Ruwan Silva, MD
Contributing Writer
Background:
Once the decision of which specialty to enter is made, the process of securing a residency position to further one’s training in that field remains. In the case of ophthalmology the process is a bit more complicated than in most other specialties. Firstly, the ophthalmology residency application process is notoriously competitive. There are generally 450 positions in the United States and approximately 800 applicants for these spots. More revealing is that the more prestigious residency training programs solicit around 300-400 applications for 3-7 positions. Also repeatedly enforced to applicants is that the standardized test scores and medical school grades of ophthalmology candidates makes this applicant pool the most competitive of any medical specialty.
In terms of application details, the process of residency matching consists of attempting to place applicants to one and only one residency training program while trying to accommodate the applicant’s favored choice of residency programs and the various programs’ favored choice of applicants. Thus, once assigned students are essentially bound to spend three years of residency in one region of the country. Since some of the more prestigious and reputable residency positions are scattered in all corners of the country, flexibility on the part of applicants is extremely valuable but often implausible given familial or social constraints. Additionally, ophthalmology applicants undergo two rounds of this “matching;” the first match occurs 2 months earlier than that of all other specialties and places ophthalmology applicants in the second through fourth years of their training (which focuses exclusively on training in ophthalmology). The second round of matching attempts to match ophthalmology applicants to their first year of residency training (internship) which is offers a broader range of medical training-usually in medicine, surgery, pediatrics or programs offering a combination of these specialties.
Personal:
What the earlier application process means is that the decision to pursue ophthalmology must occur earlier than that of other specialties and that medical students must be organized in and well-informed about their application efforts. Additionally, the process of making oneself a competitive applicant by residency programs’ standards must also occur earlier. My decision to pursue ophthalmology became definitive in January of 2007, after I had completed Stanford’s introductory course in ophthalmology. That meant that any ophthalmology specific endeavors were to occur in the 8 months immediately following that decision during which time I would also be preoccupied by additional medical school rotations. Thus, the research projects Stanford’s ophthalmology faculty graciously offered me were undertaken in the evening hours after a full day of hospital responsibilities, the result of which was many sleep deprived weeks.
An additional hurdle is completing the actual application process itself. Materials students must submit to residency programs include an official college transcript, an official medical school transcript, official standardized test score reports, 3 letters of recommendation, an essay outlining the student’s specific desire to specialize in ophthalmology and finally a curriculum vitae.
Of all the components of my application, composing my personal statement was the most enjoyable. On a free Saturday, I drove up the California coast and found a suitably isolated beach with few distractions and vistas of the Pacific Ocean. I perched above the beach, on an overlaying cliff, for several hours with only a pencil and paper and considered the process which brought me to my current desire to pursue ophthalmology. The result was my revisiting experiences from my third year of medical school, reflecting upon why ophthalmology appealed to me from a basic science research perspective and simply considering what I hoped to accomplish in my career. I placed down on paper the near stream of consciousness array of ideas, returned to my dorm room for the remainder of the day and simply organized and typed my thoughts into an essay coherently expounding upon and tethering together these ideas. I suspect many decades from now I shall look back and evaluate my career based on the professional and research goals to which that essay alludes. This initial draft was then reviewed by two of my academic advisors who returned it to me with minor editorial advice. Incorporating most of their commentary and rephrasing the essay myself over the next few days, a final copy was complete within one week. Particularly challenging was trying to convey often very subjective viewpoints with the economy of words requisite by the essay’s word limit while trying to avoid both overly emotional language and what admissions committees would view as contrived reasons for entering ophthalmology (even if these reasons were, in fact, genuine). An additional point of concern is that essay readers have seen hundreds of applications many of which have likely touched upon similar reasoning for entering ophthalmology, thus avoidance of a trite essay was also paramount.
The remainder of the application was simply a matter of ordering test results as well as transcripts from college and medical school (fairly straightforward processes given their now online and automated disposition) and putting to paper my CV, which was perhaps more burdensome. The medical school provided us with a sample CV format but the matter of actually recalling all the honors garnered and activities partaken in through both college and medical school proved exhausting. Having never actually listed all these activities and having no record of my accomplishments except in my memory, this process actually took several days. Interestingly, the most challenging subcategory of my CV to complete was actually the publication list. As aforementioned, my interest in ophthalmology was confirmed only the months prior to applying thus the research papers on which I had been working were only just being sent out for publication. Thus I had the additional task of trying to complete and submit these papers for peer review before completing my application (as I have been advised that a manuscript “in preparation” is far more nebulous and less impressive a CV notation than a manuscript status as “submitted”). Nevertheless, though time-consuming the application was finally completed after several weeks with the only task being to also forward residency selection committees letters of recommendation.
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