Ophthalmology Residency Application: Interview and Program Selection
The interview process is similar to what you have done for medical school and if you have made it this far, no additional preparation is needed. You will likely have multiple interviews with several faculty members- this a chance for them to get to know you and for you to get to know them. Here is what you need to find out about every residency program. Don't forget to take notes and meet the residents!
- What are the affiliated hospitals and facilities- public hospitals (county and VA) are where you will acquire most of your clinical and surgical experiences. Beware of weakening affiliations that may end during your residency or out-of-state affiliations that will require you to travel.
- Surgical volume- how many cases do residents graduate with? Unless you will be subspecializing in retina, oculoplastics, neuro-ophthalmology, pediatrics/strabismus or pathology, the
most important procedure is cataract surgery. Other numbers may also play a role but they are less important.
- Cataract surgery- the ACGME requirement is 90 but it is not enough to make you a good surgeon. There has been an increasing trend for residents to do general/comprehensive ophthalmology fellowships after residency because they do not do not feel comfortable starting on their own. This is especially prevalent in cities where there are multiple programs (i.e. New York, Chicago). At least 120 is needed and 150 or more is desirable.
- Laser surgery- glaucoma and retina laser can easily be incorporated to most practices and it's important you get significant exposure to these (10-20 of each type of laser
- Oculolastic surgery- it is a good idea to be able to do some basic plastic procedures such as blepharoplasties or ptosis repair; comprehensive ophthalmologists can incorporate these into
their practices (5-10 of each procedure type).
- Refractive surgery- it is difficult to get an adequate refractive surgery (LASIK) experience in most residencies but inquire whether you can be certified for these procedures.
- Glaucoma and cornea surgeries (cornea transplant)- these are of variable importance. As a general ophthalmologist, you can choose to refer these to specialists because the postoperative care can be more complicated than the surgeries themselves- the amount of clinic time invested may not be worth the reimbursement. 10-20 of glaucoma filtration surgeries (trabeculectomy and tube shunt) and 5-10 of corneal transplants will give you a good exposure to these procedures.
- Retina surgery and strabismus surgery- not important unless you plan to be a specialist in the area. You will get most of the training from your fellowship.
- Trauma surgery (open globe repair, corneal laceration repair, eyelid laceration repair)- only important if you will go into academics or if you plan to cover emergency rooms as a private physician. 5-10 of open globe and corneal laceration repairs and 5-10 eyelid laceration repairs will give a good exposure to these procedures.
- Attending coverage in clinics- it is important for public hospitals to be staffed by attending physicians for education purposes, otherwise you will just be doing busy work.
- Didactic programs- what are the didactic teaching schedules. Are there review courses to help you study for the OKAP (Ophthalmic Knowledge Assessment Program) exam (mock board exams).
- How happy are the residents- talk to the residents to find out the strengths and weaknesses of the program.
- How are the first year residents- they are going to be your senior residents and they will be the ones supervising and teaching you most of the time. Try to meet all of them if possible, you can have the best or a difficult residency experience because of them.
- How strong are each of the subspecialties- especially if you may already have an interest in a specific subspecialty. Well-known attendings in the department will help you out tremendously when you apply for fellowships.
- What is the reputation of the program- this will help you if you plan to go into academics or if you want to do fellowships. Be careful in choosing based on reputation alone because
some of the most reputable programs actually have lower surgical volume.
- Other miscellaneous but important issues:
- Call schedule
- Vacation schedule
- Allowance for attending national meetings
- Research availability and requirements
After all of your interviews, you need to put together your rank list. I have already discussed the important aspects you need to consider above. Surgical volume, the people you will be training with (residents and attendings), and and the reputation of the institution should factor heavily into you decision making process. It is important for you to NOT rank a program if you do not want to go there because if you match there, you are obligated to go under match rules. Turn in your rank list early if possible so you can get a confirmation that it has been received.
Internship application is processed through the Electronic Residency Application Service (ERAS) as part of American Association of Medical Colleges (AAMC).
The most common question people have is what type of internship to apply to- medicine, surgery, or transitional? The answer is it doesn't really matter. You should choose one that will you allow you to enjoy your year the most. There is really no point to do a hardcore intern year because the knowledge you gain is not going to be extremely useful to you. However, I would recommend electives in rheumatology, neurology, or neuro-imaging/radiology (CT/MRI) because knowledge in these areas do come in handy sometimes. Some of the grunt work you do- writing admit orders, getting used to prescribing medications, etc. will also be useful as a resident.