EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
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14 EW NEWS & OPINION April 2013 Finding continued from page 13 plastic surgery whose 2011 match rate was only 44% for U.S. seniors. Ophthalmology is still much more competitive than many specialties such as internal medicine, pediatrics, and neurology. Dr. Chang: Why did you decide to undertake this study? Dr. Naseri: For many applicants the match process is an opaque and anxiety-provoking experience. It was our goal to provide some transparency about the match and to provide data to support applicants' decision-making. For medical student applicants and their advisors, we are hopeful that the results of this study will help guide them in determining how many applications to submit, how many interviews to go on, and the overall strengths and weaknesses of their application relative to others in the applicant pool. This project was really driven by the curiosity and enthusiasm of one of our residents, Allison Loh, MD, whose own experience with the match process was still fresh in her mind. She deserves the credit for inspiring the rest of her co-authors. Dr. Chang: What factors had the highest correlation with acceptance into a residency program? Dr. Naseri: In multivariate logistic regression, the factor that was the strongest predictor of matching was attendance at an allopathic medical school (versus osteopathic). After that, the strongest predictors of Ar Arita rita Me b mian Meibomian eibom This new instrument has been designed by Dr. Reiko Arita of Saitama City, Japan to gently express meibum from dysfunctional meibom glands (MGD). The special angles of the forceps allow the surgeon to easily insert and position the tips over the eyelid parallel to the lid margin. The broad, smoothly polished jaws are then used to atraumatically compress the glands Ð relieving any occlusions with minimal pain to the patient. This instrument user-friendly while addressing an Watch Watch it! upper or lower eyelid and working from either a temporal or nasal approach. K5 -5900 K5-5900 ® 973 -989 -1600 U 800 -225 -1195 U www.katena.com matching were AOA membership, attendance at a top medical school, and attendance at a medical school with an ophthalmology residency. USMLE score was also a powerful predictor of matching; each 10-point increase in USMLE score conferred an almost 60% increase in the probability of matching successfully. Dr. Chang: Do you think that the apparent importance of medical school ranking/reputation is justified? Dr. Naseri: Others have pointed out that some of the most important characteristics in the resident selection process are difficult to determine from an application form or interview: compassion, integrity, critical thinking, passion, respect for others, etc. Since we struggle to identify and measure these noncognitive variables, many of us lean on quantitative, cognitive metrics. Grades, board scores, and educational pedigree fall into that category. If we could accurately determine these non-cognitive attributes, I suspect that the influence of variables like medical school reputation would be mitigated. This is at the heart of what makes the process so challenging. Dr. Chang: What findings surprised you the most? Dr. Naseri: While it might have been intuitive that geography would play some role, I was surprised by the magnitude of the effect of geography on the match. Nearly 60% of applicants matched in the same geographic region as their medical school. Applicants from the South and West regions were almost fourfold more likely to match in their same region as in another region. And I think our study underestimates the effect of geography since we only looked at medical school location. If one were to look at applicants' hometowns or undergraduate institutions, I suspect the effect would have been even greater. It was also interesting to find that the applicants most likely to match outside of their region were those with higher USMLE scores and those from a top 10 medical school. In conclusion, we are hopeful that the findings from this study will help guide applicants and their mentors as they navigate the stressful process of selecting the next generation of U.S. ophthalmologists. Personally, I am hopeful that this information will also assist in mitigating some of the inefficiencies of the match process. EW Contact information Naseri: Ayman.Naseri@va.gov