Advice on applying to integrated PRS

[BigMotherKelly]

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I'm a rising MS4 at a top-25 US medical school considering PRS vs ENT vs neurosurgery, and I'm hoping to get some good advice from someone in the field. Here's what my application looks like:

Step 1: 260

Grades: Honors in all clerkships. Top 10% of class for all pre-clinicals (we aren't told actual grades or class rankings, just whether we're in the top 10%).

AOA: Not announced until 9/2014, but I anticipate that I will be selected.

Research (all in surgical oncology, except clinical papers):
- 2 first-author basic science publications
- 2 other basic science publications (5th and 9th author)
- 2 first-author clinical publications
- 2 misc publications (think "Piece of My Mind"-style articles)
- 2 first-author oral presentations at major national meetings (listed on 5 other oral presentations)
- 4 first-author posters at major national meetings including one 1st prize (listed on at least 2 other posters)
- MAY have 1 more publication and 1-2 more orals/posters by September

With all of that said, I'm hoping someone can talk to me about:
1. What are my chances of matching into PRS?
2. If you think my chances are good, are they good enough to avoid double applying, or would you recommend having a back-up plan in place?
3. What can I do between now and September to continue to improve my application (beyond the obvious things like do well on my sub-I and aways, get great letters, etc.)
4. How important is Step 2 to a PRS application?
5. When and how did you make the final decision to apply to PRS?

THANK YOU!
BMK

 

[rueby25]

1. You have a great step 1 and solid research and grades, but that alone is not enough. The majority of applicants are high step scores with great grades and some research. What concerns me is the indecision concerning plastics, ENT and neurosurg. They are all pretty fundamentally different fields. ENT is surgical with a fair amount of clinical. Neurosurg sees a lot of very sick patients. High risk Hugh reward. Plastics is incredible in that it is everything. Hand, face, lower extremity, recon, cosmo. It's always interesting, and that makes it exciting. Have you spent time on any of these services?

2. It's a fair idea for anyone to double apply, but it's a personal decision. It demonstrates commitment to plastics if your backup is gen surg then fellowship. You have to ask yourself of you'd be happy doing gen surg of that fell through.

3. There's not a ton you can do between now and then. Maybe take up some interesting hobbies. Work on being personable (if you aren't already).

4. For you, step 2 is not likely to help. My chairman said that it is most beneficial to those who do marginally on step 1 and want to show that they can bear down and do better.

5. See my synopsis from above. It's incredibly rewarding and affords you the chance to work all over the body. My advice would be spend some time on service. You'll likely feel yourself drawn to one field or the other.

What I can say is don't make the mistake of applying to any of these fields because they are "the most competitive." Make sure that your personality fits. Other than that, one of the most important things you can do for your app is rotate at a few places and get great letters. That was, hands down, the most often mentioned part of my application.

Good luck.

 

[BigMotherKelly]

1. You have a great step 1 and solid research and grades, but that alone is not enough. The majority of applicants are high step scores with great grades and some research. What concerns me is the indecision concerning plastics, ENT and neurosurg. They are all pretty fundamentally different fields. ENT is surgical with a fair amount of clinical. Neurosurg sees a lot of very sick patients. High risk Hugh reward. Plastics is incredible in that it is everything. Hand, face, lower extremity, recon, cosmo. It's always interesting, and that makes it exciting. Have you spent time on any of these services?

2. It's a fair idea for anyone to double apply, but it's a personal decision. It demonstrates commitment to plastics if your backup is gen surg then fellowship. You have to ask yourself of you'd be happy doing gen surg of that fell through.

3. There's not a ton you can do between now and then. Maybe take up some interesting hobbies. Work on being personable (if you aren't already).

4. For you, step 2 is not likely to help. My chairman said that it is most beneficial to those who do marginally on step 1 and want to show that they can bear down and do better.

5. See my synopsis from above. It's incredibly rewarding and affords you the chance to work all over the body. My advice would be spend some time on service. You'll likely feel yourself drawn to one field or the other.

What I can say is don't make the mistake of applying to any of these fields because they are "the most competitive." Make sure that your personality fits. Other than that, one of the most important things you can do for your app is rotate at a few places and get great letters. That was, hands down, the most often mentioned part of my application.

Good luck.

Hey, thanks for taking the time to write--I really appreciate it.

To answer your questions, I scrubbed on ~10 cases in each field during my surgery clerkship, and I'm on ENT right now, with scheduled rotations in plastics and neurosurgery up next.

I've had a long-standing interest in neuroscience, which drew me to neurosurgery originally, but since getting some exposure to other fields during my surgery clerkship I've felt more drawn to plastics, basically for all the reasons you describe--great case diversity, incredible technical skill, opportunities to work all over the body and with specialists from a number of other interesting fields. I'm checking ENT out on the recommendation of a mentor in surgery who knows that it's an area of anatomy I like, and that I've enjoyed doing research at another intersection of cancer and surgery, but to be honest I think it's less likely to be a great fit than plastics, or even neurosurgery.

So the truth is that I'm feeling more committed to plastics with each passing day, and I hope that my upcoming rotation will help me establish a definitive answer. I'm obviously nervous about the possibility of not matching, and the hassle of double applying is daunting, but it's hard to pass over a field that I feel otherwise compelled by on those grounds alone if my chances are strong enough.

Obviously I still have a lot to sort out, but your advice lends some important clarity; thanks again for your thoughts.