Bancrofti

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Dec 21, 2010
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I'm a US IMG student from one of the big 4 carib schools. My dilemma is that I'm interested in doing something competitive, so if I want to have any shot at matching I essentially need for everything to work out perfectly. What I'm interested in is a surgical specialty, so I figured including that info would be relevant:

Choice A: Well known teaching hospital. > 30k surgeries performed per year. >600 bed capacity. NO residency program offered for my desired residency, despite department being known.

Choice B: Good hospital in region. ~15k surgeries performed per year. >600 bed capacity, additional 30k ER visits per year than choice A (not a great area). DOES have residency program

Choice C: Hospital not as reputable as first two, especially in field of interest. <10k surgeries per year. <350 bed location. However, DOES have residency program.

So I'm choosing where to do rotations between those 3. I also intend to do an away at one of the 2 locations that I don't go to. I'm not sure if my logic is correct, but ideally you want to find a good balance between having enough face time with people who actually matter in the field and rotating somewhere that you'll be comfortable and know you can do well and honor everything.

- Choice A, no residency, which is a negative, but could it also be a positive since that means you'll be dealing directly with Attendings more? Reasons to choose here would be great learning experience and LOR.
- Choice B: has residency, fairly busy as well so even though there aren't as many surgeries done as location A, it has enough which increases my chance of exposure to things.
- Choice C: small hospital in nice area. Has residency program. It's smaller and I'd assume due to the potential decreased load it might make it more feasible to make sure I have more than enough study time. Though the small size I see as a plus, could it potentially also be a negative for some reason? Also, how do you know who is considered to be reputable in your field or not? Is an LOR from any residency program director good enough?


Sorry in advance, I did a search and did find information, but nothing hit it on the head. Mostly either because of varying opinions or because the student was in a completely different situation. Had I stayed in the US this wouldn't be as big of a deal.
 

inmyslumber

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As an MD in who is involved with medical student and resident education, I really have no idea what the "Big 4" are so don't count on rotation sites seeing you differently from the "small(?)" Carribean schools.
Keeping this statement above in mind, forget about option 1. You need to do rotations with a residency program in order to maximize your chance to secure a residency. Treat the rotation as an audition rotation for that particular program.
 
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Bancrofti

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Thank you! I appreciate it. And for surgical specialties would it be advisable to go to a site with a greater volume of surgeries done annually or is that something that shouldn't really factor in to decision?

Including the "Big 4" wasn't to mean that the school has any true distinction. I just wanted to include that to stress that picking the right site for me is a pretty big deal, given the very small likelihood that I will be able to match even with a perfect application otherwise.
 

inmyslumber

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I am an Anesthesiologist so perhaps someone with closer ties to surgical residency can give their opinion.

My opinion is that, at this point, you need to have specific programs get to know you. Even if you go to a more well-known hospital and get first-assist experience, that will not necessarily help you to obtain an interview at residency programs. What use are excellent clinical skills if you are not able to get an interview and therefore not able to apply these skills to a residency position?
 
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SouthernSurgeon

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I am an Anesthesiologist so perhaps someone with closer ties to surgical residency can give their opinion.

My opinion is that, at this point, you need to have specific programs get to know you. Even if you go to a more well-known hospital and get first-assist experience, that will not necessarily help you to obtain an interview at residency programs. What use are excellent clinical skills if you are not able to get an interview and therefore not able to apply these skills to a residency position?
I'd say you are exactly right.

Clinical volume shouldn't really be the deciding factor (unless it is truly abysmally low at one of the programs - but pretty much if they can support a residency program that by definition shouldn't be the case).

If you're trying to match into a surgical subspecialty, you should be trying to maximize your facetime at a place with a residency program in that specialty.
 
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Bancrofti

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Dec 21, 2010
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Sounds good, so basically whichever site has a hospital that also has a residency program for that specialty, while also allowing for a good amount of facetime with attendings and those who influence who the chosen residents may be.

Thank you both so much for the reply. Questions that tend to be asked ad nauseam often don't get many responses, but I felt this was a little different. Happy holidays.