Question about LOR's and what else I should be doing to strengthen my app

[sswang00]

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Hello everyone. I am a 3rd year medical student applying to Optho this fall. I come from a lower tier Medical School in NY (MD program) and am not sure what my rank is. I am not junior AOA and do not know if I will be AOA next year.
USMLE Step 1: 243/99
Clinical rotation's: High Pass in Medicine, OBGYN, Anesthesia, Peds. Honors in Psych and Primary Care. Pass in Neurology. Have not done surgery yet.
Research: One first author at ARVO (still working on the manuscript). One book chapter publication (second author). Working on another project currently but doubt it will be published.

My primary question is concerning my LOR's. I will be asking my medicine attending for a letter, but am not sure who to ask for my other letters. I shadowed an Ophthalmologist for 2 weeks during the summer and am confident he will write me a stellar letter. Am I allowed to receive a letter from him if I did not do an official rotation with him? Will it hold less weight seeing that it was just volunteer work? Also, he is not well known, nor affiliated with any academic institution. I have not yet done my optho elective. I will be doing it this July/August. Even if i perform well during my rotation, I don't know how strong of a letter I could receive from someone at the site by working there just 4 weeks. I also don't know if there are any "big wigs" at the locations where I will be doing my electives. I am a bit confused where I should be getting letters from.
1. from Medicine.
2. from the optho I shadowed over the summer vs another optho during my elective?
3. Should I get one from Surgery?

I am also wondering what else I can do to strengthen my app. I know my clinical grades are not exactly stellar (I should have really honored medicine), but what else can I do? I will work hard to honor surgery for sure. I'll also try hard to work on my manuscript. Should I take step 2 early? Is there anything else I should do? I'm a bit worried about match after seeing how much more competitive it is getting every year.

 

[Visionary]

I assume from your post that your med school does not have an ophthalmology department, correct? If so, that does make things difficult. I think your Step I is fine. Grades also seem fine. I doubt you're gunning for an academic position, so you don't really need top 10 program numbers.

I would recommend going with the Medicine letter, assuming you think it will be a good one. I would consider the Ophthalmologist letter, even if it was just a 2 week shadowing, especially if you think it will be strong. As for the third letter, I would try and lock one up at one of your elective locations. Do your best to dazzle them. Use Surgery as your fallback (work your tail off on the rotation).

Finish your manuscript, and at least get it submitted somewhere before you apply. Keep working on the other project, just to demonstrate scholarly activity, if nothing else.

 

[sswang00]

I assume from your post that your med school does not have an ophthalmology department, correct? If so, that does make things difficult. I think your Step I is fine. Grades also seem fine. I doubt you're gunning for an academic position, so you don't really need top 10 program numbers.

I would recommend going with the Medicine letter, assuming you think it will be a good one. I would consider the Ophthalmologist letter, even if it was just a 2 week shadowing, especially if you think it will be strong. As for the third letter, I would try and lock one up at one of your elective locations. Do your best to dazzle them. Use Surgery as your fallback (work your tail off on the rotation).

Finish your manuscript, and at least get it submitted somewhere before you apply. Keep working on the other project, just to demonstrate scholarly activity, if nothing else.

Thanks for the advice, I will definitely try to finish up this manuscript. My home program does have an optho department. I will likely do a rotation there in July, then an away elective in August. I am just wondering what else I can do at this point.
So it is allowed to have a letter from a physician who you didn't do an official rotation with?

 

[Visionary]

Thanks for the advice, I will definitely try to finish up this manuscript. My home program does have an optho department. I will likely do a rotation there in July, then an away elective in August. I am just wondering what else I can do at this point.
So it is allowed to have a letter from a physician who you didn't do an official rotation with?

Well, that's different.

If you have a home department, it's usually recommended that you try and obtain a letter from the chairman (when I applied, some programs actually required it). If you don't know him/her, call to try and arrange a meeting. Most chairmen will be receptive to your interest and can advise you about your application.

I would also try and obtain a letter from the ophthalmologist with whom you spend the most time on rotation, assuming it's not also the chairman. The doc whom you shadowed could be a backup, but you should really have letters from academic docs, if you have access to them. Ophthalmology is a small community.