1 interview invite so far after applying to 50+ places, need advice

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General Surgeon

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I'm a 4th year med student applying to gen surg, and I'm a competitive applicant according to my deans. 240+ on step 1 and on step 2, some publications, and 1st quartile. However, I was originally going to apply for plastic surgery but I did a few critical care rotations and switched early on in my 4th year from plastics to general cause I realized I enjoyed that critical care setting and I didn't enjoy the day to day PRS as much as I thought I would. (yes its late, but my school doesn't let us do subspecialty rotations till our 4th year). I met with faculty that I've known for almost a year and asked them for general surgery recommendation letters and they said they would write strong ones on my behalf. They knew of my initial interest in PRS since at that time, I didn't know I wanted to switch. Early on in my 4th year, I told them that I had a change in heart, and general was the way I wanted to go. I gave them my CV, and I gave them my general surgery focused personal statement, and they ended up writing me a letter.

Fast forward to now, I have only had 1 interview invite (my home institution) from the 50+ places I applied to. I emailed a bunch of programs over the weekend, and one told me one of my letters said I was interested in plastics, and now I'm thinking that might be contributing to my paucity of invite. I don't know who said it, but I know they weren't trying to do anything bad by mentioning it. Ultimately, it is my fault though as I should have been more explicit in saying I want to do general surgery and that is the only thing I'm applying to.

I am in touch with my deans and academic advisor and meeting with them later today. They're gonna try and talk with my program's chair and PDs. However, I'm wondering what else I can do on my end because I really thought I had a shot at some of my reach institutions, but now I need to do damage control. I've already emailed some of the top programs I wanted to go to, and I can't send them another one saying "hey btw i know this letter says one thing, but..." cause I don't wanna be that guy that is just spamming these programs. I know I have to do something though.

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I have no advice. I can't imagine how stressed you are. Hopefully your dean can clear the misunderstanding.
 
Maybe you can ask your Dean to make some calls to some of the programs were you are likely a good fit to explain that general is where you want to be, and that you'd be a good resident there?
 
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I think the letters are your problem. When I see someone whose application screams that they are applying to a different field (research projects, 4th year rotations, etc) who then writes about their change of heart in their PS, I look for an LOR from your prior specialty's mentor saying that you've changed your mind. Few plastic surgeons are going to write two letters -- one saying how interested you are in PRS, and the other for GS. Hence, when I see that letter, I know you're not applying to my field as a backup. Alternatively, an MSPE that states clearly which field you're applying to can do the same thing, but MSPE's are long enough that it can get lost in there.

As to what to do, you don't have a ton of choices. Having either the Dean, or your PRS letter writers, contact programs and explain the confusion might help and is probably your best option. Otherwise you're stuck with getting your letters re-written and applying to new programs (which you are very late), or taking a prelim GS year and then getting a PGY-2 next year, or some other gap year. Hence, I'd focus on trying to get the problem fixed ASAP.
 
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The letters for gen surg mean that much, that someone with a step 1 like a whole SD above the mean for the field is only gonna get 1 interview out of 50 because of them? Seems hard to believe.
 
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Thats rough man... I think you should be a very competitive applicant with scores like that. There must be a red flag and it sounds like your letter written may have inadvertently harpooned your app.
 
GS is not that competitive...something seems off? Maybe you applied to only competitive programs?
 
The letters for gen surg mean that much, that someone with a step 1 like a whole SD above the mean for the field is only gonna get 1 interview out of 50 because of them? Seems hard to believe.
He's not even close to a SD above the average for the field unless he's got well over a 250. Average for GS was 235 last year.
 
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The letters for gen surg mean that much, that someone with a step 1 like a whole SD above the mean for the field is only gonna get 1 interview out of 50 because of them? Seems hard to believe.

Yes. If they think s/he is applying to gen surg as back up (which is common for integrated plastics applicants), they may not want to "waste" an interview spot on him/her as they assume s/he is unlikely to match there. I know my PD weeded out people this way. If the LOR is strongly worded toward plastics, that could be the major issue. If not, then maybe there is some other flag that the school admins can identify.
 
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Geez, my condolences. If it makes you feel better, I'm definitely learning from this and only applying to IM which is what I wanted all along instead of trying for others in the future.


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I talked with some advisors and they said that they think the reason why I don't have many interviews after looking at my apps is probably that letter. I have multiple years of plastics research and now that I have a letter that says that I have an interest in it (even though it was in the past) makes it look like I'm primarily a PRS applicant. They said they would write me a rec letter swearing that I'm only doing gen surg and that I was interested in PRS but not anymore and send it to programs. I'll probably apply to more and use that new letter just in case though. I'm just frustrated I wasn't explicitly clear with how I was applying to gen surg to my writers and now I am just waiting to see what happens. I'm hoping I don't get blacklisted from some programs cause the first few ones I applied to and emailed expressing interest were the ones I was highly interested in and now I know why (i think) they're being mum when it comes to invites. Fortunately I got along well with some fellows throughout my 3rd and 4th year and they said they would put in a good word with their old PDs. So far i've gotten 2 more interviews, but I think its largely from their help and not because programs wanna take a shot on me. I will take whatever I can get though.
 
He's not even close to a SD above the average for the field unless he's got well over a 250. Average for GS was 235 last year.
SD for general surgery applicants, not all of step 1 takers. Different population.
 
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