Dual Application - Ophthalmology and IM

[medschoolaspirant]

I am M4 applying for Ophthalmology in the 2023-2024 cycle. My school needs me to submit an application in school for the IM Dean letter now. otherwise, they can't guarantee, it will be done in time. Due to the no clarity on the Step 2 score (I am taking it in June). I am sailing in 2 boats of Ophtho or IM. I can live with both and I like and will enjoy both. I think I will most likely make it for IM. However, for Ophthalmology, I am unsure only due to having no Step 2 score yet. I have one Pass on Clerkship. One High Pass and rest all Honors. One pass is also bothering me if it makes it less competitive for Ophthalmology. That is why I am Dual Applying. Shall I put in my dean letter application, I am applying for IM Prelim. IM Categorical? IM Other? What option I should choose?

---

Members don't see this ad.

 

[voxveritatisetlucis]

What are your research and school tier?

 

[NotAProgDirector]

I think you're getting some terms mixed up. I assume you're submitting something for your IM Department letter, not your "Deans letter" or MSPE.

If that's the case, you should ask for a Categorical letter. Ophthalmology programs are now required to ensure that you get a PGY-1 as part of your match. It might be a medicine or surgery year depending on the program. But at this point, you don't have to worry that you won't get a PGY-1 if you match to Ophthalmology. Either programs will be categorical, or guarantee a prelim in the prelim match. So you don't need a DoM letter for prelim -- and I expect that most prelim programs don't really care as much (although many still ask for it).

Chance of getting a categorical position without a DoM letter is much less. Dual applying is difficult, as anyone reviewing your app is likely to see all of the Ophthal research and rotations

 

[medschoolaspirant]

What are your research and school tier?

US MD Mid-tier Medical School. Have an Ophthalmology department and rotated there for my surgery as well as Ophthalmology senior elective. both Honors. PD strong recommendation letter as well. Research- Pubs -2 first author Ophto papers. 6 - the second author mixed Pubs (Ophtho/NonOphtho- during undergrad). 6 Poster presentations. several awards in research.

 

[medschoolaspirant]

I think you're getting some terms mixed up. I assume you're submitting something for your IM Department letter, not your "Deans letter" or MSPE.

If that's the case, you should ask for a Categorical letter. Ophthalmology programs are now required to ensure that you get a PGY-1 as part of your match. It might be a medicine or surgery year depending on the program. But at this point, you don't have to worry that you won't get a PGY-1 if you match to Ophthalmology. Either programs will be categorical, or guarantee a prelim in the prelim match. So you don't need a DoM letter for prelim -- and I expect that most prelim programs don't really care as much (although many still ask for it).

Chance of getting a categorical position without a DoM letter is much less. Dual applying is difficult, as anyone reviewing your app is likely to see all of the Ophthal research and rotations

Thanks for the feedback. I appreciate the answer. Yes. I need an IM department letter to apply for Medicine. Thanks. I will add it as Medicine Categorical for the department letter. Will worry about the Prelim year as you mentioned much later during the process. I also appreciate feedback on the Dual application. I understand and respect opinions. However I truly feel, given all aways and research, it may appear, I am a heavy Ophthalmology candidate. If given the opportunity, I want to express to them a realistic view, that I may not be most competitive due to pass grade in one of my clerkship and at the time not having my Step 2 score. also, my true and equal inclination is to do Medicine, as well. It will also show, I took Medicine Acting Intern in my M4 year along with the Ophtho Senior elective.

 

[NotAProgDirector]

My point is simply this: apply to our IM program with a bunch of Ophthal research and 4th year rotations, and we won't interview you no matter what you say in your PS. We know you're applying to Ophthal and then IM as a backup. Many schools require an IM or GS AI, so that doesn't mean anything.

YMMV - other programs may care much less, or just not notice.

 

[eyeeye_captain]

From an ophtho perspective, you have a serviceable application assuming Step 2 goes well for you. You shouldn’t shoot for the stars and expect to match at Bascom, but the match rate for US seniors hovers around 90% yearly, so pretty reasonable chance you’ll wind up somewhere. Make Step 2 work for you and keep making connections with your home program - if they like you as much as you think, you’ve already got a pretty good chance.

From an IM perspective, I think there’s a 10 foot pole somewhere they’re not likely to touch you with.

 

[m1redsox]

From an ophtho perspective, you have a serviceable application assuming Step 2 goes well for you. You shouldn’t shoot for the stars and expect to match at Bascom, but the match rate for US seniors hovers around 90% yearly, so pretty reasonable chance you’ll wind up somewhere. Make Step 2 work for you and keep making connections with your home program - if they like you as much as you think, you’ve already got a pretty good chance.

From an IM perspective, I think there’s a 10 foot pole somewhere they’re not likely to touch you with.

Match rate for US MD seniors has dipped to the 70s in recent years (78% in 2023, 75% in 2022). I think you're looking at the percentage of matched applicants (90% of matched applicants were US seniors - 464/514).

With that said, OP, your research is fantastic, and I would be shocked if you didn't match ophtho. Take your time with STEP 2 studying (I'm taking it in 2.5 weeks), and your score will get there. Probably no need to have a back up.

 

[eyeeye_captain]

Match rate for US MD seniors has dipped to the 70s in recent years (78% in 2023, 75% in 2022). I think you're looking at the percentage of matched applicants (90% of matched applicants were US seniors - 464/514).

With that said, OP, your research is fantastic, and I would be shocked if you didn't match ophtho. Take your time with STEP 2 studying (I'm taking it in 2.5 weeks), and your score will get there. Probably no need to have a back up.

You’re correct, my mistake. Agree that the OP is probably fine.

 

[medschoolaspirant]

Match rate for US MD seniors has dipped to the 70s in recent years (78% in 2023, 75% in 2022). I think you're looking at the percentage of matched applicants (90% of matched applicants were US seniors - 464/514).

With that said, OP, your research is fantastic, and I would be shocked if you didn't match ophtho. Take your time with STEP 2 studying (I'm taking it in 2.5 weeks), and your score will get there. Probably no need to have a back up.

Thanks for encouraging words. Yes. I am aware about me having leg up on research. What is scaring me most is step 2. I feel I am at 250ish range now with practice. With more then a month left will try and bump it up. My friend took step 2 early. As strong on research as me if not more. Same school- mid tier MD school. Ortho candidate (not ophtho). but step 2 came as 242. That really scared me. If it happend to him then it can happen to me, as this year we decide way too late which boat to sail. Step 1 is is p/f. Step 2 wild card. Also I am stuck with 1 pass in clerkship and 1 high pass. Rest all honors. I am told research comes later in screens. Applicants get screened first screen is step 2 and second screen is clerkship. If that pass grade screens me out, I am afraid, research cant come to rescue. What is your opinion on my clerkship grades. Is that pass grade making me less competitive for Ophtho?

 

[m1redsox]

Thanks for encouraging words. Yes. I am aware about me having leg up on research. What is scaring me most is step 2. I feel I am at 250ish range now with practice. With more then a month left will try and bump it up. My friend took step 2 early. As strong on research as me if not more. Same school- mid tier MD school. Ortho candidate (not ophtho). but step 2 came as 242. That really scared me. If it happend to him then it can happen to me, as this year we decide way too late which boat to sail. Step 1 is is p/f. Step 2 wild card. Also I am stuck with 1 pass in clerkship and 1 high pass. Rest all honors. I am told research comes later in screens. Applicants get screened first screen is step 2 and second screen is clerkship. If that pass grade screens me out, I am afraid, research cant come to rescue. What is your opinion on my clerkship grades. Is that pass grade making me less competitive for Ophtho?

With your research experience, you will match with a STEP 2 in the 250s, and I would be shocked if you couldn't get that up to the 260s with over a month of studying left. The median score was a 256 this year.

As for clerkships, I also have a pass on my transcript, so I certainly hope that it will not screen us out. But for your peace of mind, we had a student match at Stanford for ophtho this year, and he had a pass on his transcript (from a mid-tier MD program). He only had one H in all of 3rd year, so in my opinion, grades are much further down on the importance list than you (or your friends) are implying. I actually highly doubt that any schools screen by clerkship grades.

 

[Billiam95]

median score of 246/247 in 2022

Know nothing about ophthalmology, but I honestly expected the mean S2 score to be much higher.

 

[medschoolaspirant]

Can you tell me where you found this information? I google, but did not see 2023 data. it is hard to believe that S2 went from a median score of 246/247 in 2022 to 256 in 2023.

can you please point where to look for ophthal 2022 median step 2 score? Where does it say it was 246/247? is it step 1 or step 2 for 2022? I am also told by my residents here in my home program, that cross 256 in step 2 and I can be good. For now its little uphill. but I have time on my hand to bring it up.

 

[medschoolaspirant]

I agreed that it will creep higher, but it will not jump 10 points over 6 months. Looking over all the recent posts on S2 scores on Reddit, the mean is around 246. LOL.

I got 2022 match report. Page 7 shows average matched candidate score was 246 in step 1. Given that info. Step 2 usually is 10 points higher then step 1. Hence appears that ball park range of 256/257 for step 2 is accurate mean for step 2 score for matched applicants.

 

[bluethroat]

You're probably going to have a tough time since a lot of ophtho programs are categorical now, so you won't be eligible to apply to the IM programs at the same places. Might have to apply to totally different locations/institutions for both.

 

[m1redsox]

Can you tell me where you found this information? I google, but did not see 2023 data. it is hard to believe that S2 went from a median score of 246/247 in 2022 to 256 in 2023.

256 is estimated from the ophthomatch 2022-2023 google sheet that floats around on reddit (n=75). The previous 246/247 is step 1 average only. I consider 256 for step 2ck to be about right because the average for plastics, neurosurgery, and ENT is ~257 according to last year's NRMP data, and ophtho is usually just a point or two below their average (at least in the last 3 years or so).

 

[medschoolaspirant]

Got step 2 result today. 258.
step1 pass.
Clership grades - IM Pass. pediatric high pass. psyc , neurology, family med, obgyn, surgery, all honors.
sub I AI- Medicine AI, home ophthalmology senior elective. 2 additional away ophthalmology elective - all honors
pubs- 2 first author Ophtho papers published. 6 non ophtho non first author papers published. multiple poster presentation.
leadership- part of school admission committee. many others
mid tier in state us Md school. Having Ophtho prpgram.

with lack of step 2 score this far, I am far down the line with dual applications. IM and Ophthalmology. In fact due to my pass clerkship grade in IM , finished my IM AI early on and got honors to show IM better grade Got all letters lined up for IM. Also lined up all Ophtho letters from my home ophtho PD and away Ophtho PD and my ophtho research guy.

any advise shall I just continue and dual apply. Is my application having enough crednetial or rather just err on side of caution and dual apply anyway, given i am so far down the pipe now?

 

[collegestud2013]

Got step 2 result today. 258.
step1 pass.
Clership grades - IM Pass. pediatric high pass. psyc , neurology, family med, obgyn, surgery, all honors.
sub I AI- Medicine AI, home ophthalmology senior elective. 2 additional away ophthalmology elective - all honors
pubs- 2 first author Ophtho papers published. 6 non ophtho non first author papers published. multiple poster presentation.
leadership- part of school admission committee. many others
mid tier in state us Md school. Having Opththo prpgram.

with lack of step 2 score this far, I am far down the line with dual applications. IM and Ophthalmology. In fact due to my pass clerkship grade in IM , finished my IM AI early on and got honors to show IM better grade Got all letters lined up for IM. Also lined up all Ophtho letters from my home ophtho PD and away Ophtho people and my ophtho research guy.

any advise shall I just continue and dual apply. Is my application having enough crednetial or rather just err on side of caution and dual apply anyway, given i am so far down the pipe now?

Would just dual apply at this point if you don't mind paying extra money for additional application fees to dual apply. If you find you are getting enough ophthalmology interviews, you can turn down some of the IM ones. There can be some randomness to the process, especially with competitive specialties and every year there are a good number of cases of strong applicants not matching competitive specialties despite what would be expected on paper. Also, you want to "hide" as much as possible on your IM applications that you're dual applying to ophtho. Most PDs will assume that when someone is dual applying, the more competitive specialty is their preferred while the less competitive is their back-up. And IM programs will rank you lower just by assuming you're apply to categorical IM as a back-up. Since ophtho uses a separate application system as IM and rest of ERAS, this may be easier to do than when dual applying two other specialties.

 

[IWishIWasBuff]

Got step 2 result today. 258.
step1 pass.
Clership grades - IM Pass. pediatric high pass. psyc , neurology, family med, obgyn, surgery, all honors.
sub I AI- Medicine AI, home ophthalmology senior elective. 2 additional away ophthalmology elective - all honors
pubs- 2 first author Ophtho papers published. 6 non ophtho non first author papers published. multiple poster presentation.
leadership- part of school admission committee. many others
mid tier in state us Md school. Having Opththo prpgram.

with lack of step 2 score this far, I am far down the line with dual applications. IM and Ophthalmology. In fact due to my pass clerkship grade in IM , finished my IM AI early on and got honors to show IM better grade Got all letters lined up for IM. Also lined up all Ophtho letters from my home ophtho PD and away Ophtho people and my ophtho research guy.

any advise shall I just continue and dual apply. Is my application having enough crednetial or rather just err on side of caution and dual apply anyway, given i am so far down the pipe now?

Just wondering why you are considering a dual application. Is ophtho that competitive or do you have a red flag that I’m not seeing?

Your step 2 is 1-2 points higher than the median even for derm. You have only 1 Pass and a good number of Honors. Your research isn’t top tier but it also seems acceptable. Seems like a solid app, unless I’m mistaken.

Asking because I am also interested in applying to ophtho and we have similar apps except I have 1 less honor -> 1 more pass. If you’re questioning whether to apply then I feel like I’m screwed.

 

[medschoolaspirant]

Just wondering why you are considering a dual application. Is ophtho that competitive or do you have a red flag that I’m not seeing?

Your step 2 is 1-2 points higher than the median even for derm. You have only 1 Pass and a good number of Honors. Your research isn’t top tier but it also seems acceptable. Seems like a solid app, unless I’m mistaken.

Asking because I am also interested in applying to ophtho and we have similar apps except I have 1 less honor -> 1 more pass. If you’re questioning whether to apply then I feel like I’m screwed.

Good question. I was dual applying as i was blind on my step 2 score till few days back. Also pass in IM was bothering me. now i have 258, which is not super high, but high enough to be not screened out. also IM AI I finished and got honors. I am just asking, as now I am here. lined up all my eras LOR. Lined up all my SF LOR. Then might as well just dual apply. As it is all ready. Hard work is all done now. Preparation is all complete now. Is Ophtho that competitve? 4 out of 5 USMD get in. Or you can read it as 1 out 5 dont get in. Thats pretty competitve like Derm. ortho, ENT, or any surgical speciality (except general surg). So i think it is a competitve speciality.

 

[medschoolaspirant]

You're probably going to have a tough time since a lot of ophtho programs are categorical now, so you won't be eligible to apply to the IM programs at the same places. Might have to apply to totally different locations/institutions for both.

Can someone help validate this for Me? I am dual applying Ophtho and IM. Can I apply on SF portal Ophtho (either joint or integrated) to institute A. I apply same institute A in ERAS IM categorical. I do understand the risk, if IM program find out they are back up speciality for me, they may not look at my application. Once and if I get matched at Ophtho program in institute A which is joint program, I will then go to ERAS and change IM categorical to IM Prelim. Is this doable? Or i will not be allowed to apply IM at all to program A, as stated here by @bluethroat

 

[NotAProgDirector]

My understanding is that all Ophthal spots now have to guarantee a connected PGY-1. So if you match to Ophthal, you will get a PGY-1. You will need to rank it in the NRMP system, but they have to match you. At least that's the way I thought it worked now?

 

[medschoolaspirant]

My understanding is that all Ophthal spots now have to guarantee a connected PGY-1. So if you match to Ophthal, you will get a PGY-1. You will need to rank it in the NRMP system, but they have to match you. At least that's the way I thought it worked now?

Thanks for reply. So my question is, as I am dual applying IM and Ophtho. Can i apply same institute for both different speciality?

 

[NotAProgDirector]

You can. Whether IM will interview you if they see your app is completely focused on Ophthal is unclear. Some may.

 

[medschoolaspirant]

Fast forward on my Interview cycle. 8 Interview Invite (II) from Ophtho programs (humbled with reality check. Expected it to be in double digit). 3 of them from home and my 2 aways. All programs doximity ranked between 50-110. Zero II from top 50 ranked programs. Applied broadly around 100+ Ophtho programs.


refresh on my stats.
step 2 258.
step1 pass.
Clership grades - IM Pass. pediatric high pass. psyc , neurology, family med, obgyn, surgery, all honors.
sub I AI- Medicine AI, home ophthalmology senior elective. 2 additional away ophthalmology elective - all honors
pubs- 2 first author Ophtho papers published. 1 second author Ophtho paper published. 6 non ophtho non first author papers published. 11 poster presentations.
leadership- part of school admission committee. some other leadership positions.
mid tier in state USMD school. Having Ophtho program.
2nd quartile. No AOA. ORM.
LOR— 1 from Ophtho Home PD. 1 from Ophtho away PD. 1 from Ophtho research mentor. I think all as good as it can be. As some interviewers quoted good things mentioned by my home PD ( I was surprised to learn in interview, my home PD knew so much details about me)

IM. Applied 40 top tier academic programs. my existing and near by regions only top tier programs. All 40 are overlapping programs with same institutes, where I have applied Ophtho, as I have applied Ophtho very broadly. LOR all different then Ophtho in ERAS. All from IM departments.from chair. APD. 2 other attending. Like to think all good LOR as well. Got 8 II for IM. Really humbled. Didn’t realise all these programs will pass on me For IM. Realised, how much competitve IM can get. 2 out of these 8 are common institute, I am also interviewing Ophtho. One of them being home, as home has invited me for Ophtho as well as IM. Also one more neighboring state has invited me for Ophtho as well as IM. Rest 6 on both list are not overlapping in IIs. so those 12 Institutes chose to either Invite me for Ophtho or IM. Not both.

Also I realise, Ophtho cycle for II may be all over, but I may get some more II for IM. As we have still some more path to go for IM.

now the real question. what are my chances for Ophtho? What are my chances for IM? Really worried as dont have enough II on both to remain in comfort zone.

should I start thinking of plan B? What should it be? SOAP? research year? Extend another year in medical school?

 

[medschoolaspirant]

You will likely match ophthalmology with 8 IV. Were your aways IV automatic? If they were not automatic, that is even better for you as you made a good impression to get an IV at their program. You have a leg up on those that did not rotate there.

Thanks for reply and encouragement. my home and both aways are mid tier USMD programs (even though all 3 are doximity higher ranked for me on my 8 Ophtho II, as rest 5 are lower ranked then these 3). I am not sure, if my aways offered every rotator an II or not. But I got it in first burst of II itself. My assumption is, as one of my letter writer is away PD as well, even for courtesy, they will offer II. my guess is these mid tier program probably will invite all home and away rotators.

 

[goldenfloofers]

From an ophtho perspective, you have a serviceable application assuming Step 2 goes well for you. You shouldn’t shoot for the stars and expect to match at Bascom, but the match rate for US seniors hovers around 90% yearly, so pretty reasonable chance you’ll wind up somewhere. Make Step 2 work for you and keep making connections with your home program - if they like you as much as you think, you’ve already got a pretty good chance.

From an IM perspective, I think there’s a 10 foot pole somewhere they’re not likely to touch you with.

Just wanted to chime in and ask about your statistics here but US seniors (I assume MD) had a 90% match rate? I thought it was closer to ~70-75% for US MD seniors, and 90% of the ophthalmology accepted residents were MD, rather than the match rate itself was 90%?

 

[eyeeye_captain]

Just wanted to chime in and ask about your statistics here but US seniors (I assume MD) had a 90% match rate? I thought it was closer to ~70-75% for US MD seniors, and 90% of the ophthalmology accepted residents were MD, rather than the match rate itself was 90%?

Yeah, I messed up my stats a while back, it’s ~75% for US seniors, the 90% is the percentage of matched applicants that were seniors. I hate statistics.

 

[goldenfloofers]

Yeah, I messed up my stats a while back, it’s ~75% for US seniors, the 90% is the percentage of matched applicants that were seniors. I hate statistics.

No worries. From your perspective would you say the 75% match rate is reassuring or discouraging? I've heard mixed opinions with some saying 3 out 4 applicants failing to match is criminal after all that hard work while some are saying 3 out of 4 is actually pretty good odds.

 

[medschoolaspirant]

With blessings of my parents, elders, and well wishes of friends, collegues and all well wishers, I matched today morning to my #1 rank Ophthal program. To program, I did One of my away Rotation. Doximity ranked around 50.ish-60ish. I want to take opportunity to Thank @eyeeye_captain , @NotAProgDirector , @collegestud2013 , @m1redsox , @bluethroat @MDMechEngr and many others who gave, guidance, support, encouragement, good wishes throughout the process. This journey was full of stress, with dual application. twice as much work, dual LOR, scheduling challenges for interviews for both tracks. best decision I made was to dual apply (even though I didnt need it in the end). But worth peace of mind it gave was priceless. In the end, I didnt need IM Application. As I matched ophthal. But I will recommed anyone little middle of pack and borderline like me (my stats above, my borderline case as, mid tier USMD school, No AOA, second quartile class rank, One Pass clerkship grade), willing to put work to dual apply for peace of mind. Thanks again everyone. Phew !

 

[eyeeye_captain]

Cool, congrats! Welcome to the club. Plenty of good programs in that tier, and it was obviously one you felt fit you since you ranked it number one.

In years past people have asked what they need to start studying as soon as they’ve matched. The answer is nothing. You don’t have much context and won’t retain much at this point. At most you could grab a Wills Eye Manual since it’s high yield and bite size.

 

[voxveritatisetlucis]

With blessings of my parents, elders, and well wishes of friends, collegues and all well wishers, I matched today morning to my #1 rank Ophthal program. To program, I did One of my away Rotation. Doximity ranked around 50.ish-60ish. I want to take opportunity to Thank @eyeeye_captain , @NotAProgDirector , @collegestud2013 , @m1redsox , @bluethroat @MDMechEngr and many others who gave, guidance, support, encouragement, good wishes throughout the process. This journey was full of stress, with dual application. twice as much work, dual LOR, scheduling challenges for interviews for both tracks. best decision I made was to dual apply (even though I didnt need it in the end). But worth peace of mind it gave was priceless. In the end, I didnt need IM Application. As I matched ophthal. But I will recommed anyone little middle of pack and borderline like me (my stats above, my borderline case as, mid tier USMD school, No AOA, second quartile class rank, One Pass clerkship grade), willing to put work to dual apply for peace of mind. Thanks again everyone. Phew !

How much research divided by pubs abstracts etc.

 

[medschoolaspirant]

How much research divided by pubs abstracts etc.

Entire application credentials posted few posts ahead on this thread. Research for all 8 years ( under grad and med school). pubs- 2 first author Ophtho papers published. 1 second author Ophtho paper published. 6 non ophtho non first author papers published. 11 poster presentations.

 

[MDMechEngr]

Congrats on matching your #1 ranked. Well deserved and well done. Good luck with your training.