Surgical Retina Fellowship Match – JAMA Ophthalmology

Surgical Retina Fellowship Match – JAMA Ophthalmology


Hey everybody, this is Steve Christiansen, and in this video I want to share with you the highlights of a paper we recently published in JAMA Ophthalmology. The paper discusses various characteristics of the surgical retina fellowship match and the association of mentor-to-program contact and applicant rank disclosure with the final match outcome. First, let me give you a little bit of background. As I was preparing my fellowship application, I had multiple questions, such as these, To how many programs should I apply? How many interviews do most applicants attend? How much is this whole process going to cost me? And, possibly most importantly, what are my chances of matching at my #1 ranked program or in my top three? I remember applying to ophthalmology residency several years ago, and I really appreciated the publication by Yousuf et al which answered some of these questions about the ophthalmology residency match, but I couldn’t find answers to my questions about the fellowship match either in the peer-reviewed literature nor on the SFMatch website. Why was this whole match process so mysterious, I thought Then, once I began interviewing at programs, I started to wonder, Should I have my mentors make special calls and send special emails for me? Did these calls or emails really make a difference? And what about my rank list, should I tell my number 1 ranked program that they were my number 1? Could disclosing my intention to rank a program number 1 actually increase my chances of matching at that number 1 ranked program? As I traveled around the country on interviews, I began to collect the email addresses of the other interviewees I met along the interview trail, so that ultimately we could discover where we all matched and stay in touch. As this list became longer and longer, I realized what a great opportunity this could be to survey my cohort of interviewees and try to answer some of these questions. After the match, I used a master list of all programs offering fellowship positions in the match, and I compared it to my list of colleagues and where they had matched, and I then made many, many personal phone calls, sent emails, text messages, etc to try and figure out where everyone had matched, and to discover their contact information. I then sent everyone whose contact info I could obtain an anonymous online survey. To strengthen the survey’s power and reproducibility, I sent a nearly identical survey to the 2017 match class Here is a quick summary of the results from this study, The survey was sent to 198 matched matched applicants, and 152, or 77%, completed the survey. Matched applicants applied to an average of 34 programs and ranked 12 of these programs. Out of the 152 matched applicants, 43% matched at their number 1 ranked program, 15% matched number 2, and 14% matched number 3. The average total cost of applications and interview-related travel was $5,500. And what about my questions about mentors making special contact to express interest in a program? Two-sided chi-square testing found no association between mentor-to-program contact and the probability of applicants matching at their number 1 ranked program. And could revealing to my top-ranked program my intention to rank them number 1 actually increase my chances of matching number 1? Matched applicants who revealed their number 1 ranking either personally or via a mentor matched at a program that was ranked lower, or more desirable, on their rank list compared with those who did not reveal their number 1 ranking. And finally, applicant disclosure of their intention to rank a program number 1, either personally or via a mentor, was associated with matching number 1. This study also produced some interesting demographic characteristics about the surgical retina fellowship match. Twenty percent of matched applicants in the 2016 match class were female, and thus the remaining 80% were male, only slightly different from the subsequent year, when 26% were female and 74% male. 76% matched while in their residency or post-residency chief year, 16% matched while completing a fellowship, and 8% matched while working as attending ophthalmologists. In addition to the application-related information that came from this study, such as number of programs to which applicants applied and ranked and the associated costs, here are a few additional key takeaways from this study. The study highlights the gender disparity within vitreoretinal surgery. This disparity is not unlike that facing ophthalmology in general. In 2014, 23% of American Academy of Ophthalmology members in the US were women, but only 14% of AAO members practicing as retina subspecialists in the US were women. While the disparity among matched vitreoretinal surgery fellows trended toward greater equality from 2016 to 2017, vitreoretinal surgery remains predominately composed of male vitreoretinal surgeons. With medical school matriculation now comprising more women than men, great future opportunity exists to decrease the gender gap within ophthalmology and within vitreoretinal surgery. In this study, we found no association between an applicant’s mentor contacting a specific program to communicate their interest in the program and the probability of the applicants matching number 1. Perhaps having a mentor contact a program on an applicant’s behalf has become an essential, unofficial component of the fellowship application, providing little differentiation between applicants, and therefore not significantly influencing applicant ranking. While a mentor contacting a program to solely express an applicant’s interest may not be associated with the final match outcome, the content of these conversations may have an effect, such as a mentor not only expressing interest, but also disclosing an applicant’s intention to rank a program number 1. It is clear from multiple studies that applicants and program directors engage in pre-match communication, often to the extent of revealing their rank-order intentions and that both parties fully admit to changing rank-order lists based on this information. In this study, we found an association between applicant disclosure of number 1 rank intention either personally or via a mentor and the probability of matching number 1. The rationale for this association may be that an applicant revealing their number 1 ranking to a program eliminates the uncertainty of the match. If a program is content with the applicant who has disclosed their intention to rank them number 1, the program may elevate that applicant’s standing on the rank list. This would effectively decrease the probability of matching a less desirable candidate and increase the probability of matching an applicant pleased with the match outcome, possibly leading to a better overall fellowship training experience for both the fellow and for the fellowship program. If you are planning to apply to surgical retina fellowship in the future, or to any fellowship in any specialty, for that matter, I hope that the results of this study will be of help to you. Please read the full article which is published in the June 1, 2018 edition of JAMA Ophthalmology for full details. Once again, this is Steve Christiansen, thanks for watching.

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