional interviews...because of my state of residence. if you have a connection to a place it's ok to let it be known or go out there. People like to train residents they think will be happy in a program.

Last but not least, you have little control over this process outside of you behavior and the impressions you give off and demonstrating hard work. People know hard work when they see it.

Good luck.

 

[eyemedstudent]

Disorganized thoughts :

You will get interviews with a 235. You are below average but not VERY below average. VERY below average is <220-225. And some of those people will still March.

It's hard to get a meaningful letter from a big wig in 1 month. I feel like most of the people who have big letters that are well written got them from people they worked with throughout medical school. I could be wrong but having attended med school with a top 5 eye program, it's my opinion.

So, perhaps a range of middle tier/sleeper programs that interest you? I don't think your letter will be in on time if you do an August elective. You could try and let them know you need a letter early on, but sometimes it's tough. Even if you don't get a letter try and form relationships. I had one faculty at an away rotation email a program for me. But ultimately it was the people I had known for a while that went to bat for me that really helped me out.

So maybe do electives at places you are very interested in that are not top 10-20. People with sub your score match to good institutions (even top 20). I know some of them well, some of it is about who you know and some of it is about away rotations and relationships formed.

Also you haven't mentioned, does your home program have an ophthalmology program? Are there opportunities for you to volunteer or even shadow when you have time? Those relationships should not go underestimated. You don't need a formal elective to have someone back you... That's how I might try and get an ophtho letter in time. If not - you can use the private guy, tho it needs to be incredible.

Basically I would do the rotations at middle tier programs you are interested in. If you want to try for a big letter at a big place it's fine. imho, nothing is really a waste. Believe in yourself and apply broadly. Your score is what it is, and it's not that bad. Also remember programs want to match people that want to be there. I got a lot of regional interviews...because of my state of residence. if you have a connection to a place it's ok to let it be known or go out there. People like to train residents they think will be happy in a program.

Last but not least, you have little control over this process outside of you behavior and the impressions you give off and demonstrating hard work. People know hard work when they see it.

Good luck.

Thanks for the response, I really appreciate it. I guess I'm just nervous because the averages keep going up and these past couple years, we have had really solid applicants not match, so I wonder how I will match if they didn't.

We do have an ophtho program I know that Aug is late but our school has put us at this disadvantage with our schedule, so it seems that almost everyone here gets their letter from their Aug rotation. They just ask at the beginning and add the letter/app a bit later. Not sure how important submitting right away is.

I really just want to match (planning on applying to every program). I will be ecstatic if I do and will really be happy anywhere. Thanks again for the help.

 

[Bronze Medal]

I agree with what DrZeke said above and will add more thoughts. You should definitely do a rotation at your home program. Additionally, if you can use absolutely any free days (or even free half days) to shadow throughout third year, that is ideal. Relationships are key and you should start forming them now. It will probably be a waste of your time to target top programs for rotations unless you have an incredibly compelling life story, big-time published research or previous connections with huge names in the field. Note that I said probably, not absolutely.

While on your away rotations, ask the residents about the faculty members who have the most sway when it comes to ranking applicants. Then do your best to (naturally, not awkwardly) interact with those people. At some programs the residents also have a large say in ranking. It varies.

You will get different advice from different people, but here is what I think about your original question: Do a rotation during August at a mid-tier program where you spend a lot of time with faculty members. Some places will have you spend a lot of time in the resident clinic which is great for learning, but less so for acquiring a LOR. Find this out ahead of time. Once you target an attending let them know after a week or two that you know it hasn't been very long, but you would be honored and grateful if they were willing to write you a strong letter of recommendation. You need this letter by mid/end of August. You should have your 3 previously mentioned letters ready to go just in case this one doesn't work out or is delayed. That way you can still submit your application by mid-August. You can always send an additional letter later.

Good luck!

 

[immunology89]

I agree with what DrZeke said above and will add more thoughts. You should definitely do a rotation at your home program. Additionally, if you can use absolutely any free days (or even free half days) to shadow throughout third year, that is ideal. Relationships are key and you should start forming them now. It will probably be a waste of your time to target top programs for rotations unless you have an incredibly compelling life story, big-time published research or previous connections with huge names in the field. Note that I said probably, not absolutely.

While on your away rotations, ask the residents about the faculty members who have the most sway when it comes to ranking applicants. Then do your best to (naturally, not awkwardly) interact with those people. At some programs the residents also have a large say in ranking. It varies.

You will get different advice from different people, but here is what I think about your original question: Do a rotation during August at a mid-tier program where you spend a lot of time with faculty members. Some places will have you spend a lot of time in the resident clinic which is great for learning, but less so for acquiring a LOR. Find this out ahead of time. Once you target an attending let them know after a week or two that you know it hasn't been very long, but you would be honored and grateful if they were willing to write you a strong letter of recommendation. You need this letter by mid/end of August. You should have your 3 previously mentioned letters ready to go just in case this one doesn't work out or is delayed. That way you can still submit your application by mid-August. You can always send an additional letter later.

Good luck!

I'm applying this year and submitted everything in early August because everyone told me to. Curious as to how important it really is to submit in in August especially if u have a circumstance like this OP. Most programs don't send out invites until October.

 

[Bronze Medal]

I'm applying this year and submitted everything in early August because everyone told me to. Curious as to how important it really is to submit in in August especially if u have a circumstance like this OP. Most programs don't send out invites until October.

You want your application complete on SF Match by the end of August. This means submitting it by mid-August. I sent mine the beginning of the third week of the month and it was complete by the middle of the fourth week. First invite two days later.

 

[eyemedstudent]

I agree with what DrZeke said above and will add more thoughts. You should definitely do a rotation at your home program. Additionally, if you can use absolutely any free days (or even free half days) to shadow throughout third year, that is ideal. Relationships are key and you should start forming them now. It will probably be a waste of your time to target top programs for rotations unless you have an incredibly compelling life story, big-time published research or previous connections with huge names in the field. Note that I said probably, not absolutely.

While on your away rotations, ask the residents about the faculty members who have the most sway when it comes to ranking applicants. Then do your best to (naturally, not awkwardly) interact with those people. At some programs the residents also have a large say in ranking. It varies.

You will get different advice from different people, but here is what I think about your original question: Do a rotation during August at a mid-tier program where you spend a lot of time with faculty members. Some places will have you spend a lot of time in the resident clinic which is great for learning, but less so for acquiring a LOR. Find this out ahead of time. Once you target an attending let them know after a week or two that you know it hasn't been very long, but you would be honored and grateful if they were willing to write you a strong letter of recommendation. You need this letter by mid/end of August. You should have your 3 previously mentioned letters ready to go just in case this one doesn't work out or is delayed. That way you can still submit your application by mid-August. You can always send an additional letter later.

Good luck!

I will definitely do one at my home program, though most likely in September/October. I've been doing my best to shadow a bunch of ophthalmologists and developing relationships. It has been tough to actually go in at my home program; for some reason they haven't been too receptive to have students shadow for some reason but I will do my best.

So you think its more important to get the application in early versus waiting for the letter/Step 2? Also, what is the best way to find out about which programs are within my reach to rotate at and also find out about the faculty time? Just talk to previous students + SDN/online?

Thanks so much for your help!

 

[Bronze Medal]

So you think its more important to get the application in early versus waiting for the letter/Step 2? Also, what is the best way to find out about which programs are within my reach to rotate at and also find out about the faculty time? Just talk to previous students + SDN/online?

Yes to your first question with regards to your LOR. Unless you absolutely need a third letter, in which case you obviously won't be able to submit your application by mid-August. With regards to Step 2 in your case, a great score could really help your application. I would recommend scheduling Step 2 early enough that your score will be available by mid-August. Unless you don't think you will be able to increase your score, in which case I would plan to delay it. I assume you are a third year. This means you have a whole year to plan your approach, make connections, and put together your application. It's great that you are thinking about these things already.

PM me if you have questions about particular programs. Otherwise search through the forums to find program reviews and talk to students from your school who have previously matched ophtho.

 

[eyemedstudent]

Yes to your first question with regards to your LOR. Unless you absolutely need a third letter, in which case you obviously won't be able to submit your application by mid-August. With regards to Step 2 in your case, a great score could really help your application. I would recommend scheduling Step 2 early enough that your score will be available by mid-August. Unless you don't think you will be able to increase your score, in which case I would plan to delay it. I assume you are a third year. This means you have a whole year to plan your approach, make connections, and put together your application. It's great that you are thinking about these things already.

PM me if you have questions about particular programs. Otherwise search through the forums to find program reviews and talk to students from your school who have previously matched ophtho.

Thanks again for your help, I really appreciate it. I think should be able to get 3 letters in time, no problem. For Step 2, I think I would have to take it by end of July in order to have enough time to properly study and get a good score, just because of the rotation schedule I'd have (I'd guess I would get my score by September in that case). I think Ill see how I feel later on, because right now I'm still fresh into 3rd year.

I will try to ask around and read as much as I can; luckily I have plenty of time before I have to start truly deciding on where to do those aways. Thanks so much!

 

[DrZeke]

Yes to your first question with regards to your LOR. Unless you absolutely need a third letter, in which case you obviously won't be able to submit your application by mid-August. With regards to Step 2 in your case, a great score could really help your application. I would recommend scheduling Step 2 early enough that your score will be available by mid-August. Unless you don't think you will be able to increase your score, in which case I would plan to delay it. I assume you are a third year. This means you have a whole year to plan your approach, make connections, and put together your application. It's great that you are thinking about these things already.

PM me if you have questions about particular programs. Otherwise search through the forums to find program reviews and talk to students from your school who have previously matched ophtho.

Do you really think his step 2 score will really make a huge deal for his 235? I just don't think it matters that much. Step 2 redemptions are for truly subpar applicants. He has a below average score but it's a respectable score nonetheless.

 

[Bronze Medal]

Do you really think his step 2 score will really make a huge deal for his 235? I just don't think it matters that much. Step 2 redemptions are for truly subpar applicants. He has a below average score but it's a respectable score nonetheless.

I think a 20 to 30-point increase could get him over the hump at a few programs. Otherwise you are correct, I don't think it will make a big difference.

 

[eyemedstudent]

Do you really think his step 2 score will really make a huge deal for his 235? I just don't think it matters that much. Step 2 redemptions are for truly subpar applicants. He has a below average score but it's a respectable score nonetheless.

I think a 20 to 30-point increase could get him over the hump at a few programs. Otherwise you are correct, I don't think it will make a big difference.

Interesting.. so I have no idea how this year will go but historically I've never been a stellar test taker. I was thinking to push myself and hope for a ~250 on Step 2. So you think that if I got a 245-255 it really wouldn't make that much of a deal? Do you think that I'd be better off not taking it until later instead (like December).. because then I'd have the option to do a 2 week 'unofficial' elective at the end of July and could maybe get in the door at one of my local programs for those two weeks instead.

 

[DrZeke]

In my experience, Step 2 is a lot like your shelf exams 3rd year. If you consistently do well on your shelf exams, and by well, I mean relative to your class average, then it gives you a sense of how tough Step 2 will be for you.

If you're confident you can hit a target above your current step 1, I say go for it. However, if studying and taking time off for step 2 is going to mess up your rotations and stuff and diminish face time with local programs, then just hold off. This is only one person's opinion, but step 2 can rescue you if you have a step 1 score that makes them doubt your ability to do well on a standardized test. Or makes them concerned that you might fail boards. Maybe you didn't destroy step 1, but across the nation you have a very respectable score. The PD's know the averages just keep going up and I just don't think they are going to be like "WOW", if you get anything under a 250 on step 2. They will probably like, step 2, "check" and move on.

DrZeke

 

[eyemedstudent]

In my experience, Step 2 is a lot like your shelf exams 3rd year. If you consistently do well on your shelf exams, and by well, I mean relative to your class average, then it gives you a sense of how tough Step 2 will be for you.

If you're confident you can hit a target above your current step 1, I say go for it. However, if studying and taking time off for step 2 is going to mess up your rotations and stuff and diminish face time with local programs, then just hold off. This is only one person's opinion, but step 2 can rescue you if you have a step 1 score that makes them doubt your ability to do well on a standardized test. Or makes them concerned that you might fail boards. Maybe you didn't destroy step 1, but across the nation you have a very respectable score. The PD's know the averages just keep going up and I just don't think they are going to be like "WOW", if you get anything under a 250 on step 2. They will probably like, step 2, "check" and move on.

DrZeke

Thanks for the input. I guess that's just a decision I'll have to make as the year goes on. I'll see how rotations go and how well I do on shelf exams throughout the year in order to make a better decision on whether I think I'll be able to kill it. If not, I guess doing a mini away rotation would be more worth it to hit one more potential residency. I appreciate the help!

 

[SphereGlobe]

I'm in a similar situation as the OP - I am a third year who just decided I want to do Ophthalmology this year. Like the OP, I also have a 235. How important is it to get my application in early? When applying to medical school, I submitted my AMCAS in very early June and I felt this made a huge difference given the rolling interview invites. Is there a soft deadline by which I should be submitting my application within the time period that SF Match is open?

 

[Trefoil]

I'm also going to say that it doesn't hurt to apply to a back up specialty. If you are 100% set on Ophtho, you could just go for it and do a research fellowship, but remember those are competitive and not a guarantee match in the end. Obviously, most people will match, but there are still a large number that fail to, and it doesn't hurt to have a plan b. I have heard of and saw strong applicants fail to match this year, so it is worth having a back up.

 

[elementals]

A bit of a dissenting opinion here -- I talked to a lot of people who didn't match this year, and unfortunately having a step score of 235 or lower was a common theme amongst a shocking number of them. I'm usually not one to say "your well-above-average score isn't good enough!", but after this year I really feel that programs are using appalling high step scores (240 or 235!) as a filter. It's just an unfortunate side effect of people starting to apply to more and more programs with higher and higher scores, resulting in programs getting flooded with 500 nearly indistinguishable apps. The easiest way for them to cut that down is to filter out below-average scores, IMGs, DOs, etc.

None of this is to say you have no chance, of course; it just means you'll have to do something to compensate. If you have a bigwig letter or a top 10 med school, I think you can fairly easily overcome this; if not, you're going to have to find other ways to stand out -- and possibly have someone call around on your behalf to get your application looked at.

If you can see yourself happy in another specialty, applying to a backup is never a bad idea either. It's exhausting, and there are definitely purists that will snit about it (so don't tell program directors that you're dual-applying, ever), but the bottom line is it's a competitive field and you need a job.

 

[SphereGlobe]

Has anyone else found 235 to be a cutoff this year? Does it go higher - even up to 240? Did these people have other things to boost them - good clinical grades, publication records and letters?

 

[Pinkertinkle]

Do 3 rotations. A rotation will usually get you an interview if you're not a jerk. 3 additional interviews are huge when most people are getting 6-10 total (see the post match survey post).