How to Approach the SF Ophthalmology Residency Match Application

When is ophthalmology match day? February 1, 2023

How important is it for applicants to submit their applications by September 1st?

Nattis: I would get it in by the deadline. We were told to submit our applications as early as possible, so I made sure to submit on the 1st possible day (which was July 1st at the time). The people who work at the SF Match are incredibly helpful in terms of letting you know if your application is complete. The earlier you get your application in the better because not only is it off your plate, but you also can update sections later pertaining to publications, scores, etc.

According to the SF Match, there are 122 programs that applicants can apply to. How do they select which programs to apply?

Nattis: Eric and I both applied to programs in the areas we wanted to live in. I liked programs that had at least 3 residents per year because you had other co-residents to learn from and lean on. I also liked programs that had all subspecialties available. There are some programs where residents rotate outside of their own home location to get exposure to certain subspecialties, which can be a disruption to some but great for others. I also gravitated towards programs that were very busy surgically.

When I met residents on the interview trail that told me they had a lot of cases during their first year, that was a tip-off that that was a place I wanted to be. Your ophthalmology residency is meant for you to get experience. You have 3 years to get your clinical and surgical experience and become comfortable with what you are doing. Whether or not you plan on doing a fellowship, you want to come out feeling confident treating patients clinically and surgically on your own.

Rosenberg: I classify programs into 3 categories: Research programs, surgical programs, and programs that do both. In a perfect world, all programs would encompass both aspects fully, but 3-4 years of training is simply not enough time to be able to accomplish everything that some people would want to get out of programs. I think all aspects are important so it’s largely person-specific and each applicant needs to decide what they want to get out of their residency program and choose accordingly.

Alanna and I agreed that we wanted to go to a place with no fellows where we got a lot of hands-on experience. We got to do a lot of everything, even things that we were not going to utilize frequently in our everyday practice. It was important for us to know that if we got into a complex situation, we would be comfortable handling it because of our experiences during residency.

There is a limit of 18 interviews that an applicant can accept. How will this affect medical students applying to residency and why do you think the SF Match implemented this policy?

Rosenberg: I think they did so to make the matching process more equitable across the field. Previously, it was said that if you received 11+ interviews, you were pretty well teed up to match. It may redistribute interviews from applicants receiving far more than 11 interviews to those who got fewer and increase their chance of matching.

Nattis: I agree. I also believe that it helps applicants be more selective and realistic in the programs they apply to. With a limit on the number of interviews you can accept, it’s not necessarily as important to apply to a huge number of programs.

In the past, Step 1 was the gold standard in determining the competitiveness of an applicant. Now that Step 1 is becoming pass/fail, will the importance be shifted to Step 2, or do you feel that more emphasis is going to be placed on other aspects of the application?

Nattis: I think the answer is going to be both. Each program weighs attributes differently, but I do believe that the shift will move towards medical school grades/class rank. That being said, if they have a huge stack of applications and need to find a criterion to narrow them down quickly, then Step 2 may gain importance. It is definitely going to be a trial-and-error process for programs over the next few years.

If you are a DO, how important is COMLEX?

Nattis: It’s important to do well on both USMLE and COMLEX--COMLEX should by no means be neglected. It is very important because it is the osteopathic board exam. It is one thing to do well on the USMLE but if you do well on the USMLE and terribly on the COMLEX, that can raise questions to programs.

Should you include only medically relevant or a combination of medically relevant and non-medically relevant jobs?

Nattis: Both are probably helpful because it helps show who you are as a person. If you did the job for a week, there is no need to include it. That said, if you did the job for the summer or took time between college and medical school to work, it is a great idea to put it in your application.

Rosenberg: I agree with Alanna. You never know where a person reading your application is going to hone in on. What if you worked at Best Buy and they did too before going to medical school? It could create a great jumping-off point to begin the conversation. It is often the most random area where you find similarities with people that may or may not be at your level of medical training. We are all people and look for commonalities and discussion points.

How many years back should you list your employment history?

Nattis: I think college is fine. If you started doing medically related jobs/research prior to college, these items may be worth including as well.

How important is it to have publications when applying to an ophthalmology residency?

Nattis: I feel it’s very important, even if they are not in the field of ophthalmology. They may carry even more weight, especially if you are interested in an academic residency program and pursuing more of an academic career.

Rosenberg: It is important, and you will see that the level of attention to research is relative to the program itself. If you are applying to the University of Washington where the vast majority of MDs also have PHDs, then they will want to hear a lot about the basic science research you conducted. If you are applying to a more community-based program that has a stronger emphasis on say surgical skill rather than research, they may not see it with the same relevance but can appreciate the level of effort and grind that went into it. It is never going to hurt you to include all your research. They want to see that you are helping to develop/evolve the field that we love. I think that that is what medicine has been about since the dawn of time.

Do publications need to be peer-reviewed or are non-peer-reviewed journals also beneficial for applicants to publish in?

Nattis: I would include everything!

How do you suggest filling the section out/formatting it?

Nattis: As long as it is organized you are going to be okay. The way you listed these categories in your CV is probably the best approach. For example, Eric and I both mirrored our CVs and formatted them in bullet points.

What do you suggest including in this section?

Nattis: This is hard because you may not know what your career objectives are yet. When I filled it out, I made sure to include that I was really focused on obtaining excellent surgical training which is incredibly important. Interestingly, I did not focus much on research goals for my residency application, yet here I am, director of research for our practice. Things change during residency and beyond. You want to fill it out honestly with full knowledge that your objectives may change, and that’s okay. I don’t think there is a wrong answer.

It is important to include what you want to get out of your ophthalmology residency program and that should include becoming competent in surgical techniques, becoming an advocate for your patients who is able to properly explain risks/benefits/alternatives, being clinically competent, and if you are interested in research, it is important to include what kind. It’s important to state how your objectives will shape you as an attending once you graduate. I think that is what programs are looking for. I can’t imagine them looking for you to say that you are going to invent the next phaco machine. They just want an honest response.

What information do you suggest including here and how would you format it?

Nattis: I would include any ophthalmology electives, externships, or summer electives. You can list your experiences in chronological order and bullet-point format.

How important do you feel public service experiences are to residency programs and how would you format this section?

Nattis: Again, I would keep this in bullet point format. I think that most applicants will have some degree of this; however, some will have more than others. I don’t think you will be judged one way or another and that they simply want to know what your involvement has been. If you look at all the questions that the SF Match asks you, they are trying to garner as much information about you as possible in a short application so that when you do have your interview, they have a good background and can reference things. I think when applicants start including points that they think programs directors would want to hear, rather than reflect on their own experiences – that is when they get themselves into trouble.

Rosenberg: Even if it is only one experience, you can include a nice excerpt from it explaining to them what you did and why it was so beneficial. There are people that make an entire career out of charity work but not everybody needs to do that. I suppose a good conclusion to draw after doing this interview, is that we do not need everyone to fit a particular mold. They are looking for well-rounded individuals.

What would be your approach to this new format?

Nattis: I would answer truthfully and in a succinct manner.

Rosenberg: I believe in net neutrality or positive. You don’t want to do anything that hurts you, so if that means defaulting to the status quo or writing something more generic then do that. If you really feel that it’s going to be beneficial to write something a little bit more personal or abstract, then do it.

Do you feel that programs are looking for certain personality traits in their applicants when reviewing personal statements?

Rosenberg: It’s funny you ask that. I think programs are having difficulty trying to assess who is going to be good/bad for their program based on generational gaps that they are having difficulty overcoming. They are probably asking the same question that you are, so my answer to that is probably no. Just be yourself and display who you are.

Bonus advice from the experts

What are the most important aspects a medical student should focus on during their first three years of medical school to become a competitive ophthalmology applicant?

Rosenberg: Study!

Nattis: “When I started medical school, I somewhat knew I wanted to do ophthalmology, but also wanted to make sure that it was the right fit for me. Even if you are lucky enough to come into medical school with some background experience in ophthalmology and you have an idea of what it’s about, it’s important to keep an open mind because you may end up really enjoying another specialty.

The best way to prepare yourself is to continuously immerse yourself and try your best regardless of the rotation and do well in your 1st and 2nd-year courses. If you find something you really like, especially between 1st and 2nd year when you have fewer obligations, look for local shadowing opportunities. That said, the best thing you can do is set yourself up with an outstanding academic foundation on paper because it is so readily available to residency programs.

Rosenberg: It is really a tricky question because of how things are changing. The USMLEs are going to a pass/fail system. Doing well on the boards really mattered before. I do not know what that will entail moving forward so you need to start looking at the other aspects that are not board-related which people look at including your course curriculum/where you fall within your own medical school and your exposure to ophthalmology. That is going to become more important than it was in the past. I think it’s a good change that’s getting enacted because it’s going to be less dependent on your boards and more dependent on your exposure to the outside field.

Nattis: Programs do put weight on how you do in medical school (they do not just look at your board scores). If you think of medical school as a marathon, your medical school grades demonstrate that you have the stamina to do well over an extended period of time, rather than only on a one-day exam.