Congratulations! You are officially part of a very special profession and can now start thinking about the next stage of your journey: the decision to pursue a fellowship. This is a big decision.
You will spend the next 30+ years of your career working in your chosen specialty, but it is not easy to make these choices early on. So, where do you start?
Start the process early
By starting early, I mean Day 1 of residency.
This does not mean you need to start residency knowing you will be a retina specialist. Your goal should always be to become the best clinician and surgeon you can be. You achieve this through maintaining curiosity, motivation, and enthusiasm during all your subspecialty rotations.
This can be challenging, especially as a resident running on little sleep. But remember that you are building the foundation for future relationships that could pave the way for your fellowship, first job, and beyond.
Below is a checklist of questions to ask yourself every step of the way to help guide you through the decision-making process.
Download the Ophthalmology Fellowship Application Checklist here
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Ophthalmology Fellowship Application Checklist
This guide to ophthalmology fellowship applications reviews how to choose the right fellowship, tips for preparing from PGY-1 to PGY-4, and a checklist to help you transition to the next step of your career.
Why opt for a fellowship?
Have you ever heard the phrase you don’t know what you don’t know? In psychology, this is called the illusion of explanatory depth, and it represents the fact that we often believe we fully understand something that we do not. This is true now more than ever in medicine.
During residency, I remember hearing from many non-refractive-trained surgeons that refractive surgery was easy. It was only after starting my cornea and refractive surgery fellowship that I realized just how much unseen nuance was involved in the art of refractive surgery. Regardless of your subspecialty, you should plan to approach your practice of medicine as a lifelong journey of growth.
As the breadth and depth of our collective knowledge continue to expand, it becomes increasingly important to subspecialize. This is especially true if you plan to offer specialized care to patients. Not only do most practices look for subspecialty training, but as patients become more informed and tech-savvy, so do patients as well.
This does not mean that fellowship training is for everyone. Think about your future career goals and use that as a guide to help form your decision.
Overview of the ophthalmology fellowship match process
The ophthalmology fellowship match occurs through the central application system (CAS), which can be found on sfmatch.org. The application system generally opens at the end of June (or early July), and it is best to get started on the application as soon as the application system opens.
A non-refundable registration fee covers the central application for up to eight programs. Any program you choose to apply to beyond that requires an additional fee.
Available areas of fellowship include:
- Anterior segment
- Cornea
- External disease
- Glaucoma
- Neuro-ophthalmology
- Oculoplastic
- Pathology
- Pediatric ophthalmology
- Retina
- Uveitis
The exception is oculoplastic surgery. While there are oculoplastic programs available in SF Match, programs that are members of the American Society of Ophthalmic Plastic & Reconstructive Surgery (ASOPRS) are part of a separate application system outside of SF Match.
Deciding which subspecialty interests you
When deciding on a career path, think about the pathology, practice environment, and patients you will be working with. If you like the advanced orbital cases and multi-specialty management of oculoplastic surgery, you will likely be restricted to academic centers.
If you love building lasting relationships with patients but worry about primarily managing a chronic disease, consider what that means as a glaucoma specialist. If you love retinal pathology, can you see yourself taking a call 15 years from now and feeling the same excitement about the pathology?
These are very tough questions to answer, especially as a resident just trying to stay afloat. However, answering these questions early on will ensure that you find a career path synchronous with your goals and passions, paving the way for a healthy and successful career! We have included a checklist to help guide you as you answer these questions at every stage of your training.
The anatomy of the application
The fellowship application includes the CAS found at sfmatch.org. In addition to completing this application, you will need three letters of recommendation and a personal statement.
Be sure to get started on this process, as the CAS requires that you manually input all of your publications, as well as several additional written responses that require some time and thought. This can take several hours and is often completed over multiple days.
You should start working on your statement in June. Focus on highlighting the past, present, and future of your story. Be sure to ask your mentors for letters at least 1 month in advance, aiming for early August submission. You should provide them with your updated curriculum vitae (CV) and explicit instructions for the submission process.
Supplemental information
Most specialties do not require Ophthalmic Knowledge Assessment Program (OKAP) scores or board scores. I am only aware of a few retina programs that requested such information. However, some programs may request a surgical video or some other video showcasing your skills (such as an instructional video of your choice).
These will be announced along the way, but it is a good idea to keep a log of surgical videos in case you need them.
Choosing fellowship programs
Unlike residency interviews, which require a large number of applications to ensure the golden number of interviews, fellowship interviews should be largely concentrated on only programs you would truly consider joining. For fellowship, it is all about finding the right fit.
The more competitive specialties, such as ASOPRS oculoplastic surgery fellowships or vitreoretinal fellowships, may require applying to more programs. Your mentors will be the best resource to help you determine the number and types of programs to apply to.
In choosing programs, consider practice setting, surgical numbers, breadth of pathology, reputation, Association of University Professors of Ophthalmology (AUPO) certification, location, and surgical mentors.
For example, suppose refractive surgery is an important part of your future career. In that case, you may not want to apply to purely cornea fellowships, which offer very little refractive exposure, even if they are considered top programs. Do your research early so that you do not face surprises after the match.
The fellowship interview process
You will generally start to get interview invites in early fall, with interviews taking place from September to November.1 Be sure to have a list of the offered interview dates for all of the programs you applied to (available in the CAS) so that you are ready for any overlap.
As with any interview, this is your chance to get to know your future colleagues. Prepare a few key points and stories that you would like to share so that you leave a lasting impression!
Match time
You made it to your final match! Once the interview process is complete, you can shift your focus to your rank list. Again, discussing this with your mentors is important, especially if you have any doubts about where you would like to be.
I suggest having your mentors reach out to the top program on your list on your behalf. Ophthalmology is a very tight-knit community; a respected colleague's call can go a long way. The rank list is often submitted in early December, with match results being made available a week later.1
Final thoughts
Applying for a fellowship can be daunting, especially when you are still a budding ophthalmologist. Start asking the important questions early in your training so that you feel confident in your choice.
Remember, there is no one-size-fits-all solution, and the decision to pursue a fellowship is always about finding the right fit for you!
