Integrated CT surgery residency

[badasshairday]

First off, the data on TAVI right now is quite poor. I'm not saying with refined technique/devices that it can't improve, but for now it remains a niche procedure for those too sick to handle surgery (who probably aren't long for this world anyways, but thats another argument).

You are right. But guess who decides who is going to be referred for valve surgery? The cardiologist. And said cardiologist now has a skill which allows him to do it himself, whether it is better or not. I'm not saying all cardiologist are crooks like this, but I'm sure it will be similar to how it was in the past (and to some extent still today) of stenting everything despite evidence showing that bypass would be better for certain patients / lesions.

Secondly, I've always heard the opposite about IR. I know it is entirely instutition dependent, but at my institution Cards and Vascular are fighting over peripheral endovascular work, with IR being relegated to mostly percutaneous fluoro guided work (biopsys, abscesses, LPs, etc.) and tumor work ( RFA, etc.). As always, the issue is about who controls the patients, and cards and vascular see patients long before an IR doc does in general. FWIW, I think vascular should take them given that they can offer both open and endovascular options to patients, while cards and IR have only one hammer so everyone looks like a nail.

You are emphasizing the importance of longitudinal care, and you are preaching to the choir. In places where VIR still has a large role in peripheral arterial disease, whether academic or community settings, they are seeing patients in clinic and obtaining direct referrals from PCP's. Similarly, CT - surgeons need to rebrand as a one shop stop themselves and offer minimally invasive cardiovascular procedures.

However, this same problem apples to CT surgery. Even if they could gain the necessary cath/wire skills, which I'm sure they could, they would be last in the referral chain. Cardiology controls those patients, and you can bet they won't be referring them to CT for caths. The time for CT surgery to get on the Cath train was many years ago, and by now its already left the station.

CT-surgeons don't need to do coronary artery interventions. They need to play an active and large role in developing percutaneous valve procedures. CT-surg should get referrals from internists and cardiologists for these procedures, because in the future these procedures will have concrete indications. And if they don't develop this, they will miss this train as well.

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[Doc187]

So those going into general surgery soon and then want to apply to CTS will be sol if the change was made after they went into gen surg? If this is something that is suppose to happen, when would it happen?

I think you'll be fine. Most CTS programs have the traditional trainign program after surgery residency, currently. If all of these programs were to switch to a 3+3 or a 4+3 model program today (in theory), they would need to keep fellows until the integrated residents had proceeded into their senior clinical years. My guess would be 5-6 years.

However, I think it won't be for another 8-10 years at least until the traditional training programs have been completely phased out.

I'm currently an M2 with intentions of either doing the traditional 5-year general surgery + 2-3 year fellowship or the 4+3 track. I want to get some more exposure before I fully commit to CT, and frankly, I also don't think I could get in to the I6 track.

That being said, if traditional fellowships are being phased out by 2020, that puts me in a precarious position because that will be right about when I'd be completing my general surgery residency and theoretically moving on to CT fellowship.

What am I to do? If I do surgery, I still had my hopes on CT, but I don't want to be midway through my training to be told that I can't do CT anymore because the fellowships simply don't exist anymore for a general surgery resident.

Advice?

 

[DoctwoB]

I'm currently an M2 with intentions of either doing the traditional 5-year general surgery + 2-3 year fellowship or the 4+3 track. I want to get some more exposure before I fully commit to CT, and frankly, I also don't think I could get in to the I6 track.

That being said, if traditional fellowships are being phased out by 2020, that puts me in a precarious position because that will be right about when I'd be completing my general surgery residency and theoretically moving on to CT fellowship.

What am I to do? If I do surgery, I still had my hopes on CT, but I don't want to be midway through my training to be told that I can't do CT anymore because the fellowships simply don't exist anymore for a general surgery resident.

Advice?

I highly doubt that all the fellowships would be phased out over a 5-7 year period. There will undoubtedly be a larger overlap as I6 programs grow and traditional fellowships shrink. Take a look at vascular, where the integrated pathway is expected to replace the fellowships, which has been going on for 5-6 years. There's still plenty of fellowships available.

 

[duckie99]

CT-surgeons don't need to do coronary artery interventions. They need to play an active and large role in developing percutaneous valve procedures. CT-surg should get referrals from internists and cardiologists for these procedures, because in the future these procedures will have concrete indications. And if they don't develop this, they will miss this train as well.

Well I just want to point out that to even be certified to do any caths at all (even a diagnostic cath) a cardiologist must do more than 300 or so caths during fellowship training (level 2 requirements). This is not a feat all fellows can accomplish depending on their interests or training institution. I don't know specifics on endovascular valve replacements but I'm sure it's a more rigorous certification requirement (I think at a minimum an interventional fellowship).

So to think there is even a chance that CT surgery can scoop up endovascular work (on top of what they already do) is a little naive. They are already needed in the room in conjunction with the cardiologists for certain types of procedures (such as difficult to access sites for endovascular valve - such as through the aorta). And last I checked CT surgeons aren't just sitting on their butts doing nothing. They're pretty busy as it stands now. I also think it is naive to think CT surgery will be phased out (like some people think) because from what I have seen a lot of CAD actually is more diffuse and requires CABG rather than PCI. Finally cardiologists aren't stupid... they're not going to risk a patient's life and attempt a contraindicated valve replacement when the patient is a good surgical candidate. That is blatant malpractice. Finally, CT surgeons also have transplant work, VADs, valve replacements (beyond TAVI), minimally invasive development (not interventional/endovascular), etc etc. There's lots of stuff going on in the field.

So to students interested in CT surgery don't let this forum worry you. Go out and talk to people in the field but realize there are plenty of downers in all fields (grass is always greener on the other side).

 

[Doc187]

I highly doubt that all the fellowships would be phased out over a 5-7 year period. There will undoubtedly be a larger overlap as I6 programs grow and traditional fellowships shrink. Take a look at vascular, where the integrated pathway is expected to replace the fellowships, which has been going on for 5-6 years. There's still plenty of fellowships available.

What about the whole thing on ABTS and how most programs are going toward 100% I6 by 2020? It just sucks because I'm right at that cutoff (I'd be PGY4 in 2019). I understand that what ABTS wants and what individual programs do don't necessarily match up, but I don't want to take a gamble at wasting 5 years of my life in general surgery if I don't have to.

General surgery is a lot less attractive to me if I won't be able to do CT unless I get into I6 after med school in 2015.

 

[EquipartHeart]

A website offering up some more information about one of the I6 CT surgery programs.

http://www.ctswot.org/

 

[SouthernSurgeon]

A website offering up some more information about one of the I6 CT surgery programs.

http://www.ctswot.org/

Just an observation from the pic on that site...he who is wearing the headlamp and the 3.5 loupes is the one doing the case, regardless of them saying it was the PGY2 doing it "skin to skin"

That said, if the staff are really letting two residents do valve cases together while they stay scrubbed out that's pretty sweet.

 

[orangesky38]

What about the whole thing on ABTS and how most programs are going toward 100% I6 by 2020? It just sucks because I'm right at that cutoff (I'd be PGY4 in 2019). I understand that what ABTS wants and what individual programs do don't necessarily match up, but I don't want to take a gamble at wasting 5 years of my life in general surgery if I don't have to.

General surgery is a lot less attractive to me if I won't be able to do CT unless I get into I6 after med school in 2015.

So I'm an I6 applicant from this year and I interviewed at many of the I6 programs, and basically spent the past 6-7 months gathering information about this process and trying to make a decision about this for myself. The mandate that all programs go I-6 by 2020 was essentially silenced. It's highly unlikely that it will happen, but with that said I think there's a big push for programs to go integrated because of the drop off of applicants to CT fellowships and the desire to attract the "best and the brightest" to the field. But the catch is that all integrated programs are not created equal, and you have to be fairly savy to pick out the red flags. CT went though a long period of instability- some places were able to maintain their income, surgeons, patient load etc through the "slump", some weren't, and are using the I6 people as a way to get their name back to where it used to be. I think as an applicant you have to look at all the programs with a discerning eye. And I'd recommend being careful about how much CT can be "smelled" on your application for gen surg, because many programs don't look favorably upon people who apply I6. I would be happy to speak specifically about this if you PM me, and I'll have a real opinion of all this at the end of next week. eek.

 

[navymd]

"And I'd recommend being careful about how much CT can be "smelled" on your application for gen surg, because many programs don't look favorably upon people who apply I6."

I disagree completely as a PD in gen surg. There are some applicants for I6 which are extremely qualified and others that are at the opposite end of the spectrum. Those of us in gen surg understand that it is competitive and that people change their minds after seeing what is out there. The right program director takes the best qualified applicant that fits with for their program and does not guess if they will definitely decide on CT or do gen surg.

I know this is not all PDs and those are the folks that worry me.

 

[RIPSanto]

So I'm an I6 applicant from this year and I interviewed at many of the I6 programs, and basically spent the past 6-7 months gathering information about this process and trying to make a decision about this for myself. The mandate that all programs go I-6 by 2020 was essentially silenced. It's highly unlikely that it will happen, but with that said I think there's a big push for programs to go integrated because of the drop off of applicants to CT fellowships and the desire to attract the "best and the brightest" to the field. But the catch is that all integrated programs are not created equal, and you have to be fairly savy to pick out the red flags. CT went though a long period of instability- some places were able to maintain their income, surgeons, patient load etc through the "slump", some weren't, and are using the I6 people as a way to get their name back to where it used to be. I think as an applicant you have to look at all the programs with a discerning eye. And I'd recommend being careful about how much CT can be "smelled" on your application for gen surg, because many programs don't look favorably upon people who apply I6. I would be happy to speak specifically about this if you PM me, and I'll have a real opinion of all this at the end of next week. eek.

I think I sent you a PM about this, but I figured it would be good to add here. Could you, or anyone who has recently applied, elaborate about what you think makes a competitive I6 candidate for interview/matching now that you have been through all this. There doesn't seem to be as much info about I6 competitiveness etc as with other specialties (no NRMP data). Thanks

 

[orangesky38]

"And I'd recommend being careful about how much CT can be "smelled" on your application for gen surg, because many programs don't look favorably upon people who apply I6."

I disagree completely as a PD in gen surg. There are some applicants for I6 which are extremely qualified and others that are at the opposite end of the spectrum. Those of us in gen surg understand that it is competitive and that people change their minds after seeing what is out there. The right program director takes the best qualified applicant that fits with for their program and does not guess if they will definitely decide on CT or do gen surg.

I know this is not all PDs and those are the folks that worry me.

I completely agree with your perspective, and I think that there are a number programs that do as well. However, I was asked directly if I applied integrated at a number of interviews and had to justify doing so and had to explain that general surgery wasn't a back up. That was the harsh reality of my experience. I disagree with the assertion that your perspective is a reflection of all, or even the majority, of general surgery programs' perspective on I6 applicants. There are a number of programs who rejected everyone who applied integrated at the same institution with the exception of 1-2 applicants. And I myself experienced the questioning first hand, as did many of my other co-applicants. The truth is some programs don't like it and some programs don't care. It's a mix. While I think what you're saying is the correct way to think for general surgery program directors, not all PD's share your enlightened perspective, and it is the applicants who suffer and who have the most to lose, and therefore need to be the most cautious. Which isn't to say that I6 applicants have no possibility of interviewing and competitive institutions. I interviewed very well and so did many of my colleagues, but it doesn't change the bias myself and my co-applicants perceived, period. But obviously I will be better able to speak to this on Friday.

I think I sent you a PM about this, but I figured it would be good to add here. Could you, or anyone who has recently applied, elaborate about what you think makes a competitive I6 candidate for interview/matching now that you have been through all this. There doesn't seem to be as much info about I6 competitiveness etc as with other specialties (no NRMP data). Thanks

Yeah of course. I'll probably write more formally about this here in a week, but as has been said here it's a bit of a mix. Per the NRMP there were 59 US grads who applied last year and 80 total. I would say that we all kind of ranged- those of us who interviewed at most programs like myself I would say had board scores like >235-245 or so. I think research was very important but not crucial, but demonstrated dedication to CT in some form was, whether that be away rotations, research, relationship with your home department etc. Obviously like any surgical specialty, good clinical grades definitely matter- I think most of us who were competitive and at most interviews honored at least 40-50% of our rotations (high passed the rest) at the low end, almost all at the high end, but it's the same as everything- the best candidates are those who are most qualified by every standard- so obviously high scores/aoa/outstanding clinical grades/great letters from important people in the field/research will make you competitive. I think that it's actually difficult for me to say at this point because match day hasn't happened yet, but in general it is quite competitive but it's also a fairly self selected bunch, so people who are at the top of the pool were at the top across the board, whereas for the "elite gen surg programs" there was a bit more of a hit and miss to it in my experience, probably because the pool of great applicants is bigger and programs have a better sense of exactly what they're looking for. But again, everything I say here is a matter of one person's opinion and aggregate experience over the past year- I'm by no means an authority and would never claim to be.

 

[mitralwiz]

any thoughts post match?

 

[orangesky38]

any thoughts post match?

Yeah. So I'm extremely happy with my result, but I will say that I feel even more strongly about what I said before about general surgery programs and I6 applicants and I can back that up. General Surgery is very competitive, especially at the "elite general surgery programs" and the elite programs are no one's back up, they are just as competitive if not more so than integrated CT. Don't let anyone tell you otherwise.

That said, definitely apply to both, in 2012, 25 spots, 56 US grads, 87 total, that's an automatic 50% no match rate so don't be ridiculous and only apply CT even if you think you're "that good" b/c so is everyone else I personally interviewed at around 20 or so programs. EXPENSIVE as hell and exhausting, but now well worth it, especially knowing how it all shook out.

If you want to do general thoracic surgery, think long and hard about whether and where you apply I6 because many of the programs may not or will not be able to give you what you need. PM me for more on this. Pittsburg and Columbia I believe are the only 2 formally ACGME approved thoracic track positions. Columbia I've only heard about by word of mouth, so wait for formal proof of that.

There is also the 4+3 option that is not well publicized so I should mention it here. Basically some general surgery programs have an agreement with their fellowship that they'll allow their categorical residents to begin their cardiothoracic fellowship at the same institution in their 4th or 5th year of residency depending on the institution. This is decided internally after the resident begins and it's largely based on performance. Many of the residencies will only pick one of the categorical residents to do the 4+3 option, and the catch is, typically these programs are heavily targeted by those interested in cardiothoracics. Mayo Clinic is the only one that offers the 4+3 option directly out of medical school. The programs that are ACGME approved for the 4+3 option who actively allow residents to go through it are Brigham and Womens, MGH, UVA, Mayo Clinic, NYU, UT-Southwestern, Wash-U, Duke, and when I was at UW I was told they had just set it up to work this year. These are the ones I can remember, there may be a couple I've forgotten. I did not include Rochester on this list because I do not believe the 4+3 option is available there despite the approval, but again, do not quote me, the institution itself is the best source of that information. Here's a link from the ACGME of the list of I6 and 4+3 programs as of 2012. These programs pop up pretty quickly so this list is actually outdated from this past year. In terms o f I6 U Mich Ann Arbor was added for us this year, as was Indiana University. Keep your ear to the ground because a lot of the new I6 programs pop up fast, so you don't want to miss them. http://www.acgme.org/acgmeweb/Portals/0/PFAssets/PublicationsNewsletters/Thoracic_Surgery_Mar12_.pdf

There's also the Early Specialization Program that 12 general surgery programs in the nation are approved for that is another way to get early exposure, but that's another level of nuance that I am not going to overwhelm this already excessively long post with. PM me about that too if you want more info.

I think my other big post match thought is that away rotations at the programs you're interested in really help a lot. If I had to estimate, I would say that >50-60% of the I6 positions either went to an internal candidate OR a student who rotated there. So a massive percentage. Aways matter for Integrated CT.

Research is very important, but not crucial, and just like general surgery the interview day is also very important, it can make or break you. Having high scores is pretty important to securing interviews, and having strong mentorship, advising and advocacy with people who are important in the field is also very important because at the end of the day the CT world is incredibly small, and having important well respected people in your corner makes all the difference. I would argue that the most important aspects are doing aways and making a strong positive impression, interviewing well, and strong letters from CT surgeons who are well respected.

Also, all of you who interview next year will get to know each other on the trail pretty well so be kind to your new friends and future colleagues. Best of luck to all of you and maybe see you next year

 

[RIPSanto]

Anyone notice a few new programs added this year? Iowa, Yale, Cinci, Cleveland Clinic, Duke?

I'm wondering how long it will take until some match data is available for this specialty. It would be nice to know for those interested in applying.

 

[MMB123]

Yeah. So I'm extremely happy with my result, but I will say that I feel even more strongly about what I said before about general surgery programs and I6 applicants and I can back that up. General Surgery is very competitive, especially at the "elite general surgery programs" and the elite programs are no one's back up, they are just as competitive if not more so than integrated CT. Don't let anyone tell you otherwise.

That said, definitely apply to both, in 2012, 25 spots, 56 US grads, 87 total, that's an automatic 50% no match rate so don't be ridiculous and only apply CT even if you think you're "that good" b/c so is everyone else I personally interviewed at around 20 or so programs. EXPENSIVE as hell and exhausting, but now well worth it, especially knowing how it all shook out.

If you want to do general thoracic surgery, think long and hard about whether and where you apply I6 because many of the programs may not or will not be able to give you what you need. PM me for more on this. Pittsburg and Columbia I believe are the only 2 formally ACGME approved thoracic track positions. Columbia I've only heard about by word of mouth, so wait for formal proof of that.

There is also the 4+3 option that is not well publicized so I should mention it here. Basically some general surgery programs have an agreement with their fellowship that they'll allow their categorical residents to begin their cardiothoracic fellowship at the same institution in their 4th or 5th year of residency depending on the institution. This is decided internally after the resident begins and it's largely based on performance. Many of the residencies will only pick one of the categorical residents to do the 4+3 option, and the catch is, typically these programs are heavily targeted by those interested in cardiothoracics. Mayo Clinic is the only one that offers the 4+3 option directly out of medical school. The programs that are ACGME approved for the 4+3 option who actively allow residents to go through it are Brigham and Womens, MGH, UVA, Mayo Clinic, NYU, UT-Southwestern, Wash-U, Duke, and when I was at UW I was told they had just set it up to work this year. These are the ones I can remember, there may be a couple I've forgotten. I did not include Rochester on this list because I do not believe the 4+3 option is available there despite the approval, but again, do not quote me, the institution itself is the best source of that information. Here's a link from the ACGME of the list of I6 and 4+3 programs as of 2012. These programs pop up pretty quickly so this list is actually outdated from this past year. In terms o f I6 U Mich Ann Arbor was added for us this year, as was Indiana University. Keep your ear to the ground because a lot of the new I6 programs pop up fast, so you don't want to miss them. http://www.acgme.org/acgmeweb/Portals/0/PFAssets/PublicationsNewsletters/Thoracic_Surgery_Mar12_.pdf

There's also the Early Specialization Program that 12 general surgery programs in the nation are approved for that is another way to get early exposure, but that's another level of nuance that I am not going to overwhelm this already excessively long post with. PM me about that too if you want more info.

I think my other big post match thought is that away rotations at the programs you're interested in really help a lot. If I had to estimate, I would say that >50-60% of the I6 positions either went to an internal candidate OR a student who rotated there. So a massive percentage. Aways matter for Integrated CT.

Research is very important, but not crucial, and just like general surgery the interview day is also very important, it can make or break you. Having high scores is pretty important to securing interviews, and having strong mentorship, advising and advocacy with people who are important in the field is also very important because at the end of the day the CT world is incredibly small, and having important well respected people in your corner makes all the difference. I would argue that the most important aspects are doing aways and making a strong positive impression, interviewing well, and strong letters from CT surgeons who are well respected.

Also, all of you who interview next year will get to know each other on the trail pretty well so be kind to your new friends and future colleagues. Best of luck to all of you and maybe see you next year

Really great thank you. I am just reading this now, and it is very helpful. I am applying this year...so looking forward to leaning alot about this myself. Btw, do you mind sharing which program you ended up at? Would love to pick your brain some more and get some more advice if I interview at your program!
thank you

 

[luckyvang]

Does anyone know if these programs take DO's? I've looked around and asked a lot of people, but there isn't enough information out there.

 

[themockjock]

Does anyone know if these programs take DO's? I've looked around and asked a lot of people, but there isn't enough information out there.

Yes, at the very least UTHCSA does (http://utcardiothoracicsurgery.com/current-trainees).

That said, I-6 is very, very competitive as it is... it is an uphill battle even for MDs to match, so DOs will be at a big disadvantage. And I would imagine that at the top I-6s (some I-6s are more equal than others...) DOs have close to a 0 chance of matching. UMich, for example, will not take DOs, full stop (per their PD, last year >50% of the candidates they interviewed were MD PhD).

That said, it might be worth applying anyway - the worst they can say is no, and if you're even remotely competitive for I-6, you'll match well into GS. Getting a good CT fellowship out of a good GS program will be very easy for you, even as a DO.

 

[luckyvang]

Thanks TheMockJock. My fears are confirmed! LOL.

 

[Buzz Me]

Getting a good CT fellowship out of a good GS program will be very easy for you, even as a DO.

...provided you put together a strong application during residency.

 

[The Buff OP]

Yeah of course. I'll probably write more formally about this here in a week, but as has been said here it's a bit of a mix. Per the NRMP there were 59 US grads who applied last year and 80 total. I would say thacores like >235-245 or so. I think research was very important but not crucial, but demonstrated dedication to CT in some form was, whether that be away rotations, research, relationship with your home department etc. Obviously like any surgical specialty, good clinical grades definitely matter- I think most of us who were competitive and at most interviews honored at least 40-50% of our rotations (high passed the rest) at the low end, almost all at the high end, but it's the same as everything- the best candidates are those who are most qualified by every standard- so obviously high scores/aoa/outstanding clinical grades/great letters from important people in the field/research will make you competitive.

If an applicant is a URM and a fluent Spanish speaker can this be a plus on the application?

 

[RIPSanto]

I understand many of the I6 programs aren't the greatest for those interested in general thoracic, but what about those interested in lung transplant surgery? Would the I6 provide good training? Can anyone comment on the path to lung transplant? Are there actually "lung transplant surgeons" or are they general thoracic surgeons who also perform transplant?

 

[The Buff OP]

I understand many of the I6 programs aren't the greatest for those interested in general thoracic, but what about those interested in lung transplant surgery? Would the I6 provide good training? Can anyone comment on the path to lung transplant? Are there actually "lung transplant surgeons" or are they general thoracic surgeons who also perform transplant?

I believe you have to do a fellowship for that. I6 is counted as a residency and the extras are fellowships. Like pediatrics and transplants. Check out the link below.
http://ctsurgery.stanford.edu/education/fellowships.html

 

[cpas]

It depends where you go. There are transplant superfellowships, but if you do enough transplant during your training program then it may not be required. 1 of the i6 trainees at my program wants to do heart failure surgery/ lung tx/ ecmo but is not doing a superfellowship. A lot of the i6 programs also say that your 6th yr is like a superfellowship year where you can specialize in whatever you would like and spend more time in that area.

 

[cpas]

If anyone has any questions about i6 programs, feel free to post or PM me. i6 interview season is essentially finished, and I can give you whatever information i've learned throughout my sub-i's and talking to people throughout the interview trail.

 

[mitralwiz]

ditto on the cpas post. its feburary start thinking about subis guys/girls. They are important. Word for the wise, there are MANY great programs out there that are not getting subis or very few. It seems that subis cluster at Stanford and Emory for the most part. Obviously people rotate other places but those were the most popular places to rotate this year. Read between the lines. In any case PM if you have qs. Ill post something longer after Feb 26. Good luck.

 

[mitralwiz]

Some program reviews for future applicants:

Penn: Amazing place. 1 year of gen surg at community program where you do 400+cases. By the time you are pgy3 you can cannulate and prepare to go on bypass with a PA, and do some AVRs, distal anastomoses, tons of caths and a few interventions. The complexity of cases is the highest here. David V's being done in multiple rooms per day is very routine. One of the satellite hospitals offer off pump coronary experience as well as minimally invasive mitrals. They are attempting to recruit a robotic mitral surgeon here. Dr Acker is very dynamic and can open any door you want career wise. Probably the most coveted spots on the trail. They are expanding to two spots next year, or at least they are trying. Dont get to do much in peds cases which is downside, and Dr. Acker is very open about this.

Columbia: Huge heart failure volume. The Directors of the VAD and transplant service are probably the best teachers I have personally come across. They really are patient and let the fellows do the entire case. By the end of pgy3 you should be able to have patients ready to go on bypass with one of the fellows assisting, do proximals, and maybe a few distals, no valves. The pgy4-6 experience is very balanced, allows elective time and dedicated time on interventional cardiology. One of the faculty members is truly a hybrid surgeon and advocates for you to be involved in TAVR and cath. The gen surg time is primarily done in a satellite community hospital that provides an excellent experience but it is in NJ. Argenziano is a phenomenal teacher and gets the residents involved early. Solid program.

Emory: Huge coronary volume, 60-70% off pump. Just recruited a robotic mitral surgeon, and one of their exisiing faculty members is getting to be very proficient in robotics so by the time you are a pgy5-6 the robotic practice will be very well established. Aortic surgery is huge. Thourani runs a big TAVI program and allows the fellows to do a lot in the transapical cases. Further Ed Chen does an enormous number of root procedures and has just started doing the Ross procedure. Atlanta is great, and the people here are probably a lot nicer than most cardiac surgeons. There are multiple hospitals so very different than some of the East Coast programs.

USC: This imo is one of the best programs in the country. Dr. Baker is very progressive in getting residents involved early. There is a perfused cadaver program, so you get to learn mammary harvesting with the closest to the real thing as possible. In addition they have a cannulation model. With these resources you get very good with these techniques early on, and in a comfortable setting. The pgy1-2 residents are getting to do a lot, with great support from all faculty. The program is not top heavy, it is likely the most balanced through the 6 years of all I6 programs. The complexity is very high, and Dr. Starnes is very open to fellows doing stuff in his cases. The experience at LACounty is unparalleled. I6 residents routinely do cases skin to skin. 2 of their faculty members run basic science labs. The peds experience here is only matched by Michigan and Emory. You get to do a lot in the peds cases and they do 800-900 cases a year, maybe more. Importantly you actually get to do complex peds cases. They usually take their own for their coveted congenital fellowship. So if you are into peds this place is amazing.

Hope this helps some people.

 

[mitralwiz]

Match Results start filling in Friday, name and medical school. Good luck.

USC-
USC-
Stanford-
Stanford-
UC David-
Yale-
Yale-
Emory-
Emory-
Northwestern-
Indiana-
Iowa-
Kentucky-
Maryland-
Michigan-
Michigan-
LIJ-
Sinai-
Columbia-
Columbia-
Rochester-
Duke-
Duke-
UNC-
Cincy-
CCF-
Penn-
Pitt-
Pitt-
MUSC-
Texas, San Antonio-
Virginia-
Washington-
Wisconsin-

 

[member1202]

Match Results start filling in Friday, name and medical school. Good luck.

USC-
USC-
Stanford-
Stanford-
UC David-
Yale-
Yale-
Emory-
Emory-
Northwestern-
Indiana-
Iowa-
Kentucky-
Maryland-
Michigan-
Michigan-
LIJ-
Sinai-
Columbia-
Columbia-
Rochester-
Duke-
Duke-
UNC-
Cincy-
CCF-
Penn-
Pitt-AJ Cardounel, Ohio State University
Pitt-
MUSC-
Texas, San Antonio-
Virginia-
Washington-
Wisconsin-

 

[member1202]

Match Results start filling in Friday, name and medical school. Good luck.
USC-
USC-
Stanford-
Stanford-
UC David-
Yale-
Yale-
Emory-
Emory-
Northwestern-
Indiana-
Iowa-
Kentucky-
Maryland-
Michigan-
Michigan-
LIJ-
Sinai-
Columbia-
Columbia-
Rochester-
Duke-
Duke-
UNC-
Cincy-
CCF-
Penn-
Pitt-AJ Cardounel, Ohio State University
Pitt-
MUSC-
Texas, San Antonio-
Virginia-
Washington-
Wisconsin-

 

[mitralwiz]

USC-
USC-
Stanford-
Stanford-
UC David-
Yale-
Yale-
Emory-
Emory-
Northwestern-
Indiana-
Iowa-
Kentucky-
Maryland-
Michigan-
Michigan-
LIJ-
Sinai-
Columbia- Antonio Polanco, Mt Sinai
Columbia-
Rochester-
Duke-
Duke-
UNC-
Cincy-
CCF-
Penn-
Pitt-AJ Cardounel, Ohio State University
Pitt-
MUSC-
Texas, San Antonio-
Virginia-
Washington-
Wisconsin-[/quote]

 

[Origin]

Hey you guys, I started this post when I barely got accepted into medical school. Now I am a 4th year and still my interest has not changed: still want to do the integrated CT surgery (I6) residency programs.

I have a question concerning Step 2:
After using the program as my inspiration, I mustered a Step 1 score of 257. I was wondering, should I still take Step 2? I hear from people that due to my Step 1 score, it would be a risk... but I was wondering if I6 programs now demand a Step 2 score in order to get an interview.

Thanks!

 

[themp]

Hey you guys, I started this post when I barely got accepted into medical school. Now I am a 4th year and still my interest has not changed: still want to do the integrated CT surgery (I6) residency programs.

I have a question concerning Step 2:
After using the program as my inspiration, I mustered a Step 1 score of 257. I was wondering, should I still take Step 2? I hear from people that due to my Step 1 score, it would be a risk... but I was wondering if I6 programs now demand a Step 2 score in order to get an interview.

Thanks!

Take Step 2 CS as soon as possible; there's no reason to wait except to prolong your suffering. It's easy and you'll pass, it's just long, painful, and annoying.

In terms of Step 2 CK, given your strong step 1 score, programs won't need to see your step 2 score. However, they will want to see that you've scheduled/taken/passed it. A programs worst nightmare is matching someone who puts off or fails Step 2, preventing them from starting in July. Let them know when you're taking it, and as soon as you get your score or hear you passed, let the program know.

With that said, I'd just take it and get it out of the way. You'll do fine, it's easier than step 1. Breeze through UWorld and go for it. It'll only get harder and you'll only forget more as your brain wastes away during the perpetual vacation that is 4th year. Good luck.

 

[spicysoup55]

Anyone have the stats for how many applicants there were this cycle? For how many spots? What about avg step 1 score?

How does the competitiveness compare with other surgical subspecialties such as ENT, neurosurgery, ortho, etc?

 

[SouthernSurgeon]

Anyone have the stats for how many applicants there were this cycle? For how many spots? What about avg step 1 score?

How does the competitiveness compare with other surgical subspecialties such as ENT, neurosurgery, ortho, etc?

27 programs, 35 spots.

64 US senior applicants (28 matched); 40 independent applicants (7 matched)

No data on step 1 scores, etc directly through the NRMP.

Per CiM website, step 1 avg ~242

In terms of ratio of applicants to spots, it is extremely tight.

In terms of overall application strength/competitiveness, it falls somewhere between general surgery and the subspecialties but not as bad as plastics/uro/ent.

There are a number of threads addressing this already that I recommend you look at.

 

[spicysoup55]

27 programs, 35 spots.

64 US senior applicants (28 matched); 40 independent applicants (7 matched)

No data on step 1 scores, etc directly through the NRMP.

Per CiM website, step 1 avg ~242

In terms of ratio of applicants to spots, it is extremely tight.

In terms of overall application strength/competitiveness, it falls somewhere between general surgery and the subspecialties but not as bad as plastics/uro/ent.

There are a number of threads addressing this already that I recommend you look at.

Thanks for the stats!

Since there are so few spots and a high applicant:spot ratio, do connections play a more important role than in other competitive specialties? I'm assuming all applicants would be highly qualified with good grades, step scores, and performance on rotations, so connections would be a major distinguishing factor. Would you be at a disadvantage if your school does not offer an I6 program?