Is ophthalmology worth pursuing (US IMG)?

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Step 1: 226

Hello,
Right off the bat, my IMG status and low step 1 score place me in the category of "undesirable" in this field. However, here is why I would make a great ophthalmologist: I love the field (medicine & surgery, lifestyle, complexity, all the cool tools, intimacy and entrustment with the patient), I love research and I have a year's worth of previous experience in the field (50 hrs/week). I randomly wound up working for a self-employed ophthalmologist in the New York area, the year before I started M1. I quickly became the senior assistant, and an asset to the clinic. I got to witness most of what comes with the general field (cataract surgeries w/ iStent, SLTs, LPIs, pterygiums, glaucomas, Avastin, FOCAL & PRP, angiography, papillomas, chalazions), and performed many functions myself (e.g., visual acuity test, IOL Master, Visual field test, B-scan, pachymetry, Perkins & Tonopen, OCT, fundus photography), seeing around 30 patients a day on average. I know what needs to go in the patient chart, the common diagnoses, treatments, imaging interpretations, and even the billing codes.

My publications include an abstract, and a paper on a retrospective study (vascular), and two neuroscience papers (where I performed in vivo surgeries and recordings).

I have a scholarship that covers about 1/4 to 1/3 of my tuition.

My situation is that my wife and I have two little boys under the age of 2, and she is also in medical school (same year as me) and we would like to be in the same general area (will possibly do couples match).

I believe that my previous employer will vouch for me to residency directors if I only ask.

My question is, should I even bother or should I be realistic and become a great internist?

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[Slide]

I help with reviewing which applicants make it through the initial cull at my program. Imma bout to give it to you straight, and it’s only because I want to help you now, rather than when you’re years into this process.

You are absolutely right that you would be considered undesirable based on your stats. In fact, you will most likely be one of the first applications to be culled, even before we actually look at the applications. I suspect this will be true for most other places.

Your best chance as an IMG to get an interview is your step 1, and you blew it. You have to understand that we receive hundreds of highly qualified applications. It’s great you have experience, but so do many other applicants; it doesn’t make you that unique. All the stuff you mentioned about experience doesn’t matter, because part of the point in residency is learning the different styles from your attendings, which may differ from your experience greatly.

If you’re couples matching, your chances are pretty much nil, unless your wife is the second coming of William Osler, and even then it would be an extremely tough sell. If you were single, I would say your best chance to match would be to dominate step 2, and do 1-2 years of pre-residency research at a well known institution. Then, hope you can get an interview anywhere in the US or Puerto Rico (more likely?), and still be prepared to have a low chance of matching.

I hate to say it bluntly like this but you need to hear it like this. We get so many qualified applicants we are looking for reasons to not interview them. We have more than enough internal candidates to fill our residency if we deemed it so. The unfortunate thing about being an IMG is that the competitive specialties are closed off to you if you don’t have a perfect application. If you want to be with your family, your better bet is to pick a less competitive field, but that’s a choice you would have to decide on.

 

[LightBox]

It has nothing to do with being "undesirable" and all to do with supply and demand. As Slide mentioned, ophtho already gets hundreds of applicants from stellar candidates. Why would a Program want to deal with an IMG and all of the extra associated paperwork, when they have their pick of the litter? One caveat: if you have a personal connection with some faculty, then you will have an advantage. I've seen some *****s match at top-notch programs because they were family friends with "bigwigs".

 

[dantt]

The good news is ophthalmology is an early match so if you get a spot somewhere, your wife will be able to limit her applications/interviews to where you match. You can even double apply to internal medicine and either change your prelim to categorical or your categorical to prelim depending upon the program.

 

[Like]

Thank you for your answers! I heard that back in the day doctors used to finish an internal medicine residency and then apply for an ophthalmology residency. One of the places I am going to apply for internal medicine (and is within reach for me), also has an ophthalmology residency. Perhaps, I can get my foot in the door that way, because I don't see myself taking years off for research while my loans accrue and my boys go hungry.