Anyone do a Surgery Prelim?

[Inygma]

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Hey all! I was wondering if anyone did a surgery prelim in California, Nevada, or Arizona and your thoughts on your year. Feel free to PM also if you want =)

Edit: Or any general thoughts on surgery prelims (even if you did yours outside of the above states)

Thank you!

 

[Psai]

No because i don't hate myself

 

[Tulaner]

I did, but then again I originally did surgery before I switched to anesthesia.

For the love of all that is holy don’t do a surgery prelim unless you are forced to. I seriously aged 5-10 years in that 12 months and almost lost my marriage. That’s basically a standard experience.

 

[deleted171991]

I did, but then again I originally did surgery before I switched to anesthesia.

For the love of all that is holy don’t do a surgery prelim unless you are forced to. I seriously aged 5-10 years in that 12 months and almost lost my marriage. That’s basically a standard experience.

+1. Plus you'll learn so much more about co-existing diseases (stuff that's really important for an anesthesiologist) as a medical prelim.

 

[vector2]

Hey all! I was wondering if anyone did a surgery prelim in California, Nevada, or Arizona and your thoughts on your year. Feel free to PM also if you want =)

Edit: Or any general thoughts on surgery prelims (even if you did yours outside of the above states)

Thank you!

At the end of the day, you will be managing the pt's medical problems when they present for surgery. You are much better off doing an internship where you get heavy exposure to medical wards and MICU and some light exposure to cardiology, pulm, radiology, and ER. Managing the alphabet soup of COPD, PNA, CHF, CAD, CVA, CKD, ESLD, HTN, sepsis, anemia etc is a million times more important than putting in an NG for an SBO or ordering an ultrasound for a hot gallbladder.

 

[SolidWater]

I did a surgery prelim in NYC. It wasn't that bad but as others have said, you don't learn as much medicine as those who do medicine prelim.

However, it did make moving into anesthesiology (hours, work, activities) that much better.

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[deleted171991]

Let me put it this way: I am an intensivist, but I still rely on stuff I learned back when I was a medical intern. Having a good medical attending or senior resident teach you well is priceless (and so I went back and did a critical care fellowship which included 3 months of MICU).

 

[Inygma]

Thanks for all your replies.

I don't want to do a surgery prelim, but I'm standing at 7 anesthesia interviews and 1 prelim interview. One of (If not) my top choice right now is an advanced only position. I'm wondering if I should add surgery prelim in the city that goes unmatched (i know bad sign) every year to ensure I have a spot and don't have to move twice

 

[Psai]

Thanks for all your replies.

I don't want to do a surgery prelim, but I'm standing at 7 anesthesia interviews and 1 prelim interview. One of (If not) my top choice right now is an advanced only position. I'm wondering if I should add surgery prelim in the city that goes unmatched (i know bad sign) every year to ensure I have a spot and don't have to move twice

If you match advanced without prelim, your school will probably be accomodating to taking you as an intern

 

[Inygma]

If you match advanced without prelim, your school will probably be accomodating to taking you as an intern

I’m a DO with no home hospital

 

[SolidWater]

I’m a DO with no home hospital

Hundreds of surgery prelim spots go unmatched yearly. Many medicine prelims too - just not as many.

(Meaning you will find somewhere to do an internship.)

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[Southpaw]

Do what you must to get to your advanced years of anesthesiology. But you'll gain far more medical knowledge in a year of medicine. It's not even close. Your medicine attendings, by nature, will also be more invested in your learning as they aren't running off to the OR at every opportune moment. You'll have the rest of your career to pick the brains of surgeons, who by and large won't pay much attention to the surgical prelims.

 

[TheLoneWolf]

Do what you must to get to your advanced years of anesthesiology. But you'll gain far more medical knowledge in a year of medicine. It's not even close. Your medicine attendings, by nature, will also be more invested in your learning as they aren't running off to the OR at every opportune moment. You'll have the rest of your career to pick the brains of surgeons, who by and large won't pay much attention to the surgical prelims.

This.

 

[Ras Tafari]

It all depends on what you can tolerate the most. Personally, I did a preliminary surgery internship at a brand new residency program at the beach.

Pros:
Tons of autonomy
Tons of surgical and procedural experience far beyond what most interns get because it was a new program
Significantly "ahead" of the medicine interns in procedural skill (everything equalizes by like 6 months into CA-1)
Lived a stone's throw from the beach
The work hours made my anesthesia work hours seem like a cakewalk
Developed better understanding of what our surgeon colleagues are focused on and plans of care
Did not have to round endlessly and see patients in clinic except for a handful of days

Cons:
At times too much autonomy
Horrendous work hours
Did not learn nearly as much medical mgmt of common chronic conditions as the medicine interns
Had zero life and did I mention horrendous work hours?
Prelim program was in a different city than my anesthesia residency, so did not get to form those strong "in the trenches" bonds with the other anesthesia residents since most of us did intern years all over the country

For me, it came down to my preference to work insane surgical intern hours over rounding for hours and talking endlessly about the same patients day in and day out. Theree's no right answer and either path will get you where you want to be eventually. Actually, there is a right answer...do a transitional year 😉

 

[HalO'Thane]

I would also recommend looking into Transitional Year programs. It may offer the best of both worlds. Mine was still heavy on Internal Medicine months but I still had great exposure to ED, General Surgery, SICU, and MICU. Plus I had the option of a few cush rotations that allowed me to read up on Anesthesia for the following year, study for Step 3, and to catch up on sleep and have a social life.

 

[ToKingdomCome]

I’m a DO with no home hospital

Worst case scenario you can probably scramble into a DO TRI after the acgme match. I'm a DO and I know of several friends who applied gas who didnt match acgme prelim, do this

 

[towelonthefloor]

Worst case scenario you can probably scramble into a DO TRI after the acgme match. I'm a DO and I know of several friends who applied gas who didnt match acgme prelim, do this

The issue with doing this is that when you reapply, the year you did the TRI may not count towards anything. If I remember correctly, the TRI has to have initial accreditation at least for it to count towards an intern year.
I’m also a DO but doing an ACGME internship. I qualify for R spots and can apply to A spots without worrying about an internship.
Without a true internship, you’ll have no choice but to repeat intern year.

 

[Eagles6389]

The issue with doing this is that when you reapply, the year you did the TRI may not count towards anything. If I remember correctly, the TRI has to have initial accreditation at least for it to count towards an intern year.
I’m also a DO but doing an ACGME internship. I qualify for R spots and can apply to A spots without worrying about an internship.
Without a true internship, you’ll have no choice but to repeat intern year.

This is a great point. Wouldn’t you be able to see if the DO TRI program has initial accreditation before you agree to scramble into that program though?

 

[towelonthefloor]

This is a great point. Wouldn’t you be able to see if the DO TRI program has initial accreditation before you agree to scramble into that program though?

Yes you should be able to look them up.
But idk how many would be actually available after the match. All the desirable spots would have been applied to and likely taken. And whatever is remaining, there’s no guarantee these have initial accreditation status.