Mar 19, 2020
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Applied to a competitive surgical subspecialty, matched prelim surgery at a good academic center. Planning on fully committing to general surgery and not looking back now. What should I be doing or thinking about now? American MD student, step 1 high 230s, step 2 low 250s. Ok clinical grades, honored all my surgical subspecialty grades on aways, dozens of non general surgery pubs. No gen surg letters yet, I figured I’d get them at my prelim program but a bari surgeon I had a good relationship with offered to write me a letter, so it’s definitely one letter out of the way. Will I get shafted by applying categorical as a graduate? Should I only focus on getting a position outside the match? Any use in also applying to integrated cardiothoracic or vascular residencies? Help a brother out, thanks in advance.
 

ThoracicGuy

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Applied to a competitive surgical subspecialty, matched prelim surgery at a good academic center. Planning on fully committing to general surgery and not looking back now. What should I be doing or thinking about now? American MD student, step 1 high 230s, step 2 low 250s. Ok clinical grades, honored all my surgical subspecialty grades on aways, dozens of non general surgery pubs. No gen surg letters yet, I figured I’d get them at my prelim program but a bari surgeon I had a good relationship with offered to write me a letter, so it’s definitely one letter out of the way. Will I get shafted by applying categorical as a graduate? Should I only focus on getting a position outside the match? Any use in also applying to integrated cardiothoracic or vascular residencies? Help a brother out, thanks in advance.

You might have a chance of continuing on where you are a prelim. Otherwise, they generally will help you get other places as well. Certainly look towards the match, but I would focus on general surgery spots. I think integrated residencies are not likely to look towards someone that is currently a prelim.

Focus on your ABSITE. That score will do some good for a PGY2 spot.
 
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Dr.LeoSpaceman

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Reach out to the PD early and let him know your intention to pursue a categorical GS spot. Not unreasonable to do so prior to even getting there, and specifically asking if you can get a schedule with exposure to core faculty from whom you could ask for letters.

EDIT: I'll add another. If you're a prelim at an academic place, reach out to the senior residents and figure out which faculty are productive in clinical research. Make contacts early, and try to get involved (whether your own project, or another resident's). But if you do thisnyou need to be ready to be proactive and productive. If you ask to do it, but are getting three reminder emails before you complete a task, it's going to backfire.

And that's going to be the way you have to approach the whole year. Not to sound dire, but erase any plans for the next year. You don't want to be as good as the categoricals...you are striving to show you are better. You can't change what's on paper, but the work ethic/personal interaction piece is one that you have control over and is going to create opportunities.
 
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