Applying To Vitreoretinal Surgery Fellowship

Advice from recent candidates.

By /with contributions from Paul Baker, MD; Leon Charkoudian, MD; Vivek Chaturvedi, MD; and Hani Salehi-Had, MD
 

Applying to vitreoretinal fellowship is an exciting process. It is an opportunity to visit many programs, perhaps for the first time, and forge friendships with new colleagues with whom you may work throughout your career. The application process, with all of its thrill, remains daunting in its uncertainty. To help navigate and guide residents through the fellowship application process, we interviewed four up-and-coming vitreoretinal fellows who offered advice from their recent experiences. Please share this article with current third-year residents who may not yet subscribe to Retina Today.
-Darrell E. Baskin, MD; Jeremy D. Wolfe, MD; and Chirag P. Shah, MD, MPH

1. What advice would you give first- and second-year residents interested in retina to better prepare them for the application process and strengthen their candidacy?
Strong ophthalmology residents make strong vitreoretinal fellows. Residency is the only time a candidate will be exposed to all subspecialties; he or she should take advantage of this comprehensive exposure, learn to operate well, and develop clinical judgment to treat patients with any eye disease. With this in mind, it is also important to stay well-rounded, continue extracurricular activities, and work well with colleagues.

For those with an interest in retina, it is important to spend time in retina clinic and in the retina operating room. This enables residents to gain perspective on the field and to make an informed decision when choosing (or not choosing) retina as a career. It is also important to identify a mentor who can offer advice on potential research projects and help during the application process.

Finally, there is no doubt that research is important. All of our contributors felt that research, coupled with good performance as a resident, were the key components of a strong retina fellowship application. Dr. Salehi-Had specifically stated that he believes research to be a good way to gain some expertise in a particular topic while working closely with one or more attendings. Fostering good relationships with attendings early in residency will make it easier to ask for letters of recommendation come application season.

2. To how many retina fellowship programs did you apply? How many interviews did you attend?
Each of our correspondents reported that they applied to between eight and 20 programs and attended five to 13 interviews. Dr. Charkoudian noted that some interview dates conflict among programs. Although this can limit interview choices, our experience is that some programs may entertain alternate dates if requested politely. Some programs will occasionally offer interviews at academic meetings in lieu of their traditional onsite interview. This approach places both parties at a slight disadvantage, but it may have its merits.

3. What advice would you give third-year residents applying to fellowship?
Our correspondents had plenty of useful advice for third-year residents applying for fellowship. Recommendations included that residents send their applications in early and never underestimate how long getting a letter of recommendation completed can take. Contact each program coordinator and ensure that all of their application requirements have been met. If possible, try to plan a flexible resident rotation during the fall interview season, especially October and November.

Dr. Chaturvedi recommended acquiring a travel credit card if you do not already possess one; the expenditures of the interview trail can exceed $3,000.

During the interviews, do your best to relax and ask all the questions that come to mind. Many applicants reported compiling a spreadsheet to document program details (both important, like surgical volume, and mundane, like free lunch or parking) for later review. After the interviews, discuss your rank list with your family and close friends, and then stay in touch with the programs in which you are most interested. Consider having your mentor place a phone call to your first choice fellowship to inform them of your interest.

4. Retina fellowship programs range from more academic to more clinical/surgical, with most programs falling somewhere in the middle of this spectrum. What should applicants look for in a program?
This spectrum is similar to residency programs. Pick vitreoretinal fellowship programs that fit your interests and anticipated future career. If you wish to have a research-oriented practice in an academic institution, you should go to a program that allows dedicated research time with exposure to the appropriate faculty in the field. If you wish to enter private practice, a high volume clinical and surgical fellowship will suit you better than a more academic, research-oriented program.

Of course, most people fall somewhere in between, as do most programs. Speaking with current vitreoretinal fellows and your mentor will help identify the programs along this spectrum. Another way to gauge the nature of individual programs is to find out what types of jobs recent fellowship graduates have taken. In most cases, you will quickly get a sense if a particular program's strengths fit your interests during the interview.

5. What factors determined your own preference and rank of programs?
The two most important considerations for all of our correspondents were quality of the program and location. It was recommended that applicants seek programs where attendings offer excellent mentorship, both in the clinic and operating room. It is important for programs to achieve a healthy balance between supervision and independence. Dr. Baker was attracted to programs where fellows benefited from a system of graduated independence in the operating room. During the interviews, try to gauge the happiness of current fellows, which may help predict your own well-being at particular programs.

Location is also an important consideration. Being happy outside work is important in maintaining balance during a busy fellowship such as retina. Family considerations are, of course, of utmost importance. Further, if one wants to practice in a certain region of the country, it may be helpful to develop regional connections during fellowship. If this is the case, inquire about a restrictive covenant, which may limit your geographic options in close proximity to your fellowship institution.

In summary, successful application to vitreoretinal fellowship requires good preparation from the start of residency, clinically, surgically, and academically. There are many factors to consider when choosing programs, although the most important depend on your career goals and overall happiness. It is a fun process that can be navigated fruitfully with ample preparation and a bit of good luck.

Paul Baker, MD, is a third-year resident at Wills Eye Institute, where he will be staying for vitreoretinal fellowship. He may be reached at pbakerny@yahoo.com.

Leon Charkoudian, MD, is a third-year resident at Scheie Eye Institute who will be starting a vitreoretinal fellowship at Emory Eye Center. He may be reached at Leon.Charkoudian@uphs.upenn.edu.

Vivek Chaturvedi, MD, is a third-year resident at Tufts-New England Eye Center who will be starting a vitreoretinal fellowship at Rush-Illinois Retina Associates. He may be reached at vivek.vedi@gmail.com.

Hani Salehi-Had, MD, is a third-year resident at the Massachusetts Eye and Ear Infirmary who will be starting a vitreoretinal fellowship at Doheny Retinal Institute. He may be reached at hani_salehi@meei.harvard.edu.

Darrell E. Baskin, MD; Jeremy D. Wolfe, MD; and Chirag P. Shah, MD, are second-year vitreoretinal fellows at Wills Eye Institute in Philadelphia, PA. Dr. Baskin may be reached at darrellbaskin@gmail.com; Dr Wolfe may be reached at jeremydwolfe@gmail.com; and Dr. Shah may be reached at cshah@post.harvard.edu.

 

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About Retina Today

Retina Today is a publication that delivers the latest research and clinical developments from areas such as medical retina, retinal surgery, vitreous, diabetes, retinal imaging, posterior segment oncology and ocular trauma. Each issue provides insight from well-respected specialists on cutting-edge therapies and surgical techniques that are currently in use and on the horizon.