Radiology to Ophthalmology Switch

[fromd4rk2light]

Hi! I am an incoming PGY-1 who recently matched at a Top Radiology program located in the Midwest (R1 year starting '24). While I am tremendously grateful to have matched at a cush, world class program, I seem unable to shake my interest in Ophthalmology that flourished through multiple rotations in medical school. I applied to Ophthalmology this past cycle and unfortunately went unmatched despite having many interviews. I know that Radiology is an excellent field, and I would very happily train at my currently-assigned institution, but it hurts me to summarily dismiss both the long days at the slit lamp trying to independently work up patients and catch the neovascularization of their irises as well as the many hours shadowing cataract surgery hoping to one day perform one myself.

This is a serious inquiry, and I wanted to create this post to signal to 1. Ophthalmology residents in the class of '27 who discover that they may be happier in another comfortable, well-compensated field and 2. Program Directors that are looking to either expand their resident complement or fill an unexpected vacancy. For the latter, I understand that a handful of positions open each year and are often filled internally, so I wanted to proactively advertise my interest as a well-qualified resident for any that may arise. I have 2 academic mentors well-known in the field of Ophthalmology who are happy to advocate on my behalf for any vacancies, and I have a very strong resumé for any PDs interested (AOA, competitive step scores, research awards and multiple 1st author publications). Please direct any communications to [email protected].

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[PLA2]

how many interviews and why do you think you didn't match

 

[fromd4rk2light]

Near cap for interview count. Met with a couple PDs after the Ophtho match who were kind enough to comb through my entire app with me. Was told that my letters were actually very strong and that there were no real weaknesses or red flags; apparently sometimes strong applicants fall through the cracks *shrug*. For Rads, got multiple T10-20 interviews, was told that I was "ranked to match" at 2 non-top programs, and ultimately matched at my #1, so I doubt it was a personality thing.

 

[Slide]

Unfortunately I think you may have been victim to one of the biggest perils of virtual interviews. Anecdotally comparing results between in person interviews and virtual interviews, it seems good applicants on paper can “fall through” the cracks. Last year we had a lot of repeat applicants who we thought would have matched somewhere. For retina fellowships, several great programs went unmatched when virtual interviews were launched.

My theory is that with programs giving so many more interviews for virtual interviews, it’s messing up the rank algorithm. With in person interviews, you had to make hard decisions sometimes of which interviews to go to (due to conflicting dates), and fewer interview spots were available. In terms of game theory, this is ideal for most applicants because different “tiers” and geographic areas of applicants stay together and don’t cross over as much. Thus, more in-person interviews help by denying an interview spot to another candidate, and also forces applicants to be more selective of interviews if necessary. With virtual interviews, now these boundaries have broken down. Now you can interview to your hearts content, and if lucky enough, double up on interviews. This In person, good applicants would rank 10-12 programs, but 15 to even 25-30 for virtual interviews. Likewise, in our program, we’ve increased the number of applicants by 50%.
While it is cheaper for everyone to do interviews virtually, overall I think they’re terrible. It’s one thing to interview someone virtually for a desk job, it’s another for someone you’ll be working with closely for 4 years with a lot on the line.

If for some reason you do decide to try the match process again, pray they’re in-person.

 

[LightBox]

I would have loved virtual interviews when I was a resident/fellow. It would have saved a ton of $$. An alternative would be for programs just to interview everyone at one central location. It's just crazy how much applicants have to spend on airfare/hotel while other employers would pay for everything.

 

[Slide]

I would have loved virtual interviews when I was a resident/fellow. It would have saved a ton of $$. An alternative would be for programs just to interview everyone at one central location. It's just crazy how much applicants have to spend on airfare/hotel while other employers would pay for everything.

And my response that is that "be careful of what you wish for". The prior system isn't perfect but it's believe me, it's much better than virtual interviews. From an applicant standpoint, it's in your favor. On the interviewer side, it was harder to stay motivated due to the format and sheer volume of interviews - I'd rather see 60-80 patients a day than grind out 25-30 virtual interviews. Yes you may save money but I don't know if this is something that would be worth it. With how messed up the ranking algorithm turned out, I've seen several "safe" candidates not match.

I don't have evidence to back this up, but anecdotally with virtual interviews and in my geographic region, more residents and those who did away rotations matched at their home institution. So yes you may save money with virtual interviews, but more risky.

 

[fromd4rk2light]

Appreciate all the insight above. Perhaps the earliness of my post in the academic year evinces my optimism that positions will open up over the next year or two, as I've come across enough people in ophthalmology (and medicine in general) that have navigated non-traditional paths and chanced upon sudden openings every year. Patience. Gratitude. Grit. 3 indispensable tools that have brought me this far in my training; they'll continue to serve me well. This unexpected outcome is but a single plot-twist in the story I'm writing. As I now start intern year, I am content to be a physician at all and to be matched to a phenomenal radiology program. Should eye surgery call my number again, I'll be ready.

 

[builderstorch]

Appreciate all the insight above. Perhaps the earliness of my post in the academic year evinces my optimism that positions will open up over the next year or two, as I've come across enough people in ophthalmology (and medicine in general) that have navigated non-traditional paths and chanced upon sudden openings every year. Patience. Gratitude. Grit. 3 indispensable tools that have brought me this far in my training; they'll continue to serve me well. This unexpected outcome is but a single plot-twist in the story I'm writing. As I now start intern year, I am content to be a physician at all and to be matched to a phenomenal radiology program. Should eye surgery call my number again, I'll be ready.

why does this sound straight out of chatgpt

 

[PLA2]

Appreciate all the insight above. Perhaps the earliness of my post in the academic year evinces my optimism that positions will open up over the next year or two, as I've come across enough people in ophthalmology (and medicine in general) that have navigated non-traditional paths and chanced upon sudden openings every year. Patience. Gratitude. Grit. 3 indispensable tools that have brought me this far in my training; they'll continue to serve me well. This unexpected outcome is but a single plot-twist in the story I'm writing. As I now start intern year, I am content to be a physician at all and to be matched to a phenomenal radiology program. Should eye surgery call my number again, I'll be ready.

Not sure why you're speaking like this, but it's a little weird lol. Definitely ask for some candid feedback about how you interviewed and your personality, which are very important for being selected for residency

 

[fromd4rk2light]

Not sure why you're speaking like this, but it's a little weird lol. Definitely ask for some candid feedback about how you interviewed and your personality, which are very important for being selected for residency

Appreciate the well-intentioned feedback. Thankfully, I'm glad to be matched to an exceptional program that was interested in my flavor of "weird." I don't see myself applying for residency again - well at least not the traditional way - but for what its worth, I did speak to two separate Ophtho PDs (in the month between the SFMatch and NRMP Match) who kindly shared that they thought I was very pleasant to speak with during our interview. I genuinely appreciate you reaching out to help a stranger, but I've had the time to both ask mentors who actually know me well and to reflect deeply myself on what led to this unexpected outcome. If anyone is interested in either recruiting a respectful, hardworking resident or switching into a different field, I'd love to privately hear more! But, respectfully, I do think at this juncture, anonymous speculation on the 1000 ways I may have fallen short, is less helpful .


Also, otherwise very excited to train in radiology. Very excited about AI facilitating my reports. But not very excited about AI like ChatGPT eroding from the emotion that people weave into their writing haha - although my last post may have admittedly been a little over the top.