Chances of getting categorical surgery from prelim?

[GonefromTX]

Hey everyone,

I just learned today that I didn't match, and I'm thinking of applying to general surgery prelim spots, with the hope that next year I'll be able to get some good LoRs and apply to general surgery categorical. A bit of a background on me: Step 1/2: 250/249, 3rd year clerkships 2H/2HP/3P, non-AOA, 5 surgery publications. I applied for ortho this cycle and didn't match after 9 interviews. Student affairs said I have no red flags but there are just 17 people from my class doing ortho this year. I am giving up on any possibility of a career in orthopedics, since next year there will be 19 people and my application will probably lose competitiveness just for being out of medical school for a year.

I am honestly thrilled for a possible career in general surgery, as I have been between these two specialties for a long time (Its really difficult to dual apply for ortho and gen surg and I had to make a choice). However, I read some paper published that general surgery prelims have only about a 30+% chance to land a categorical spot after 1 year, and about 55% after doing a PGY 2 prelim.

Am I reading these statistics right? Is there something Im missing (eg many of them are IMGs, many decided to pursue a different specialty etc)? I'm hoping to get answers here to gain some realistic expectations on my chances of matching into any surgery categorical from a surgery prelim, if I applied broadly with good letters next year.

Thank you for reading and thanks in advance for any insight/ advice you may have for me.

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[nimbus]

Overall those stats may be correct but you need to examine the subsets of people doing preliminary surgery. Doubt they apply to you. I bet lots of GS programs would love to have you.

 

[Splenda88]

Agree with nimbus...

My question is: Wouldn't it be better to apply next cycle?

 

[GonefromTX]

Agree with nimbus...

My question is: Wouldn't it be better to apply next cycle?

You mean postpone graduation until next year and reapply?

 

[Rekt]

You mean postpone graduation until next year and reapply?

I was always under the impression that this is the best option if a person does not obtain a spot from the SOAP.

 

[GonefromTX]

I was always under the impression that this is the best option if a person does not obtain a spot from the SOAP.

What If I get an offer for a prelim spot through soap? is that better than postponing graduation?

 

[Spikebd]

If you only end up in a preliminary surgery year don’t fret. Are you a USMD? If so, try to get a categorical spot in SOAP. If you can’t, then find the best prelim surgery year you think you can tolerate. Preferably look for one where you can get some OR time. Trust me, there are some out there that will let you operate a little bit. Then focus this spring and summer on getting new letters of rec so you can apply right away when interviews open in September. Also, impress the hell out of your program director and ask them to make phone calls on your behalf. Pester them. This is your career. Be aggressive. It’ll work out.

 

[GonefromTX]

If you only end up in a preliminary surgery year don’t fret. Are you a USMD? If so, try to get a categorical spot in SOAP. If you can’t, then find the best prelim surgery year you think you can tolerate. Preferably look for one where you can get some OR time. Trust me, there are some out there that will let you operate a little bit. Then focus this spring and summer on getting new letters of rec so you can apply right away when interviews open in September. Also, impress the hell out of your program director and ask them to make phone calls on your behalf. Pester them. This is your career. Be aggressive. It’ll work out.

Thanks for the reply, yes I am an USMD. Yeah, seems like there's no categorical spots GS open in this SOAP, so I'll have to aim for a prelim.

Say I do all that, do you think I'll have a realistically good chance to match categorical GS in the next cycle? Wondering because if I fail to match again I'll be out of school for 2 years, and would that be bad for applying to any specialty?

 

[Spikebd]

Thanks for the reply, yes I am an USMD. Yeah, seems like there's no categorical spots GS open in this SOAP, so I'll have to aim for a prelim.

Say I do all that, do you think I'll have a realistically good chance to match categorical GS in the next cycle? Wondering because if I fail to match again I'll be out of school for 2 years, and would that be bad for applying to any specialty?

You WILL match categorical GS if your scores are what you say they are. You might not even have to repeat an intern year if you get lucky.
Don’t fall in love with a single program. You might have to move after your PGY-1 year. It’s still possible you get a categorical spot at a place you do your prelim, but don’t expect it.
Get new letters now, this spring. Get ready to work hard come July 1. It’ll be intense but you’ll learn on the job. Be polite and hardworking. Let people know your story and your goals. You have to sell yourself. Start working on that this week in the SOAP. Keep working on it your entire career. Grow from this experience.

 

[Splenda88]

You mean postpone graduation until next year and reapply?

I would with your stats and use general surgery as a backup plan... I think you will be a shoo-in for GS

 

[Winged Scapula]

You are correct in that only 30% of prelims get a categorical position after PGY-1 but many (most?) were not competitive for GS in the first place. Another subcategory are those who are doing Prelim "just to do something".

Thus, every Prelim I knew in your situation matched, a couple even into Ortho.

The tough part is that you only have a couple of months to shine before applying again and it can be tough taking time off for interviews during PGY-1.

 

[anon6134]

it can be tough taking time off for interviews during PGY-1.

I find it laughable and near criminal to employ someone at a one year position while simultaneously hindering their ability to find a job after the program has the chance to replace them with another indentured servant 12 months later

 

[Winged Scapula]

I find it laughable and near criminal to employ someone at a one year position while simultaneously hindering their ability to find a job after the program has the chance to replace them with another indentured servant 12 months later

Ok.

 

[afib123]

Those are excellent stats for gen surg. Good advice here. Soap into Prelim then apply (guessing that's okay than just staying at home or doing research).

 

[GonefromTX]

Thank you all for the advice, I'll be trying to soap into prelim and reapply next year.

 

[OrthoTraumaMD]

Sorry to hear that you didn’t match. Good luck with general surgery — it is a good field.

 

[MediCane2006]

Hey everyone,

I just learned today that I didn't match, and I'm thinking of applying to general surgery prelim spots, with the hope that next year I'll be able to get some good LoRs and apply to general surgery categorical. A bit of a background on me: Step 1/2: 250/249, 3rd year clerkships 2H/2HP/3P, non-AOA, 5 surgery publications. I applied for ortho this cycle and didn't match after 9 interviews. Student affairs said I have no red flags but there are just 17 people from my class doing ortho this year. I am giving up on any possibility of a career in orthopedics, since next year there will be 19 people and my application will probably lose competitiveness just for being out of medical school for a year.

I am honestly thrilled for a possible career in general surgery, as I have been between these two specialties for a long time (Its really difficult to dual apply for ortho and gen surg and I had to make a choice). However, I read some paper published that general surgery prelims have only about a 30+% chance to land a categorical spot after 1 year, and about 55% after doing a PGY 2 prelim.

Am I reading these statistics right? Is there something Im missing (eg many of them are IMGs, many decided to pursue a different specialty etc)? I'm hoping to get answers here to gain some realistic expectations on my chances of matching into any surgery categorical from a surgery prelim, if I applied broadly with good letters next year.

Thank you for reading and thanks in advance for any insight/ advice you may have for me.

Definitely think you will be competitive for general surgery as a prelim. If you’d like to shoot me a PM I can give you some more specific advice about at least one program 🙂

 

[lalalaaaaaa]

Hey OP! Sorry you didn't match, but you have a killer gen surg app. 100% talk to an advisor today (if you haven't soaped yet) about NOT SOAPing and taking an extra year in medical school. Reapplying as a student is much much easier. Lets you do some rotations in gen surg for LOR, and you apply as a student which is better. You can also chill a bit because you dont need to add anything to your app since it seems so strong. I would be weary of the prelim just because interviewing during the prelim year is brutal (I met a bunch of people doing it on the interview trail, but it seemed hard) . Either way you will likely match if you reapply into gen surg. Good luck!

 

[GonefromTX]

Hey OP! Sorry you didn't match, but you have a killer gen surg app. 100% talk to an advisor today (if you haven't soaped yet) about NOT SOAPing and taking an extra year in medical school. Reapplying as a student is much much easier. Lets you do some rotations in gen surg for LOR, and you apply as a student which is better. You can also chill a bit because you dont need to add anything to your app since it seems so strong. I would be weary of the prelim just because interviewing during the prelim year is brutal (I met a bunch of people doing it on the interview trail, but it seemed hard) . Either way you will likely match if you reapply into gen surg. Good luck!

Hey! Thankfully I talked to my school's gen surg PD and she told me they allow time for us to go on interviews, and she seems very optimistic about taking their prelims into categorical if they work hard. If my home program offers me a spot I'll take it.

 

[lalalaaaaaa]

Hey! Thankfully I talked to my school's gen surg PD and she told me they allow time for us to go on interviews, and she seems very optimistic about taking their prelims into categorical if they work hard. If my home program offers me a spot I'll take it.

sounds like a great option. a supportive prelim program is HUGE, especially if the PD is supportive. good luck!