Do most people who want to do plastics try to get into one of the integrated residency programs? What are the pros/cons for the GS route?
It's my opinion that if you know you want to be a plastic surgeon by the third year of medical school, you should pursue an integrated residency program.
It has the following advantages over the GS-->fellowship path:
- Shorter length of training (6 or 7 years PRS + 1-2 year subspecialty fellowship versus 5-7 years GS residency + 3 year plastics fellowship +/- 1-2 year sub specialty fellowship).
- Quicker exposure to operative experience in plastic surgery. (In other words, you may get bored spending 5 years learning how to do endoscopic cholecystectomies, which won't really make you a more competent plastic surgeon)
The disadvantages are:
- More difficult match process -- typical match rate is about 40-50%; versus the GS->fellowships, which typically have a 70-90% success rate.
- Poor GS know how, poor ICU know how, because of shorter experiences in both these realms. I gladly accept that I will never ever be competent in the abdomen or thorax. I will also never be able to care for anything beyond a free-flap in the SICU. That said, I hate the SICU, so some people might see this as an advantage.
Can you give us a run down on how you did in med school? Any specific research projects in plastics? What advice can you give to someone that's entering med school and might be interested in plastics?
I was not an AOA candidate. I also did not honor medicine or surgery... or any other rotation. I was just too much of a jackass to tow the typical med student subservience without a reason. For example, I didn't stay late to deliver an extra baby because it would get the ObGyn resident to like me more (unless she/he was hot). I did the required amount of work and learning when I wasn't interested and no more. I knew what my exact interests were and could always find better use of my time... which leads me to the following:
I scored above 250 on step I and did a dedicated year of clinical + basic science research, which continued in my clinical years. I had 10+ publications, presentations, etc. My mentors in research wrote excellent letters. PRS, like most subspecialty surgical communities, is very tight knit, and LORs are probably the most important deciding factor at the end of the day IMHO. Attendings call each other and talk about you too!
Advice - if you want to do plastics, start looking into it early. Try to get clinical research opportunities early. Take Step I seriously. Get attendings to like you. They really are the power brokers in the world of academic plastics.
I'm living in 2015. What year are you in?
You can skip the regret phase if you cycle quickly enough
I will have to experiment. Hard to speed-sip bourbon.
Can I take over your thread and turn into the FML show?
I'm not sure what the FML show is, but is it hot?
Not a plastics resident, but yes, most people go the integrated route.
The number of positions available in the general surgery route are dwindling.
Pros to general surgery:
-Easier to get a residency slot compared to plastics
Cons to general surgery:
-Everything else (signed, a proud general surgery resident)
Get out of my thread, foo. JK. You can stay....if you're hot.
How early in medical school did you realize you wanted to do plastics?
I am afraid of finding out that want to do a speciality (competitive or not) in say 3rd year & I wouldn't have enough time to tailor my app for it.
I started reaching out to faculty, researching, studying for Step I after my first year summer. I learned about plastics early and got hooked up early. It's hard to get hooked up in the middle of your third or fourth year. That usually requires a year off to make it happen. I do recommend committing early. You may say... what if I change my mind? But I counter that as you get older, you will find that you will experience the opportunity costs of each choice more intensely. In other words, too bad.
What's your favorite procedure and why?
I love breasts. I think a well done TUG or DIEP is super cool. However, I think a paramedian forehead flap to reconstruct a nasal dorsum/tip is pretty schweet too. That brings me to another wonderful thing about plastics -- we do all sorts of ridiculous things, and it's great variety. You really never get bored... at least in residency you don't. But if you become an attending and specialize in labiaplasties, then that's your thing.
