Transitional year vs research year for IMGs aiming for ophthalmology

[Doctor Rabbit]

Hi everyone!

I’m a final year med student in Taiwan and my wife is a licensed MD in Taiwan. We both aim to pursue a career as an ophthalmologist in the States and are very concerned about our situations.
As IMGs, doing a transitional year sounds amazing to us as it provides us with the opportunity to familiarize ourselves with the US healthcare system and hopefully also get hands-on opportunities in ophthalmology at the same time.
However, we have heard that doing a TY could be a red flag for future matching as it’s very rare for someone to aim to match into transitional year residency unless they can not get into categorical positions, which is unfortunately, very likely to be our case during our first year in the States, due to our lack of experience with the US healthcare system and any sort of connections with US ophthalmologists, let alone getting LORs from them.

We have seen some programs that include 4-6 months of selective blocks in which ophthalmology is one of the options. We are wondering if this usually implies that we are able to rotate in ophthalmology for 4-6 months straight or if there would be an upper limit for ophthal rotation and we would have to choose from other selective specialties.

An alternative option for us doing a TY is to do a research year. We have heard that one of the good things about doing a research year is that it can provide an opportunity to develop a stronger longitudinal relationship with a faculty member and perhaps adding some publications to strengthen our CVs. But we are concerned that we won’t be getting enough opportunities for any kind of clinical experiences during the research year, so by the end of our research year program we are still unfamiliar with the US healthcare system.

Thank you for your time in reading this post. Any suggestions would be very much appreciated since resources are rather limited for IMGs.

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[eyeeye_captain]

First, clearly you and your wife are very accomplished individuals, and I congratulate you on doing so well professionally.
Second, I want you to do well, because everybody wins when everybody wins.
Third, oh boy, you have a mountain to climb.

Ophthalmology in the USA is not averse to good IMG candidates. The problem is, your application REALLY has to jump off the page. And now you're talking about two applications.

If you look at the last 3 years of residency match data for IMGs:
Of all applicants, 41.9% received interviews, with 39.6% of those matching, which is a 16.6% overall rate.
If you look at last year, 39.4% received interviews, with 32.6% of those matching, which is a 12.8% overall rate.

No matter what you do, especially if you and your wife want to be in the same city, it's going to be tough - there are only around 460 residency spots yearly. Like I said previously, I want you to win, but being realistic, it's going to take a lot of luck.

Research years will be more useful than a TY. That gives you a chance to connect with people who know people (ophtho being a small field) and build a CV. Those TY programs that let you do a ton of ophtho do not generally have the big name folks who can call a residency program and say "take this guy/gal." These years have significant differences in compensation and location, which can be a real issue.

 

[gyngyn]

Although Ophthalmology does not participate in the NRMP Match, you can get an idea what your odds might be in other specialties here: https://www.nrmp.org/wp-content/uploads/2022/07/Charting-Outcomes-IMG-2022_Final.pdf

 

[voxveritatisetlucis]

Even low tier USMD students have a tough time with ophthalmology. You would likely need to have solid connections (ie multiple research years and or be connected to a PD) to be competitive

 

[OraclePL]

Research year. As an IMG you may need more than one. Think long and hard about how much time and effort you’re willing to spend on the ophthalmology dream.

If you do research aim for a program that has either taken IMGs in the past, or with someone with some weight. In a small world like ophthalmology a letter from a big name carries far.

 

[NotAProgDirector]

Agree with the advice above. You will need outstanding USMLE scores (Step 1 is P/F, only Step 2 is scored). You'll need outstanding research - and that's almost certainly more than one year (unless you have great research from Taiwan). And even with that, chances are not good. Not mentioned in your post is whether you need a visa or not -- needing a visa will decrease your chances.

And getting a Transitional Year spot is also not easy, especially without US experience. And no, you won't be able to do 6 months of Ophthal as a TY resident -- you'll likely get a max of 2-4 weeks or so (although that might depend upon the program).

The honest truth: very unlikely for one of you to get a spot, essentially impossible for both. If you want to come to the US, choose another field. As a final year student, do rotations here in the US (although they often require prior completion of the USMLE exams).

 

[Mr.Smile12]

Giving a different perspective, I suggest finding an International observership. No it won't get you directly where you want to go, but if you want to take a few months to a year, see if a hospital or academic medical center has such spots your can apply to. Find out what is involved.

I don't know if you go to professional conferences already, but I would also network with US faculty or programs there if there are some courses you can take in the United States for a few months, maybe you can do it.

 

[estes8000]

Transitional year programs that offer more than one month of ophthalmology only accept people who have already matched (a few months before) into the ophthalmology residency program at the same medical center as the transitional year.

 

[Esmolol]

Disclaimer: I do not know much about the whole process, thus take it with a grain of salt. I do not know you nor do I know your wife, and I do not know your immigration status thus I am going to make assumptions that both of you are average and that both of you need a visa.

Ophthalmology is quite competitive and matching it is challenging. Matching it as a couple is even more challenging. Matching it as a couple of non-US IMGs falls probably at the very far end of the challenging spectrum. Both of you would have to go through the whole USMLE process (Step 1, Step 2 CK, and possibly Step 3). Then - there is the visa issue...

Transitional years, as far as I know, are offered to graduates who have an advanced program after that already lined up or they re-apply next year.

A research year at a US institution would possibly be a good idea. It'd give you exposure to the US. Most likely not clinical practice because you'd be doing research - not clinics. It'd give you a "way in" but it wouldn't be a magical key to the future. And, again, there is the visa issue which I think for a research year would be harder to overcome than for an actual match.

 

[Doctor Rabbit]

Thank you all for the detailed advices!! We really appreciate all the helps and now have a better understanding of our situations as well as possible future planning. We can't thank you all enough for all these helps and we will continue to work hard to achieve our dreams. We wish everyone a very happy new year!