Yoshihiro Yonekawa, Mass Eye & Ear
Eric Nudleman, UCSD
Jon Prenner, NJ Retina
RETINA Roundup Editors
Congratulations to all of the 3rd year ophthalmology residents who recently matched into retina fellowships! The application process is always enjoyable as you meet old friends from the residency interview days, chat with luminaries that you may have cited in your papers, and learn about great programs in our field.
On the other hand, it can be an anxiety provoking process with many unknowns. Which programs should one apply to? What are different types of programs looking for? What is the algorithm from which rank lists made? These are the beginning of a list of common questions that residents ask each other and mentors for advice on.
Today, we have your answers.
Fifteen retina fellowship program directors throughout the country graciously provided their insights into the inner workings of the retina fellowship match. We hope you enjoy this series of articles, and a special thanks to the program directors that made the time in their busy schedules for RETINA Roundup:
Thomas Albini, Bascom Palmer Eye Institute, University of Miami
Audina Berrocal, Bascom Palmer Eye Institute, University of Miami
R.V. Paul Chan, Illinois Eye and Ear Infirmary, University of Illinois Chicago
Dean Eliott, Mass Eye & Ear, Harvard Medical School
Sharon Fekrat, Duke Eye Center, Duke University School of Medicine
Harry Flynn, Bascom Palmer Eye Institute, University of Miami
Tarek Hassan, Associated Retinal Consultants, Oakland University William Beaumont School of Medicine
William F. Mieler, Illinois Eye and Ear Infirmary, University of Illinois Chicago
Darius Moshfeghi, Byers Eye Institute, Stanford University School of Medicine
Prithvi Mruthyunjaya, Byers Eye Institute, Stanford University School of Medicine
Anton Orlin, Department of Ophthalmology, Weill Cornell Medical College
Chirag Shah, Ophthalmic Consultants of Boston / Tufts University School of Medicine
Arunan Sivalingam, Mid Atlantic Retina, Wills Eye Hospital, Thomas Jefferson University
Elliott Sohn, Department of Ophthalmology and Visual Sciences, University of Iowa
Christina Weng, Cullen Eye Institute, Baylor College of Medicine
How do you select applicants for interviews?
Anton Orlin (Cornell): It has definitely become more difficult deciding whom to give interviews to, given how strong the applicant pool has become. Factors that we consider very important include recommendations from trusted colleagues, reputation of the residency program and the demonstration of leadership and commitment to the field (research/publications, lectures, society involvement).
Elliott Sohn (Iowa): A group of retina faculty review applications and grade them based on letters of recommendation, surgical abilities (usually in letters), genuine interest in retina, research/publications, clinical experience and ability. Occasionally we’ll get unsolicited emails and calls from faculty we know at other programs and this can help too.
Arunan Sivalingam (Wills): We have an interview committee (10 to 12 members) who review applicants and rank 1 for interview and 2 for no interview. We run an Excel spreadsheet and cut off the interviews at the top 18.
R.V. Paul Chan/William F. Mieler (UIC): I think it’s important to go beyond the numbers and the USMLE scores. What have they accomplished? Who are they as people? We like to see people who are passionate about Retina, and also have a reasonably balanced lifestyle. The letters of recommendation are also a critical piece of the selection process, and hearing from the candidate’s current mentor(s).
Dean Eliott (Mass Eye & Ear): We have several faculty (usually about 4-5) carefully read every application, with particular focus on the personal statement, list of publications, and letters of recommendation. We invite applicants with the highest aggregate scores.
Prithvi Mruthyunjaya/Darius Moshfeghi (Stanford): Many programs search for applicants who represent a “good fit” to work with the attendings, patients, and support staff. While these are important qualities, we seek applicants who are likely to make an impact. At least 2 of us review all the applications, individually rank our preferences, then combine lists. Typically there is a 90% concordance and the remaining 10% come from interesting discussions.
Sharon Fekrat (Duke): Each year, 4 of our 8 vitreoretinal surgery faculty thoroughly review each and every submitted application and assign a numerical rating to the application. These 4 ratings are then averaged. The top 10-14 (depending on how the numbers shake out) are invited for interviews.
Christina Weng (Baylor): It’s tough! Retina fellowship candidates tend to be strong residents to begin with, so it can be challenging when you’re forced to choose 15 or 20 interviewees out of an impressive pool. While I assess applicants holistically, the most important factors to me are: 1) where they trained for residency, 2) recommendation letters, and 3) research or other academic endeavors. Residency training plays a large role in how well-prepared someone is to handle the increased autonomy and responsibilities of fellowship, especially at a clinically and surgically rigorous program like Baylor. Recommendation letters are tremendously valuable in providing insight about a candidate that may not be evident from the application—this is particularly true when there are multiple applicants from the same institution or when I know the letter writer personally.
What qualities make the best fellows?
What do you look for in applicants?
R.V. Paul Chan/William F. Mieler (UIC): Fellows who are honest, sincere, take responsibility, pay attention to detail, and don’t shy away from hard work generally make the best fellows. Although having natural talent is great, I think having the right attitude and dedication to Retina is critical.
Sharon Fekrat (Duke): These qualities make the best fellows: Perspective. Dedication. Internal motivation. The ability to collaborate. Someone who can carry the load without dumping on their co-fellows (or attendings). Someone whom you can say something to once and it gets done. Someone who seeks out research projects and actually sees it to completion. Someone who truly wants to be the best that they can be, is ready to give it their ‘all’ during their two year fellowship, and who seeks out opportunity.
We look for the following in applicants: letters of recommendation, residency training, surgical skills, academic pursuits, publications, interpersonal skills.
Harry Flynn/Nina Berrocal/Tom Albini (Bascom): We try to pick individuals who will be caring, honest and ethical practitioners. A strong academic background (publications and presentations at national meetings), humility and a “team player attitude” are also very important. The stand-out applicants are hard working, no-nonsense, inquisitive, and want to make a difference in the field and in the life of others. Humility is a key trait which is present in the very best fellows. Significant experiences in academic and/or clinical retina are essential for the applicant to really know what he or she is getting into. On that note, we have had success with candidates from a legacy family with parents in Ophthalmology or Retina because they understand exactly the demands of a Retina Fellowship. In addition, we often interview individuals in which their Residency Program Director has promised them a Retina job following fellowship completion which may play into our decision process.
Arunan Sivalingam (Wills): We consider the candidate’s residency programs, research, written and verbal recommendations, STEP 1 and 2 board scores as well as OKAPs and interpersonal skills. Our fellows interact daily with the Wills residents and need to show interest in teaching. A successful fellow will be a hardworking team player, clinically excellent, ethical and intellectually curious. They should demonstrate willingness to utilize the resources available through our faculty to become an excellent physician and surgeon, and above all, take outstanding care of our patients.
Chirag Shah (OCB/Tufts): The best fellows are often the best applicants, those with a proven track record of excellence throughout their careers. They tend to be intelligent, diligent, responsible, caring, careful, collegial, and respectful. They are team players who will serve as extensions of their attendings during fellowship. Applicants training in strong residency programs tend to be known entities, as strong residencies select for strong residents, and then cultivate and foster their ophthalmology skills. We also place a lot of weight on letters of recommendation.
Prithvi Mruthyunjaya/Darius Moshfeghi (Stanford): We seek fellows who have demonstrated passion, enthusiasm, and fortitude. Our goal is to train fellows who will “move the needle” in the field of retina through clinical care, surgery, innovation, research and teaching. We want candidates who have demonstrated excellence at every level of training but more importantly those who have made the very most of opportunities at the institutions they have trained at. For us, it is not a numbers game (test scores, numbers of papers, etc), but it is a quality game.
Anton Orlin (Cornell): Most fellows can learn how to operate and become knowledgeable clinicians, but from our experience the best fellows are hardworking, trustworthy, ethical, self-aware and team players. We look for applicants with a reputation of having these personality traits.
How do you identify applicants that may become leaders beyond fellowship?
Arunan Sivalingam (Wills): Since all applicants we interview have demonstrated leadership, research and dedication, it is very difficult to predict who will continue to contribute to the field beyond fellowship.
Prithvi Mruthyunjaya/Darius Moshfeghi (Stanford): We look for early evidence of independence, diligence, durability, and outside the box thinking in their research, ability to complete projects, and entrepreneurial spirit.
R.V. Paul Chan/William F. Mieler (UIC): This is difficult to determine from an interview alone. So speaking with their mentors helps us understand who the candidate is, and what their character is. During their fellowship, a lot will also depend on us and what we can do for them regarding opportunities and mentorship during and after their fellowship. Mentorship is actually a lifelong process.
Elliott Sohn (Iowa): If applicants have been leaders in at least one role (and it doesn’t even have to be in medicine but could be advocacy, science, volunteerism, sports, music, etc.), there’s a chance they’ll be leaders in something beyond fellowship. But in the end, no doubt that it’s up to the individual to have the desire and drive to be a leader.
Sharon Fekrat (Duke): Every one of the applicants will be leaders in some way, whether it is in their community or in their practice or on a national or international stage. However, identifying applicants who will be national/international leaders is the million dollar question and it can be very challenging to determine that. In general, past performance predicts future performance. Actions speak louder than words. The applicant has to be ‘hungry’, want to make a difference, and be a mover and a shaker.
Do publications matter in an application? Why or why not?
Christina Weng (Baylor): Residency is a busy time, and I do not expect candidates to have dozens of publications. However, I do take note of research and academic endeavors because I feel that they are reflective of one’s drive. They also demonstrate to me that the person is able to manage clinical duties along with other work activities.
Arunan Sivalingam (Wills): Yes, it matters. Our program would like the fellows to continue publishing after they finish and contribute to our field beyond clinical practice.
Elliott Sohn (Iowa): They do in that they should reflect the person’s exposure to research and writing. If someone had limited opportunity, having several publications can be meaningful because it shows the go-getter and potentially scientific mindset to make future contributions. It would be problematic if someone spent 5 years doing research and has only one or two middle-author publications. We all know that authorship on papers can get complicated, but the more involved the person is in a meaningful research project that is seen to publication, the better authorship status they should have. But not all great ideas make it to publications, and these contributions are often fleshed out by at least one of the letter writers.
Sharon Fekrat (Duke): Yes, the more first author publications the better. It demonstrates commitment to the pursuit of academic excellence.
Prithvi Mruthyunjaya/Darius Moshfeghi (Stanford): Publications represent a metric for interest, enthusiasm, and commitment to the field. If didactics, grand rounds, clinic, and surgery are the core requirements of any ophthalmology residency, then publications and research are the extra credit. A waning publication record over time may indicate burn out, whereas a recent burst of activity may represent a less solid commitment to the field than a solid track record over a long period of time.
Please stay tuned for PART II: INTERVIEW DAY & RANK LIST