Applying to both prelim gen surg and anesthesia

[Solarium]

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If I already applied to anesthesia (both advanced and categorical), and I also want to do a year of prelim surgery as PGY-1 to test the waters of general surgery, what would be the best way to apply to surgery?

1. prelim surgery with intention of anesthesia at PGY-2
2. prelim surgery with intention of general surgery at PGY-2
2. prelim surgery with intention of general surgery + anesthesia at PGY-2
3. prelim surgery + categorical surgery with intention of anesthesia at PGY-2
5. prelim surgery + categorical surgery with intention of general surgery at PGY-2
4. prelim surgery + categorical surgery with intention of general surgery + anesthesia at PGY-2

Which of the choices would be least offensive to both fields?

 

[Brunette1981]

If you apply to prelim surgery with the intention of doing anesthesia as a PGY2, you are still doing a standard anesthesia application since you can do a prelim med, surgery, or TY as an intern for noncategorical programs.

The question is, do you want to do surgery or do you want to do anesthesia? That's what you should figure out before you go through the application process.

A PGY1 surgery resident (correct me if I am wrong here surgeons) doesn't see the inside of an OR - you handle the floor patients. Not sure how that would help you decide if you wanted to do GSurg. And my understanding is many surgery programs have lots of prelims to do that work that they have neither the intention nor the space to advance to a PGY2 so it probably wouldn't help you as a "backdoor" route to GSurg either.

Anesthesia is typically pretty open to taking people already in residency who have changed career tracks (many programs reserve 1-2 spots for the stellar defectors of other residencies at their own hospital), but you seem to be going about this a strange way. I would decide what you want to do NOW and do that rather than try to hedge your bets.

 

[Samoa]

First of all, you don't HAVE to identify your intended specialty on your prelim application for surgery. Secondly, it wouldn't raise any questions if you applied to a surgery program as both categorical and prelim, without specifying an intended field. Once you get an interview, you can discuss your intentions there. It's a smart thing to do as a surgery applicant, so you don't have to scramble.

However, since anesthesia programs do coordinate with the respective departments at their institutions for the prelim year, at some point, your dual application would be outed, and if you haven't been upfront with both programs, it will look dishonest and could get you booted from both rank lists.

So if you're going to do it, be sure to apply for surgery only at institutions where you're not applying for anesthesia.

It would be better to decide now, if you can. But sometimes people can't, or they just haven't seen enough of either field to make a good decision. I don't think that should be held against applicants, though it often is.

 

[Solarium]

Great info, thanks. I ended up applying to anesthesia 1st, then only to prelim surgery spots for those programs that have advanced CA-1 positions, stating that I would be interested in a PGY-2 anesthesia spot and used the anesthesia personal statement. For gen surg programs that I didn't already apply to anesthesia (about double the residency spots of anesthesia for general surgery) I applied to categorical positions only and used a general surgery personal statement.

I know I should make a decision, but I don't want to live the rest of my life regreting such an important life decision. I'm doing a surg elective as we speak and an anesthesia next, hopefully by the time I'm done with these I'll have the answer.

One more thing, if I applied to both cat and prelim surg spots, would it come off to the PD that I'm hesitant and unsure what I want to do, or rather that I want to do gen surg so much that I don't care what type of position I get in?

 

[Law2Doc]

...
A PGY1 surgery resident (correct me if I am wrong here surgeons) doesn't see the inside of an OR - you handle the floor patients. ....

This statement is true for the bigger programs, and particularly those associated with med schools. It's false for the smaller more community based programs, where extra sets of hands in the OR are often in shorter supply than the number of folks needed on the floors.

My larger concern would be that a prelim surgery position frequently leads nowhere. If you want surgery, you want to be categorical -- a prelim spot should be a last resort to get into that field.

 

[Doctor4Life1769]

This statement is true for the bigger programs, and particularly those associated with med schools. It's false for the smaller more community based programs, where extra sets of hands in the OR are often in shorter supply than the number of folks needed on the floors.

My larger concern would be that a prelim surgery position frequently leads nowhere. If you want surgery, you want to be categorical -- a prelim spot should be a last resort to get into that field.

Why does it lead nowhere? What if someone is applying prelim surg and a different residency program (non-surg, non-IM)?? Does a prelim surg also knock you out of other options, too??

 

[Brunette1981]

It doesn't lead nowhere if you already have a categorical spot. It's just that prelim surgery spots are often dangled in front of applicants (particularly IMGs) as a way to "get into" surgery with the idea that if they kill themselves all year long the current program they are at will offer a PGY2 spot. And then get all the floor/scut work out of the prelims that they can.

Usually there is no PGY2 spot for these prelims. The big surgery programs may have a dozen prelims and have 0-1 spots at the PGY2 level. Also, have completed a prelim and only a prelim doesn't get you certification or a job and may make getting another residency harder because you used up a year of funding.

Essentially the prelims end up being cheap labor but don't get a career out of working so hard.

 

[Samoa]

A PGY1 surgery resident (correct me if I am wrong here surgeons) doesn't see the inside of an OR - you handle the floor patients.

This is actually very program-dependent. There are large, well-regarded, med school-affiliated programs out there where prelims are treated exactly the same as categorical residents. Two that come to mind are UCSF and UW.

I don't know how it would look to apply to both prelim and categorical general surgery. If you have a very strong application, it might raise questions about whether you're applying in a more competitive field (where you'd need a surgery internship) and are using general surgery as a backup. If you have a weak application, it might look determined but realistic.

But if you're going to do a prelim in surgery, go someplace where they treat all their interns equally. Don't waste your time and educational opportunity on a program that regards you as just a warm body to fill in schedule holes.