4th year electives planning for general surgery

[fatefeather]

Hi all,

My 4th year starts in March. I'll be taking 4 weeks off for step 2 so I'll probably start in April. I want to go into general surgery. I have a few ideas on how I want to arrange my electives but I'm not sure if they are legit or just fanciful thinking. Hope someone can point me to the right direction:

1. I need to confirm this with my advisor but I think I can only take at most 3 general surgery electives (not sure if they include sub-I or aways). But my plan is to keep my sub-I as late as possible before the ERAS deadline, let's say August, and have all the other general surgery electives (including aways) before that. In this way I can prepare myself better for the sub-I and hopefully perform better and get a good letter.

2. Speaking of "as late as possible before the ERAS deadline", when is the latest month I can do a sub-I so I can still get the letter before the deadline?

3. I'm also thinking about doing an away rotation in a top program. I want to keep this even later than my sub-I for the same reason stated above.

4. I'm more or less an introvert so people skills are not my forte. Fortunately my 3rd year general surgery rotation at the GI unit went well and most of the attendings liked me. Should I do my sub-I in the GI unit then, or go to a different unit (say endocrine) to "broaden my sight" so to speak?

5. One of the GI attending does research. He is also the director for the GI elective. Is it worthwhile to do a 4-week research rotation with him so he can get to know me better? And how likely is it to get a paper out before September from this 4 week rotation at this point of time from your experiences?

6. What non-surg electives would you recommend for a surg applicant? I want to keep myself busy and keep learning instead of cruising through 4th year.

These are all my questions. Sorry for the long post. Thank you in advance for your help.

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[Winged Scapula]

Hi all,

My 4th year starts in March. I'll be taking 4 weeks off for step 2 so I'll probably start in April. I want to go into general surgery. I have a few ideas on how I want to arrange my electives but I'm not sure if they are legit or just fanciful thinking. Hope someone can point me to the right direction:

1. I need to confirm this with my advisor but I think I can only take at most 3 general surgery electives (not sure if they include sub-I or aways). But my plan is to keep my sub-I as late as possible before the ERAS deadline, let's say August, and have all the other general surgery electives (including aways) before that. In this way I can prepare myself better for the sub-I and hopefully perform better and get a good letter.

2. Speaking of "as late as possible before the ERAS deadline", when is the latest month I can do a sub-I so I can still get the letter before the deadline?

ERAS opens this year for ACGME programs on 9/5/19. I would expect your application to be in then or soon after, so generally the latest you could do a rotation expecting to get a letter in support of your application would be early August.

3. I'm also thinking about doing an away rotation in a top program. I want to keep this even later than my sub-I for the same reason stated above.

Away rotations are not necessary for ACGME general surgery. Then can also be a double edged sword. Its hard to shine when you are being compared the students who know things that you don't: the EMR, the attending, where the bathrooms are. By the time you've figured all that out, its time to end the rotation. Unless you're a person who shines in person and looks better in person than on paper, it may not be wise to do one unless there is a speciality that you can't see at your program. Remember students at "top programs" tend to be top students. Will you fare well in comparison to them?

4. I'm more or less an introvert so people skills are not my forte. Fortunately my 3rd year general surgery rotation at the GI unit went well and most of the attendings liked me. Should I do my sub-I in the GI unit then, or go to a different unit (say endocrine) to "broaden my sight" so to speak?

Variety is nice, but I don't think it really matters with the exception of doing too much in one specialty (ie, Ortho) can make it look like you aren't really interested in Gen Surg.

5. One of the GI attending does research. He is also the director for the GI elective. Is it worthwhile to do a 4-week research rotation with him so he can get to know me better? And how likely is it to get a paper out before September from this 4 week rotation at this point of time from your experiences?

Almost impossible.

I'm a bit confused about your terminology. "GI" is a medical subspecialty, not surgical. Do you mean colorectal or foregut? I suppose if you felt a letter from him would bolster your application, a rotation with him would be worthwhile but it sounds like you have other attendings in that department who would write you a favorable one.

6. What non-surg electives would you recommend for a surg applicant? I want to keep myself busy and keep learning instead of cruising through 4th year.

These are all my questions. Sorry for the long post. Thank you in advance for your help.

Radiology
SICU (and ICU rotation is an excellent one for the end of 4th year to get you up to speed for internship)
Gastroenterology (if you are required to do a Medical Sub-I this might be a good choice)

 

[fatefeather]

ERAS opens this year for ACGME programs on 9/5/19. I would expect your application to be in then or soon after, so generally the latest you could do a rotation expecting to get a letter in support of your application would be early August.

Thank you. You are the best.

Could I ask one more question: If I'm interested in integrated vascular surgery therefore I have to do an away, what is the lastest time to do an away? Is it also early August? I remember last year when I was rotating in neurosurgery in September, I still saw several students rotating in our department and all of them were applying in that cycle as well.

 

[Winged Scapula]

Thank you. You are the best.

Could I ask one more question: If I'm interested in integrated vascular surgery therefore I have to do an away, what is the lastest time to do an away? Is it also early August? I remember last year when I was rotating in neurosurgery in September, I still saw several students rotating in our department and all of them were applying in that cycle as well.

Yes it’s the same.

It would appear to be a mistake to me, especially if applying for a competitive specialty like integrated vascular or neurosurgery, and not have a complete application at the start of the cycle.

There’s probably no issue with submitting a single letter later in the cycle but frankly it sounds like your colleagues got poor advice. Conventional wisdom, and I see no reason to deviate from that year, is that you have everything ready to go in the late summer so that when the application cycle opens your application is complete. Bear in mind some programs will not review incomplete applications. I think waiting and submitting important letters of support late will only hurt you. If it’s your only option then so be it but it’s not the best one in my mind.

 

[fatefeather]

Yes it’s the same.

It would appear to be a mistake to me, especially if applying for a competitive specialty like integrated vascular or neurosurgery, and not have a complete application at the start of the cycle.

There’s probably no issue with submitting a single letter later in the cycle but frankly it sounds like your colleagues got poor advice. Conventional wisdom, and I see no reason to deviate from that year, is that you have everything ready to go in the late summer so that when the application cycle opens your application is complete. Bear in mind some programs will not review incomplete applications. I think waiting and submitting important letters of support late will only hurt you. If it’s your only option then so be it but it’s not the best one in my mind.

I'm not sure about their situations but what if they just came here to do an away so they can get an interview invite? I have heard some programs invite everyone who rotates at their department. Also, even if that's not the case, from your perspective, is it worth it to do an away as late as in September to just leave a good impression at a program?

 

[Winged Scapula]

I'm not sure about their situations but what if they just came here to do an away so they can get an interview invite? I have heard some programs invite everyone who rotates at their department.

What, pity invites? Sure some programs invite everyone who rotates for a "courtesy interview". But if they invite everyone how is that meaningful, how does that reflect on your application and how does that mean anything other than they are doing it because its expected or policy? Wouldn't you rather have an invitation because your application warranted it?

If there was data that said, "we interview everyone who rotates here and every year we take X number of students that we wouldn't have considered before" then its worth a shot. But its a long shot.

Also, even if that's not the case, from your perspective, is it worth it to do an away as late as in September to just leave a good impression at a program?

Sure *if* you honestly feel you can leave a good impression. As noted above, away rotations are double edged swords. It can be hard to be a superstar for 30 days.